Results: During acute allograft rejection, we identified a differential transmigration pattern of monocyte subsets by intravital imaging. We found non-classical monocytes to be pro-inflammatory and infiltrate the allograft primarily. CRP significantly increased activation and cytokine expression of this monocyte subset, thus accelerating clinical allograft rejection.
Conclusion:Non-classical monocytes primarily infiltrate allogeneic tissue and contribute to acute rejection after allogeneic transplantation. Differential activation of these cells by CRP aggravates innate immune response and accelerates clinical allograft rejection, thus representing potential targets for immunomodulatory therapies.
Upper limb trauma cases vary from simple to high energy impactful injuries, with different etiologies; situations which frequently require unique, demanding and challenging endeavors in order to obtain the most favorable outcome. Experience, good decision-making and knowledge of functional goals are mandatory in order to elaborate a therapeutic plan and execute it accordingly. Although cases differ in nature and prognosis, respecting a set of therapeutic principles whilst dealing with either simple or complex cases, will enhance patient outcome and give the surgeon the confidence to tackle any kind of upper limb trauma. After clearing out vital threat, the emergency surgery represents the first threshold in achieving and restoring normal function and biomechanics, mostly in young and labor active patients, with the mindset to salvage as much tissue as possible, with a thorough debridement and step-by-step approach to different types of tissues. Secondary surgery and reconstructive surgery can be planned timely, with prior discussion with both the therapist and the patient in order to enhance patient’s upper limb function and aesthetic and ensure social reintegration.
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