title: Systemic release of cytokines and heat shock proteins in porcine models of polytrauma and hemorrhage*.
abstract: OBJECTIVE
  To define systemic release kinetics of a panel of cytokines and heat shock proteins in porcine polytrauma/hemorrhage models and to evaluate whether they could be useful as early trauma biomarkers.
  
  
  METHODS
  Prospective observational study.
  
  
  METHODS
  Research laboratory.
  
  
  METHODS
  Twenty-one Yorkshire pigs.
  
  
  METHODS
  None.
  
  
  RESULTS
  Pigs underwent polytrauma (femur fractures/lung contusion, P), hemorrhage (mean arterial pressure 25-30 mm Hg, H), polytrauma plus hemorrhage (P/H), or sham procedure (S). Plasma was obtained at baseline, in 5- to 15-min intervals during a 60-min shock period without intervention, and in 60- to 120-min intervals during fluid resuscitation for up to 300 min. Plasma was assayed for interleukin-1β, interleukin-4, interleukin-5, interleukin-6, interleukin-8, interleukin-10, interleukin-12/interleukin-23p40, interleukin-13, interleukin-17, interleukin-18, interferonγ, transforming growth factor-β, tumor necrosis factor-α, heat shock protein 40, heat shock protein 70, and heat shock protein 90 by enzyme-linked immunosorbent assay. All animals after S, P, and H survived (n = 5/group). Three of six animals after P/H died. Interleukin-10 increased during shock after P and this increase was attenuated after H. Tumor necrosis factor-α increased during the shock period after P, H, and also after S. P/H abolished the systemic interleukin-10 and tumor necrosis factor-α release and resulted in 20% to 30% increased levels of interleukin-6 during shock. As fluid resuscitation was initiated, tumor necrosis factor-α and interleukin-10 levels decreased after P, H, and P/H; heat shock protein 70 increased after P; and interleukin-6 levels remained elevated after P/H and also increased after P and S.
  
  
  CONCLUSIONS
  Differential regulation of the systemic cytokine release after polytrauma and/or hemorrhage, in combination with the effects of resuscitation, can explain the variability and inconsistent association of systemic cytokine/heat shock protein levels with clinical variables in trauma patients. Insults of major severity (P/H) partially suppress the systemic inflammatory response. The plasma concentrations of the measured cytokines/heat shock proteins do not reflect injury severity or physiological changes in porcine trauma models and are unlikely to be able to serve as useful trauma biomarkers in patients.
authors: Burn and Shock Trauma Institute, Loyola University Chicago, Stritch School of Medicine, Maywood, IL, USA.
authors: Todd A
authors: TA
authors: Baker
authors: Jacqueline
authors: J
authors: Romero
authors: Harold H
authors: HH
authors: Bach
authors: Joel A
authors: JA
authors: Strom
authors: Richard L
authors: RL
authors: Gamelli
authors: Matthias
authors: M
authors: Majetschak
mesh_terms: D000818:Animals; D016207:Cytokines / Q000097:blood*; D004195:Disease Models, Animal; D005260:Female; D006360:Heat-Shock Proteins / Q000097:blood*; D006470:Hemorrhage / Q000097:blood* / Q000276:immunology*; D008297:Male; D009104:Multiple Trauma / Q000097:blood* / Q000276:immunology*; D013552:Swine
chemical_list: D016207:Cytokines; D006360:Heat-Shock Proteins