The role of thoracic trauma in inflammatory responses, apoptosis and bacterial translocation following multipl trauma

Ayan, Erhan; Köksel, Oğuz; Polat, Ayşe; Tamer, Lülüfer; Ersöz, Gülden; Demir, Murat; Yaroğlu, Hatice Yildirim; Akdağ, Alper; Özdülger, Ali; Erden, Sema

doi:10.5505/tjtes.2013.29660

Cited by 2 publications

(1 citation statement)

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“…Significant evidence of the disruption of the gastrointestinal (gut) and blood–brain barriers (BBB) has been observed in individuals with neurocognitive impairments, autism, and schizophrenia ( 24 , 42 , 59 , 102 ). Notably, certain conditions that increase the likelihood of delirium are also linked to both increased intestinal permeability and the translocation of LPS or bacteria from the gut into the bloodstream causing tissue damage ( 103 ), bone fracture ( 104 , 105 ), aging ( 106 ), stroke ( 107 ), sepsis ( 108 , 109 ), liver failure ( 110 , 111 ), uremia ( 112 , 113 ), alcohol ( 114 , 115 ), malnutrition ( 116 , 117 ), and psychological stressors ( 118 , 119 ). Furthermore, these risk variables were also linked to BBB disintegration ( 120 – 127 ), which is considered a prevalent and significant contributing factor to delirium ( 128 ).…”

Section: Discussionmentioning

confidence: 99%

Increased IgA-mediated responses to the gut paracellular pathway and blood–brain barrier proteins predict delirium due to hip fracture in older adults

Thisayakorn,

Thipakorn,

Tantavisut

et al. 2024

Front. Neurol.

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IntroductionDelirium is accompanied by immune response system activation, which may, in theory, cause a breakdown of the gut barrier and blood–brain barrier (BBB). Some results suggest that the BBB is compromised in delirium, but there is no data regarding the gut barrier. This study investigates whether delirium is associated with impaired BBB and gut barriers in elderly adults undergoing hip fracture surgery.MethodsWe recruited 59 older adults and measured peak Delirium Rating Scale (DRS) scores 2–3 days after surgery, and assessed plasma IgG/IgA levels (using ELISA techniques) for zonulin, occludin, claudin-6, β-catenin, actin (indicating damage to the gut paracellular pathway), claudin-5 and S100B (reflecting BBB damage), bacterial cytolethal distending toxin (CDT), LPS-binding protein (LBP), lipopolysaccharides (LPS), Porphyromonas gingivalis, and Helicobacter pylori.ResultsResults from univariate analyses showed that delirium is linked to increased IgA responses to all the self-epitopes and antigens listed above, except for LPS. Part of the variance (between 45–48.3%) in the peak DRS score measured 2–3 days post-surgery was explained by independent effects of IgA directed to LPS and LBP (or bacterial CDT), baseline DRS scores, and previous mild stroke. Increased IgA reactivity to the paracellular pathway and BBB proteins and bacterial antigens is significantly associated with the activation of M1 macrophage, T helper-1, and 17 cytokine profiles.ConclusionHeightened bacterial translocation, disruption of the tight and adherens junctions of the gut and BBB barriers, elevated CDT and LPS load in the bloodstream, and aberrations in cell–cell interactions may be risk factors for delirium.

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Section: Discussionmentioning

confidence: 99%

Increased IgA-mediated responses to the gut paracellular pathway and blood–brain barrier proteins predict delirium due to hip fracture in older adults

Thisayakorn,

Thipakorn,

Tantavisut

et al. 2024

Front. Neurol.

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Risk factors and prevention of nosocomial pneumonia in polytrauma

Шапкин¹,

Seliverstov²,

Стекольников³

2020

Pulʹmonologiâ (Mosk.)

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Nosocomial pneumonia (NK) is one of the most frequent complications of polytrauma leading to death. Meanwhile, the recommendations on prevention of NK in case of polytrauma have not been specified so far. This is due in large part to the lack of study of the pathophysiology of severe combined trauma. The review presents the results of modern experimental and clinical studies of the effect of shock, immune distress syndrome, posttraumatic immunosuppression, the phenomenon of mutual aggravation of lesions, age, sex, concomitant pathology on the risk of NK in polytrauma. The role of iatrogenic risk factors for NK in polytrauma – intubation of trachea and artificial lung ventilation (AVL), massive hemotransfusions, immobilization, the phenomenon of “second strike” after multiple surgeries has been determined. The most effective measures of NK prevention are reduction of the duration of AVL, prevention of oropharyngeal colonization and aspiration in case of AVL, use of inhalation antibacterial drugs, antishock measures, early mobilization of the patient, the earliest possible stable functional osteosynthesis by minimally traumatic methods. The data on the effectiveness of selective decontamination of intestines, probiotics and glucocorticosteroids for the prevention of NK in polytrauma are inconsistent. A promising area of NK prophylaxis may be the development of agents that regulate the complex mechanisms of immune response to polytrauma and prevent secondary acute lung injury and post-traumatic immunosuppression.

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The role of thoracic trauma in inflammatory responses, apoptosis and bacterial translocation following multipl trauma

Abstract: BACKGROUND: Blunt chest trauma and its complications are commonly encountered in emergency medicine. Herein, we used a rat model to investigate the role of thoracic trauma in inflammation, apoptosis and bacterial translocation following multiple traumas.

Cited by 2 publications

References 26 publications

Increased IgA-mediated responses to the gut paracellular pathway and blood–brain barrier proteins predict delirium due to hip fracture in older adults

Increased IgA-mediated responses to the gut paracellular pathway and blood–brain barrier proteins predict delirium due to hip fracture in older adults

Risk factors and prevention of nosocomial pneumonia in polytrauma

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