Abstract
Due to their immunomodulatory and regenerative capacity, human bone marrow-derived mesenchymal stem cells (hBMSCs) are promising in the treatment of patients suffering from polytrauma. However, few studies look at the effects of sera from polytraumatized patients on hBMSCs. The aim of this study was to explore changes in hBMSC properties in response to serum from polytrauma patients taken at different time points after the trauma incident. For this, sera from 84 patients with polytrauma (collected between 2010 and 2020 in our department) were used. In order to test the differential influence on hBMSC, sera from the 1st (D1), 5th (D5), and 10th day (D10) after polytrauma were pooled, respectively. As a control, sera from three healthy donors (HS), matched with respect to age and gender to the polytrauma group, were collected. Furthermore, hBMSCs from four healthy donors were used in the experiments. The pooled sera of HS, D1, D5, and D10 were analyzed by multicytokine array for pro-/anti-inflammatory cytokines. Furthermore, the influence of the different sera on hBMSCs with respect to cell proliferation, colony forming unit-fibroblast (CFU-F) assay, cell viability, cytotoxicity, cell migration, and osteogenic and chondrogenic differentiation was analyzed. The results showed that D5 serum significantly reduced hBMSC cell proliferation capacity compared with HS and increased the proportion of dead cells compared with D1. However, the frequency of CFU-F was not reduced in polytrauma groups compared with HS, as well as the other parameters. The serological effect of polytrauma on hBMSCs was related to the time after trauma. It is disadvantageous to use BMSCs in polytraumatized patients at least until the fifth day after polytrauma as obvious cytological changes could be found at that time point. However, it is promising to use hBMSCs to treat polytrauma after five days, combined with the concept of “Damage Control Orthopedics” (DCO).
Highlights
Polytrauma is not a mere addition of multiple injuries; instead, it has significant effects on the entire body function and changes in pathophysiology
The level of the proinflammatory factors IL-6 (Figure 1(b)) and IL-8 (Figure 1(c)) as well as the level of the anti-inflammatory cytokine IL-10 (Figure 1(d)) showed a four times fold short-term increase on the first day after polytrauma compared to HS and decreased to two or three times higher when compared to D5 and D10
Five and ten days after the trauma incident, the level of IL-6, IL-8, and IL-10 had declined to the same level that was found in the HS group
Summary
Polytrauma is not a mere addition of multiple injuries; instead, it has significant effects on the entire body function and changes in pathophysiology. People affected by this kind of injury often suffer from serious disabilities and, in extreme cases, lose their lives. The most widely accepted classification system for polytrauma is the Injury Severity Score (ISS). The ISS is derived from the AIS by calculating the sum of the squares of the AIS scores of the three most severely injured body regions [4, 5]. The new “Berlin definition” states that polytrauma is defined by an AIS ≥ 3 for two or more different body regions and one or more additional variables from five physiologic parameters [8]
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