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Decreased neutrophil L-selectin expression in patients with systemic inflammatory response syndrome.

OBJECTIVE
To determine whether the expression of L-selectin is reduced in patients with systemic inflammatory response syndrome (SIRS) compared with control subjects, to test the effect of exudation of neutrophil L-selectin expression, and to measure soluble serum concentrations of shed L-selectin in the two groups.


DESIGN
Prospective study.


SETTING
Intensive care unit in a tertiary care hospital (Royal Victoria Hospital, Montreal).


PATIENTS
Twenty-five patients with SIRS and 20 healthy, age-matched controls.


INTERVENTIONS
Collection of exudate neutrophils from skin window and circulating neutrophils from venous blood.


OUTCOME MEASURES
Neutrophil L-selectin levels, measured with the use of fluorocytometry, and soluble L-selectin levels, measured with the use of enzymelinked immunosorbent assay.


RESULTS
There is a significant reduction in L-selectin expression on circulating neutrophils in patients with SIRS, compared with control subjects. Exudation of neutrophils to an extravascular site resulted in a dramatic down-regulation of L-selectin in both groups. Serum levels of soluble L-selectin were higher in patients with SIRS than in control subjects.


CONCLUSIONS
The loss of L-selectin may be partly responsible for reduced neutrophil exudation to extravascular sites in patients with SIRS.