Palmer Jessica L, Deburghgraeve Cory R, Bird Melanie D, Hauer-Jensen Martin, Kovacs Elizabeth J
Department of Surgery, Burn and Shock Trauma Institute, Loyola University Medical Center, Maywood, Illinois, USA.
J Burn Care Res. 2011 Mar-Apr;32(2):317-23. doi: 10.1097/BCR.0b013e31820aafa9.
Combined radiation and burn injuries are likely to occur after nuclear events, such as a meltdown accident at a nuclear energy plant or a nuclear attack. Little is known about the mechanisms by which combined injuries result in higher mortality than by either insult alone, and few animal models exist for combined radiation and burn injury. Herein, the authors developed a murine model of radiation and scald burn injury. Mice were given a single dose of 0, 2, 4, 5, 6, or 9 Gray (Gy) alone, followed by a 15% TBSA scald burn. All mice receiving ≤4 Gy of radiation with burn survived combined injury. Higher doses of radiation (5, 6, and 9 Gy) followed by scald injury had a dose-dependent increase in mortality (34, 67, and 100%, respectively). Five Gy was determined to be the ideal dose to use in conjunction with burn injury for this model. There was a decrease in circulating white blood cells in burn, irradiated, and combined injury (5 Gy and burn) mice by 48 hours postinjury compared with sham (49.7, 11.6, and 57.3%, respectively). Circulating interleukin-6 and tumor necrosis factor-α were increased in combined injury at 48 hours postinjury compared with all other treatment groups. Prolonged overproduction of proinflammatory cytokines could contribute to subsequent organ damage. Decreased leukocytes might exacerbate immune impairment and susceptibility to infections. Future studies will determine whether there are long lasting consequences of this early proinflammatory response and extended decrease in leukocytes.
在核事件（如核电站熔毁事故或核攻击）后，可能会发生辐射与烧伤合并伤。对于合并伤导致死亡率高于单一损伤的机制，人们了解甚少，而且辐射与烧伤合并伤的动物模型也很少。在此，作者建立了一种辐射与烫伤合并伤的小鼠模型。给小鼠单独给予0、2、4、5、6或9格雷（Gy）的单次剂量辐射，随后进行15%体表面积的烫伤。所有接受≤4 Gy辐射并伴有烧伤的小鼠在合并伤后存活。更高剂量的辐射（5、6和9 Gy）后再进行烫伤，死亡率呈剂量依赖性增加（分别为34%、67%和100%）。确定5 Gy是该模型中与烧伤合并使用的理想剂量。与假手术组相比，烧伤、辐射及合并伤（5 Gy与烧伤）小鼠在伤后48小时循环白细胞减少（分别为49.7%、11.6%和57.3%）。与所有其他治疗组相比，合并伤小鼠在伤后48小时循环白细胞介素-6和肿瘤坏死因子-α增加。促炎细胞因子的长期过度产生可能导致随后的器官损伤。白细胞减少可能会加剧免疫损害和感染易感性。未来的研究将确定这种早期促炎反应和白细胞持续减少是否会产生长期后果。
