In vivo viability of 111In-labelled granulocytes demonstrated in a sham-dialysis model

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Abstract
In seven febrile patients undergoing regular dialysis treatment, sham-dialysis with a dialyzer equipped with a cuprophane membrane was performed during a routine 111In-oxine white blood cell scan with “pure” granulocytes isolated on a discontinuous gradient (Percoll/plasma: n = 5; Metrizamide/plasma: n =2). The patients were in contact with the cuprophane membrane over 45 or 90 min. Twenty-five (±5) minutes after the start of the dialysis, the peripheral leucocyte count (59 ± 22%) and the 111 In activity in the peripheral blood decreased to a minimum of their initial range (64 + 21%) because of leucocyte activation. The activity over both lungs increased symmetrically (29+ 15%), the spleen activity decreased (14.8 + 8%) and the liver activity remained constant. At the end of the dialysis (45—90 min post-injection), the number of circulating neutrophils, peripheral 111In activity and activity distribution in the organs regained their initial level. In conclusion, these data confirm previously described data concerning the sequestration of neutrophils into the lung during dialysis treatment. The data demonstrate the origin of the activated neutrophils in the circulation and the spleen. The identical behaviour of 111In-oxine-labelled and unlabelled granulocytes is demonstrated. Additionally, the accumulation of activity in the spleen is due not to opsonized cells but to sequestrated neutrophils, which are able to migrate from the spleen after adequate activation. The migration of activated cells into the lung explains the diagnostic difficulties posed by diffuse lung uptake in leucocyte scans in patients with leucocyte-activating diseases.