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Critical Care Research and Practice
Volume 2012, Article ID 720950, 7 pages
http://dx.doi.org/10.1155/2012/720950
Research Article

Mechanical Ventilation and the Titer of Antibodies as Risk Factors for the Development of Transfusion-Related Lung Injury

1Department of Intensive Care Medicine, Academic Medical Center, 1105 AZ Amsterdam, The Netherlands
2Laboratory of Experimental Intensive Care and Anesthesiology (LEICA), Academic Medical Center, 1105 AZ Amsterdam, The Netherlands
3Department of Anesthesiology, Academic Medical Center, 1105 AZ Amsterdam, The Netherlands
4Department of Pathology, Academic Medical Center, 1105 AZ Amsterdam, The Netherlands
5Bioceros B.V., 3584 CM Utrecht, The Netherlands
6Departments of Respiratory Medicine and Experimental Immunology, Academic Medical Center, 1105 AZ Amsterdam, The Netherlands

Received 13 February 2012; Accepted 5 April 2012

Academic Editor: Mark T. Keegan

Copyright © 2012 A. P. J. Vlaar et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Purpose. Onset of transfusion-related acute lung injury (TRALI) is suggested to be a threshold-event. Data is lacking on the relation between titer of antibodies infused and onset of TRALI. We determined whether onset of TRALI is dependent on the titer of MHC-I antibodies infused in a combined model of ventilator-induced lung injury and antibody-induced TRALl. Methods. BALB/c mice were ventilated for five hours with low (7.5 ml/kg) or high (15 ml/kg) tidal volume. After three hours of MV, TRALI was induced by infusion of 0.5 mg/kg, 2.0 mg/kg or 4.5 mg/kg MHC-I antibodies. Control animals received vehicle. After five hours of MV, animals were sacrificed. Results. MV with high tidal volumes resulted in increased levels of all markers of lung injury compared to animals ventilated with low tidal MV. In ventilator-induced lung injury, infusion of 4.5 mg/kg of antibodies further increased pulmonary wet-to-dry ratio, pulmonary neutrophil influx and pulmonary KC levels, whereas infusion of lower dose of antibodies did not augment lung injury. In contrast, mice ventilated with low tidal volumes did not develop lung injury, irrespective of the dose of antibody used. Conclusions. In the presence of injurious MV, onset of TRALI depends on the titer of antibodies infused.