Early inflammatory response in polytraumatized patients: Cytokines and heat shock proteins. A pilot study

Guisasola, M.C.; Ortíz, Alberto; Chana, Francisco; Alonso, Bárbara; Vaquero, Javier

doi:10.1016/j.otsr.2015.03.014

Cited by 27 publications

(28 citation statements)

References 28 publications

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“…This is consistent with previous studies showing elevated IL-6 levels in trauma patients [23;24]. The lack of a measurable IL-1β, TNFα or IL-10 in the plasma may be inpart due to the time of sample collection, which was approximately 1 week post-injury.…”

Section: Discussionsupporting

confidence: 92%

Toll-like receptor responses are suppressed in trauma ICU patients

Holloway

Nicholson

Rani

et al. 2016

Journal of Surgical Research

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Background Inflammation and activation of the innate immune system is often associated with traumatic injury and may involve alterations in Toll-like receptor (TLR)-mediated responses. Methods A prospective observational study was designed and conducted. Twenty-one severely injured (ISS = 16-41) trauma ICU patients and 6 healthy volunteers that served as controls were enrolled. Anticoagulated whole blood was collected at 2-12 days after ICU admission and incubated in the presence of media alone (baseline), zymosan (TLR2 agonist) or LPS (TLR4 agonist) for 3 hrs. Supernatant levels of inflammatory cytokines (IL-1β, -6, -10, TNFα) were determined. Results TLR2 and TLR4-mediated activation of whole blood cell cultures from both healthy volunteers and subjects induced elevated cytokine levels over that observed in unstimulated cultures. Baseline values of IL-6 were significantly elevated in subject cultures as compared to healthy volunteers. Healthy volunteer cultures had 2-3-fold greater levels of IL-6 and TNFα than subject cultures when stimulated with zymosan (TLR2 agonist) or LPS (TLR4 agonist). IL-1β and IL-10 levels did not differ significantly between healthy volunteers and subjects. Conclusions The ability of circulating leukocytes from trauma ICU patients to be activated by TLR agonists is markedly suppressed and may play a role in the development of subsequent infectious complications.

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Section: Discussionsupporting

confidence: 92%

Toll-like receptor responses are suppressed in trauma ICU patients

Holloway

Nicholson

Rani

et al. 2016

Journal of Surgical Research

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“…HSP70 serum concentrations have been up to ten times higher immediately after injury in polytraumatized patients versus control subjects, levels that remained elevated until 48 h after the accident following a time kinetics concordant with that previously described [75,248]. The magnitude of this increase was related to injury severity and prediction of secondary infection [249].…”

Section: Heat Shock Proteinssupporting

confidence: 79%

Damage-associated molecular patterns in trauma

Relja

Land

2019

Eur J Trauma Emerg Surg

129

131

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In 1994, the "danger model" argued that adaptive immune responses are driven rather by molecules released upon tissue damage than by the recognition of "strange" molecules. Thus, an alternative to the "self versus non-self recognition model" has been provided. The model, which suggests that the immune system discriminates dangerous from safe molecules, has established the basis for the future designation of damage-associated molecular patterns (DAMPs), a term that was coined by Walter G. Land, Seong, and Matzinger. The pathological importance of DAMPs is barely somewhere else evident as in the posttraumatic or post-surgical inflammation and regeneration. Since DAMPs have been identified to trigger specific immune responses and inflammation, which is not necessarily detrimental but also regenerative, it still remains difficult to describe their "friend or foe" role in the posttraumatic immunogenicity and healing process. DAMPs can be used as biomarkers to indicate and/or to monitor a disease or injury severity, but they also may serve as clinically applicable parameters for optimized indication of the timing for, i.e., secondary surgeries. While experimental studies allow the detection of these biomarkers on different levels including cellular, tissue, and circulatory milieu, this is not always easily transferable to the human situation. Thus, in this review, we focus on the recent literature dealing with the pathophysiological importance of DAMPs after traumatic injury. Since dysregulated inflammation in traumatized patients always implies disturbed resolution of inflammation, so-called model of suppressing/inhibiting inducible DAMPs (SAMPs) will be very briefly introduced. Thus, an update on this topic in the field of trauma will be provided.

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“…Cytokines are important components of the immune response, and their release correlates with the degree of trauma depending on the extent of the associated injury [ 8 ]. Cytokines such as IL-6 serve as markers for the severity of trauma and early identification of high-risk patients for the development of posttraumatic MODS (multi organ dysfunction syndrome) [ 9 ].…”

Section: Introductionmentioning

confidence: 99%

A new multiple trauma model of the mouse

Fitschen-Oestern

Lippross

Klueter

et al. 2017

BMC Musculoskelet Disord

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BackgroundBlunt trauma is the most frequent mechanism of injury in multiple trauma, commonly resulting from road traffic collisions or falls. Two of the most frequent injuries in patients with multiple trauma are chest trauma and extremity fracture. Several trauma mouse models combine chest trauma and head injury, but no trauma mouse model to date includes the combination of long bone fractures and chest trauma. Outcome is essentially determined by the combination of these injuries. In this study, we attempted to establish a reproducible novel multiple trauma model in mice that combines blunt trauma, major injuries and simple practicability.MethodsNinety-six male C57BL/6 N mice (n = 8/group) were subjected to trauma for isolated femur fracture and a combination of femur fracture and chest injury. Serum samples of mice were obtained by heart puncture at defined time points of 0 h (hour), 6 h, 12 h, 24 h, 3 d (days), and 7 d.ResultsA tendency toward reduced weight and temperature was observed at 24 h after chest trauma and femur fracture. Blood analyses revealed a decrease in hemoglobin during the first 24 h after trauma. Some animals were killed by heart puncture immediately after chest contusion; these animals showed the most severe lung contusion and hemorrhage. The extent of structural lung injury varied in different mice but was evident in all animals. Representative H&E-stained (Haematoxylin and Eosin-stained) paraffin lung sections of mice with multiple trauma revealed hemorrhage and an inflammatory immune response. Plasma samples of mice with chest trauma and femur fracture showed an up-regulation of IL-1β (Interleukin-1β), IL-6, IL-10, IL-12p70 and TNF-α (Tumor necrosis factor- α) compared with the control group. Mice with femur fracture and chest trauma showed a significant up-regulation of IL-6 compared to group with isolated femur fracture.ConclusionsThe multiple trauma mouse model comprising chest trauma and femur fracture enables many analogies to clinical cases of multiple trauma in humans and demonstrates associated characteristic clinical and pathophysiological changes. This model is easy to perform, is economical and can be used for further research examining specific immunological questions.

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Early inflammatory response in polytraumatized patients: Cytokines and heat shock proteins. A pilot study

Abstract: case-control study.

Cited by 27 publications

References 28 publications

Toll-like receptor responses are suppressed in trauma ICU patients

Toll-like receptor responses are suppressed in trauma ICU patients

Damage-associated molecular patterns in trauma

A new multiple trauma model of the mouse

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