Shock : molecular, cellular, and systemic pathobiological aspects and therapeutic approaches : the official journal the Shock Society, the European Shock Society, the Brazilian Shock Society, the International Federation of Shock Societies
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CD4 + T regulatory cells (Tregs) have been shown to be key players of the anti-inflammatory response syndrome following trauma. The mechanisms regulating the activation of Tregs following injury remain unclear. Recent evidence suggests that platelets play a protective role. The objective of this study was to examine whether Tregs and platelets interact following trauma. The focus was to reveal whether reciprocal activation takes place or not. ⋯ Our observations indicate for the first time that reciprocal activation of platelets and Tregs is part of the protective immune response following trauma. Platelets modulate the immunologic host response to trauma-induced injury by augmenting the activation of Tregs. In addition, Tregs are capable of modulating the hemostatic function of platelets. The newly described reciprocal interaction might be a suitable clinical target for the development of immunomodulatory drugs following trauma.
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A proportion of trauma patients are thought to develop persistent immunosuppression and inflammation, manifesting as prolonged patterns of multi-organ dysfunction (MOD). We aimed to evaluate MOD patterns in relation to admission variables and outcomes in trauma haemorrhage. ⋯ PRMOD was associated with substantial morbidity, however it remains unclear if this protracted pattern of MOD is simply due to worse admission variables including shock, injury load and age. Further research into MOD patterns following trauma haemorrhage is warranted.
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Hemorrhagic traumatic shock (HTS) and reperfusion is often associated with general inflammatory response and organ dysfunction. Recent preclinical studies have shown that APOSEC exerts cytoprotective and/or immunomodulating effects. We evaluated the therapeutic potential of APOSEC in a HTS model in rats. ⋯ Here we show for the first time that APOSEC ameliorates the HTS-related apoptosis, inflammation, cell and liver injury, and long term outcome in rats.
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Multiple organ failure (MOF) following severe trauma is associated with an increased morbidity and mortality. Due to intestinal mucosal lesions and disorders of the gut barrier following haemorrhagic shock, the intestine contributes decisively to the development of MOF. As mild therapeutic hypothermia has been introduced to have protective effects on post-traumatic organ injuries, we analysed the protective effects on the intestine. ⋯ Induced hypothermia preserves the functional enterocyte mass after severe trauma. Therefore, induced hypothermia might represent a potential therapeutic strategy to avoid posttraumatic organ dysfunction, although further studies regarding the safety and long term effects are required.
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Intestinal ischemia-reperfusion (I/R) injury can occur in clinical settings such as organ transplantation, cardiopulmonary bypass and trauma. The noble gas helium attenuates I/R injury in a number of animal organs and thus may offer a strategy for reducing I/R-induced intestinal injury in clinical settings. In the present study, we used four different helium preconditioning (HPC) profiles to investigate the potential beneficial effect of HPC on I/R-induced intestinal injury. ⋯ The results showed that the HPC profile consisting of three cycles of 10 or 15 min of helium breathing and three cycles of 5 min of air breathing reduced I/R-induced intestinal injury, cell apoptosis, and the inflammatory response. However, the 2- or 5-min helium breathing did not confer any protective effects. It seems that longer helium episodes should be used in HPC profiles designed to attenuate intestinal I/R injury.