Farnebo Simon, Lars-Erik Karlander, Ingrid Steinwall, Sjögren Florence, Folke Sjöberg
Int J Clin Exp Med. 2009 Nov 26;2(4):354-62.
Background. Inflammation plays an important part in the healing process. Little is known about the extent local inflammatory trauma response interacts with the central circulation and inflammation produced by central organs. The aim of the present study was to examine whether high cut-off microdialysis catheters offer potential to in real time assess interstitial cytokines variations in conjunction to markers of metabolism distal to a blunt vascular contusion. Methods. In a standardised contusion trauma model, microdialysis catheters (high MW (100kDa)) were inserted in the gracilis muscle distal to the trauma for the local assessment of IL-6, IL-8, TNF-alpha, total protein and the metabolic mediators (glycerol, puruvate and lactate). The contra lateral uninjured leg served as control of the centrally mediated inflammation propagated to the extremities. Results. The trauma led to a significant and quantitatively large (8-10 fold) increase in inflammatory cytokines (IL6 and 8) as measured both in the injured and control legs. There was only a minor, and not significant increase in concentrations of cytokines in the injured leg compared to the control leg.. There were no signs of ischemia in either leg. Conclusion. The new finding in this study is that both central, and local, inflammatory responses as well as metabolic mediators may be assessed continuously in skeletal muscle tissue distal to a major injury in an animal model. The findings suggest that the large trauma elicits a generalised inflammatory response to trauma rather than propagating a local one distal to the trauma.
背景。炎症在愈合过程中起着重要作用。关于局部炎症创伤反应与体循环以及中枢器官产生的炎症之间的相互作用程度,人们了解甚少。本研究的目的是检验高截留微透析导管是否有潜力实时评估钝性血管挫伤远端的间质细胞因子变化以及代谢标志物。方法。在标准化的挫伤创伤模型中,将微透析导管(高截留分子量(100kDa))插入创伤远端的股薄肌中,以局部评估白细胞介素 - 6(IL - 6)、白细胞介素 - 8(IL - 8)、肿瘤坏死因子 - α(TNF - α)、总蛋白以及代谢介质(甘油、丙酮酸和乳酸)。对侧未受伤的腿作为传播至四肢的中枢介导炎症的对照。结果。创伤导致受伤腿和对照腿中炎症细胞因子(IL - 6和IL - 8)显著且在数量上大幅增加(8 - 10倍)。与对照腿相比,受伤腿中细胞因子浓度仅有轻微且不显著的增加。两条腿均无缺血迹象。结论。本研究的新发现是,在动物模型中,对于重大损伤远端的骨骼肌组织,可以连续评估中枢和局部的炎症反应以及代谢介质。研究结果表明,严重创伤引发的是对创伤的全身性炎症反应,而非在创伤远端传播局部炎症反应。