Molecular Biology, Department of Biomedical Sciences, Rocky Vista University College of Osteopathic Medicine, Parker, Colorado. ORCID: https://orcid.org/0000-0001-9695-712X.
Military Medicine Program; Professor, Clinical Surgery, Rocky Vista University College of Osteopathic Medicine, Parker, Colorado.
Am J Disaster Med. 2024;19(1):33-43. doi: 10.5055/ajdm.0468.
The objective of this study was to investigate possible immune cytokine trends throughout a week-long surgical simulation mass-casualty training session in order to determine the effects of stress inoculation on the immune system.
Thirty-seven military medical students participated in a hyper-realistic surgical simulation training event conducted at Strategic Operations site in San Diego, California. Salivary samples were collected every morning of the stress training exercise for 4 consecutive days. Cortisol, along with a panel of 42 immune cytokines, was measured using multiplex enzyme-linked immunosorbent assays from Eve Technologies. The determined concentrations were averaged and plotted on a scatter plot, and then points were fit to a second-order polynomial trendline of best fit to measure.
The cytokines epidermal growth factor, growth-related oncogene-α, interleukin (IL)-1α, and platelet-derived growth factor-AA followed a noted pattern of cortisol decrease throughout the week. In addition, cytokines IL-27, granulocyte colony stimulating factor, IL-10, and IL-13 demonstrated a late peak, followed by a return to baseline at the conclusion of training. Finally, the cytokine monocyte chemoattractant protein-1 displayed a decline throughout the week followed by an increase on the last day of stress training.
Altogether, these results help to identify important biomarkers that may help to improve long-term stress adaptation and prevent post-traumatic stress disorder following exposure to repeated stress.
本研究旨在调查一周手术模拟大规模伤亡训练课程中可能存在的免疫细胞因子趋势，以确定应激接种对免疫系统的影响。
37 名军事医学生参加了在加利福尼亚州圣地亚哥战略行动地点进行的超逼真手术模拟培训活动。在应激训练的连续 4 天的每天早晨收集唾液样本。使用 Eve 技术的多指标酶联免疫吸附测定法测量皮质醇以及 42 种免疫细胞因子的一组。确定的浓度进行平均，并绘制在散点图上，然后拟合到二次多项式趋势线以进行最佳拟合测量。
细胞因子表皮生长因子、生长相关癌基因-α、白细胞介素（IL）-1α和血小板衍生生长因子-AA 随着皮质醇在整个星期内的下降呈现出明显的模式。此外，细胞因子 IL-27、粒细胞集落刺激因子、IL-10 和 IL-13 表现出后期高峰，然后在训练结束时恢复到基线。最后，细胞因子单核细胞趋化蛋白-1在整个星期内呈下降趋势，然后在应激训练的最后一天增加。
总之，这些结果有助于确定重要的生物标志物，这些标志物可能有助于改善长期应激适应并预防暴露于重复应激后发生创伤后应激障碍。
