gms | German Medical Science

Objectives: Human bone marrow derived mesenchymal stem cells (hBMSCs) have the potential to be useful in the treatment of patients suffering from polytrauma due to their immunomodulatory and regenerative capacity. The cells are particularly promising for treating the systemic inflammatory response syndrome, as well as bone defects. Therefore, this study aimed to investigate which changes in the hBMSCs properties resulted from incubation with serum from polytraumatized patients, and to find out at which time point could be successful for the treatment with hBMSCs.

Methods: Sera from 84 patients with polytrauma with an Injury Severity Score ≥ 16 from the polytrauma serum bank and four healthy hBMSCs donors from hBMSCs-bank of MHH were used in this study. Sera from the 1^st (D1), the 5^th (D5) and the 10^th day (D10) after trauma were selected and pooled, respectively. As a control, a pooled serum from three healthy donors (HS), matched in respect to age and sex to the polytrauma group was used. Afterwards, the pooled sera of HS, D1, D5, D10 were added to the cultured hBMSCs to perform the following methods: cell proliferation, colony forming unit fibroblast assay (CFU-F), cell viability and toxicity, cell migration, wound repair ability, osteogenic, and chondrogenic differentiation. LSD and Kruskal-Wallis test were used, depending on data distribution pattern tested by the Shapiro-Wilk test. A p-value ≤ 0.05 was considered as statistical significant deviation.

Results and Conclusion: The results showed that D5 serum from polytraumatized patients significantly reduced hBMSCs cell proliferation capacity (132,071.67 ± 25,770.13 cells; p < 0.05) compared to HS (224,842.50 ± 56,999.37 cells) and the leads to a significantly increased proportion of dead cells (6.56 ± 2.71%; p < 0.05) compared to D1 (3.37 ± 1.27%) and D10 (4.31 ± 3.17%) after 72 hours cultivation, but no significant effects on cell viability were observed after 24 hours.The CFU-F frequency of D5 (8.30 ± 5.95%; p < 0.05) and D10 (7.50 ± 5.22%; p < 0.05) was significantly reduced when compared to HS (16.30 ± 4.10%). The other analyzed parameters of D1, D5 and D10, however, were not significantly affected, namely cell migration, wound repair ability, osteogenic, and chondrogenic differentiation.

The serological effect of polytrauma on hBMSCs was related to the time after trauma. The results suggested that it is disadvantageous to use hBMSCs in polytraumatized patients five days after the incidence as obvious cytological changes could be found at that time point. However, it is promising to use hBMSCs to treat polytrauma after 10 days, combined with the concept of "Damage Control Orthopaedics" (DCO).