Department of Surgery and Sepsis and Critical Illness Research Center, University of Florida College of Medicine, Gainesville, Florida, USA.
Surg Infect (Larchmt). 2023 Nov;24(9):773-781. doi: 10.1089/sur.2023.154. Epub 2023 Oct 30.
Severe trauma and hemorrhagic shock lead to persistent anemia. Although biologic gender is known to modulate inflammatory responses after critical illness, the impact of gender on anemia recovery after injury remains unknown. The aim of this study was to identify gender-specific differences in anemia recovery after critical illness. Male and proestrus female Sprague-Dawley rats (n = 8-9 per group) were subjected to lung contusion and hemorrhagic shock (LCHS) or LCHS with daily chronic stress (LCHS/CS) compared with naïve. Hematologic data, bone marrow progenitor growth, and bone marrow and liver gene transcription were analyzed on day seven. Significance was defined as p < 0.05. Males lost substantial weight after LCHS and LCHS/CS compared with naïve males, while female LCHS rats did not compared with naive counterparts. Male LCHS rats had a drastic decrease in hemoglobin from naïve males. Male LCHS/CS rats had reduced colony-forming units-granulocyte, -erythrocyte, -monocyte, -megakaryocyte (CFU-GEMM) and burst-forming unit-erythroid (BFU-E) when compared with female counterparts. Naïve, LCHS, and LCHS/CS males had lower serum iron than their respective female counterparts. Liver transcription of BMP4 and BMP6 was elevated after LCHS and LCHS/CS in males compared with females. The LCHS/CS males had decreased expression of bone marrow pro-erythroid factors compared with LCHS/CS females. After trauma with or without chronic stress, male rats demonstrated increased weight loss, substantial decrease in hemoglobin level, dysregulated iron metabolism, substantial suppression of bone marrow erythroid progenitor growth, and no change in transcription of pro-erythroid factors. These findings confirm that gender is an important variable that impacts anemia recovery and bone marrow dysfunction after traumatic injury and shock in this rat model.
严重创伤和失血性休克可导致持续性贫血。尽管生物性别已知可调节重症疾病后的炎症反应，但性别对创伤后贫血恢复的影响尚不清楚。本研究旨在确定性别对重症疾病后贫血恢复的影响。雄性和动情前期雌性 Sprague-Dawley 大鼠（每组 8-9 只）与未处理组相比，分别接受肺挫伤和失血性休克（LCHS）或 LCHS 合并每日慢性应激（LCHS/CS）处理。第 7 天分析血液学数据、骨髓祖细胞生长以及骨髓和肝脏基因转录。定义显著性为 p < 0.05。与未处理雄性相比，LCHS 和 LCHS/CS 后雄性体重明显减轻，而雌性 LCHS 大鼠则无明显变化。雄性 LCHS 大鼠的血红蛋白水平与未处理雄性相比急剧下降。与雌性相比，雄性 LCHS/CS 大鼠的集落形成单位-粒细胞、红细胞、单核细胞、巨核细胞（CFU-GEMM）和红细胞生成集落形成单位（BFU-E）减少。与雌性相比，未处理、LCHS 和 LCHS/CS 的雄性血清铁含量较低。与雌性相比，LCHS 和 LCHS/CS 后雄性肝脏的 BMP4 和 BMP6 转录水平升高。与 LCHS/CS 雌性相比，LCHS/CS 雄性骨髓中红细胞生成前体因子的表达减少。在创伤后合并或不合并慢性应激后，雄性大鼠表现出明显的体重减轻、血红蛋白水平显著下降、铁代谢失调、骨髓红系祖细胞生长明显受抑制，以及红细胞生成前体因子转录无变化。这些发现证实，在该大鼠模型中，性别是影响创伤和休克后贫血恢复和骨髓功能障碍的一个重要变量。
