Artikel
The impact of a unilateral femur fracture on systemic neutrophil activation in pigs
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Autoren
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Michel Teuben
- Universitätsklinikum Utrecht, Klinik für Unfallchirurgie, Utrecht, Netherlands
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Roman Pfeifer
- Universitätsklinikum Aachen, Klinik für Unfallchirurgie, Aachen, Germany
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Klemens Horst
- RWTH Aachen, Klinik für Unfall- und Wiederherstellungschirurgie, Aachen, Germany
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Taco Blokhuis
- Universitätsklinikum Utrecht, Klinik für Unfallchirurgie, Utrecht, Netherlands
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Leo Koenderman
- Universitätsklinikum Utrecht, Abteilung für Experimentelle Pneumologie, Utrecht, Netherlands
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Hans-Christoph Pape
- Universitäts- und Poliklinik der RWTH Aachen, Klinik für Orthopädie und Unfallchirurgie, Schwerpunkt Unfallchirurgie, Aachen, Germany
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Frank Hildebrand
- Universitätsklinikum Aachen, Klinik für Unfall- und Wiederherstellungschirurgie, Aachen, Germany
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Luke Leenen
- University Medical Center Utrecht, Surgery, Utrecht, Netherlands
| Veröffentlicht: | 10. Oktober 2016 |
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Gliederung
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Objectives: Activation and migration of polymorphonuclear neutrophils (PMNs) are key mechanisms in the development of complications such as ARDS and MODS. Intramedullary nailing (IMN) for the treatment of femur fractures primes PMNs and evokes a systemic inflammatory response. This study was aimed to investigate the feasablity of a porcine model with a unilateral femur fracture to study neutrophil activation. We therefore hypothesized that intramedullary nailing in pigs leads to activation of the blood neutrophil pool, and also results in the appearance of mobilzation of young (CD16dim) neutrophils in peripheral blood.
Methods: A standardized unilateral femur fracture was induced in male pigs (30-40kg). After 90 minutes these fractres were fixated by intramedullary nailing. Therafter pigs were observed for 72 hours. Sham animals were only subjected to general anesthesia and mechanical Ventilation. Blood was collected prior to intervention and after 6,24,48 and 72 hours after nailing. Membrane receptor expression levels of CD11b (Mac-1), CD16 (FcyRIII), CD62L (L-selectin) were measured by flowcytometry and compared over time. Young neutrophils were identified by specific cell surface expression of CD16/CD62L and their band shaped nucleus.
Results: All animals survived the 72 hour observation period. Absolute leucocyte count in pigs showed a similar pattern over time as the human situation. Flowcytometry analysis revealed profound neutrophil activation after trauma and fracture stabilization. The membrane receptor expression levels of CD11b on PMNs increased significantly after trauma. Furthermore the receptor expression of CD16 decreased during the first 2 days, which can be explained by the mobilzation of CD16 dim neutrophils from the bone marrow. Minor systemic inflammation was observed in sham animals.
Conclusion: Intramedullary nailing for the treatment of femur fractures results in activation of blood neutrophils in pigs. Furthermore the mobilization of neutrophil subtypes is similar to the human situation. This makes the porcine model of monotrauma model very suitable for proof-of-principle interventions with novel therapeutic strategies for trauma.
