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Interrelationships Between Platelet Activity and the Immunoinflammatory Response to Severe Injury
Author(s) -
Morris Rachel,
Schaffer Beverly,
Lundy John,
Pidcoke Heather,
Cap Andrew,
Schwacha Martin
Publication year - 2015
Publication title -
the faseb journal
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.709
H-Index - 277
eISSN - 1530-6860
pISSN - 0892-6638
DOI - 10.1096/fasebj.29.1_supplement.641.2
Subject(s) - medicine , platelet , platelet activation , coagulation , inflammation , burn injury , immunology , tumor necrosis factor alpha , gastroenterology , proinflammatory cytokine , surgery
Background Critical injury causes alterations in coagulation and inflammation. Activation of these systems is critical to counteract the initial threats of hemorrhage and infection; however prolonged propagation is associated with poor outcomes. How coagulation and inflammation interact is an area of keen interest. The aim of this study is to correlate changes in circulating inflammatory mediators with coagulation in trauma (ISS>15) and burn patients. Methods Blood samples were drawn from trauma (n=10) and burn (n=10) patients and healthy volunteers (HV; n‐10). Coagulation parameters (sCD40L, D‐Dimers), cytokines (IL‐6, IL‐10, IL‐17a, TNFα) and inflammatory markers (HSP‐72) were assessed. Results The subjects were predominately male (85%) and ~44 years of age. A marked increase in IL‐6 and IL‐10 was observed in both injury groups, whereas only the trauma group showed an increase in IL‐17a and TNFα compared with HV. HSP‐72 levels were 3‐fold higher in the trauma group, but not elevated in the burn group compared with the HVs. In contrast, sCD40L, a marker of platelet activation, was elevated 10‐25 fold, and D‐Dimers were elevated 5‐8 fold in both injury groups. A strong correlation between IL‐17a and sCD40L was observed in the HVs and the burn group (R 2 > 0.80), but not the trauma group (R 2 =0.02). Conclusion These results show that the post‐injury inflammatory response is paralleled by activation of coagulation. However, in trauma patients, a critical interrelationship between platelet activation and the Th‐17 response appears to be lacking, which may contribute to coagulopathic complications and warrants further study.