Effects of acute Trental infusion on white blood cell rheology in patients with critical leg ischaemia

Abstract

Changes in the circulatory behaviour of white cells may contribute to the progression of tissue ischaemia. To investigate whether the therapeutic effects of pentoxifylline might result from an inhibition of white cell activation and rheological changes, we measured the filterability of cell suspensions derived from patients with critical leg ischaemia, before and after infusion of 600mg of this agent. Activation was also assessed, using morphological criteria and by measuring plasma levels of granulocyte elastase. It was found that the flow rate of mononuclear cells through 8 μm pore filters was increased after treatment, but no significant changes were found for granulocytes or unfractionated white cells. Nor were there any changes in the number of cells judged to be active or in plasma elastase. However, it was noticeable that those patients with worse granulocyte flow or higher levels of activation did tend to show improvement after treatment. Thus there is some evidence of an in vivo affect of pentoxifylline on white cell behaviour, possibly made evident in this study by its ability to reduce the cell response to the process of sample preparation.