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Does beta blockade postinjury prevent bone marrow suppression?

Alicia M Mohr¹, Ihab O ElHassan, Edward J Hannoush

¹Division of Trauma, Department of Surgery, UMDNJ-New Jersey Medical School, Newark, New Jersey 07103, USA. mohr@umdnj.edu

The Journal of Trauma

|May 26, 2011

Summary

Beta blockade (BB) administered after trauma and hemorrhagic shock (HS) reduces bone marrow suppression and hematopoietic progenitor cell (HPC) mobilization to injured tissue. This treatment may minimize long-term bone marrow suppression without worsening lung healing.

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Area of Science:

Trauma and injury research
Hematology
Pharmacology

Background:

Trauma-induced hypercatecholaminemia suppresses bone marrow (BM) hematopoietic progenitor cell (HPC) growth and increases their egress to injured tissues.
Beta blockade (BB) administered before injury mitigates HPC mobilization and restores BM HPC growth.
This study investigates BB's effects when given after both tissue injury and hemorrhagic shock (HS).

Purpose of the Study:

To examine the therapeutic potential of beta blockade (BB) administered after combined tissue injury and hemorrhagic shock (HS).
To assess the impact of post-injury BB on bone marrow (BM) hematopoietic progenitor cell (HPC) function and mobilization.
To evaluate the effect of BB on hematologic parameters and lung injury healing in a rat model.

Main Methods:

Male Sprague-Dawley rats underwent lung contusion (LC) followed by hemorrhagic shock (HS).
Propranolol (BB) was administered after HS, with daily follow-up doses.
Bone marrow and lung tissues were analyzed for HPC growth, hematologic parameters, and lung injury histology at 1 and 7 days post-injury.

Main Results:

Combined LC/HS significantly suppressed BM CFU-E growth and increased HPC egress to injured tissue compared to LC alone.
BB administration post-LC/HS ameliorated BM suppression, reduced anemia, and decreased HPCs in injured lung tissue.
Lung injury scores indicated no adverse effect of BB on lung healing.

Conclusions:

Immediate post-resuscitation propranolol administration significantly reduces BM suppression following injury and shock.
The protective effects of BB on BM function are sustained for at least 7 days with daily administration.
BB may minimize long-term BM suppression after trauma and resuscitation without compromising lung healing.