Article
Lipidomic profiling reveals significant posttraumatic changes of the circulating lipid in a porcine polytrauma model
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Authors
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Yohei Kumabe
- Zurich University Hospital, Department of Trauma, Zurich, Switzerland
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Yannik Kalbas
- Zurich University Hospital, Department of Trauma, Zurich, Switzerland
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Sascha Halvachizadeh
- Zurich University Hospital, Department of Trauma, Zurich, Switzerland
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Thorsten Hornemann
- Zurich University Hospital, Department of Trauma, Zurich, Switzerland
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Roman Pfeifer
- Zurich University Hospital, Department of Trauma, Zurich, Switzerland
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Paola Cinelli
- Zurich University Hospital, Department of Trauma, Zurich, Switzerland
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Hans-Christoph Pape
- Zurich University Hospital, Department of Trauma, Zurich, Switzerland
| Published: | October 26, 2021 |
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Outline
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Objectives: Pro-inflammatory mediators released after trauma and the subsequent inflammatory response are important factors in the development of complications in polytraumatized patients. New methods for the investigation of specific circulating and organ bound lipids have found rapidly increasing usage investigating metabolic and cardiovascular disease, however have not yet been applied in the field of trauma. Several lipid subgroups have been shown to mediate inflammatory response. In the current study, we employed a well-established porcine polytrauma model and investigated the posttraumatic intravasation of 233 specific lipids.
Methods: 54 male Pigs (Swiss landrace) weighing 50 ± 5kg underwent general anesthesia for 6 hours. Pigs were split in polytrauma (PT), monotrauma (MT) and sham group. PT received a combined injury of blunt chest trauma with a lung contusion, a grade II (AAST) liver laceration, controlled hemorrhagic shock (mean arterial pressure (MAP) 30 ± 5 mm Hg for 60 minutes), and femoral shaft fracture. MT received an isolated femoral shaft fracture. After 60 minutes animals were resuscitated with crystalloid fluids and fractures received intramedullary nailing. Venous blood was taken regularly from baseline (B) to 6hours (6h) post trauma. Lipid concentrations and lipid composition were investigated using mass spectrometry. 233 specific lipids were analyzed.
Results and Conclusion: Lipids were organized into 17 subgroups based on molecular characteristics. Dilution was normalized for Albumin. Total lipid concentration, especially CEs (cholesteric esters) decreased significantly (p<0.05) in PT (Total: 30609 ± 17459 nM/mL at B and 14570 ± 6660 nM/mL at 6h). AcCa (Acylcarnitines), PC (phosphatidylcholine) and FA (fatty acyls) showed a significant (p<0.05) increase directly after polytrauma. Five subgroups (Cers (ceramides), DAGs (Diacylglyceroles), LPCs (lysophosphatidylcholine), PEs (Phosphatidylethanolamine) and TGs (triacylglycerols)) increased significantly in MT group after trauma and in in both groups after treatment (p<0.05). Almost all sub groups of lipids in MT and PT showed significant decrease 6 hours post trauma.
Our results clearly suggests that intravasal lipid composition was significantly changed after trauma and treatment with intramedullary reaming and nailing. Corresponding factors might be the posttraumatic intravasation of lipids from bone marrow, a response to posttraumatic cytokine storm or the onset of a hypermetabolic state. Individual pathways have yet to be investigated and collation with clinical data is needed.
