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软组织创伤后免疫调节的起源:细胞外热休克蛋白的潜在作用。

Origin of immunomodulation after soft tissue trauma: potential involvement of extracellular heat-shock proteins.

作者信息

Flohé Stefanie B, Bangen Jörg M, Flohé Sascha, Agrawal Hemant, Bergmann Katja, Schade F Ulrich

机构信息

Surgical Research, Department of Trauma Surgery, University Hospital Duisburg-Essen, Essen, Germany.

出版信息

Shock. 2007 May;27(5):494-502. doi: 10.1097/shk.0b013e31802dec51.

Abstract

Severe injury may lead to immunosuppression, multiple organ failure, and death. The aim of the study was to investigate the direct impact of soft tissue destruction on the development of trauma-associated immunomodulation. Hip surgery was considered to represent an isolated soft tissue trauma that allowed for the examination of changes taking place locally at the site of trauma or systemically with regard to monocyte function and leukocyte redistribution. Peripheral blood and wound fluid collected from the drains of 21 patients after hip surgery were analyzed to determine the cellular composition and/or the responsiveness of mononuclear cells (MNCs) to lipopolysaccharide (LPS). Different factors present in the wound fluids were tested for their capacity to modulate the MNC of healthy individuals with regard to cytokine and chemokine secretion. We found that various factors, including heat-shock protein (HSP) 60 and HSP70, were locally released at the site of soft tissue trauma and could be detected in wound fluids. The wound fluid-derived MNC (but not the peripheral blood-derived MNC) showed an impaired capacity to release TNF-alpha after LPS stimulation. Cell-free wound fluid suppressed in healthy individuals the LPS-induced TNF-alpha secretion by MNC. After surgery, granulocytosis was found in peripheral blood and in wound fluids, but monocytopenia was restricted to wound fluids. In parallel, wound fluids induced in healthy individuals the release by MNC of distinct chemokines specific for granulocytes and monocytes. These wound fluid-mediated effects of TNF-alpha suppression and chemokine induction could be mimicked by recombinant human HSP70 and, in part, by HSP60. Thus, tissue-derived factors, such as HSP70 released after injury, suppress monocyte function and, therefore, might favor the development of immunosuppression after severe injury.

摘要

严重损伤可能导致免疫抑制、多器官功能衰竭和死亡。本研究的目的是调查软组织破坏对创伤相关免疫调节发展的直接影响。髋关节手术被认为是一种孤立的软组织创伤,可用于检查创伤部位局部或全身单核细胞功能和白细胞再分布的变化。对21例髋关节手术后患者引流管中收集的外周血和伤口液进行分析,以确定细胞组成和/或单核细胞(MNC)对脂多糖(LPS)的反应性。检测伤口液中存在的不同因素调节健康个体MNC分泌细胞因子和趋化因子的能力。我们发现,包括热休克蛋白(HSP)60和HSP70在内的多种因素在软组织创伤部位局部释放,并可在伤口液中检测到。LPS刺激后,伤口液来源的MNC(而非外周血来源的MNC)释放TNF-α的能力受损。无细胞伤口液抑制健康个体中LPS诱导的MNC分泌TNF-α。手术后,外周血和伤口液中发现粒细胞增多,但单核细胞减少仅限于伤口液。同时,伤口液诱导健康个体中MNC释放粒细胞和单核细胞特异性的不同趋化因子。TNF-α抑制和趋化因子诱导的这些伤口液介导的效应可被重组人HSP70模拟,部分可被HSP60模拟。因此,组织来源的因子,如损伤后释放的HSP70,抑制单核细胞功能,因此可能有利于严重损伤后免疫抑制的发展。

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