Sears Benjamin W, Volkmer Dustin, Yong Sherri, Himes Ryan D, Lauing Kristen, Morgan Michele, Stover Michael D, Callaci John J
Department of Orthopaedics, Loyola University Medical Center, Maywood, IL, USA.
J Inflamm Res. 2010 Aug 1;2010(3):105-114. doi: 10.2147/JIR.S12853.
Evaluation of the systemic inflammatory status following major orthopedic trauma has become an important adjunct in basing post-injury clinical decisions. In the present study, we examined the correlation of serum and lung inflammatory marker levels following bilateral femur fracture. MATERIALS AND METHODS: 45 Sprague Dawley rats underwent sham operation or bilateral femoral intramedullary pinning and mid-diaphyseal closed fracture via blunt guillotine. Animals were euthanized at specific time points after injury. Serum and lung tissue were collected, and 24 inflammatory markers were analyzed by immunoassay. Lung histology was evaluated by a blinded pathologist. RESULTS: Bilateral femur fracture significantly increased serum markers of inflammation including interleukin (IL)-2, IL-6, IL-10, GM-CSF, KC/GRO, MCP-1, and WBC. Femur fracture significantly increased serum and lung levels of IL-1a and KC/GRO at 6 hours. Lung levels of IL-6 demonstrated a trend towards significance. Histologic changes in pulmonary tissue after fracture included pulmonary edema and bone elements including cellular hematopoietic cells, bone fragments and marrow emboli. DISCUSSION AND CONCLUSION: Our results indicate that bilateral femur fracture with fixation in rats results in increases in serum markers of inflammation. Among the inflammatory markers measured, rise in the serum KC/GRO (CINC-1), a homolog to human IL-8, correlated with elevated levels of lung KC/GRO. Ultimately, analysis of serum levels of KC/GRO (CINC-1), or human IL-8, may be a useful adjunct to guide clinical decisions regarding surgical timing.
评估重大骨科创伤后的全身炎症状态已成为伤后临床决策的一项重要辅助手段。在本研究中，我们检测了双侧股骨骨折后血清和肺组织炎症标志物水平之间的相关性。
45只Sprague Dawley大鼠接受假手术或双侧股骨髓内穿针及经钝性断头刀造成的股骨干中段闭合性骨折。在损伤后的特定时间点对动物实施安乐死。收集血清和肺组织，并通过免疫测定法分析24种炎症标志物。由一位不知情的病理学家评估肺组织学情况。
双侧股骨骨折显著增加了包括白细胞介素（IL）-2、IL-6、IL-10、粒细胞-巨噬细胞集落刺激因子（GM-CSF）、KC/生长调节致癌基因α（KC/GRO）、单核细胞趋化蛋白-1（MCP-1）和白细胞（WBC）在内的血清炎症标志物水平。股骨骨折在6小时时显著增加了血清和肺组织中IL-1α和KC/GRO的水平。肺组织中IL-6水平呈现出显著趋势。骨折后肺组织的组织学变化包括肺水肿以及含有细胞造血细胞、骨碎片和骨髓栓子的骨成分。
我们的结果表明，大鼠双侧股骨骨折并固定会导致血清炎症标志物水平升高。在所检测的炎症标志物中，血清KC/GRO（趋化因子诱导蛋白-1，CINC-1）升高，它是人类IL-8的同源物，与肺组织中KC/GRO水平升高相关。最终，分析血清中KC/GRO（CINC-1）或人类IL-8的水平可能有助于指导关于手术时机的临床决策。
