Prevention of Trauma/Hemorrhagic Shock-Induced Mortality, Apoptosis, Inflammation and Mitochondrial Dysfunction

Abstract

Trauma complicated by hemorrhagic shock (T/HS) on the battlefield is distinct from the civilian arena especially with regards to clinical diagnosis and resuscitation protocols. Progress towards development of new first-responder resuscitation adjuvants for polytrauma and blast injuries that will maintain tissue viability requires that an agent that demonstrates efficacy in animal models that mimic T-HS and resuscitation in the civilian setting also work in animal models of T-HS that mimic combat casualties and battlefield management. We developed a rat T-HS model in which we demonstrated: 1) 72% mortality at 48 hr, 2) hypovolemic circulatory collapse, 3) left ventricular contractile dysfunction, 4) apoptosis of cardiomyocytes, alveolar epithelial cells, hepatocytes and leukocytes, 5) organ inflammation, 6) organ-specific alterations in the apoptosis transcriptome and 7) increased susceptibility to bacterial infections. Especially notable was the finding that apoptosis and inflammation required resuscitation. Remarkably, use of IL-6 (10 ug/kg) as a resuscitation adjuvant: 1) reduced mortality 5 fold, 2) prevented hypovolemic circulatory collapse, 3) prevented ventricular contractile dysfunction, 4) prevented apoptosis of cardiomyocytes, alveolar epithelial cells, hepatocytes and leukocytes, 5) reduced organ inflammation, 6) normalized the apoptosis and inflammation transcriptome in the heart, lung and liver and 7) reduced T-HS-mediated increased susceptibility to bacterial infections.

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Document Details

Document Type
Technical Report
Publication Date
Dec 01, 2012
Accession Number
ADA612818

Entities

People

  • David J Tweardy

Organizations

  • Baylor College of Medicine

Tags

DTIC Thesaurus Topics

  • Blood
  • Cardiovascular Physiological Phenomena
  • Cell Physiological Processes
  • Cells
  • Gene Expression
  • Health Services
  • Hemorrhagic Shock
  • Medical Personnel
  • Wound Infections
  • Wounds And Injuries

Fields of Study

  • Biology
  • Medicine

Readers

  • Cardiovascular Physiology
  • Immunology and Pathology
  • Trauma Surgery or Emergency Medicine.