Öztaş Yasin, Aslan Yusuf Ertuğrul, Şener Elif Funda, Dana Halime, Tuğhan Emre, Günay Nurullah, Demiryürek Abdullah Tuncay
Department of Emergency Medicine, Faculty of Medicine, Erciyes University, Kayseri, 38039, Turkey.
Department of Medical Biology, Faculty of Medicine, Erciyes University, Kayseri, 38039, Turkey.
Eur J Trauma Emerg Surg. 2025 Apr 8;51(1):167. doi: 10.1007/s00068-025-02853-3.
The aim of this research is to access the expression of adenosine A3 receptor (ADORA3) and nitric oxide synthase 3 (NOS3) genes and serum levels of ADORA3 and NOS3 in patients with multiple trauma with hemorrhagic shock.
The study was performed at Erciyes University between November 2022 and March 2024, in a prospective and controlled manner. Patients diagnosed with traumatic hemorrhagic shock and requiring transfusion in the emergency department were selected as the patients group. Gene expressions were analyzed using quantitative real-time PCR analysis in total RNA samples and serum levels of NOS3 and ADORA3 were detected using ELISA measurements.
In patients with multiple trauma, adenosine A3 receptor (ADORA3) gene expression showed a significant increase at discharge when compared to healthy controls (P < 0.05). However, serum levels of ADORA3 showed significant decreases at all stages (i.e. at admission, at 24 h, and at discharge) of patients. Although no significant changes were detected in NOS3 gene expression, marked decreases in serum NOS3 levels were observed at admission and at 24 h in multiple trauma patients (P < 0.05). ADORA3 and NOS3 gene expressions were found to be significantly diminished in nonsurvivors.
The study emphasizes the importance of ADORA3 and NOS3 gene expressions in influencing shock progression in multiple trauma patients. The increase in ADORA3 gene expression may play a role in restoring vascular reactivity after traumatic shock. Decreased serum NOS3 and ADORA3 levels can contribute to the shock progression in the pathophysiology of multiple trauma.
本研究旨在探讨创伤失血性休克多发伤患者腺苷 A3 受体（ADORA3）和一氧化氮合酶 3（NOS3）基因的表达以及 ADORA3 和 NOS3 的血清水平。
本研究于 2022 年 11 月至 2024 年 3 月在埃尔西耶斯大学进行，采用前瞻性对照研究方法。将在急诊科诊断为创伤失血性休克且需要输血的患者选为患者组。使用定量实时 PCR 分析总 RNA 样本中的基因表达，并使用 ELISA 测量法检测 NOS3 和 ADORA3 的血清水平。
与健康对照组相比，多发伤患者出院时腺苷 A3 受体（ADORA3）基因表达显著增加（P < 0.05）。然而，患者在所有阶段（即入院时、24 小时时和出院时）ADORA3 的血清水平均显著降低。尽管 NOS3 基因表达未检测到显著变化，但多发伤患者入院时和 24 小时时血清 NOS3 水平显著降低（P < 0.05）。发现非幸存者中 ADORA3 和 NOS3 基因表达显著降低。
本研究强调了 ADORA3 和 NOS3 基因表达在影响多发伤患者休克进展中的重要性。ADORA3 基因表达的增加可能在创伤性休克后恢复血管反应性中发挥作用。血清 NOS3 和 ADORA3 水平降低可导致多发伤病理生理学中的休克进展。
