L-selectin shows time and gender dependency in association with MODS.
BACKGROUND
Recent investigations have demonstrated gender related immunologic alterations after trauma. These complications arise due to polymorphonuclear granulocytes (PMN) interacting with endothelium via L-selectin. Therefore, the purpose of this study was to investigate gender related differences in the expression of L-selectin in relation to posttraumatic multiple organ dysfunction syndrome (MODS).


METHODS
Multiply injured patients were prospectively entered in the study. MODS was determined using the Denver score. The concentration of L-selectin on the surface of PMN was determined using flow cytometry during a 14 days' period.


RESULTS
48 patients were included in the study. The kinetics of L-selectin were different comparing male and female patients. Male patients with MODS initially showed a rapid decrease of surface L-selectin from 80 to 20 ng/ml. A return to admission levels was related to MODS. Male patients without MODS displayed elevated L-selectin levels up to 140 ng/ml. Female patients, however, all showed an initial rapid decrease of L-selectin to 20 ng/ml. Women who developed posttraumatic MODS had significantly increased levels up to 110 ng/ml before development of MODS developed.


CONCLUSIONS
We feel that a gender related dimorphism in the initial L-selectin expression following trauma exists and is associated with MODS. These findings indicate new therapeutic means for the treatment of MODS. Therapies should be timely and gender dependently coordinated.
Department of Trauma Surgery, Hannover Medical School, Carl-Neuberg-Strasse 1, D-30625, Germany. griensven.martijn.van@mh-hannover.de
Martijn
M
van Griensven
Tanja
T
Barkhausen
Frank
F
Hildebrand
Martin
M
Grotz
Lutz
L
Mahlke
Reinhard
R
Meier
Andreas
A
Seekamp
Christian
C
Krettek
Hans-Christoph
HC
Pape
D000293:Adolescent; D000328:Adult; D000368:Aged; D015415:Biomarkers / Q000097:blood; D005260:Female; D006801:Humans; D015601:Injury Severity Score; D019041:L-Selectin / Q000097:blood*; D008297:Male; D008875:Middle Aged; D009102:Multiple Organ Failure / Q000097:blood*; D009504:Neutrophils / Q000378:metabolism; D011446:Prospective Studies; D012737:Sex Factors
D015415:Biomarkers; D019041:L-Selectin