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In vitro and in vivo effects of salbutamol on neutrophil function in acute lung injury

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Perkins, Gavin D., Nathani, N., McAuley, Daniel F., Smith, F. Gao (Fang Gao) and Thickett, David R. (2007) In vitro and in vivo effects of salbutamol on neutrophil function in acute lung injury. Thorax, Vol.62 (No.1). pp. 36-42. doi:10.1136/thx.2006.059410

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Official URL: http://dx.doi.org/10.1136/thx.2006.059410

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Abstract

Background: Intravenous salbutamol (albuterol) reduces lung water in patients with the acute respiratory
distress syndrome (ARDS). Experimental data show that it also reduces pulmonary neutrophil accumulation or
activation and inflammation in ARDS.
Aim: To investigate the effects of salbutamol on neutrophil function.
Methods: The in vitro effects of salbutamol on neutrophil function were determined. Blood and
bronchoalveolar lavage (BAL) fluid were collected from 35 patients with acute lung injury (ALI)/ARDS, 14
patients at risk from ARDS and 7 ventilated controls at baseline and after 4 days’ treatment with placebo or
salbutamol (ALI/ARDS group). Alveolar–capillary permeability was measured in vivo by thermodilution
(PiCCO). Neutrophil activation, adhesion molecule expression and inflammatory cytokines were measured.
Results: In vitro, physiological concentrations of salbutamol had no effect on neutrophil chemotaxis, viability
or apoptosis. Patients with ALI/ARDS showed increased neutrophil activation and adhesion molecule
expression compared with at risk-patients and ventilated controls. There were associations between alveolar–
capillary permeability and BAL myeloperoxidase (r = 0.4, p = 0.038) and BAL interleukin 8 (r = 0.38,
p = 0.033). In patients with ALI/ARDS, salbutamol increased numbers of circulating neutrophils but had no
effect on alveolar neutrophils.
Conclusion: At the onset of ALI/ARDS, there is increased neutrophil recruitment and activation. Physiological
concentrations of salbutamol did not alter neutrophil chemotaxis, viability or apoptosis in vitro. In vivo,
salbutamol increased circulating neutrophils, but had no effect on alveolar neutrophils or on neutrophil
activation. These data suggest that the beneficial effects of salbutamol in reducing lung water are unrelated to
modulation of neutrophil-dependent inflammatory pathways.

Item Type: Journal Article
Subjects: R Medicine > RC Internal medicine
Divisions: Faculty of Science, Engineering and Medicine > Medicine > Warwick Medical School
Library of Congress Subject Headings (LCSH): Respiratory distress syndrome, Adult -- Treatment, Albuterol -- Physiological effect, Neutrophils
Journal or Publication Title: Thorax
Publisher: BMJ Group
Official Date: 2007
Dates:
DateEvent
2007Published
Volume: Vol.62
Number: No.1
Page Range: pp. 36-42
DOI: 10.1136/thx.2006.059410
Institution: University of Warwick
Theses Department: Department of Sociology
Thesis Type: PhD
Status: Peer Reviewed
Publication Status: Published
Access rights to Published version: Restricted or Subscription Access
Funder: West Midlands Intensive Care Society

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