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*
Division of Experimental Pathology, Albany Medical College, Albany, NY 12208;
New York State Department of Health, Wadsworth Center for Laboratories and Research, Albany, NY 12223; and
Department of Pediatrics, Baylor College of Medicine, Houston, TX 77030
| Abstract |
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| Introduction |
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Following traumatic bone injury, activated neutrophils often accumulate within lung tissue, causing pulmonary damage and the development of the adult respiratory distress syndrome (ARDS)4 (4, 5). Interestingly, long bone fractures also result in the deposition of marrow-derived fatty acids in the circulation (6). These fat emboli, which contain oleic acid as the major fatty acid component (6, 7), lead to the generation of free fatty acids upon hydrolysis (4). Previous observations from our laboratory indicate that free fatty acids amplify the mobilization of the myeloperoxidase-containing granules of neutrophils (8). Thus, elevations in plasma-free fatty acids might activate neutrophils, promoting the release of granular contents and enhancing damage to the pulmonary vascular endothelium and interstitium. This hypothesis is supported by the observation that the i.v. administration of oleic acid into experimental animals results in the accumulation of neutrophils in the lungs and the pathologic manifestations of ARDS (9). Moreover, the generation of fat emboli subsequent to trauma precedes the development of respiratory distress, suggesting that free fatty acids might promote the sequestration of neutrophils in the lungs (4).
Having previously demonstrated that oleic acid stimulates the mobilization of myeloperoxidase-containing granules, we hypothesized that oleic acid also might induce the fusion of CD11b/CD18-containing granules and vesicles with the plasma membrane. Interestingly, the cell surface expression of CD11b/CD18 is markedly increased on neutrophils from trauma patients both before and after the development of ARDS (10). In addition, specific inhibitors of CD11b/CD18-ligand binding attenuate the adherence of neutrophils to the pulmonary vascular endothelium in several in vivo models of respiratory distress (11, 12). In the present study, we have examined both the cell surface expression and affinity status of CD11b (and, by implication, CD18) in response to oleic acid and the role of these affinity states in oleic acid-mediated homotypic (aggregation) and heterotypic (endothelial attachment) neutrophil adhesion. Our results demonstrate that micromolar amounts of oleic acid increase the cell surface expression of CD11b and induce the high affinity state of this integrin. These responses are greatly enhanced when the extracellular pH is slightly acidic and are, at least in part, dependent on oleic acid-mediated cytosolic acidification. Furthermore, oleic acid, through a CD11b-mediated mechanism, induces neutrophil aggregation and neutrophil-endothelial cell attachment. These results implicate oleic acid as a possible agonist of neutrophil aggregation, sequestration, and activation. These observations may help explain the etiology of ARDS arising from fat embolism in which trauma-induced release of fatty material is followed by the accumulation of neutrophils within the pulmonary circuit.
| Materials and Methods |
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Oleic acid, oleic acid methyl ester, and PMA were purchased from Sigma (St. Louis, MO). Stock solutions of fatty acids and PMA were prepared in ethanol and dimethylsulfoxide, respectively, and stored at -70°C. The following mAb were used: LM2/1 (anti-CD11b, IgG1) was purified from hybridoma supernatants (American Type Culture Collection, Rockville, MD) by the method described by Harlow and Lane (13); CBRM1/5 (mAb specific for a high affinity form of CD11b, IgG1) was a gift of Dr. T. Springer (Boston, MA); CL15.2 (anti-CD54, IgG1) was purchased from Leinco Technologies (St. Louis, MO); and 2',7'-bis-(2-carboxyethyl)-5-(and -6)-carboxyfluorescein, acetoxymethyl ester (BCECF-AM) was obtained from Molecular Probes (Eugene, OR). Nigericin and carbonyl cyanide p-(trifluoromethoxy)phenylhydrazone (FCCP) were from Sigma.
Cell preparation
Human neutrophils were isolated from venous blood of healthy volunteers (following informed consent) by the method of Redl et al. (14). Typically, 40 ml of blood was drawn into a 60-ml syringe containing 1000 U/ml of heparin and 20 ml of 6% Hetastarch. After gentle mixing, the blood was allowed to settle for 45 min. The leukocyte-rich plasma was removed and centrifuged at 500 x g for 7 min. Erythrocytes were then lysed with H2O, and isotonicity was restored with hypertonic NaCl. After low speed centrifugation, the leukocytes were resuspended in HBSS without Ca2+ and Mg2+ (HBSS-) and applied to the top of a solution of isosmotic NaCl and Percoll at a specific density of 1.075. The cells were centrifuged at 10,000 x g for 20 min at 4°C, and the neutrophils were collected from the bottom layer. The cells were washed twice and resuspended in HBSS- and held briefly at 4°C. This procedure yielded >95% neutrophils according to light scatter analysis using a FACScan (Becton Dickinson, San Jose, CA). Whole blood was drawn from human donors approximately 12 h postprandial for experiments involving analysis of neutrophils in whole blood.
HUVEC were isolated from umbilical cords according to the method described by Jaffe et al. (15). Briefly, an umbilical cord (<2 h old) was rinsed externally with distilled H2O and then with 70% alcohol. A blunt-tipped cannula was inserted into each end of the cord and secured with sterile umbilical tape. Blood was removed from the cord by connecting a 50-cc sterile syringe to one cannula and flushing HBSS- through the vein. This was performed for both ends of the cord. Collagenase solution (20 ml at 1 mg/ml) was then infused into the cord until the remaining HBSS- was displaced. The cannula opposite the syringe was closed and the collagenase solution was infused until the vein was fully distended. The cannula connected to the syringe was then closed and the cord was incubated at 37°C for 15 min. After incubation, the cord was gently massaged to enhance the liberation of endothelial cells and flushed with 20 to 30 ml of HBSS. The flushed cells were centrifuged for 7 min at 500 x g, suspended in medium (M199 containing FBS (20%), 50 µg/ml heparin, 50 µg/ml endothelial cell growth supplement, and 25 µg/ml gentamicin), and then cultured on gelatin-coated tissue culture dishes. Endothelial cells were used when confluent and between passages 1 and 6.
Incubation conditions
For cell adhesion and flow-cytometric experiments, neutrophils were suspended at 1 x 106 cells/ml in a modified Ringers buffer (2.86 mM KCl, 124.88 mM NaCl, 5.5 mM D-glucose, 1 mM CaCl2, 0.5 mM MgCl2, and varying concentrations of 12 mM NaH2PO4, 12 mM Na2HPO4, and NaHCO3 depending on the required pH). To obtain buffers with specific NaHCO3 and H+ concentrations, Ringers buffer prepared with monobasic phosphate was mixed in different ratios with Ringers buffer prepared with dibasic phosphate. Each of these buffers was prepared the night before the experiment and allowed to equilibrate at 37°C under 5% CO2. Before addition of the test compounds, the cells were equilibrated for 10 min at 37°C with 5% CO2. The cells were then incubated, under these same culture conditions, for various intervals in the presence of several concentrations of oleic acid or PMA.
A number of assays, including the intracellular pH measurements, neutrophil aggregation, and inhibition of intracellular acidification with FCCP, were performed in air and in these cases the Ringers buffer was buffered with 10 mM HEPES rather than NaHCO3.
Flow cytometry
Isolated neutrophils were analyzed for their surface expression of specific Ags using indirect flow cytometry, as described by Sengelov et al. (2). The cells were fixed in 2% paraformaldehyde, 0.5% gluteraldehyde in PBS for 15 min at 4°C and then washed twice in PBS containing 0.5% (w/v) BSA. To block FcR, the cells were resuspended at 5 x 106 cells/ml in PBS containing 100 µg/ml of human IgG. After 30 min at 4°C, an Ag-specific mAb or mouse IgG1 was added at a final concentration of 10 µg/ml. The cells were placed at 4°C for 1 h, washed twice with PBS, and resuspended at 5 x 106 cells/ml in PBS containing 100 µg/ml of human IgG. Fluorescein-conjugated goat anti-mouse IgG was then added at a 1/200 dilution. After a 30-min incubation at 4°C in the dark, the cells were washed twice with PBS, resuspended in 300 µl of 1% formaldehyde, and analyzed by flow cytometry (FACScan and Cell Quest; Becton Dickinson). The mean fluorescence intensity for specific Abs was corrected for nonspecific fluorescence by subtracting the mean fluorescence obtained with mouse IgG1. Approximately 15,000 to 20,000 events were analyzed per sample. For flow-cytometric analysis of neutrophils in whole blood, the granulocyte population was identified and analyzed on the basis of their forward and side scatter characteristics.
Neutrophil adhesion assay
HUVEC were cultured on 48-well tissue culture plates and washed twice with PBS containing 1 mM Ca2+ and Mg2+ (PBS+) before use. Neutrophils (1 x 106 cells/ml) were exposed to oleic acid in Ringers buffer at pH 6.65 or pH 7.40 for 5 min at 37°C under 5% CO2. Each sample was aliquoted (3 x 105 neutrophils in 300 µl) into four wells containing HUVEC monolayers. Neutrophil contact with HUVEC was promoted by centrifuging the plate for 3 min at 500 x g. The plate was then incubated for 5 min under tissue culture conditions. Unattached cells were gently washed away four times with PBS+. The adherent cells were then fixed for 15 min with 0.1% paraformaldehyde in PBS+. Neutrophil attachment was quantitated by averaging the number of cells counted in three fields in each well under x100 magnification. This average was used to calculate the number of cells per well according to the following formula: Cells per well = average cell number per field x 76.23, where 76.23 = (area of well)/(area of ocular grid) = (100.81 mm2)/(1.3225 mm2).
Neutrophil aggregation assay
Neutrophil homotypic aggregation in response to oleic acid was investigated utilizing a modification of the method described by Philips et al. (16). Isolated neutrophils (5 x 106 cells/ml) were suspended in Ringers buffer containing 10 mM HEPES and then equilibrated for 5 min at 37°C. Before addition of oleic acid, light transmission through 500 µl of sample was recorded for 1 min to establish a stable baseline of no aggregation (Chrono-Log Aggregometer, model 430 VS). Oleic acid was then added, and light transmission through the sample was measured continuously for 5 min. The aggregometer records the transmission of light through a cell suspension as a function of time (minutes). Because light transmission is inversely proportional to the numbers of individual (unaggregated) cells in the suspension, an increase in light transmission indicates a reduction in individual cells due to aggregation. The aggregometer is standardized to 0 and 100% aggregation before each experiment. Therefore, the slope of the line generated by the aggregometer also indicates the percentage of the total cells aggregating per minute. Thus, aggregation was reported as percentage of total cells aggregated per minute.
Intracellular pH measurements
The effects of oleic acid on intracellular pH were investigated using the pH-sensitive dye BCECF-AM. Neutrophils were suspended at 5 x 106 cells/ml in PBS and incubated for 20 min with 4 µM of the acetoxymethyl ester form of BCECF-AM. Cells were washed twice with PBS and suspended at 1 x 106 cells/ml in a modified Ringers buffer. Fluorescence determination of intracellular pH was performed at 37°C. The ratio of excitation intensity at 505 nm to that at 439 nm is pH sensitive and was utilized to cancel signal errors due to variations in BCECF-AM concentration, path length, esterase activity, and subcellular localization (Molecular Probes). The emission was observed at 535 nm. Baseline intracellular pH was determined for 1 min before the addition of oleic acid. The calibration of fluorescence versus intracellular pH (pHi) was performed by the K+/nigericin method described by Thomas et al. (17).
| Results |
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The effects of oleic acid on the cell surface expression of CD11b
(and, by implication, CD18) on neutrophils were assessed using flow
cytometry. These experiments were performed at pH 7.4, 6.9, and 6.6 to
elucidate whether the effects of oleic acid on CD11b expression could
be influenced by the acidic environment prevailing in inflammatory
sites, which ranges between pH 5.7 and 7.2 (18). Cell surface CD11b
increased approximately twofold above control cells at pH 7.4 and
fivefold at pH 6.6 after a 5-min exposure to oleic acid (Fig. 1
). The oleic acid-mediated increase in
CD11b was both time and dose dependent. For example, exposure of
neutrophils to oleic acid at pH 7.4 caused an increase in CD11b
expression after 5 min to a level 2.5-fold above that of the control
cells (Fig. 2
A). The
concentrations of oleic acid used in these experiments were well below
the concentration of circulating oleic acid measured in patients at
risk for ARDS, such as those undergoing surgical implantation of hip
prostheses (152.2 µM) (7).
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The effects of oleic acid on the expression of CD11b on neutrophils in
whole blood also were investigated to determine whether this fatty acid
could induce CD11b expression under more physiologic conditions. Whole
blood contains approximately 0.5 mM albumin, which has three high
affinity fatty acid binding sites per molecule (20). The results shown
in Figure 3
indicate that the cell
surface expression of CD11b on neutrophils increased in a
dose-dependent manner when whole human blood was exposed to oleic acid.
These results suggest that oleic acid, particularly when the
concentrations exceed the fatty acid binding capacity of albumin, is
likely to increase CD11b/CD18 expression by neutrophils within the
circulation.
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Regulation of CD11b/CD18 on neutrophils involves modulation of
both the cell surface expression of this integrin and the affinity of
this integrin for its ligands. As shown in Figure 4
, both PMA and oleic acid induced the
expression of a high affinity epitope of CD11b, as indicated by the
binding of CBRM1/5, a mAb specific for the high affinity state of this
integrin (3). In the case of oleic acid, this response was regulated by
the extracellular pH in a manner similar to the oleic acid-mediated
increase in CD11b expression described earlier. For example, exposure
of neutrophils to oleic acid at pH 6.6 caused a 10-fold increase in
CBRM1/5 binding above control cells versus a 0.01-fold increase at pH
7.4 (Fig. 4
). Furthermore, at pH 6.6, oleic acid increased the
expression of the high affinity epitope of CD11b to a greater extent
than PMA (Fig. 4
). Thus, in addition to promoting cell surface
expression of CD11b on neutrophils, oleic acid also increases the
affinity of CD11b/CD18 in a pH-dependent manner.
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Expression of the high affinity epitope of CD11b/CD18 would be
expected to promote the attachment of neutrophils to CD11b/CD18 ligands
such as fibrin(ogen) and ICAM-1. Indeed, when neutrophils were exposed
to oleic acid at pH 7.4, their adherence to HUVEC monolayers and to
fibrinogen increased 3.4-fold and 4.1-fold above control cells,
respectively (Table I
). This increased
adherence was mediated by CD11b because the enhanced attachment of
oleic acid-treated neutrophils to both fibrinogen and HUVEC was blocked
by neutrophil-inhibitory factor (NIF), a specific inhibitor of
CD11b/CD18-mediated adherence (21) (Table II
). The attachment of oleic acid-treated
neutrophils to HUVEC also was completely prevented by the
CD11b-blocking mAb, CBRM1/5 (Table II
). In this case, we should note
that the likely counterligand on HUVEC, ICAM-1, is constitutively
expressed under our culture conditions (22). Inexplicably, oleic acid
reduced the attachment of neutrophils to fibrinogen or to HUVEC when
the extracellular pH was lowered to 6.6 (Table I
). Reducing the
extracellular pH to 6.6 did not affect the general adherence
capabilities of the neutrophils, since acidic pH did not affect the
baseline level of neutrophil attachment and did not alter neutrophil
attachment induced by PMA (Table I
).
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Several investigators have demonstrated an intracellular
acidification caused by fatty acid-mediated transport of protons into
cells, but the possible importance of this acidification in the
regulation of cellular processes has not been elucidated (23). The
influence of extracellular pH on oleic acid-mediated responses
described above suggested that oleic acid might exert its effects by
intracellular acidification. To determine whether oleic acid might
lower cytosolic pH (pHi), neutrophils were loaded with the
pH-sensitive fluorescence indicator, BCECF-AM, and then exposed to
oleic acid. Fluorescence ratio analysis indicated that oleic acid
reduced pHi in a manner dependent on extracellular pH (Fig. 6
A). For example, when the
extracellular pH was 7.4, 6.9, and 6.6, oleic acid acutely reduced
pHi by 0.16, 0.21, and 0.32 pH units, respectively (Fig. 6
A).
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| Discussion |
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receptor R1 (data not shown) and
stimulates the release of myeloperoxidase (8; Jeitner and Eaton, in
preparation), which are contained within the specific granules and
azurophil granules, respectively (25). In addition, oleic acid does not
affect the cell surface expression of ß2 integrins that
are not stored within granules or vesicles, such as CD11a/CD18 (data
not shown). Therefore, it appears that oleic acid causes a generalized
degranulation response, probably involving each type of granule
produced by neutrophils. The mechanism(s) responsible for oleic acid-mediated mobilization of neutrophil granules is not fully understood. The well-known profusogenic actions of free fatty acids might be important in promoting fusion of intracellular granules with the plasma membrane, which is a phenomenon well described in other circumstances (26, 27). A second, but not mutually exclusive, mechanism might involve oleic acid-mediated cytosolic acidification. This is supported by the observation that the oleic acid-mediated increase in CD11b expression was enhanced when the extracellular pH was reduced from 7.4 to 6.6. Furthermore, addition of oleic acid caused a substantial drop in intracellular pH, which also was enhanced when the extracellular milieu was acidic. Indeed, free fatty acids, including oleic acid, are known to cause intracellular acidification by transporting protons across cell membranes via their carboxyl group (24). Hence, when we exposed neutrophils to oleic acid methyl ester, which is incapable of carrying a proton on its carboxylate moiety and does not cause intracellular acidification, we did not observe an increase in CD11b expression. In addition, prevention of cytosolic acidification by a proton ionophore partially inhibited the oleic acid-mediated increase in CD11b expression, which further supports a role for intracellular acidification in the degranulation response induced by oleic acid.
The precise role of cytosolic acidification in the mobilization of neutrophil granules by oleic acid remains elusive. However, one possibility is that oleic acid-mediated intracellular acidification reorganizes the cytoskeleton in a manner that favors degranulation. In resting neutrophils, the actin cortex might prohibit degranulation by forming a barrier between intracellular granules and the plasma membrane. The actin-binding protein, gelsolin, regulates the length of actin filaments by severing the noncovalent bonds between actin subunits within the filament, leading to isolation of actin networks and fluidization of the cell cortex (28). Gelsolin activity is induced by elevated intracellular Ca2+ levels (28). However, at pH 6.75, the Ca2+ requirement for the severing activity of gelsolin is reduced significantly and, at pH <6, gelsolin severs actin in the absence of Ca2+ (29). Thus, oleic acid might increase the activity of gelsolin by reducing the cytosolic pH, which in turn would act to sever the actin cortex, thereby allowing granules passage to the plasma membrane.
Most agonists that increase the cell surface expression of CD11b also increase the ligand-binding activity of this integrin (3). CBRM1/5 is a mAb that recognizes an activation epitope on a subset of CD11b molecules on neutrophils after stimulation with chemoattractants or phorbol esters, but does not recognize CD11b on resting cells (3). Our results demonstrate that oleic acid induces the expression of a high affinity epitope of CD11b on neutrophils, as indicated by CBRM1/5 binding.
The increase in the high affinity epitope of CD11b by oleic acid
involves oleic acid-mediated intracellular acidification. This is
supported by the observation that enhanced expression of the CBRM1/5
epitope occurred preferentially under conditions of low extracellular
pH, which corresponded to exaggerated reductions in cytosolic pH
mediated by oleic acid. In addition, induction of the high affinity
epitope of CD11b by oleic acid was partially inhibited with a proton
ionophore, thus further supporting a role for cytosolic acidification
in mediating this response. It is well known that integrin-ligand
binding can cause integrins to signal the activation of the
Na+/H+ antiporter and increase intracellular pH
(30). However, to the best of our knowledge, this is the first report
that demonstrates modulation of integrin affinity by intracellular pH
itself. This suggests that cytosolic acidification is involved in
"inside-out" signaling and may be a novel mechanism for regulation
of integrin activation. In this regard, we note that charge reversal
mutations within the cytoplasmic domains of conserved amino acid
sequences of integrin
and ß subunits have been shown to
constitutively activate the
IIbß3 integrin
(31). This may occur through disruption of salt bridges between the
and ß subunits that are thought to be important in regulating
integrin activity (31). Therefore, oleic acid-mediated cytoplasmic
acidification might induce the high affinity epitope of CD11b by
altering the ionic charge of the membrane-proximal amino acids that
participate in forming the salt bridge. This could modify the
association between the
and ß subunits, resulting in
conformational changes that expose the high affinity epitope of
CD11b/CD18.
In addition to direct effects on the
and ß subunits of
CD11b/CD18, cytosolic acidification mediated by oleic acid can
potentially alter the affinity state of CD11b/CD18 by modifying its
association with the cytoskeleton. The function of integrins is thought
to be at least partially regulated by their interactions with the actin
network via actin-binding proteins (32). Interestingly, talin,
which associates with ß1 integrins in vitro (33), has
been demonstrated to interact with actin more frequently under acidic
conditions (34). Perhaps by lowering the cytosolic pH, oleic acid can
affect integrin-actin interactions by modifying the association of
actin-binding proteins with actin. Recently, it has been shown that
disruption of the actin cytoskeleton is necessary for the expression of
a high affinity epitope of CD11a/CD18 on resting lymphocytes (35). As
previously discussed, reductions in cytoplasmic pH by oleic acid can
potentially reduce actin filament formation by activating proteins such
as gelsolin. The disruption of actin filaments in this manner may alter
the interaction between CD11b/CD18 and the cytoskeleton, which could
lead to conformational changes of CD11b/CD18 that increase the affinity
state of this integrin.
Since oleic acid induces the expression of a high affinity epitope of CD11b/CD18, we investigated the consequences of this response on neutrophil heterotypic and homotypic adherence. We found that oleic acid stimulated CD11b/CD18-dependent neutrophil aggregation, and neutrophil attachment to fibrinogen-coated plates and to endothelial cell monolayers. Thus, expression of the high affinity epitope of CD11b by oleic acid corresponds to an increase in the function of this integrin. Interestingly, neutrophil aggregation was preferentially induced by oleic acid under conditions of low extracellular pH, which also promoted enhanced expression of the high affinity epitope of CD11b. However, under neutral conditions, the weak induction of the CBRM1/5 epitope by oleic acid preferentially stimulated heterotypic adherence. The reason for this differential response on neutrophil adherence by oleic acid is not fully understood. Perhaps neutrophil heterotypic attachment involves a low to moderate affinity state of CD11b, while neutrophil homotypic aggregation occurs, and is favored, when a large number of CD11b molecules are in a high affinity state. It has recently been demonstrated that cytosolic acidification prevents neutrophil spreading and retains neutrophils in a round shape (36). Hence, maybe under acidic conditions, the combination of high affinity CD11b/CD18 integrins and a persistent round morphology may favor neutrophil aggregation over heterotypic attachment.
Induction of CD11b/CD18-dependent neutrophil aggregation and heterotypic attachment by oleic acid may help explain neutrophil accumulation in the lungs of patients with ARDS secondary to fat embolus. In this disease state, large numbers of neutrophils are retained as aggregates within the pulmonary microcirculation and also emigrate into the alveolar interstitium (37, 38). Clinical disorders that result in ARDS are accompanied by increases in circulating phospholipase A2 activity and elevations in plasma-free fatty acids, particularly oleic acid (5, 39). Interestingly, one experimental animal model of ARDS involves i.v. infusion of oleic acid, which causes the pathologic manifestations of ARDS, including the accumulation of neutrophils within the pulmonary microcirculation (6). However, it is still not known why mobilization of fatty acids into the bloodstream leads to neutrophil-mediated lung injury and the subsequent development of ARDS.
Our observations suggest that protein-free oleic acid might play a role in sequestering neutrophils in the lungs by increasing the cell surface expression and activity of CD11b/CD18 on neutrophils. The concentrations of oleic acid used in our experiments involving purified neutrophils were within the pathophysiologic range measured in patients at risk for ARDS, such as those undergoing hip prosthesis implantation surgery (7). Given that whole blood contains approximately 0.5 mM albumin, which has three to six fatty acid binding sites per molecule, the concentrations of protein-free oleic acid in our whole blood experiments were probably also within pathologic concentrations seen in vivo. Thus, it is likely that oleic acid can induce the cell surface expression and activity of CD11b on circulating neutrophils when concentrations of oleic acid exceed the fatty acid binding capacity of albumin, since we observed an oleic acid-mediated increase in the cell surface expression of CD11b on neutrophils in whole blood. Indeed, the expression of CD11b/CD18 is up-regulated on circulating neutrophils in trauma patients with ARDS when compared with healthy individuals (10). In addition, adherence of neutrophils to the pulmonary vascular endothelium in several in vivo models of respiratory distress is attenuated by anti-CD11b/CD18 and NIF (11, 12). Therefore, the induction of CD11b activity by oleic acid implicates this fatty acid as an agonist of neutrophil recruitment during ARDS.
The acidic environment in which we observed an enhanced effect of oleic acid on CD11b activity, neutrophil degranulation, and neutrophil aggregation can potentially occur in the pulmonary microcirculation during ARDS (as well as in areas of focal inflammation). In general, inflammatory sites are usually acidic (pH 5.77.2) (18), due in part to the release of fatty acids from both microbial metabolism and the actions of phospholipases from host cells. Similarly, fatty acids released into the circulation during ARDS can potentially reduce the pH in the microcirculation. In addition, ischemia and hypoxia, which often occur during ARDS, can cause localized areas of acidosis within pulmonary tissue. In this regard, it is also noteworthy that the dissociation of oleic acid from albumin is favored in acidic environments (40). Taken together, our results suggest that, in the pulmonary microcirculation during ARDS and in interstitial foci of inflammation, neutrophil adhesion and degranulation and CD11b/CD18-dependent neutrophil aggregation may be greatly enhanced by the combination of low pH and free fatty acids, such as oleic acid.
| Acknowledgments |
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| Footnotes |
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2 Current address: Department of Physiology and Cell Biology, Albany Medical College, Albany, NY 12208. ![]()
3 Address correspondence and reprint requests to Dr. Thomas M. Jeitner, New York State Department of Health, Wadsworth Center for Laboratories and Research, Albany, NY 12223. ![]()
4 Abbreviations used in this paper: ARDS, adult respiratory distress syndrome; BCECF-AM, 2',7'-bis-(2-carboxyethyl)-5-(and -6)-carboxyfluorescein, acetoxymethyl ester; FCCP, carbonyl cyanide p-(trifluoromethoxy)phenylhydrazone; NIF, neutrophil-inhibitory factor; pHi, intracellular pH. ![]()
Received for publication January 20, 1998. Accepted for publication June 5, 1998.
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