The potential of adipokines in identifying multiple trauma patients at risk of developing multiple organ dysfunction syndrome

Julian Haupt,Peter Biberthaler,Marc Hanschen,Alexander T. Haug,Martijn van Griensven,Viktoria Bogner-Flatz,Niels Krysiak,Marina Unger

doi:10.1186/s40001-021-00511-z

Abstract

BackgroundMultiple organ dysfunction syndrome (MODS) and the consecutive multiple organ failure (MOF) are severe and dreaded complications with a high mortality in multiple trauma patients. The aim of this study was to investigate the potential of the adipokines leptin, resistin, interleukin-17A and interleukin-33 as possible biomarkers in the early posttraumatic inflammatory response and for identifying severely traumatized patients at risk of developing MODS.MethodsIn total, 14 multiple trauma patients with an injury severity score (ISS) ≥ 16 as well as a control group of 14 non-multiple trauma patients were included in this study and blood samples were taken at the time points 0, 6, 24, 48 and 72 h after admission. For the trauma patients, the SIRS and Denver MOF score were determined daily. The quantitative measurement of the plasma concentrations of the adipokines was performed using ELISA.ResultsIn the statistical analysis, the multiple trauma patients showed statistically significant higher plasma concentrations of leptin, resistin, IL-17A and IL-33 compared to the control group. In addition, there was a statistically significant positive correlation between the concentrations of resistin, IL-17A and IL-33 and the corresponding SIRS scores and between the concentrations of resistin, IL-17A and IL-33 and the corresponding Denver MOF scores. Finally, ROC curve analysis revealed that the adipokines leptin and IL-17A are suitable diagnostic markers for the discrimination between multiple trauma patients with and without MOF.ConclusionsLeptin and IL-17A could be suitable diagnostic markers to identify severely injured patients with a developing SIRS and MOF earlier, to adjust surgical therapy planning and intensive care.

Highlights

Multiple organ dysfunction syndrome (MODS) and the consecutive multiple organ failure (MOF) are severe and dreaded complications with a high mortality in multiple trauma patients
100% of all multiple trauma patients fulfilled the criteria for systemic inflammatory response syndrome (SIRS), on the second day 46.15% and on the third and fourth day 50%
Four patients suffered MOF according to the Denver MOF score with a value of > 3 within 3 days after trauma

Summary

Introduction

Multiple organ dysfunction syndrome (MODS) and the consecutive multiple organ failure (MOF) are severe and dreaded complications with a high mortality in multiple trauma patients. While overall mortality caused by severe trauma has decreased over the years, multiple organ dysfunction syndrome (MODS). Characteristic for the pro-inflammatory immune response, the systemic inflammatory response syndrome (SIRS), is a local and systemic production of various mediators such as pro-inflammatory cytokines, complement factors, acute phase proteins and an accumulation of immune cells at the site of inflammation [6]. Adipokines are bioactive proteins that are produced by adipocytes and cells of the immune system [12, 13]. Adipokines exert their effect on metabolism, immunity and inflammation via an endocrine, paracrine and autocrine secretion mode [14]

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