Different experimental multiple trauma models induce comparable inflammation and organ injury

Borna Relja,Baolin Xu,Kernt Köhler,Katrin Bundkirchen,Bing Yang,Claudia Neunaber

doi:10.1038/s41598-020-76499-z

Abstract

Multiple injuries appear to be a decisive factor for experimental polytrauma. Therefore, our aim was to compare the inflammatory response and organ damage of five different monotrauma with three multiple trauma models. For this, mice were randomly assigned to 10 groups: Healthy control (Ctrl), Sham, hemorrhagic shock (HS), thoracic trauma (TxT), osteotomy with external fixation (Fx), bilateral soft tissue trauma (bsTT) or laparotomy (Lap); polytrauma I (PT I, TxT + HS + Fx), PT II (TxT + HS + Fx + Lap) and one multi-trauma group (MT, TxT + HS + bsTT + Lap). The inflammatory response and organ damage were quantified at 6 h by analyses of IL-6, IL-1β, IL-10, CXCL1, SAA1, HMGB1 and organ injury. Systemic IL-6 increased in all mono and multiple trauma groups, while CXCL1 increased only in HS, PT I, PT II and MT vs. control. Local inflammatory response was most prominent in HS, PT I, PT II and MT in the liver. Infiltration of inflammatory cells into lung and liver was significant in all multiple trauma groups vs. controls. Hepatic and pulmonary injury was prominent in HS, PT I, PT II and MT groups. These experimental multiple trauma models closely mimic the early post-traumatic inflammatory response in human. Though, the choice of read-out parameters is very important for therapeutic immune modulatory approaches.

Highlights

Multiple injuries appear to be a decisive factor for experimental polytrauma
The level of circulating CXCL1 were significantly increased in both PT groups and in the MT group compared to Ctrl, Sham, Fx, Lap, hemorrhagic shock (HS), bilateral soft tissue trauma (bsTT) and TxT groups, respectively (p < 0.05, Fig. 1b)
CXCL1 was significantly enhanced in the HS group compared to Ctrl, Lap, bsTT or TxT group, respectively (p < 0.05, Fig. 1b)

Summary

Introduction

Multiple injuries appear to be a decisive factor for experimental polytrauma. our aim was to compare the inflammatory response and organ damage of five different monotrauma with three multiple trauma models. Hepatic and pulmonary injury was prominent in HS, PT I, PT II and MT groups These experimental multiple trauma models closely mimic the early post-traumatic inflammatory response in human. Patients who initially survive certain trauma types and injury pattern are at high risk for developing post-injury complications with organ dysfunctions or infections, which are caused by the complex immune response to t rauma[6,7]. The definition of the ISS is vulnerable, since it does not always reflect the physiological course after injury[17,18] Additional criteria such as laparotomy, severe shock, admission to the intensive care unit, a systemic inflammatory response s yndrome[19], or combining the concept of different injury patterns with the addition of physiological responses are defining the new “Berlin definition” of polytraumatized patients[20]. Considering the definition of polytrauma according to the ISS or the new Berlin

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Conclusion