Reperfusion-induced leukocyte infiltration: role of elastase.

Polymorphonuclear leukocytes are known to accumulate in tissues subjected to ischemia and reperfusion. Studies on endothelial cell monolayers suggest that limited release of elastase plays an important role, via basement membrane degradation, in the leukocyte diapedesis and extravasation elicited by proinflammatory mediators. Thus the objective of this study was to define the role of elastase in the leukocyte infiltration associated with reperfusion of the ischemic bowel. In one series of experiments the cat small intestine was subjected to 3 h of ischemia (blood flow reduced to 20% of base line) and 1 h of reperfusion. Neutrophil accumulation was quantified by measurement of tissue myeloperoxidase activity in mucosal biopsies obtained during base-line, ischemic, and reperfusion periods. Pretreatment with either of the elastase inhibitors Eglin C and L658,758 significantly attenuated the neutrophil infiltration induced by reperfusion but not by ischemia per se. In another series of experiments, leukocyte adherence and extravasation were monitored in cat mesenteric venules subjected to 1 h of ischemia and reperfusion. Pretreatment with L658,758 significantly attenuated the increased rates of leukocyte adherence and extravasation induced by reperfusion, with a proportionately greater reduction in leukocyte extravasation rate. These results indicate that elastase release is an important factor in reperfusion-induced neutrophil infiltration.