Interactions of neutrophils with silver-coated vascular polyester grafts.

Background: In reconstructive vascular surgery, infection is one of the most feared complications because of the high mortality. While the antimicrobial effect of a silver-coated endoprosthesis has been proven in experimental trials, there are no reports on its interactions with granulocytes, the first effector cells in general inflammation and in infection.

Materials And Methods: Therefore, we investigated whether silver coating of vascular polyester grafts affects receptor expression, mediator release, and functions of human neutrophils relevant for microbicidal activity and the wound-healing process. Naïve neutrophils were analyzed for their cellular receptors such as cluster of differentiation (CD)62L, CD11b, CXCR2, and fMLP-R, the mediators interleukin 8, granulocyte elastase (human neutrophil elastase), and leukotriene B4 (LTB4) as well as for microbicidal capacity (oxidative burst) in vitro. In addition, the role of plasma coating for receptor expression was addressed.

Results: There was both a decrease of CD62L and CXCR2 expression and an increase of CD11b, fMLP-R expression, elastase release, and LTB4 generation, which were statistically significant (p = 0.04; p = 0.01; p = 0.0; p = 0.0; p = 0.01; p = 0.02, respectively) in the presence of the silver-coated graft compared with non-silver-coated vascular grafts. In addition, microbicidal activity was significantly (p = 0.0) impaired by the silver-coated graft. Coating of the vascular grafts with plasma did not alter the former observations significantly.

Conclusion: The results may indicate that silver-coated vascular polyester grafts activate neutrophils chronically which may favor tissue destruction and impaired antimicrobial effects.