In vitro and in vivo effects of salbutamol on neutrophil function in acute lung injury
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.
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Official URL: http://dx.doi.org/10.1136/thx.2006.059410
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 Medicine > Warwick Medical School|
|Library of Congress Subject Headings (LCSH):||Respiratory distress syndrome, Adult -- Treatment, Albuterol -- Physiological effect, Neutrophils|
|Journal or Publication Title:||Thorax|
|Page Range:||pp. 36-42|
|Institution:||University of Warwick|
|Theses Department:||Department of Sociology|
|Access rights to Published version:||Restricted or Subscription Access|
|Funder:||West Midlands Intensive Care Society|
1 Rubenfeld GD, Caldwell E, Peabody E, et al. Incidence and outcomes of acute
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