TY - JOUR
T1 - Standardized porcine unilateral femoral nailing is associated with changes in PMN activation status, rather than aberrant systemic PMN prevalence
AU - Teuben, Michel Paul Johan
AU - Pfeifer, Roman
AU - Horst, Klemens
AU - Simon, Tim-Philipp
AU - Heeres, Marjolein
AU - Kalbas, Yannik
AU - Blokhuis, Taco
AU - Hildebrand, Frank
AU - Koenderman, Leo
AU - Pape, Hans-Christoph
AU - Leenen, Luke
N1 - Funding Information:
B. Auner1, P. Störmann1, B. Relja1, I. Marzi1, T. P. Simon2, G. Marx2, A. Haug3, L. Egerer3, M. V. Griensven3, M. Kalbitz4, M. Huber-Lang4, R. Tolba5, K. Reiss6, S. Uhlig6, K. Horst7,8, M. Teuben7,8, R. Pfeifer7,8, K. Almahmoud7,8, Y. Kalbas7,8, H. Lüken7,8, K. Almahmoud7,8, F. Hildebrand7,8, H. C. Pape7,8.1Department of Trauma-, Hand- and Reconstructive Surgery, University Hospital Frankfurt, Goethe University, Frankfurt/Main, Germany;2Department of Intensive Care and Intermedicine Care, RWTH Aachen University, Germany;3Department of Trauma Surgery, Technical University Munich, Germany;4Department of Orthopedic Trauma, Hand-, Plastic-, and Reconstructive Surgery, University of Ulm, Germany;5Institute for Laboratory Animal Science and Experimental Surgery, RWTH Aachen University, Germany;6Institute of Pharmacology and Toxicology, RWTH Aachen University, Germany;7Department of Orthopaedic Trauma, RWTH Aachen University, Germany; University Hospital Zurich,8University of Zurich, Zurich, Switzerland.
Funding Information:
This project was supported by the AO-Foundation (project no. S-14–14P, Roman Pfeifer), Alexandre Suermanfund (University Medical Centre Utrecht, 2012, Michel Teuben), Annafund for orthopedic research (Michel Teuben), DAAD (Deutscher Akademischer Austauschdienst, Michel Teuben), Prof. Michael van Vloten-stipendium (Michel Teuben). There was no influence of the funding body on the design of the study and collection, analysis, and interpretation of data and in writing the manuscript.
Publisher Copyright:
© 2021, The Author(s).
PY - 2022/6
Y1 - 2022/6
N2 - PURPOSE: Intramedullary nailing (IMN) of fractures is associated with increased rates of inflammatory complications. The pathological mechanism underlying this phenomenon is unclear. However, polymorphonuclear granulocytes (PMNs) seem to play an important role. We hypothesized that a femur fracture and standardized IMN in pigs is associated with altered appearance of PMNs in circulation and enhanced activation status of these cells.METHODS: A porcine model including a femur fracture and IMN was utilized. Animals were randomized for control [anesthesia + mechanical ventilation only (A/MV)] and intervention [A/MV and unilateral femur fracture (FF) + IMN] conditions. PMN numbers and responsiveness, integrin (CD11b), L-selectin (CD62L) and Fcγ-receptor (CD16 and CD32)-expression levels were measured by flowcytometry of blood samples. Animals were observed for 72 h.RESULTS: Circulatory PMN numbers did not differ between groups. Early PMN-responsiveness was retained after insult. PMN-CD11b expression increased significantly upon insult and peaked after 24 h, whereas CD11b in control animals remained unaltered (P = 0.016). PMN-CD16 expression levels in the FF + IMN-group rose gradually over time and were significantly higher compared with control animals, after 48 h (P = 0.016) and 72 h (P = 0.032). PMN-CD62L and CD32 expression did not differ significantly between conditions.CONCLUSION: This study reveals that a femur fracture and subsequent IMN in a controlled setting in pigs is associated with enhanced activation status of circulatory PMNs, preserved PMN-responsiveness and unaltered circulatory PMN-presence. Indicating that monotrauma plus IMN is a specific and substantial stimulus for the cellular immune system. Early alterations of circulatory PMN receptor expression dynamics may be predictive for the intensity of the post traumatic response.
AB - PURPOSE: Intramedullary nailing (IMN) of fractures is associated with increased rates of inflammatory complications. The pathological mechanism underlying this phenomenon is unclear. However, polymorphonuclear granulocytes (PMNs) seem to play an important role. We hypothesized that a femur fracture and standardized IMN in pigs is associated with altered appearance of PMNs in circulation and enhanced activation status of these cells.METHODS: A porcine model including a femur fracture and IMN was utilized. Animals were randomized for control [anesthesia + mechanical ventilation only (A/MV)] and intervention [A/MV and unilateral femur fracture (FF) + IMN] conditions. PMN numbers and responsiveness, integrin (CD11b), L-selectin (CD62L) and Fcγ-receptor (CD16 and CD32)-expression levels were measured by flowcytometry of blood samples. Animals were observed for 72 h.RESULTS: Circulatory PMN numbers did not differ between groups. Early PMN-responsiveness was retained after insult. PMN-CD11b expression increased significantly upon insult and peaked after 24 h, whereas CD11b in control animals remained unaltered (P = 0.016). PMN-CD16 expression levels in the FF + IMN-group rose gradually over time and were significantly higher compared with control animals, after 48 h (P = 0.016) and 72 h (P = 0.032). PMN-CD62L and CD32 expression did not differ significantly between conditions.CONCLUSION: This study reveals that a femur fracture and subsequent IMN in a controlled setting in pigs is associated with enhanced activation status of circulatory PMNs, preserved PMN-responsiveness and unaltered circulatory PMN-presence. Indicating that monotrauma plus IMN is a specific and substantial stimulus for the cellular immune system. Early alterations of circulatory PMN receptor expression dynamics may be predictive for the intensity of the post traumatic response.
KW - Activation status
KW - Inflammation
KW - Intra-medullary nailing
KW - Polymorphonuclear neutrophils
KW - Porcine modelling
UR - http://www.scopus.com/inward/record.url?scp=85107785109&partnerID=8YFLogxK
U2 - 10.1007/s00068-021-01703-2
DO - 10.1007/s00068-021-01703-2
M3 - Article
C2 - 34114052
SN - 1863-9933
VL - 48
SP - 1601
EP - 1611
JO - European Journal of Trauma and Emergency Surgery
JF - European Journal of Trauma and Emergency Surgery
IS - 3
ER -