Inhibition of CD18 or CD11b attenuates acute lung injury after acid instillation in rabbits

Folkesson, Hans G., and Michael A. Matthay. Inhibitionof CD18 or CD11b attenuates acute lung injury after acid instillation in rabbits. J. Appl. Physiol. 82(6):1743-1750, 1997.Acid-induced lung injury is mediatedprimarily by activated neutrophils. Although a prior study demonstratedthat acid-induced neutrophil influx into the air spaces was not CD18dependent, we hypothesized that either a neutralizing anti-CD18monoclonal antibody (MHM23) or a neutrophil inhibitory factor (NIF),NIF (CD11b,18), might attenuate acid-induced lung injury in rabbits byinterfering with neutrophil activation. This hypothesis derived from invitro studies that reported that anti-CD18 therapy prevented tumornecrosis factor--induced neutrophil activation. Hydrochloric acid(pH = 1.5 in one-third normal saline) or one-third normal saline (4 ml/kg) was instilled into the lungs of ventilated, anesthetizedrabbits. The rabbits were studied for 6 h. In acid-instilled rabbitswithout the anti-CD18 monoclonal antibody or NIF (CD11b,18), severelung injury developed. In acid-instilled rabbits, pretreatment (5 minbefore acid) with the anti-CD18 monoclonal antibody (2 mg/kg iv) orpretreatment with the NIF (anti-CD11b,18, 10 mg/kg iv) prevented50-70% of acid-induced abnormalities in oxygenation, the increasein extravascular lung water, and extravascular protein accumulation.The anti-CD18 monoclonal antibody was associated with a significantincrease in air space neutrophils by bronchoalveolar lavage, suggesting that the neutrophils respond normally to chemotactic stimuli but thatthe neutrophils did not injure the lung even though they accumulated inthe air spaces. In summary, neutralization of CD18 attenuates the acutelung injury after acid instillation without reducing the number ofneutrophils in the air spaces, suggesting that anti-CD18 therapy may bebeneficial because of its capacity to reduce neutrophil activation.