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. 2023 Jul;27(13):1859-1866.
doi: 10.1111/jcmm.17786. Epub 2023 Jun 16.

Elevation of neutrophil-derived factors in patients after multiple trauma

Marie-Therese Lingitz  1 , Gregor Wollner  2 , Jonas Bauer  3 , Hannes Kuehtreiber  3   4 , Michael Mildner  5 , Dragan Copic  6 , Daniel Bormann  3   4 , Martin Direder  2 , Claus Georg Krenn  1 , Thomas Haider  2 , Lukas Leopold Negrin  2 , Hendrik Jan Ankersmit  3   4
Affiliations

Elevation of neutrophil-derived factors in patients after multiple trauma

Marie-Therese Lingitz et al. J Cell Mol Med. 2023 Jul.

Abstract

Trauma represents one of the leading causes of death worldwide. Traumatic injuries elicit a dynamic inflammatory response with systemic release of inflammatory cytokines. Disbalance of this response can lead to systemic inflammatory response syndrome or compensatory anti-inflammatory response syndrome. As neutrophils play a major role in innate immune defence and are crucial in the injury-induced immunological response, we aimed to investigate systemic neutrophil-derived immunomodulators in trauma patients. Therefore, serum levels of neutrophil elastase (NE), myeloperoxidase (MPO) and citrullinated histone H3 (CitH3) were quantified in patients with injury severity scores above 15. Additionally, leukocyte, platelet, fibrinogen and CRP levels were assessed. Lastly, we analysed the association of neutrophil-derived factors with clinical severity scoring systems. Although the release of MPO, NE and CitH3 was not predictive of mortality, we found a remarkable increase in MPO and NE in trauma patients as compared with healthy controls. We also found significantly increased levels of MPO and NE on Days 1 and 5 after initial trauma in critically injured patients. Taken together, our data suggest a role for neutrophil activation in trauma. Targeting exacerbated neutrophil activation might represent a new therapeutic option for critically injured patients.

Keywords: CitH3; MPO; NE; neutrophils; trauma patients.

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Conflict of interest statement

The authors declare no competing interests.

Figures

FIGURE 1
FIGURE 1
Serum levels of markers of neutrophil activation are elevated following trauma. Grouped box plots depicting the changes in serum levels of (A) CitH3, (B) MPO and (C) NE in trauma patients up to 10 days post injury. Healthy volunteers served as controls. Comparison of polytrauma patients and healthy controls, values given as median with IQR, * indicates p < 0.05 ** indicates p < 0.01, *** indicates p < 0.001.
FIGURE 2
FIGURE 2
Grouped box plots depicting the changes in serum levels of (A) CitH3, (B) MPO and (C) NE in survivors and nonsurvivors up to 10 days post injury. Comparison of surviving and nonsurviving polytrauma patients; values given as median with IQR.
FIGURE 3
FIGURE 3
Grouped box plots depicting the changes in serum levels of (A) thrombocytes, (B) leukocytes, (C) CRP and (D) fibrinogen in survivors and up to 10 days post injury. Values given as median with IQR, * indicates p < 0.05.
FIGURE 4
FIGURE 4
Serum levels of markers of neutrophil activation are elevated in severely injured patients. Box plots depicting the changes in serum levels of (A) CitH3, (B) MPO and (C) NE in moderately and severely injured trauma patients up to 10 days post injury. Values given as median with IQR, * indicates p < 0.05.
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