The Immune Microenvironment of Human Fracture/Soft-tissue Hematomas and its Relationship to Systemic Immunity

Hauser, Carl J.; Zhou, Xinchun; Joshi, Pratibha; Cuchens, Marvin A.; Kregor, Philip J.; Devidas, Mineeshka; Kennedy, Robert J.; Poole, Galen V.; Hughes, James L.

doi:10.1097/00005373-199705000-00021

Cited by 128 publications

(93 citation statements)

References 19 publications

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“…HIV has also been shown to affect other chemical mediators, including interleukins 1 and 6 and tumour necrosis factor, which have been shown to play a role in the fracture repair process [8][9][10].…”

Section: Introductionmentioning

confidence: 99%

Fracture management in HIV positive individuals: a systematic review

Wijesekera

Graham

Lalloo

et al. 2016

International Orthopaedics (SICOT)

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Purpose: Human immunodeficiency virus (HIV) infection could potentially play an important role in the management of fractures as they have been shown to affect fracture healing and the post-operative risk of implant sepsis.Methods: A systematic review of the relevant literature was performed on PubMed and Scopus databases. Twenty-six studies were identified, critiqued and analysed accordingly. No randomised controlled trials were identified.Results: HIV positivity was not shown to influence an individual's risk of early wound infection in operatively managed closed fractures. Thank you for your kind comments on our unique systematic review. We have responded to the reviewers and made the changes suggested. Authors' response Many thanks for your comments. The suggested references however interesting, does not seem to cater to this population of interest. The suggested first article focusses on myocardial complications in those undergoing arthroplasty. The second suggested article main emphasis is on spinal trauma and does not refer to the HIV population. Thus we have decided not to go forth inserting these references and no further actions were taken. We do think that these articles are useful and may be included in a future study.Reviewer #2: This is a nice review paper suggesting the well-known fact that there is a place in HIV patients to surgical fixation of fractures.However the authors should: 1) Explain in the "Introduction" and in the "Discussion" the meaning of ART and the new development in this mode of treatment and describe the change in morbidity and mortality in HIV patients" in the last few years and the relation of this change to their findings Authors' response Many thanks for your comments. We agree that a further explanation on ART should be included to the reader. This was included in the "Introduction." Clarification on the morbidity and mortality reduction since the introduction of ART in HIV infected patients was also included. Regarding discussing the new developments in ART, this is a whole topic in itself and beyond the scope of this review. However, we are currently finalising a similar systematic review focusing on the effect of ART on bone metabolism and fracture healing which we will submit for consideration for publication in your journal soon. Authors' action Powered by Editorial Manager® and ProduXion Manager® from Aries Systems CorporationThe following changes have been made; The introduction of Anti-Retroviral Therapy (ART) in 1997 altered the course and nature of patients infected with HIV by increasing the duration of asymptomatic infection and increasing life expectancy [2,3]. ART is a combination of medication given to those affected with the disease. This suppresses the viral load and improves the patient immunological status [4]. A 50% reduction in morbidity and mortality has been reported in those with a CD4 T-cell count of >500cells/mm3 and have been started on ART promptly [5,6]. However, despite near normal life expectancy, there is little evidence to...

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Section: Introductionmentioning

confidence: 99%

Fracture management in HIV positive individuals: a systematic review

Wijesekera

Graham

Lalloo

et al. 2016

International Orthopaedics (SICOT)

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“…Because it was known that these complications induce the circulating levels of soluble cytokines as IL-6 [12,13], age, gender, working condition, types of hernia and anesthesia, and Data are expressed as mean±SD duration of operation were summarized in Table 1. There was no difference between groups, except the type of hernia.…”

Section: Resultsmentioning

confidence: 99%

The Comparison of Inflammatory Responses and Clinical Results After Groin Hernia Repair Using Polypropylene or Polyester Meshes

et al. 2013

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The aim of this study was to compare the clinical results and the inflammatory responses against polypropylene and polyester meshes after groin hernia repair. Ninety patients with unilateral inguinal hernia randomly underwent Shouldice herniorrhaphy or Lichtenstein hernioplasty using polypropylene or polyester meshes. Venous blood samples were collected to evaluate serum interleukin-6 (IL-6) and C-reactive protein (CRP) levels. Postoperative acute and chronic pain and time to attain to normal activities were evaluated. IL-6 levels decreased to preoperative levels in all groups at 48th hour. CRP levels of mesh-implanted groups are significantly higher than preoperative level at 48th hour, while it reduced to preoperative level in Shouldice herniorrhaphy group. Patients treated with mesh repair had less postoperative acute pain and recovered more rapidly than those who underwent Shouldice herniorrhaphy. It was concluded that polypropylene and polyester meshes used in hernia repair caused similar inflammatory responses and that clinical results after groin hernia repair with these prostheses were not significantly different.

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“…For example, authors have shown that cytokine concentrations after injury appear to be highest in injured tissue and there are differences in systemic and local measurements. 16 There also appears to be a correlation between cytokine levels and distance from the lesion. 7 Understanding this spatial and temporal relationship of cytokine levels could be beneficial in targeting cytokines in the process of tissue repair and regeneration 17 and would be of interest in investigating SCI.…”

Section: Discussionmentioning

confidence: 96%

A pilot study on temporal changes in IL-1β and TNF-α serum levels after spinal cord injury: the serum level of TNF-α in acute SCI patients as a possible marker for neurological remission

Biglari¹,

Swing

Child

et al. 2015

Spinal Cord

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Study design: Serum levels of interleukin-1β (IL-1β) and tumour necrosis factor-α (TNF-α) were measured over a 12-week period in 23 patients with spinal cord injury (SCI) with and without neurological improvement. Objectives: To determine the course of IL-1β and TNF-α in patients with SCI and observe a possible relationship between improvements in neurological functioning and cytokine levels. Setting: All patients were treated at the BG Trauma Centre, Ludwigshafen, Germany. All lab work was done at the University Hospital, Heidelberg. Methods: Spinal cord injury was classified according to the American Spinal Injury Association (ASIA) impairment scale (AIS) in 23 patients. TNF-α and IL-1β levels were measured upon arrival at the hospital, after 4 h, 9 h and 12 h, on days 1 and 3 and at the end of weeks 1, 2, 4, 8 and 12. Results: Temporal changes in TNF-α and IL-1β in SCI patients were seen. Patients with AIS improvement (Group 1) had significantly lower TNF-α levels at 9 h compared with patients without AIS improvement (Group 2; Po0.01). The course of IL-1β fluctuated greatly between 4 h and week 1 in the groups; however, between 2 and 12 weeks post trauma, there was an overall decline in both groups. Conclusion: Measuring serum levels of TNF-α and IL-1β over time could be useful in tracking the course of SCI. Our data show differences in measured cytokines over a 12-week period for SCI patients with and without neurological improvement.

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The Immune Microenvironment of Human Fracture/Soft-tissue Hematomas and its Relationship to Systemic Immunity

Cited by 128 publications

References 19 publications

Fracture management in HIV positive individuals: a systematic review

Fracture management in HIV positive individuals: a systematic review

The Comparison of Inflammatory Responses and Clinical Results After Groin Hernia Repair Using Polypropylene or Polyester Meshes

A pilot study on temporal changes in IL-1β and TNF-α serum levels after spinal cord injury: the serum level of TNF-α in acute SCI patients as a possible marker for neurological remission

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