在炎症性中介的时间依赖性变化与创伤相关的静脉血栓栓塞结合有关
Atharwa R Mankame1, Kelly E Sanders, Jessica C Cardenas
1Department of Surgery, Center for Translational Injury Research, McGovern Medical School, The University of Texas Health Science Center at Houston, Houston, Texas.
Shock (Augusta, Ga.)
|August 30, 2023
概括
患有较高水平某些炎症介质的重创患者,包括IL-6,IL-8和MCP-1,面临静脉血栓栓塞 (VTE) 的风险增加. 这些炎症标志物独立地预测VTE的发展和创伤后加速发病.
科学领域:
- 免疫学 免疫学 免疫学
- 血液学 血液学 血液学
- 创伤外科 手术 创伤外科
背景情况:
- 严重的创伤会引发显著的先天性免疫系统激活.
- 已知炎症和凝血通路相互作用.
- 可溶性炎症媒介可能会导致创伤后静脉血栓塞栓症 (VTE) 风险.
研究的目的:
- 确定可独立预测创伤患者静脉瘤风险的血炎症媒介.
- 研究特定细胞因子/化学因子与静脉瘤发育之间的关联.
主要方法:
- 实用随机最佳血小板和血比率 (PROPPR) 研究的二次分析.
- 使用Bio-Plex在服用后的多个时间点测量了27种细胞因子/化学因子的血水平.
- 采用多变量逻辑回归和Cox比例危险建模来评估VTE预测因素.
主要成果:
- 15%的患者 (86/575) 发生了静脉瘤.
- 在VTE患者中观察到IL-1ra,IL-6,IL-8,IL-10,eotaxin,G-CSF,IP-10,MCP-1和RANTES的水平升高.
- IL-6,IL-8,干扰素-γ诱导蛋白 (IP-10) 和单细胞化学吸引蛋白1 (MCP-1) 独立地与静脉瘤相关.
- IL-6,IL-8和MCP-1预测了加速的静脉瘤发育.
结论:
- 持续的全身炎症是严重创伤后推动静脉瘤风险的关键因素.
- 准先天性免疫激活可能为VTE预防提供新的治疗策略.
- 炎症与凝血和内皮激活的标志物相关,突出显示了复杂的病理生理联系.
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