Homeier Jil-Madeline, Bundkirchen Katrin, Winkelmann Marcel, Graulich Tilman, Relja Borna, Neunaber Claudia, Macke Christian
Trauma Department and Department of Anesthesiology and Intensive Care, Hannover Medical School, 30625 Hannover, Germany.
Trauma Department, Hannover Medical School, 30625 Hannover, Germany.
Life (Basel). 2021 Nov 17;11(11):1252. doi: 10.3390/life11111252.
While improvements in pre-hospital and in-hospital care allow more multiple trauma patients to advance to intensive care, the incidence of posttraumatic multiple organ dysfunction syndrome (MODS) is on the rise. Herein, the influence of a selective IL-6 trans-signaling inhibition on posttraumatic cytokine levels was investigated as an approach to prevent MODS caused by a dysbalanced posttraumatic immune reaction. Therefore, the artificial IL-6 trans-signaling inhibitor sgp130Fc was deployed in a murine multiple trauma model (femoral fracture plus bilateral chest trauma). The traumatized mice were treated with sgp130Fc (FP) and compared to untreated mice (WT) and IL-6 receptor knockout mice (RKO), which received the same traumas. The overall trauma mortality was 4.4%. Microscopic pulmonary changes were apparent after multiple trauma and after isolated bilateral chest trauma. Elevated IL-6, MCP-3 and RANTES plasma levels were measured after trauma, indicating a successful induction of a systemic inflammatory reaction. Significantly reduced IL-6 and RANTES plasma levels were visible in RKO compared to WT. Only a little effect was visible in FP compared to WT. Comparable cytokine levels in WT and FP indicate neither a protective nor an adverse effect of sgp130Fc on the cytokine release after femoral fracture and bilateral chest trauma.
尽管院前和院内护理的改善使更多的多发伤患者能够进入重症监护,但创伤后多器官功能障碍综合征(MODS)的发病率仍在上升。在此,研究了选择性IL-6转信号抑制对创伤后细胞因子水平的影响,作为预防由创伤后免疫反应失衡引起的MODS的一种方法。因此,人工IL-6转信号抑制剂sgp130Fc被应用于小鼠多发伤模型(股骨骨折加双侧胸部创伤)。对创伤小鼠用sgp130Fc(FP)进行治疗,并与未治疗的小鼠(WT)和接受相同创伤的IL-6受体敲除小鼠(RKO)进行比较。总体创伤死亡率为4.4%。多发伤后以及孤立的双侧胸部创伤后可见明显的肺部微观变化。创伤后测量到IL-6、MCP-3和RANTES血浆水平升高,表明成功诱导了全身炎症反应。与WT相比,RKO中IL-6和RANTES血浆水平显著降低。与WT相比,FP中仅可见轻微影响。WT和FP中可比的细胞因子水平表明,sgp130Fc对股骨骨折和双侧胸部创伤后的细胞因子释放既无保护作用也无不良影响。