Location-dependent effects of trauma on oxidative stress in humans.

Luis Servia,Mariona Badia,José C E Serrano,Neus Montserrat,Reinald Pamplona,Manuel Portero-Otin,Javier Trujillano,Juan Carlos Lopez-Delgado

doi:10.1371/journal.pone.0205519

Abstract

Though circulating antioxidant capacity in plasma is homeostatically regulated, it is not known whether acute stressors (i.e. trauma) affecting different anatomical locations could have quantitatively different impacts. For this reason, we evaluated the relationship between the anatomical location of trauma and plasma total antioxidant capacity (TAC) in a prospective study, where the anatomical locations of trauma in polytraumatic patients (n = 66) were categorized as primary affecting the brain -traumatic brain injury (TBI)-, thorax, abdomen and pelvis or extremities. We measured the following: plasma TAC by 2 independent methods, the contribution of selected antioxidant molecules (uric acid, bilirubin and albumin) to these values and changes after 1 week of progression. Surprisingly, TBI lowered TAC (919 ± 335 μM Trolox equivalents (TE)) in comparison with other groups (thoracic trauma 1187 ± 270 μM TE; extremities 1025 ± 276 μM TE; p = 0.004). The latter 2 presented higher hypoxia (PaO2/FiO2 272 ± 87 mmHg) and hemodynamic instability (inotrope use required in 54.5%) as well. Temporal changes in TAC are also dependent on anatomical location, as thoracic and extremity trauma patients’ TAC values decreased (1187 ± 270 to 1045 ± 263 μM TE; 1025 ± 276 to 918 ± 331 μM TE) after 1 week (p < 0.01), while in TBI these values increased (919 ± 335 to 961 ± 465 μM TE). Our results show that the response of plasma antioxidant capacity in trauma patients is strongly dependent on time after trauma and location, with TBI failing to induce such a response.

Highlights

It is generally assumed that critical care patients, as well as experimental models of acute trauma, show an increase in tissue oxidative stress (OS), as indicated by systematic reviews [1]
The values of total antioxidant capacity (TAC) measured by FRAP in trauma patients were higher, while those of ABTS were lower
There was a reduction in FRAP and an increase in ABTS values at day 7 after intensive care unit (ICU) entry, the increase in ABTS values being significant in all trauma locations and larger in PEXT trauma

Summary

Introduction

It is generally assumed that critical care patients, as well as experimental models of acute trauma, show an increase in tissue oxidative stress (OS), as indicated by systematic reviews [1]. This may be the basis for the positive response to some antioxidant treatments in this context [2]. The deleterious effects of RS are limited by antioxidant defense systems, which counteract their potential to modify biomolecules.

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Conclusion