Changes in the pattern of plasma extracellular vesicles after severe trauma

Area of Science:

• Trauma research
• Biomedical engineering
• Vascular biology

Background:

• Circulating extracellular vesicles (EV) may influence post-traumatic complications.
• Understanding EV dynamics after injury is crucial for managing patient outcomes.

Purpose of the Study:

• To quantify plasma extracellular vesicle (EV) levels up to 28 days post-trauma.
• To assess the pro-coagulant and inflammatory properties of these EVs.

Main Methods:

• Studied 37 trauma patients (ISS >15) and 24 healthy controls.
• Collected plasma samples serially up to 28 days post-injury.
• Quantified EVs using Nanoparticle Tracking Analysis (NTA) and Flow Cytometry (FC); assessed functional effects in coagulation and leukocyte adhesion assays.

Main Results:

• Plasma EV concentrations were significantly elevated in trauma patients compared to controls, persisting for 28 days.
• Flow cytometry revealed increased EV counts from platelets, leukocytes, and endothelial cells in trauma patients.
• EVs in patient plasma accelerated coagulation and promoted leukocyte adhesion to endothelial cells, correlating with EV levels.

Conclusions:

• Extracellular vesicles (EVs) are significantly increased in plasma following severe traumatic injury.
• Both NTA and FC indicate elevated EV levels, with FC capturing a smaller subpopulation.
• These trauma-induced EVs exhibit pro-coagulant and pro-inflammatory activities, potentially influencing clinical outcomes.