Albumin and hydroxyethyl starch modulate oxidative inflammatory injury to vascular endothelium

Anesthesiology. 2004 Jan;100(1):51-8. doi: 10.1097/00000542-200401000-00012.


Background: Human serum albumin is used clinically to maintain colloid osmotic pressure and is viewed to serve an antioxidant role in the vascular compartment via binding of redox-active metal complexes, transport of nitric oxide, and the oxidant-scavenging reactions of the single thiol of human serum albumin, cys34. Because of these potentially desirable adjunctive actions, we evaluated the purity and thiol redox state and compared the relative effects of clinically available 25% human serum albumin preparations with a starch-derived colloid, 6% hydroxyethyl starch, in in vitro models of inflammatory vascular injury.

Methods: Bovine aortic endothelial cell responses to chemical, enzymatic, and cell-derived reactive inflammatory mediators in the presence of human serum albumin or hydroxyethyl starch were assessed.

Results: The cys34 thiol of fresh human serum albumin preparations was 70-85% oxidized and contained a population of human serum albumin (approximately 25% of total) having the cys34 resistant to reduction by 2-mercaptoethanol and NaBH4. Treatment of bovine aortic endothelial cells with human serum albumin dose-dependently protected from HOCl-mediated 14C-adenine release, with this protective effect of human serum albumin not dependent on protein thiol status. Addition of human serum albumin to cell media provided no protection from the cytotoxic actions of peroxynitrite and xanthine oxidase-derived reactive species. Binding of activated polymorphonuclear leukocytes to bovine aortic endothelial cells was significantly amplified by hydroxyethyl starch and inhibited by human serum albumin administration. The binding of neutrophil-derived myeloperoxidase to bovine aortic endothelial cells, a mediator of multiple oxidative and nitric oxide-consuming reactions, was also inhibited by human serum albumin and enhanced by hydroxyethyl starch.

Conclusions: Clinical human serum albumin preparations show modest intrinsic non-thiol-dependent antiinflammatory properties in vitro, a phenomenon that was not observed with hydroxyethyl starch.

Publication types

  • Research Support, Non-U.S. Gov't
  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Animals
  • Cattle
  • Cells, Cultured
  • Electrophoresis, Polyacrylamide Gel
  • Endothelial Cells / drug effects
  • Endothelial Cells / pathology
  • Endothelium, Vascular / pathology*
  • Humans
  • Hydroxyethyl Starch Derivatives / therapeutic use*
  • Neutrophils / drug effects
  • Oxidation-Reduction
  • Peroxidase / blood
  • Peroxidase / metabolism
  • Plasma Substitutes / therapeutic use*
  • Serum Albumin / chemistry
  • Serum Albumin / therapeutic use*
  • Sulfhydryl Compounds / chemistry
  • Vasculitis / pathology*
  • Vasculitis / prevention & control*


  • Hydroxyethyl Starch Derivatives
  • Plasma Substitutes
  • Serum Albumin
  • Sulfhydryl Compounds
  • Peroxidase