title: Systemic inflammatory effects of traumatic brain injury, femur fracture, and shock: an experimental murine polytrauma model.
abstract: OBJECTIVE
  Despite broad research in neurotrauma and shock, little is known on systemic inflammatory effects of the clinically most relevant combined polytrauma. Experimental investigation in an animal model may provide relevant insight for therapeutic strategies. We describe the effects of a combined injury with respect to lymphocyte population and cytokine activation.
  
  
  METHODS
  45 male C57BL/6J mice (mean weight 27 g) were anesthetized with ketamine/xylazine. Animals were subjected to a weight drop closed traumatic brain injury (WD-TBI), a femoral fracture and hemorrhagic shock (FX-SH). Animals were subdivided into WD-TBI, FX-SH and combined trauma (CO-TX) groups. Subjects were sacrificed at 96 h. Blood was analysed for cytokines and by flow cytometry for lymphocyte populations.
  
  
  RESULTS
  Mortality was 8%, 13% and 47% for FX-SH, WD-TBI and CO-TX groups (P < 0.05). TNFα (11/13/139 for FX-SH/WD-TBI/CO-TX; P < 0.05), CCL2 (78/96/227; P < 0.05) and IL-6 (16/48/281; P = 0.05) showed significant increases in the CO-TX group. Lymphocyte populations results for FX-SH, WD-TBI and CO-TX were: CD-4 (31/21/22; P = n.s.), CD-8 (7/28/34, P < 0.05), CD-4-CD-8 (11/12/18; P = n.s.), CD-56 (36/7/8; P < 0.05).
  
  
  CONCLUSIONS
  This study shows that a combination of closed TBI and femur-fracture/ shock results in an increase of the humoral inflammation. More attention to combined injury models in inflammation research is indicated.
authors.affiliation: Department of Trauma and Orthopaedic Surgery, Cologne Merheim Medical Center, Faculty of Health-School of Medicine, Witten/Herdecke University, Ostmerheimer Straße 200, 51109 Cologne, Germany. probstc@kliniken-koeln.de
authors.forename: C
authors.initials: C
authors.lastname: Probst
authors.forename: M J
authors.initials: MJ
authors.lastname: Mirzayan
authors.forename: P
authors.initials: P
authors.lastname: Mommsen
authors.forename: C
authors.initials: C
authors.lastname: Zeckey
authors.forename: T
authors.initials: T
authors.lastname: Tegeder
authors.forename: L
authors.initials: L
authors.lastname: Geerken
authors.forename: M
authors.initials: M
authors.lastname: Maegele
authors.forename: A
authors.initials: A
authors.lastname: Samii
authors.forename: M
authors.initials: M
authors.lastname: van Griensven
mesh_terms: D000777:Anesthetics / Q000494:pharmacology; D000818:Animals; D001930:Brain Injuries / Q000150:complications / Q000276:immunology / Q000503:physiopathology*; D016207:Cytokines / Q000097:blood; D004195:Disease Models, Animal; D005264:Femoral Fractures / Q000150:complications / Q000276:immunology / Q000503:physiopathology*; D005434:Flow Cytometry / Q000379:methods; D056724:Immunity, Humoral; D007249:Inflammation / Q000276:immunology / Q000503:physiopathology*; D016131:Lymphocyte Subsets / Q000166:cytology; D008297:Male; D051379:Mice; D008810:Mice, Inbred C57BL; D012769:Shock / Q000150:complications / Q000276:immunology / Q000503:physiopathology*; D013997:Time Factors
chemical_list: D000777:Anesthetics; D016207:Cytokines