title: Surgical inflammatory stress: the embryo takes hold of the reins again.
abstract: The surgical inflammatory response can be a type of high-grade acute stress response associated with an increasingly complex trophic functional system for using oxygen. This systemic neuro-immune-endocrine response seems to induce the re-expression of 2 extraembryonic-like functional axes, i.e. coelomic-amniotic and trophoblastic-yolk-sac-related, within injured tissues and organs, thus favoring their re-development. Accordingly, through the up-regulation of two systemic inflammatory phenotypes, i.e. neurogenic and immune-related, a gestational-like response using embryonic functions would be induced in the patient's injured tissues and organs, which would therefore result in their repair. Here we establish a comparison between the pathophysiological mechanisms that are produced during the inflammatory response and the physiological mechanisms that are expressed during early embryonic development. In this way, surgical inflammation could be a high-grade stress response whose pathophysiological mechanisms would be based on the recapitulation of ontogenic and phylogenetic-related functions. Thus, the ultimate objective of surgical inflammation, as a gestational process, is creating new tissues/organs for repairing the injured ones. Since surgical inflammation and early embryonic development share common production mechanisms, the factors that hamper the wound healing reaction in surgical patients could be similar to those that impair the gestational process.
authors: Department of Surgery, School of Medicine, Complutense University of Madrid, Madrid, Spain.
authors: Maria-Angeles
authors: MA
authors: Aller
authors: Jose-Ignacio
authors: JI
authors: Arias
authors: Isabel
authors: I
authors: Prieto
authors: Carlos
authors: C
authors: Gilsanz
authors: Ana
authors: A
authors: Arias
authors: Heping
authors: H
authors: Yang
authors: Jaime
authors: J
authors: Arias
mesh_terms: D000818:Animals; D047108:Embryonic Development; D006801:Humans; D007249:Inflammation / Q000209:etiology*; D013514:Surgical Procedures, Operative / Q000009:adverse effects*
references: Clin Sci (Lond). 2012 Feb;122(4):143-59
references: 22029668
references: Exp Dermatol. 2012 Jul;21(7):497-503
references: 22716244
references: Curr Probl Surg. 2011 Mar;48(3):148-212
references: 21295632
references: Curr Mol Med. 2012 Jun;12(5):574-91
references: 22515979
references: PLoS One. 2011 May 12;6(5):e19721
references: 21589862
references: J Physiol Pharmacol. 2010 Oct;61(5):509-21
references: 21081794
references: Nature. 2006 Dec 14;444(7121):860-7
references: 17167474
references: FASEB J. 2007 Feb;21(2):325-32
references: 17267386
references: Placenta. 2001 Apr;22 Suppl A:S70-7
references: 11312634
references: Mol Immunol. 2010 Mar;47(6):1244-54
references: 20116105
references: J Biosci. 2011 Aug;36(3):517-29
references: 21799263
references: Curr Pharm Des. 2009;15(12):1385-400
references: 19355976
references: Br J Surg. 2012 Jan;99 Suppl 1:40-50
references: 22441854
references: Nat Rev Genet. 2011 Nov 03;12(12):833-45
references: 22048664
references: Science. 2011 Oct 7;334(6052):98-101
references: 21921156
references: Cell. 2011 Sep 16;146(6):873-87
references: 21925313
references: Nat Rev Immunol. 2008 Nov;8(11):837-48
references: 18927578
references: Chest. 2011 Jul;140(1):205-211
references: 21729891
references: Best Pract Res Clin Haematol. 2011 Mar;24(1):49-57
references: 21396592
references: Methods Achiev Exp Pathol. 1991;15:XI-XV
references: 1762546
references: Semin Liver Dis. 2010 Aug;30(3):215-25
references: 20665374
references: Amyloid. 2012 Mar;19(1):5-14
references: 22320226
references: Brain Behav Immun. 2010 May;24(4):525-8
references: 19896530
references: J Pharm Bioallied Sci. 2011 Jan;3(1):118-27
references: 21430962
references: Dis Mon. 2009 Aug;55(8):476-526
references: 19595297
references: J Invest Dermatol. 2006 Aug;126(8):1697-704
references: 16845409
references: Nat Rev Genet. 2010 Oct;11(10):710-22
references: 20838411
references: Pathophysiology. 2003 May;9(3):133-153
references: 14567930
references: Exp Biol Med (Maywood). 2004 Feb;229(2):170-81
references: 14734796
references: Br J Haematol. 2008 Oct;143(2):180-90
references: 18783400
references: J Thromb Haemost. 2011 Jul;9 Suppl 1:118-29
references: 21781247
references: Clin Dev Immunol. 2012;2012:175041
references: 21977049
references: Curr Opin Obstet Gynecol. 2011 Apr;23(2):109-16
references: 21386681
references: Peptides. 2011 Oct;32(10):2137-40
references: 21939704
references: J Clin Endocrinol Metab. 2005 Feb;90(2):1171-5
references: 15562012
references: J Lipid Res. 2005 Oct;46(10):2168-74
references: 16061954
references: Eur J Pharmacol. 2011 Jun 11;660(1):213-9
references: 21208604
references: Am J Physiol Endocrinol Metab. 2011 Jul;301(1):E11-24
references: 21540450
references: J Hematol Oncol. 2011 May 24;4:24
references: 21609465
references: Cardiovasc Res. 2003 May 1;58(2):390-8
references: 12757873
references: Atherosclerosis. 2012 Jul;223(1):69-77
references: 22304794
references: Anat Rec (Hoboken). 2008 Dec;291(12):1587-602
references: 19037853
references: Nature. 2002 Dec 19-26;420(6917):846-52
references: 12490957
references: N Engl J Med. 1999 Feb 11;340(6):448-54
references: 9971870
references: J Endocrinol. 2011 May;209(2):153-67
references: 21357682
references: Surg Today. 2010 Sep;40(9):793-808
references: 20740341
references: Cardiovasc Hematol Agents Med Chem. 2008 Oct;6(4):272-7
references: 18855639
references: Subcell Biochem. 2010;51:183-227
references: 20213545
references: PLoS One. 2011;6(7):e22538
references: 21799891
references: Mol Hum Reprod. 1998 Sep;4(9):857-62
references: 9783845
references: Nature. 2006 Jun 29;441(7097):1075-9
references: 16810242
references: Int Rev Cell Mol Biol. 2012;295:109-37
references: 22449488
references: Int J Dev Biol. 2003;47(7-8):467-77
references: 14756322
references: Clin Rev Allergy Immunol. 2011 Feb;40(1):66-73
references: 20352526
references: Brain Res. 2012 Oct 2;1476:71-85
references: 22285436
references: Fibrogenesis Tissue Repair. 2011 Oct 19;4(1):23
references: 22011363
references: QJM. 2006 Sep;99(9):581-93
references: 16905749
references: Crit Care Med. 2010 Oct;38(10 Suppl):S590-9
references: 21164402
references: Cell Mol Life Sci. 2012 Mar;69(6):915-30
references: 22009455
references: Injury. 2007 Dec;38(12):1336-45
references: 18048040
references: Scand J Trauma Resusc Emerg Med. 2010 May 17;18:27
references: 20478066
references: Circ Res. 2012 Jan 20;110(2):356-69
references: 22267840
references: Neurochem Res. 2010 Dec;35(12):1875-9
references: 20978849
references: Ann Surg. 1993 Aug;218(2):111-9
references: 8342990
references: J Cell Biochem. 2009 Jul 1;107(4):586-91
references: 19415688
references: Lymphology. 2006 Sep;39(3):110-7
references: 17036631
references: Eur J Nutr. 2011 Jun;50(4):219-33
references: 21547407
references: Clin Dev Immunol. 2012;2012:983203
references: 22028730
references: Am J Surg. 2001 Dec;182(6):558-62
references: 11839317
references: Int J Dev Biol. 2010;54(6-7):1019-31
references: 20711980
references: Ann Surg. 2011 Dec;254(6):1066-74
references: 21832942
references: Hum Reprod Update. 2000 May-Jun;6(3):268-78
references: 10874572
references: Differentiation. 2011 Mar;81(3):153-61
references: 21339038
references: Nat Rev Mol Cell Biol. 2011 Aug 23;12(9):551-64
references: 21860391
references: Methods Achiev Exp Pathol. 1991;14:133-73
references: 1682788
references: Fibrogenesis Tissue Repair. 2011 Sep 08;4:20
references: 21902837
references: Curr Opin Endocrinol Diabetes Obes. 2010 Apr;17(2):156-60
references: 20177380
references: Endocrinology. 2005 Jun;146(6):2531-8
references: 15774561
references: Arch Surg. 1980 Oct;115(10):1151-4
references: 7000034
references: Proc Natl Acad Sci U S A. 1990 Feb;87(3):1057-60
references: 1689057
references: J Intern Med. 2005 Feb;257(2):156-66
references: 15656874
references: Thromb Res. 2009 Feb;123(4):622-30
references: 18614205
references: Int J Dev Biol. 2010;54(2-3):269-80
references: 19876833
references: Med Hypotheses. 2012 Jun;78(6):721-31
references: 22405850
references: Curr Opin Crit Care. 2006 Aug;12(4):325-32
references: 16810043
references: Nutrients. 2012 Jan;4(1):52-67
references: 22347618
references: Hum Reprod. 1994 Jun;9(6):1175-9
references: 7962397
references: Dev Dyn. 2011 Aug;240(8):2002-10
references: 21761483
references: Dialogues Clin Neurosci. 2011;13(3):263-78
references: 22034143
references: Injury. 2007 Dec;38(12):1409-22
references: 18048034
references: Dialogues Clin Neurosci. 2011;13(3):251-62
references: 22034252
references: J Neuropsychiatry Clin Neurosci. 1998 Spring;10(2):230-1
references: 9722327
references: Am J Obstet Gynecol. 1995 Dec;173(6):1884-8
references: 8610781
references: Int J Dev Biol. 2010;54(2-3):495-505
references: 19757392
references: Brain Behav Immun. 2008 Jan;22(1):3-14
references: 17900859
references: Theor Biol Med Model. 2010 Sep 14;7:37
references: 20840764
references: Nat Rev Mol Cell Biol. 2003 Nov;4(11):897-901
references: 14625539
references: Med Sci Monit. 2006 Oct;12(10):RA225-34
references: 17006415
references: Endocrinology. 2011 Nov;152(11):4019-32
references: 21878511
references: Nature. 2010 Jun 10;465(7299):793-7
references: 20535209
references: Stem Cells Transl Med. 2012 Jan;1(1):44-50
references: 23197639
references: J Invest Dermatol. 2007 Mar;127(3):514-25
references: 17299434
references: Nat Rev Neurosci. 2011 Nov 30;13(1):22-37
references: 22127301
references: Mol Med. 2008 Mar-Apr;14(3-4):195-204
references: 18079995
references: Trends Immunol. 2011 Feb;32(2):57-65
references: 21233016
references: J Exp Med. 2011 Mar 14;208(3):421-8
references: 21402747
references: Ann Plast Surg. 2010 May;64(5):632-5
references: 20395817
references: Exp Cell Res. 2010 Aug 15;316(14):2213-9
references: 20471978
references: Mini Rev Med Chem. 2010 Jan;10(1):32-40
references: 20105129
references: J Reprod Immunol. 2011 Mar;88(2):112-7
references: 21277024
references: J Inflamm (Lond). 2006 Mar 29;3:5
references: 16571116
references: Dev Growth Differ. 2002 Feb;44(1):11-22
references: 11869288
references: Dis Model Mech. 2011 Sep;4(5):569-74
references: 21810906
references: J Lipid Res. 2011 Dec;52(12):2111-2135
references: 21976778
references: Exp Gerontol. 2011 Feb-Mar;46(2-3):90-5
references: 20833240
references: Int J Exp Pathol. 2011 Jun;92(3):158-67
references: 21355940
references: Int J Exp Pathol. 2007 Apr;88(2):85-94
references: 17408451
references: J Leukoc Biol. 2007 Feb;81(2):383-92
references: 17041004
references: Int J Dev Biol. 2009;53(8-10):1529-40
references: 19757397
references: Nat Rev Endocrinol. 2009 Jul;5(7):374-81
references: 19488073
references: Neurosci Biobehav Rev. 2010 Sep;35(1):115-21
references: 20026349
references: Amino Acids. 2008 Aug;35(2):291-3
references: 17710362
references: Hum Reprod. 1994 Jan;9(1):161-6
references: 8195341
references: Nat Rev Endocrinol. 2010 Jun;6(6):335-46
references: 20421882
references: J Psychosom Res. 2002 Jan;52(1):1-23
references: 11801260
references: Cells Tissues Organs. 2010;192(2):93-105
references: 20215735
references: Psychoneuroendocrinology. 2005 Jan;30(1):1-10
references: 15358437
references: N Engl J Med. 2010 Sep 30;363(14):1341-50
references: 20879883
references: Exp Cell Res. 2011 Mar 10;317(5):575-89
references: 21223965
references: Placenta. 2012 Feb;33 Suppl:S55-62
references: 22019198
references: J Steroid Biochem Mol Biol. 2010 May 31;120(2-3):105-15
references: 20045727
references: Cancer Lett. 2012 Jan 1;314(1):24-33
references: 22050907