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(Journal of Leukocyte Biology. 2001;70:261-273.)
© 2001 by Society for Leukocyte Biology

Effects of hypertonic saline on expression of human polymorphonuclear leukocyte adhesion molecules

M. Thiel*, F. Buessecker*, K. Eberhardt*, A. Chouker*, F. Setzer*, U. Kreimeier*, K.-E. Arfors{dagger}, K. Peter* and K. Messmer{ddagger}

* Department of Anesthesiology and the
{ddagger} Institute for Surgical Research, Klinikum Grosshadern, Ludwig-Maximilians-Universität, Munich, Germany and
{dagger} Sidney Kimmel Cancer Center, San Diego, California

Correspondence: Manfred Thiel, M.D., Department of Anesthesiology, Klinikum Grosshadern, Ludwig-Maximilians-University, 81377, Munich, Germany. E-mail: manfred.thiel{at}ana.med.uni-muenchen.de


    ABSTRACT
 TOP
 ABSTRACT
 INTRODUCTION
 MATERIALS AND METHODS
 RESULTS
 DISCUSSION
 REFERENCES
 
Hypertonic saline prevents vascular adherence of neutrophils and ameliorates ischemic tissue injury. We hypothesized that hypertonic saline attenuates N-formyl-methionyl-leucyl-phenylalanine (fMLP)-stimulated expression of adhesion molecules on human polymorphonuclear leukocytes (PMNLs). fMLP-stimulated up-regulation of ß2-integrins was diminished by hypertonic saline but not by hypertonic choline chloride-, mannitol-, or sucrose-modified Hanks’ buffered salt solution. Shedding of L-selectin was decreased by hypertonic saline and choline chloride but not by hypertonic mannitol or sucrose. When the effects of hypertonic sodium chloride- and choline chloride-modified media were compared, neither solution affected fMLP-receptor binding but both equally inhibited fMLP-stimulated increase in intracellular calcium, ionophore A23187, and phorbol myristate acetate (PMA)-stimulated numerical up-regulation of ß2-integrins. Analysis of mitogen-activated protein (MAP) kinases p38 and p44/42 for phosphorylation revealed that hypertonic solutions did not differ in preventing fMLP-stimulated increases in phospho-p38 and phospho-p44/42. Resting PMNLs shrunk by hypertonic saline increased their volume during incubation and further during chemotactic stimulation. Addition of amiloride further enhanced inhibition of up-regulation of ß2-integrins. No fMLP-stimulated volume changes occurred in PMNLs exposed to hypertonic choline chloride, resulting in significant cell shrinkage. Results suggest a sodium-specific inhibitory effect on up-regulation of ß2-integrins of fMLP-stimulated PMNLs, which is unlikely to be caused by alterations of fMLP receptor binding, decrease in cytosolic calcium, attenuation of calcium or protein kinase C-dependent pathways, suppression of p38- or p44/42 MAP kinase-dependent pathways, or cellular ability to increase or decrease volumes.

Key Words: sodium chloride • osmolarity • neutrophils • CD18 • CD62L


    INTRODUCTION
 TOP
 ABSTRACT
 INTRODUCTION
 MATERIALS AND METHODS
 RESULTS
 DISCUSSION
 REFERENCES
 
During ischemia-reperfusion, circulating polymorphonuclear leukocytes (PMNLs) become activated by numerous inflammatory stimuli, as evidenced by profound changes in the expression of adhesion molecules located on these cells [1 ]. On tethering of PMNLs by L-selectin-mediated rolling and subsequent firm adhesion by ß2-integrins to endothelial cells [2 ], the PMNLs’ ß2-integrins provide additional stimulation by outside-in cosignalling, which contributes to the enhanced extracellular release of cytotoxic oxygen radicals and proteolytic enzymes [3 ]. Thus, tissue injury induced primarily by ischemia becomes aggravated by PMNLs sequestered secondarily during reperfusion. In support of the concept of a second hit caused by neutrophils, there are reports of the efficacy of antineutrophil therapies. For instance, neutrophil depletion by administration of antineutrophil antibodies prior to ischemia-reperfusion clearly reduces tissue damage [4 ]. Moreover, the use of antibodies directed at specific adhesion molecules located on either endothelial cells or circulating PMNLs has been shown to be highly effective in the prevention of organ damage from hemorrhagic shock [5 ].

A more recent advance in the therapy of hemorrhagic and traumatic shock is represented by the concept of small-volume resuscitation. Intravenous application of hypertonic saline was shown to rapidly restore macrohemodynamic functions and tissue perfusion. Although there is accumulating evidence for the effectiveness of small-volume resuscitation in preventing organ dysfunction after posttraumatic and hemorrhagic shock under clinical conditions [6 ], the mode of action of hypertonic saline at the cellular level is still not completely understood. Besides mobilizing water from swollen endothelial cells, thereby restoring capillary diameters and flow, intravital microscopy has demonstrated that hypertonic saline can also inhibit the adhesion of PMNLs particularly to the endothelia of postcapillary venules [7 ]. Because adherence of PMNLs to postcapillary venules was shown to correlate with increases of flow resistance and vascular leakage [7 ], prevention of PMNL adhesion by hypertonic saline might significantly ameliorate tissue injury after ischemia reperfusion. Moreover, small-volume resuscitation in hemorrhagic shock was shown to prevent neutrophil margination [8 ] and intra-alveolar sequestration [9 ].

Although modulation of neutrophil adhesion molecules by hypertonic saline has already been addressed in two other studies, we set out to study the effects of hypertonic saline on the expression of ß2-integrins and L-selectin on human PMNLs in more detail. In particular, we questioned whether possible effects on adhesion molecule expression are related specifically to changes in the sodium cation itself or nonspecifically to the mere increase in the extracellular osmolarity. In this study, we present data suggesting that an increase in the concentration of the sodium cation rather than hypertonicity itself is responsible for the N-formyl-methionyl-leucyl-phenylalanine (fMLP)-stimulated inhibition of the numerical and functional up-regulation of ß2-integrins.


    MATERIALS AND METHODS
 TOP
 ABSTRACT
 INTRODUCTION
 MATERIALS AND METHODS
 RESULTS
 DISCUSSION
 REFERENCES
 
Reagents
Basic Hanks’ balanced salt solution (HBSS) was manufactured from soluble ingredients by the Klinikum Grosshadern Hospital’s own pharmacy. Basic HBSS was modified in the content of sodium chloride, choline chloride, mannitol, and sucrose by the addition of appropriate amounts of the respective compounds to produce the desired osmolarities. All solutions were titrated to pH 7.4, and contamination by endotoxin was ruled out by use of a Limulus amebocyte lysate assay (Endotoxin Coatest; Chromogenix, Mölndal, Sweden). Osmolarity of solutions was checked with an osmometer (Micro-Osmometer 3MO; Advanced Instruments, Needham Heights, MA). Basic HBSS contained the following substances in distilled water in grams per liter: NaCl, 1.6; KCl, 0.4; MgCl2, 0.1; MgSO4, 0.1; CaCl4, 0.18; Na2HPO4, 0.15; KH2PO4, 0.06; glucose,1; and NaHCO3, 0.3. The osmolarity of basic HBSS was ~80 mosmol/L. Specific stimuli, chemotactic tripeptide fMLP, phorbol myristate acetate (PMA), and ionophore A12387 were from Sigma Chemicals (Deisenhofen, Germany). Lipopolysaccharide (LPS) (Escherichia coli O55:B) was from Gibco BRL Life Technologies (Cambridge, UK). All basic chemicals and materials needed for sodium dodecyl sulfate (SDS)-gel electrophoresis were from Bio-Rad Laboratories (Munich, Germany). Cell lysis buffer, polyclonal rabbit anti-phospho-p38 mitogen-activated protein (MAP) kinase, anti-p38 MAP kinase (MAPK), anti-phospho-p44/42, anti-p44/42, and a luminol-enhanced chemiluminescence-based Phototope-HRP Western blot detection system were purchased from New England Biolabs (Frankfurt, Germany). Secondary polyclonal horseradish peroxidase-labeled sheep anti-rabbit antibodies were obtained from Dianova (Hamburg, Germany).

Determination of adhesion molecules
Heparinized venous blood (final activity, 10 U/mL) (Vetren Na, Promonta GmbH, Hamburg, Germany) was drawn from healthy volunteers. Anticoagulated blood samples were washed two times with HBSS of desired composition at room temperature to remove plasma proteins. Washed blood cells were reconstituted to the initial hematocrit with the same HBSS used for removal of plasma constituents. Aliquots of washed blood cells were incubated in a water bath at 37°C for 30 min. Thereafter, PMNLs were stimulated with different concentrations of fMLP for 15 min, inducing either half-maximal (10-8 M) or maximal (10-7 M) changes in the expression of adhesion molecules [10 ]. In addition, experiments were carried out in which receptor-independent activation of cells was induced by addition of PMA and ionophore A23187 to achieve protein kinase C (PKC)- and calcium-dependent stimulation of PMNLs, respectively.

To validate our experimental setup and methods, we tested the effects of hypertonic sodium chloride-modified HBSS at 500 mosmol/L on the LPS-stimulated numerical up-regulation of ß2-integrins and shedding of L-selectin. To this end, washed blood cells were incubated with HBSS of desired osmolarities containing 10% heat-inactivated fetal calf serum. After incubation at 37°C for 30 min, LPS was added at a final concentration of 100 ng/mL. Activation of cells was stopped after 20 min by putting cells on ice. Expression of adhesion molecules of PMNLs was determined prior to and at the end of the incubation period by flow cytometry. For this purpose, blood cells were incubated for 20 min on ice with fluorescein isothiocyanate (FITC)-labeled monoclonal antibody IB4 [immunoglobulin (Ig) G2a] or Dreg 200 (IgG1), which specifically bind either to the ß2 chain of human integrins (CD18) or L-selectin (CD62L). The monoclonal antibody CBRM1/5 was used to detect an extracellularly located neoepitope on the human {alpha}2 chain CD11b, which is expressed only when activation-dependent conformational changes of this ß2-integrin occur [11 ]. Consequently, the epitope CBRM1/5 can be considered to represent an activation reporter epitope. The monoclonal antibody CBRM1/5 was a kind gift from T. A. Springer (Harvard Medical School, Boston, MA). Because the antibody was not labeled by a fluorochrome, PMNL-bound CBRM1/5 was detected by a secondary polyclonal anti-mouse FITC-labeled antibody (La Roche, Mannheim, Germany). Leukocyte populations and specificity of binding of antibodies were assessed as previously described [10 ]. CBRM1/5 was used at twice the saturating concentration, and specificity of binding was demonstrated by an isotype-matched control mouse IgG1 antibody (DAKO, Glostrup, Denmark). There was no binding of the secondary anti-mouse FITC-labeled antibody to PMNLs either in the absence or in the presence of the control mouse IgG1 antibody. Additional control experiments revealed that binding of antibodies was not affected by the sodium- or choline-dependent osmolarity. Fluorescence was analyzed using a Becton Dickinson (Heidelberg, Germany) FACScan equipped with an argon laser emitting 15 mW of light at 488 nm. Linear list mode data were collected for 5,000 events from each sample. The linear fluorescence amplifier gain at constant photomultiplier voltage was adjusted as necessary to position the signal on scale for each sample. With FACScan software, mean fluorescence channel numbers were calculated and normalized to a gain of 1.0. The corrected mean channel number (CMCN) was computed according to the following formula: CMCN = observed mean channel number/amplifier gain.

Estimation of cell volume
The volume of cells was estimated by forward light scatter values (FSCs) [12 ] calculated as mean channel numbers at constant photomultiplier voltage normalized to a gain of 1.0. To validate estimations of cell volume by FSCs under our experimental conditions, cell volumes of isolated neutrophils were manipulated by incubation in hypertonic or hypotonic sodium choline-modified HBSS, and cell volume and FSCs were determined simultaneously by use of a Multisizer II Coulter Counter (Coulter Electronics, Krefeld, Germany) and by flow cytometer measurements. The correlation between the absolute cell volume and the FSC was as follows: cell volume (fl) = 222.2 + 0.246 x FSC (CMCN); N = 15; r = 0.955; and P = 0.000 (correlation coefficient according to the method of Pearson).

Measurement of fMLP receptor expression
The number of cell surface fMLP receptors expressed by peripheral blood neutrophils was estimated by the binding of a fluorescein derivative of formyl-Nle-Leu-Phe-Nle-Tyr-Lys (fNLPNTL-FITC) (Molecular Probes Inc., Eugene, OR). Heparinized whole blood was washed two times with sodium chloride- or choline chloride-modified basic HBSS of desired osmolarity. After reconstitution to the initial hematocrit, the cells were incubated for 30 min at 37°C. At 5 min before the end of the incubation period, LDS 751 (Molecular Probes) was added at a final concentration of 10-5 M. Each cell suspension was aliquoted, diluted with ice-cooled modified basic HBSS of appropriate osmolarity, and incubated for an additional period of 30 min on ice. Thereafter, fNLPNTL-FITC was added at concentrations ranging from 0 and 10-10 M to 10-7 M in the absence or presence of unlabeled fMLP in excess (10-4 M) to block nonspecific binding. After 30 min, neutrophil-bound fNLPNTL-FITC was assessed in blood cell suspensions by linear fluorescein fluorescence intensities on FL-1 after gating on neutrophils in FSC/SSC dot blots obtained by setting the threshold on FL-3 for LDS-stained nuclear cells. Specific binding of fNLPNTL-FITC was calculated by the difference between FL-1 fluorescence intensities measured in the absence and presence of blocking concentrations of unlabeled fMLP.

Isolation of PMNLs and determination of intracellular calcium
PMNLs were isolated from heparinized whole blood by continuous Percoll density gradient centrifugation as previously described [1 ]. Granulocytes were washed two times with isotonic HBSS, cell numbers were counted, and the concentrations were adjusted to 106 cells/mL. Because cell separation procedures were previously shown to activate PMNLs, we determined expression of ß2-integrins and L-selectin on PMNLs prior to and after cell isolation. During cell isolation, only a slight increase in the numerical expression of ß2-integrins and no changes of L-selectin levels occurred when compared with baseline values determined before cell purification (ß2-integrins, 136.2 ± 28.4 vs. 105.4 ± 21.7; L-selectin, 54.9 ± 3.95 vs. 56.8 ± 8.8; expression after cell isolation compared with baseline, n = 6).

To determine relative changes in intracellular concentrations of calcium ions, the fluorescence intensities of the calcium-sensitive dye Fluo-3 (Molecular Probes, Inc., Eugene, OR) and of SNARF-1 (Molecular Probes) obtained at its isoemissive point were measured, and the ratio of the two fluorescence intensities was calculated. This method has been shown to overcome variation in basal fluorescence intensity because of heterogeneity in intracellular dye concentration or compartmentalization [13 ]. Because granulocytes change their cell volume when incubated in media with different osmolarities, any effects of cell volume on Fluo-3 signals were eliminated by calculating the ratio to the fluorescence intensity of the concomitantly loaded fluorescence dye SNARF-1 recorded at its isoemissive point. At that point, the intensity of the fluorescence of SNARF-1 is independent of activation-dependent changes in intracellular pH. For loading cells with Fluo-3 and SNARF-1, acetoxy-methyl ester derivatives of both compounds were added to 106 cells/mL at final concentrations of 5 x 10-6 M and 1 x 10-6 M, respectively. After incubation of cells for 20 min at 37°C, the dye-loaded cells were washed two times with either sodium chloride- or choline chloride-modified HBSS of desired osmolarity. Cells were incubated for an additional 10 min at 37°C and activated by the addition of fMLP at final concentration of 10-7 or 10-8 M. Kinetics of fluorescence signals were recorded intermittently for 5-s periods of measurement separated by 10-s periods of cytometer downtime for Fluo-3 on FL-1 and SNARF-1 on FL-3 using CHRONYS software (Becton Dickinson). Cell suspensions were kept at 37°C during measurements. From linear list mode data collected for 5,000 events from each sample, the CMCN was computed for FL-1 and FL-3 as described above. Although cells were double stained, there was no need to set compensation on the instrument.

Detection of phospho-p38 and phospho-p44/42 in polymorphonuclear leukocytes
Isolated PMNLs were incubated with sodium chloride- or choline chloride-modified basic HBSS of the desired osmolarities and stimulated with fMLP (10-7 M) as described above for determination of adhesion molecules. Activation of cells was stopped 2 min after the addition of the chemotactic tripeptide by adding 10 volumes of ice-cold incubation medium and then subjecting the cells to rapid centrifugation. In control experiments with LPS, performed to demonstrate the reliability of our Western blotting system, isolated PMNLs were incubated in the same way as the other stimuli to assess the effects of hypertonic sodium-modifed HBSS on the expression of adhesion molecules.

For immunoblotting, cell pellets were lysed with lysing buffer and sonicated in a water bath for 2 min. Lysed samples were kept at -80°C until use. After thawing, protein concentrations in samples were determined by photometry (Protein Assay ESL, Boehringer Mannheim, Mannheim, Germany), and the specimens were boiled in Laemmli sample buffer for 10 min before analysis by 10% sodium dodecyl sulfate-polyacrylamide gel electrophoresis. The amounts of protein loaded per slot were ~60 µg for determination of phospho-p44/42 and ~200 µg for determination of phospho-p38. Protein loading was kept constant for lanes of an individual gel. After transfer to nitrocellulose membranes and blockage by nonfat dry milk at room temperature for at least 1 h, membranes were incubated with the appropriate antibodies at room temperature overnight. The dilution was 1:500 for anti-phospho-p38, 1:1,000 for anti-p38, 1:4,000 for anti-phospho-p44/42 [extracellular regulated kinase (ERK) 1/2], and anti-p44/42 (ERK1/2). After washing, primary antibodies were detected by binding of secondary horseradish peroxidase-conjugated antibodies and luminol-enhanced chemiluminescence illuminating X-ray films. After development, the films were subjected to densitometry. Optical densities (ODs) were corrected for background density, and the results are expressed as OD units (ODus) per square millimeter. In addition to direct measurements, equal loading of lanes with proteins was also determined intermittently by stripping membranes and reprobing for phosphorylation-independent total anti-p38 or anti-p44/42.

Statistics
All data were tested for normal distribution by the one-sample Kolmogorov-Smirnov test. Effects of incubation conditions (resting vs. stimulated and changes in osmolarities) were analyzed by repeated-measures analysis of variance, comparing the mean of each level to the mean of the level of interest with levels of significance, corrected according to the method of Bonferroni. For comparison of phosphorylation of MAPKs, a paired t-test and correction of levels of significance according to the method of Bonferroni were performed. Data are presented as means ± SD. All calculations were done using SPSS 10.0 software (SPSS Inc, Chicago, IL).


    RESULTS
 TOP
 ABSTRACT
 INTRODUCTION
 MATERIALS AND METHODS
 RESULTS
 DISCUSSION
 REFERENCES
 
Effects of sodium chloride on the fMLP-stimulated expression of adhesion molecules
Variation of the sodium chloride-dependent osmolarity had no statistically significant effect on the number of ß2-integrins on PMNLs determined at baseline (i.e., immediately after venipuncture) (Fig. 1A ). After incubation of resting cells for 45 min at 37°C (0 M fMLP), numerical expression of ß2-integrins did not change, excluding the possibility of nonspecific activation of cells under our experimental conditions. However, when fMLP was added at 10-8 M and 10-7 M after 30 min of preincubation of cells under normo-osmolar conditions (290 mosmol/L), numbers of ß2-integrins increased half-maximally and maximally within the next 15 min, respectively. This fMLP-stimulated numerical up-regulation of ß2-integrins was significantly inhibited by an increase in the sodium-dependent extracellular osmolarity. When PMNLs were activated by fMLP under normo-osmolar conditions, expression of the ß2-integrin CD11b/CD18 activation-reporter antigen CBRM1/5 was strongly inhibited at concentrations of 350 and 410 mosmol/L, respectively (Fig. 1B) . Stimulation of PMNLs by fMLP at 10-8 M and 10-7 M caused a decrease in the number of cell-surface-bound L-selectin molecules by half and almost to zero, respectively, under normo-osmolar conditions (Fig. 1C) . In comparison with the inhibitory effects of hypertonic saline on the expression of ß2-integrins (Fig. 1A and 1B) , a pronounced attenuation of the shedding of L-selectin was observed only when PMNLs were activated with the suboptimal concentration of fMLP at 10-8 M. The shedding of L-selectin from maximally activated PMNLs was decreased only to a small extent—although significantly—by the highest osmolarity (410 mosmol/L).



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Figure 1. Effect of saline-modified HBSS on the fMLP-stimulated numerical up-regulation of ß2-integrins (A), the expression of the CD11b/CD18 activation reporter epitope CBRM1/5 (B), and the shedding of L-selectin (C). Anticoagulated whole-blood specimens, washed free of plasma with saline-modified basic HBSS ( see Materials and Methods), were preincubated for 30 min at 37°C. After stimulation with fMLP (10-7 M) for an additional 15 min at 37°C, cells were put on ice, and expression of ß2-integrins as well as of L-selectin was determined by binding of FITC-labeled monoclonal antibodies IB4, CBRM1/5, and Dreg200. The CBRM1/5 antibody binds specifically to an activation-dependent neoepitope on CD11b/CD18. Basal values refer to measurements performed immediately after blood specimens were withdrawn and washed (i.e., prior to the start of the preincubation period). Osmolarities (mosM/L) were as follows: open bar, 230; coarsely hatched bar, 290; finely hatched bar, 350; closed bar, 410. n = 6; data are means ± SD, *, P < 0.05 vs. fMLP at 0 M; #, P < 0.05 vs. 290 mosM/L; repeated-measure analysis of variance was performed with adjustment of levels of significance for multiple comparisons according to the method of Bonferroni; rel. units, relative units.

 
Effects of choline chloride, mannitol, and sucrose on the fMLP-stimulated expression of adhesion molecules
To differentiate between the effects of changes in extracellular osmolarity and sodium-specific effects, experiments were performed in which sodium was replaced in part by choline. The choline cation, unlike the sodium cation, does not enter cells. In contrast to hypertonic sodium chloride-modified HBSS, an increase in the choline chloride-dependent osmolarity did not inhibit the fMLP-stimulated numerical up-regulation of ß2-integrins (Fig. 2A ).



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Figure 2. Effect of choline chloride-modified HBSS on the fMLP-stimulated numerical up-regulation of ß2-integrins (A), the expression of the CD11b/CD18 activation reporter epitope CBRM1/5 (B), and the shedding of L-selectin (C). For further explanation, see the legend to Figure 1 .

 
As expected, the expression of the activation reporter epitope CBRM1/5 was again increased after stimulation of PMNLs by fMLP at 10-8 and 10-7 M (Fig. 2B) . Although increasing osmolarities of choline chloride tended to inhibit the expression of CBRM1/5 when induced by the lower concentration of fMLP (10-8 M), the effects observed did not reach the level of significance. Moreover, choline chloride-modified medium did not inhibit the expression of CBRM1/5 caused by stimulation of PMNLs with the higher concentration of fMLP (10-7 M). Thus, in contrast to hypertonic saline-modified medium, hypertonic choline chloride-modified medium failed to inhibit the fMLP-stimulated up-regulation of ß2-integrins.

When hypertonic choline chloride solution was tested in relation to the shedding of L-selectin stimulated by the lower concentration of fMLP (10-8 M), hypertonic choline chloride, like hypertonic saline, inhibited the loss of this type of adhesion molecule from the surface of PMNLs (Fig. 2C) but again could not inhibit shedding because of the high fMLP concentration (10-7 M).

Similar to the results obtained for choline chloride, increasing osmolarities of the nonionic compound mannitol did not inhibit the fMLP-stimulated numerical up-regulation of ß2-integrins (Fig. 3A ). In contrast to hypertonic sodium and choline chloride solutions, hypertonic mannitol-modified medium did not attenuate the fMLP-induced shedding of L-selectin (Fig. 3B) . Similiar results (Table 1 ) were obtained when osmolarity was increased by stimulation with sucrose instead of mannitol—neither of which enters cells. When we tested urea, to which the cell membrane is permeable, significant hemolysis occurred even when it was added to basic HBSS in amounts to achieve an osmolarity of 290 mosmol/L. For this reason, the effects of urea-dependent osmolarities on expression of adhesion molecules by neutrophils were not assessed.



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Figure 3. Effect of mannitol-modified HBSS on fMLP-stimulated numerical up-regulation of ß2-integrins (A) and the shedding of L-selectin (B). For further explanation, see the legend to Figure 1 .

 

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Table 1. Effect of Sucrose-Modified HBSS on the fMLP-Stimulated Numerical Expression of ß2-integrins and Shedding of L-selectin

 
The results obtained by stimulation with mannitol and sucrose demonstrate that a mere increase in extracellular osmolarity is not sufficient to account for the effects of the hypertonic ionic solutes sodium chloride or choline chloride on the fMLP-stimulated changes in adhesion molecule expression.

Effects of sodium chloride and choline chloride on cell surface binding of fNLPNTL-FITC
Because the contrasting effects of hypertonic saline and choline chloride on the up-regulation of ß2-integrins might be explained by differences in the ability of the solutions to interfere with the interaction of fMLP and their cell surface receptors, the effects of sodium chloride-modified and choline chloride-modified media were compared in relation to the specific binding of fNLPNTL-FITC to PMNLs.

In these experiments, which were conducted under the same experimental conditions used for the study of the effects of osmolarity on the fMLP-induced changes in adhesion molecule expression, no differences were observed with respect to the type of major cations used (sodium vs. choline) or the osmolarity selected (230 vs. 410 mosmol/L). As expected for the interaction of the fluorescent ligand with a receptor site, dose-response curves were of sigmoidal shape, reaching half-maximal and maximal saturating concentrations of binding at ~2–3 x 10-9 M and at 1 x 10-8 M, respectively (Fig. 4 ).



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Figure 4. Comparison of the effects of sodium chloride- and choline chloride-modified HBSS (A and B, respectively) on fMLP receptor binding. Heparinized whole blood washed free of plasma with sodium chloride- or choline chloride-modified basic HBSS of the desired osmolarity was preincubated under the same conditions as in the study of fMLP-stimulated adhesion molecule expression. Specific binding of the FITC-labeled receptor ligand fNLPNTL was assessed as described in Materials and Methods. Osmolarities (mosM/L) are indicated as follows: {circ}, 230; {square}, 290; {triangleup}, 350; and {triangledown}, 410; symbols shown represent mean values of five experiments with neutrophils from different volunteers per curve.

 
Effects of sodium and choline chloride on fMLP-stimulated intracellular calcium and expression of adhesion molecules elicited by receptor-independent stimuli
To determine whether the contrasting effects of hypertonic saline and choline chloride solutions on the expression of ß2-integrins might be caused by differences in the modulation of intracellular calcium- or PKC-dependent pathways, the influence of both types of solutions on the fMLP-induced changes in intracellular calcium and the numerical expression of ß2-integrins stimulated by the ionophore A23187 and the phorbol ester PMA was studied. As expected, the Fluo-3/SNARF-1 ratio, a measure of intracellular concentrations of free calcium ions, decreased after incubation of resting PMNLs for 30 min at 37°C in increasing sodium-dependent osmolarities (Fig. 5 ). After stimulation of cells with fMLP, the time course of the Fluo-3/SNARF-1 ratio exhibited a biphasic response, reaching maximum levels from 1 to 15 min after addition of the chemotactic tripeptide. Compared with normo-osmolar conditions, the early and the late increases in Fluo-3/SNARF-1 ratios were inhibited at higher osmolarities of sodium chloride. Comparison of the effects of sodium chloride- and choline chloride-modified HBSS on resting and fMLP-stimulated Fluo-3/SNARF-1 ratios demonstrated no significant differences with respect to the osmolarities tested at all points in time.



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Figure 5. Comparison of the effects of sodium chloride (•)- and choline chloride ({circ})-modified HBSS on the fMLP-stimulated increase in intracellular calcium. Isolated PMNLs were loaded with the calcium-sensitive dye Fluo-3 and the pH-sensitive dye SNARF-1 for 20 min at 37°C. The loaded cells were washed with sodium chloride- or choline chloride-modified basic HBSS of desired osmolarity. After an additional incubation period of 10 min at 37°C, cells were activated at time zero by addition of fMLP, and then changes in intracellular calcium were assessed by determining the ratio of Fluo-3 and SNARF-1 fluorescence intensities via flow cytometry. For details, see Materials and Methods. n = 6; values are means ± SD; *, P < 0.05 vs. time 0; #, P < 0.05 vs. 290 mosmol/L repeated-measure analysis of variance with adjustment for multiple comparisons according to the method of Bonferroni. mosmol, milliosmole(s).

 
In agreement with the lack of difference between hypertonic saline and hypertonic choline in modulation of the binding of fMLP to its receptors and concentrations of intracellular calcium ions, both types of hypertonic solutions again did not differ in their effects on the numerical up-regulation of ß2-integrins induced by the ionophores A23187 and PMA, respectively. Hypertonic saline-modified as well as hypertonic choline chloride-modified media significantly inhibited the calcium- and the PKC-dependent increases in the number of ß2-integrins (Fig. 6 and Fig. 7 ).



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Figure 6. Comparison of the effects of sodium chloride- and choline chloride-modified HBSS (A and B, respectively) on the ionophore A23187-induced numerical expression of ß2-integrins. rel. units, relative units. n = 6; values are means ± SD; *, P < 0.05 vs. A23187 0 M; #, P < 0.05 vs. 290 mosmol/L.

 


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Figure 7. Comparison of the effects of hypertonic saline- and choline chloride-modified HBSS (A and B, respectively) on the PMA-induced numerical expression of ß2-integrins. n = 6; values are means ± SD; *, P < 0.05 vs. PMA 0 M; #, P < 0.05 vs. 290 mosmol/L. rel. units, relative units.

 
Effects of sodium chloride and choline chloride on the fMLP-stimulated phosphorylation of MAPK p38 and p44/42
To look for possible effects of sodium chloride- or choline chloride-dependent osmolarity on activation of MAPKs p38 and p44/42 (ERK1/2) in resting and fMLP-stimulated PMNLs, polyclonal anti-phospho-p38 MAPK (Thr180-Tyr182) or anti-phospho-p44/42 MAPK (Thr202-Tyr204) antibodies were used. These antisera detect p38 MAPK or p44 and p42 MAPKs (ERK1 and ERK2) only when MAPKs are catalytically activated by dual phosphorylation at Thr180 and Tyr182 or by phosphorylation at Thr202 and Tyr204, respectively. Incubation of unstimulated PMNLs in hypertonic sodium chloride-modified or choline chloride-modified HBSS medium (37°C, 30 min) at either 350 or 410 mosmol/L did not significantly affect the basal state of phosphorylation of p38 (Fig. 8A and B ) or p44/42 (ERK-1/2) (Fig. 9A and B ) compared with isotonic HBSS. After stimulation of PMNLs by fMLP (10-7 M) under isotonic conditions for 2 min, a time period after which phosphorylation of MAPKs was almost maximal in time course experiments (data not shown), site-specific phosphorylation of p38 and p44/42 (ERK1/2) increased significantly compared with unstimulated values. The same extent of phosphorylation of MAPKs was observed when cells were activated in 350-mosmol hypertonic sodium chloride-modified and choline chloride-modified media (Fig. 8A and 9A) . Thus, at an osmolarity of 350 mosmol/L, neither sodium chloride-modified nor choline chloride-modified HBSS medium had any inhibitory effect on the fMLP-stimulated phosphorylation of MAPKs.



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Figure 8. Comparison of the effects of sodium chloride- and choline chloride-modified medium on the phosphorylation state of p38 in resting and fMLP-stimulated PMNLs. Isolated PMNLs were incubated in sodium chloride- or choline chloride- (coarsely hatched and finely hatched bars, respectively) modified HBSS medium for 30 min at concentrations of 350 mosmol/L (A) and 410 mosmol/L (B) and stimulated by fMLP. Open bars = experiments run in parallel in sodium chloride- modified HBSS of 290 mosmol/L. Cell activation was stopped 2 min after addition of the chemotactic tripeptide. Phosphorylation of p38 at Thr180 and Tyr182 was assessed by immunoblotting. For details, see Materials and Methods. n = 6; values are means ± SD; *, P < 0.05 vs. fMLP 0 M; paired t-test with adjustment for multiple comparisons according to the method of Bonferroni.

 


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Figure 9. Comparison of the effects of sodium chloride- and choline chloride-modified medium on phosphorylation state of p44/42 in resting and fMLP-stimulated PMNLs. Isolated PMNLs were incubated in sodium chloride- or choline chloride-modified HBSS medium (coarsely and finely hatched bars, respectively) for 30 min at 350 mosmol/L (A) or 410 mosmol/L (B) and stimulated by fMLP. Open bars = experiments run in parallel in sodium chloride-modified HBSS of 290 mosmol/L. Cell activation was stopped 2 min after addition of the chemotactic tripeptide. Phosphorylation of p44/42 at Thr 202 and Tyr 204 was assessed by immunoblotting. For details see Materials and Methods. ODu, optical density units. n = 6; values are means ± SD;*, P < 0.05 compared with fMLP 0 M; §, P < 0.05 vs. choline chloride modified HBSS and PMLP 10-7m; paired t-test with adjustment for multiple comparisons according to the method of Bonferroni.

 
When cells were incubated in sodium chloride-modified or choline chloride-modified medium at an osmolarity of 410 mosmol/L, no effect on basal phosphorylation of p38 was obtained in resting PMNLs compared with isotonic controls (Fig. 8B) . With respect to p44/42, a statistically significant but very small decrease in the phosphorylation of this MAPK was observed with 410 mosmol sodium chloride (Fig. 9B) . After addition of fMLP, phosphorylation of p38 as well as of p44/42 again significantly increased under isotonic conditions. No fMLP-stimulated increase in phosphorylated p38 was obtained in the presence of 410 mosmol sodium chloride-modified or choline chloride-modified medium. There was no difference between sodium chloride and choline chloride hypertonic media on the fMLP-stimulated phosphorylation of p38. Concerning fMLP-stimulated phosphorylation of p44/42, both sodium chloride-modified and choline chloride-modified media at 410 mosM/L exerted a strong inhibitory effect (Fig. 9B) . Comparison of both types of hypertonic solutions revealed that hypertonic saline-modified medium inhibited fMLP-stimulated phosphorylation of p44/42 more strongly than hypertonic choline chloride-modified medium did. Although this effect was statistically significant, it was very small.

The effects of sodium chloride- or choline chloride-dependent osmolarity on the phosphorylation state of MAPKs as assessed by densitometry (Fig. 8 and 9) are also shown by individual blots (Fig. 10 and Fig. 11 ).



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Figure 10. Immunoblot of phospho-p38 (A) and phospho-p44/42 (B) from resting and fMLP-stimulated PMNLs incubated in sodium-modified HBSS. Isolated PMNLs were incubated in sodium chloride-modified HBSS medium for 30 min at concentrations of 290 and 350 mosmol/L and stimulated with fMLP for 2 min. There was no effect of sodium chloride-modified HBSS at a concentration of 350 mosmol/L on the fMLP-stimulated phosphorylation of p38 or p44/42 in PMNLs. The membranes were then stripped and reprobed with anti-p38 or anti-p44/42 antibodies to verify equal loading of protein in all lanes (lower small panels). For details, see Materials and Methods.

 


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Figure 11. Immunoblot of phospho-p38 (A) and phospho-p44/42 (B) from resting and fMLP-stimulated PMNLs incubated in sodium chloride- and choline chloride-modified HBSS. Isolated PMNLs were incubated in sodium chloride- or choline chloride-modified HBSS medium for 30 min at 37°C at concentrations of 290 and 410 mosmol/L and stimulated by fMLP for 2 min. Both hypertonic solutions inhibited the fMLP-stimulated increase in site-specific phosphorylation of MAPKs. There was no visible difference between the inhibition of MAPKs by hypertonic sodium chloride–modified medium and the inhibition by choline chloride-modified medium. mosmol, milliosmole(s). For details, see Materials and Methods.

 
Effects of sodium chloride on the LPS-stimulated phosphorylation of p38 and p44/42
LPS was recently shown to be a strong activator of the MAPK p38 [14 ]. In agreement with this report, incubation of PMNLs with LPS strongly increased the tyrosine phosphorylation of p38 under normo-osmolar conditions (Fig. 12 ). This strong stimulatory effect was inhibited by more than 60% when cells were activated in the presence of 500 mosmol/L of sodium chloride. As expected, LPS-stimulated up-regulation of ß2-integrins and shedding of L-selectin were also decreased by hypertonic sodium-modified medium compared with normo-osmolar conditions. These results confirm those reported previously [14 ] and hence demonstrate that our methods were sensitive enough to identify effects of hypertonic saline on the phosphorylation state of p38 in human neutrophils. It is noteworthy that when PMNLs were activated by LPS at a concentration of 100 ng/mL (shown above) to stimulate phosphorylation of p38, phosphorylation of p44/42 did not occur (data not shown).



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Figure 12. Immunoblot of phospho-p38 (A) and expression of CD18 (B) and L-selectin (C) in resting and LPS-stimulated PMNLs in sodium-modified HBSS. Isolated PMNLs were incubated in sodium chloride-modified HBSS medium for 30 min at 37°C at concentrations of 290 and 500 mosmol/L and were stimulated by LPS (100 ng/mL) for an additional 20 min. Under normo-osmolar conditions, LPS clearly stimulated phosphorylation of p38, which was visibly inhibited by hypertonic saline-modified medium. Densitometric measurements showed a decrease of ~60% by hypertonic saline compared with the value obtained under normo-osmolar conditions. In parallel with this effect of hypertonic saline on the p38 MAPK phosphorylation, hypertonic saline decreased the LPS-induced numerical up-regulation of ß2-integrins and the shedding of L-selectin. rel. units, relative units.

 
Effects of sodium and choline chloride on fMLP-stimulated FSC values
To estimate changes of cell volume, the FSCs were determined in those isolated neutrophils that were used to study the effects of sodium chloride and choline chloride on the fMLP-stimulated changes of intracellular calcium. After incubation of cells at increasing sodium chloride- or choline chloride-dependent osmolarities for 30 min at 37°C (Fig. 13 , time zero), FSCs of resting cells were significantly decreased compared with normo-osmolar conditions. Although PMNLs were incubated at the same extracellular osmolarities, cells bathed in hypertonic saline-modified medium had higher FSC values than those bathed in hypertonic choline chloride-modified medium, indicating that PMNLs preincubated in hypertonic choline chloride were significantly more shrunken and that PMNLs preincubated in hypertonic saline were able to react with a relative volume increase. When cells were stimulated with fMLP, only PMNLs incubated in hypertonic saline-modified medium further increased their FSC values significantly.



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Figure 13. Comparison of the effects of hypertonic saline (•)- and choline chloride ({circ})-modified HBSS on the fMLP-stimulated changes in FSCs. FSCs were determined during the experiments conducted for the evaluation of the effects of hypertonic saline and choline chloride on intracellular calcium transients. For further explanation of experimental conditions and time course, see the legend to Figure 5 . n = 6; values are means ± SD; *, P < 0.05 vs. time 0; #, P < 0.05 compared with 290 mosmol/L by repeated-measure analysis of variance; §: P < 0.05 between groups by paired t-test. All levels of significance were adjusted for multiple comparisons according to the method of Bonferroni. rel. units, relative units.

 
Effects of amiloride on the up-regulation of ß2-integrins
To identify the role of a relative increase in cell volume in the sodium-specific inhibition of the fMLP-stimulated up-regulation of ß2-integrins, the Na+/H+ exchange blocker amiloride was used at 10-3 M, a concentration that was previously shown to completely inhibit the increase in cell volume caused by fMLP [15 ]. As shown in Figure 14 , amiloride added to washed blood samples at a concentration of 10-3 M enhanced the inhibition by hypertonic sodium chloride of the fMLP-stimulated up-regulation of ß2-integrins. This result argues against a role of the ability of cells to increase their cell volume or the entrance of sodium via the antiporter into cells in the inhibition of the fMLP-stimulated up-regulation of ß2-integrins by hypertonic saline.



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Figure 14. Effect of amiloride on the inhibition of the fMLP-stimulated up-regulation of ß2-integrins (A) and the expression of the CD11b/CD18 activation-reporter epitope CBRM1/5 (B). Cells were preincubated and stimulated with fMLP in the absence and presence of amiloride (10-3 M; closed bars). Osmolarities in mosmoles per liter were as follows: broadly striped bars, 290; thinly striped bars, 350; hatched bars, 410. For further explanation see the legend to Figure 1 .

 

    DISCUSSION
 TOP
 ABSTRACT
 INTRODUCTION
 MATERIALS AND METHODS
 RESULTS
 DISCUSSION
 REFERENCES
 
We report the following three major, novel findings with respect to the effect of hypertonicity on the fMLP-stimulated expression of adhesion molecules of human polymorphonuclear leukocytes: (1) hypertonic saline- but not hypertonic choline chloride-modified HBSS significantly inhibits the numerical up-regulation of ß2-integrins and the expression of the activation reporter epitope CBRM1/5 (Fig. 1A and 1B and 2A and 2B) ; (2) both types of hypertonic solutions can inhibit the shedding of L-selectin from activated human neutrophils (Fig. 1C and 2C) , and (3) hypertonic mannitol- and sucrose-modified HBSS fail to inhibit the fMLP-stimulated up-regulation of ß2-integrins and shedding of L-selectin (Fig. 3 and Table 1 ).

From these observations, the following conclusions can be drawn: (1) hypertonic saline exerts its inhibitory action on the fMLP-stimulated up-regulation of ß2-integrins by a sodium-specific effect rather than by an effect induced by hyperosmolarity itself; (2) hypertonic saline appears to prevent activation-dependent shedding of L-selectin by an increase in osmolarity rather than by a sodium cation-specific effect; and (3) there might be a specific role of chloride anions in the inhibition of the shedding of L-selectin, given the finding that hypertonic mannitol- and sucrose-modified HBSS did not attenuate the fMLP-stimulated shedding of L-selectin.

Although hypertonic saline has been shown to induce shedding of L-selectin in in vitro [16 ] and in vivo models of hemorrhagic shock [8 , 9 ] and hence has been suggested to account for prevention of injury to microvascular endothelial cells by impediment of selectin-dependent leukocyte adhesion [2 ], we did not further pursue the possible specific role of chloride anions in the regulation of shedding of L-selectin but focused on the difference observed between hypertonic-saline-modified and hypertonic-choline chloride-modified HBSS in inhibiting the expression of ß2 integrins. To this end, we compared the effects of the two hypertonic solutions on signaling pathways known to mediate activation of human polymorphonuclear leukocytes through the chemotactic tripeptide fMLP.

Effects of hypertonic saline and hypertonic choline chloride on binding of fMLP to its receptor and receptor-dependent classical signaling
To discern the mechanism by which sodium may specifically affect the up-regulation of ß2-integrins, we compared the effects of hypertonic saline-modified medium and hypertonic choline-modified medium on different steps in the classical fMLP receptor-signaling cascade. As one might have expected from the observation that hypertonic saline and choline chloride solutions did not differ with respect to the inhibition of the fMLP-stimulated shedding of L-selectin, direct analysis of specifically bound fNLPNTL-FITC confirmed no differences in binding of the fluorescein-conjugated fMLP derivative regarding the type of the major cations used (sodium vs. choline) or the osmolarity selected (230 vs. 410 mosM/L) (Fig. 4) .

There were also no differences between the effects of hypertonic-saline-modified and choline chloride-modified HBSS on fMLP-induced calcium changes (Fig. 5) and the numerical up-regulation of ß2-integrins stimulated by the calcium ionophore A23187 (Fig. 6) . These findings are in agreement with the suppression of the fMLP-stimulated increase in intracellular calcium caused by an increase in extracellular tonicity irrespective of whether hypertonic N-2-hydroxyethylpiperazine-N'-2-ethanesulfonic acid buffered salt solution, sodium sulfate, or sucrose was used [17 ].

Regarding modulation of PKC-dependent pathways, hypertonic saline-modified and choline chloride-modified media inhibited the numerical up-regulation of ß2-integrins to the same extent (Fig. 7) . Similar findings have been reported on the effects of hypertonic saline on the fMLP- and PMA-stimulated numerical expression of CD11b/CD18 [9 ] and on the production of oxygen radicals elicited by the chemotactic peptide or the phorbol ester [18 , 19 ], but to our knowledge there are no comparable published data relating to the effects of hypertonic choline on adhesion molecule expression and oxygen radical production elicited by these compounds.

Considered together, these findings suggest that hypertonicity, irrespective of the cation (sodium or choline), can inhibit calcium- and PKC-dependent pathways in the fMLP receptor-induced signaling. Because fMLP-stimulated numerical up-regulation of ß2-integrins and expression of the activation reporter epitope CBRM1/5 were not inhibited by hypertonic choline chloride, the attenuation of the classical pathways of fMLP signaling (Ca+ and PKC) appears not to solely account for the down-regulation of ß2-integrin expression by hypertonic saline.

Effects of hypertonic saline and hypertonic choline chloride on the fMLP-stimulated tyrosine-specific phosphorylation of MAPKs p38 and p44/42
Recent in vitro studies suggest a strong role for the activation of p38 not only in the shedding of L-selectin induced by hypertonicity [16 ] but also for the up-regulation of ß2-integrins after stimulation of PMNLs by endotoxin [14 ] or tumor necrosis factor [20 ]. Endotoxin was shown to strongly stimulate phosphorylation of p38 and to induce up-regulation of ß2-integrins. Blockage of p38 activity by the specific inhibitor SB203580 abolished the expression of ß2-integrins stimulated by hypertonicity [16 ], endotoxin, or tumor necrosis factor [20 ].

Hypertonic saline alone was shown in neutrophils to slightly stimulate phosphorylation of p38, which was followed by a strong inhibition of the endotoxin- and fMLP-induced phosphorylation-dependent activation of this enzyme [21 ]. It was suggested that hypertonic prestimulation of p38 rendered the MAPK refractory for subsequent activation [21 ]. We were not able to demonstrate an increase in the phosphorylation of p38 by hypertonic saline at 350 or 410 mosmol/L, a finding also reported by others [22 ].

Phosphorylation of p38 on stimulation with fMLP was not inhibited by 350 mosM/L of sodium chloride-modified HBSS but was attenuated at a concentration of 410 mosmol/L (Fig. 8A and 8B) . Because fMLP-stimulated tyrosine phosphorylation of p38 was shown in human neutrophils to partially depend on activation of PKC and cytosolic calcium transients [23 ], our observation of inhibition of the calcium- and PMA-induced up-regulation of ß2-integrins by hypertonic saline (Fig. 6A and 7A) is consistent with the inhibition of the activation of p38 by sodium chloride-modified HBSS at the higher tonicity. However, since hypertonic choline-modified HBSS also diminished the A23187- and PMA-induced up-regulation of ß2-integrins (Fig. 6B and 7B) , one could have expected that p38 phosphorylation would be inhibited by hypertonic choline chloride-modified medium as well. Accordingly, there was no difference between hypertonic sodium chloride- and choline chloride-modified HBSS with respect to their effects on basal and fMLP-stimulated phosphorylation of p38 at osmolarities of 350 and 410 mosmol/L.

Thus, the sodium-specific effect in the hypertonic inhibition of fMLP-stimulated up-regulation of ß2-integrins is unlikely to be explained at the level of activation of p38. To add complexity, hypertonic saline at 350 mosmol/L already significantly decreased fMLP-stimulated ß2-integrin expression but not p38 phosphorylation (Fig. 1A and Fig. 8A ), making p38 alone unlikely to account for fMLP-stimulated expression of ß2-integrins. It is interesting that inhibition of p38 by SB203580 failed to inhibit fMLP-stimulated, integrin-dependent adhesion of neutrophils [20 ].

In contrast, endotoxin-induced phosphorylation of p38 was inhibited by hypertonic saline by ~60 % (Fig. 12) . In parallel, hypertonic saline decreased the up-regulation of ß2-integrins and the shedding of L-selectin in endotoxin-stimulated PMNLs. These observations not only confirm results reported previously by others [14 ] but also demonstrate the sufficient sensitivity of our methods to assess hypertonic saline-mediated changes in stimulus-induced p38 phosphorylation.

During studies to determine a possible role of p44/42 in the sodium-specific effect of hypertonic inhibition of ß2-integrin up-regulation, results were obtained that were similar to those for p38 phosphorylation. Hypertonic sodium chloride and choline chloride did not visibly differ in their effects on basal and fMLP-stimulated p44/42 phosphorylation either at 350 mosmol/L or at 410 mosmol/L, although there was a statistically significantly stronger inhibition of p44/42 phosphorylation by hypertonic saline at the higher osmolarity (Fig. 9A and 9B) . There are several findings that make this slightly stronger inhibition by hypertonic saline on p44/42 phosphorylation an unlikely explanation for the sodium specific effect. First, in the case of tumor necrosis factor-induced up-regulation of ß2-integrins, selective inhibition of p44/42 MAPKs ERK1/2 by PD 98059 was without any effect [24 ]. Second, as with p38, hypertonic saline at 350 osmol/L decreased significantly the fMLP-stimulated up-regulation of ß2-integrins but not the phosphorylation of p44/42 (Fig. 1A and 9A) . Third, endotoxin clearly increased expression of ß2-integrins and caused shedding of L-selectin without any phosphorylation of p44/42 (data not shown). Concerning the role of MAPKs, the results of the present study suggest that phosphorylation of neither p38 nor p44/42 can actually account for the sodium-specific inhibitory effect on the fMLP-stimulated up-regulation of ß2-integrins.

Effects of hypertonicity-associated changes in cell volume on fMLP-stimulated expression of ß2-integrins
Because there is evidence that a cell can detect changes in its own volume and generate signals for regulation of mechanisms to keep its volume constant, we also analyzed the effects of hypertonic saline and choline chloride on FSCs of neutrophils. As shown in Figure 13 , PMNLs incubated in hypertonic saline for 30 min at 37°C prior to stimulation with fMLP had significantly higher FSCs than cells exposed to hypertonic choline of the same osmolarity. This observation indicates that hypertonic-saline-exposed PMNLs had increased their cell volumes, a process that was inhibited in hypertonic-choline-bathed cells because of the inability of the Na+/H+ exchangers to transport choline cations into the cells [15 ]. After stimulation of PMNLs with fMLP, again only hypertonic-saline-bathed cells further increased their volumes. Therefore, mechanisms associated with the regulation of cell volume might generate signals that inhibit the fMLP-stimulated up-regulation of ß2-integrins. However, when PMNLs were incubated with amiloride at a concentration shown by others to abolish the gains in cell volumes induced by fMLP [15 , 25 ], the inhibition of the chemotactically stimulated numerical up-regulation of ß2-integrins and the expression of the activation-reporter epitope CBRM1/5 were further enhanced (Fig. 14) . In addition, prevention of the increase in cell volumes of osmotically shrunken neutrophils (e.g., by incubation of cells in hypertonic choline chloride, which is not transported by the antiport) did not cause inhibition of the up-regulation of ß2-integrins (Fig. 2) . Therefore, one can conclude that neither the signals induced by a decrease in cell volume nor the transport of sodium into the cell through the antiporter is responsible for inhibition of the up-regulation of ß2-integrins by hypertonic saline.

Role of extracellular and intracellular sodium in the inhibition of up-regulation of ß2-integrins
A recently published study on osmotic inhibition of exocytosis in neutrophils suggested that hypertonic saline inhibits exocytosis of all types of granules by enhanced submembranous F-actin ring formation and abolishment of depolymerization, irrespective of the stimulus used (fMLP, PMA, A23187, or LPS) [26 ]. Because prevention and induction of F-actin polymerization decreased and the inhibitory action of hypertonic saline increased, respectively, the authors concluded that cytoskeletal remodeling appears to be a key component in the neutrophil-suppressive effects of hypertonic saline. It is noteworthy that blockage of tyrosine phosphorylation by specific kinase inhibitors (e.g., for p38 by SB203580) had no effect on the osmotically induced actin polymerization. When neutrophils were permeabilized for monovalent cations by nystatin, addition of NaCl (+100 mM) increased polymerization of actin in neutrophils kept at constant cell volumes, whereas addition of sucrose (+ 200 mM) only decreased cell volumes without induction of F-actin. Based on these findings, the authors concluded that elevation of intracellular ionic strength might be an important contributor but that reduced cell volume itself did not seem to be sufficient for actin modeling. The latter conclusion fits well with our observation that the expression of ß2-integrins was inhibited by the addition of NaCl but not by choline chloride, mannitol, or sucrose, which all decrease cell volume but cannot enter cells. However, one may argue that in intact cells, shrinking results in a concomitant increase in intracellular cation concentrations because of the ensuing water efflux. This should be the same with NaCl and choline chloride, since the latter induced more shrinkage, as shown in Figure 13 . Thus, experiments suggest the involvement of the extracellular rather than (or in addition to) the intracellular sodium cation concentrations in the inhibition of the fMLP-stimulated up-regulation of ß2–integrins. Why this requirement for increases in both extracellular and intracellular sodium (or metal) cation concentrations is restricted to the inhibition of the fMLP-induced response remains to be clarified by further experiments.


    ACKNOWLEDGEMENTS
 
This study was supported by the Friedrich-Baur Stiftung.

The authors gratefully acknowledge the skillful technical assistance of Sabine Fischer, Gaby Kröger, Marion Hörl, and Ursula Göttler from the Clinic of Anesthesiology. Some of this research was conducted by Kay Eberhardt and Florian Setzer in partial fulfillment of their requirements for doctorial theses from the medical faculty of the Ludwig-Maximilians-University of Munich, Munich, Germany.

Received November 2, 1999; revised April 12, 2001; accepted April 16, 2001.


    REFERENCES
 TOP
 ABSTRACT
 INTRODUCTION
 MATERIALS AND METHODS
 RESULTS
 DISCUSSION
 REFERENCES
 

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