Document Detail


Release of anti-inflammatory mediators after mechanical trauma correlates with severity of injury and clinical outcome.
MedLine Citation:
PMID:  7474003     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Excessive synthesis of proinflammatory cytokines [tumor necrosis factor (TNF)-alpha and interleukin (IL)-1 beta] after trauma has been correlated with poor outcome. Recently, naturally occurring inhibitors of TNF-alpha and IL-1 beta have been characterized such as soluble TNF receptors (sTNFRs) and IL-1 receptor antagonist (IL-1ra). The present study was undertaken to determine whether injury results in a rise of circulating sTNFRs and IL-1ra. If so, whether plasma levels of these anti-inflammatory mediators correlate with severity of injury and clinical outcome of these patients. Injured patients (n = 213) showed significantly increased sTNFR and IL-1ra plasma levels throughout the observation period of 14 days, compared with healthy volunteers (n = 127). Patients with severe injury (Injury Severity Score > 16 points) revealed higher levels (p < 0.05) of sTNFRs and IL-1ra than patients with minor trauma (Injury Severity Score < or = 16 points). Patients who died from injury demonstrated increased (p < 0.05) sTNFR p55 and IL-1ra plasma levels, compared with survivors. Thus, anti-inflammatory mechanisms are activated after trauma dependent on severity of injury. Because increased plasma levels of anti-inflammatory reacting proteins portended poorly for patient survival, these mediators may contribute to prediction of outcome after severe injury.
Authors:
W Ertel; M Keel; M Bonaccio; U Steckholzer; H Gallati; J S Kenney; O Trentz
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Publication Detail:
Type:  In Vitro; Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  The Journal of trauma     Volume:  39     ISSN:  0022-5282     ISO Abbreviation:  J Trauma     Publication Date:  1995 Nov 
Date Detail:
Created Date:  1995-12-21     Completed Date:  1995-12-21     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  0376373     Medline TA:  J Trauma     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  879-85; discussion 885-7     Citation Subset:  AIM; IM    
Affiliation:
Department of Surgery, University of Zurich, Switzerland.
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MeSH Terms
Descriptor/Qualifier:
Adult
Cytotoxicity Tests, Immunologic
Enzyme-Linked Immunosorbent Assay
Female
Humans
Injury Severity Score
Interleukin 1 Receptor Antagonist Protein
Interleukin-1
Male
Receptors, Interleukin-1 / antagonists & inhibitors*
Receptors, Tumor Necrosis Factor / analysis*
Sialoglycoproteins / blood*
Wounds and Injuries / blood*,  mortality
Chemical
Reg. No./Substance:
0/IL1RN protein, human; 0/Interleukin 1 Receptor Antagonist Protein; 0/Interleukin-1; 0/Receptors, Interleukin-1; 0/Receptors, Tumor Necrosis Factor; 0/Sialoglycoproteins

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