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Impact of monocytic cytokines in polytrauma patients with orthopedics injures
Affiliation:1. Department of Orthopaedics, Jai Prakash Narayan Apex Trauma Centre, All India Institute of Medical Sciences, New Delhi, 110029, India;2. Department of Laboratory Medicine, Jai Prakash Narayan Apex Trauma Centre, All India Institute of Medical Sciences, New Delhi, 110029, India;3. Department of Neuroanesthesia, Jai Prakash Narayan Apex Trauma Centre, All India Institute of Medical Sciences, New Delhi, 110029, India;1. Department of Orthopaedics, Indraprastha Apollo Hospital, New Delhi, India;2. Department of Orthopaedics, All India Institute of Medical Sciences (AIIMS), New Delhi, India;3. Department of Orthopaedics, Post Graduate Institute of Medical Education and Research (PGIMER), Chandigarh, India;4. Department of Pediatric Surgery, Post Graduate Institute of Medical Education and Research (PGIMER), Chandigarh, India;5. Department of Pediatrics, Indraprastha Apollo Hospital, New Delhi, India;1. Department of Orthopaedics, Nizam’s Institute of Medical sciences, Punjagutta, Hyderabad, Telangana 500082, India;2. Department of Biochemistry, Nizam’s Institute of Medical sciences, Punjagutta, Hyderabad, Telangana 500082, India;3. Department of Radiology, Nizam’s Institute of Medical sciences, Punjagutta, Hyderabad, Telangana 500082, India
Abstract:ObjectiveOrthopedic injuries are a growing epidemic affecting predominantly, the young population, after trauma. Polytrauma patients with a femoral fracture and with Injury Severity Score of >15 are of special concern because of complications like Systemic inflammatory response syndrome (SIRS), Multi-organ dysfunction syndrome (MODS) and sepsis. Against this background. We aimed to assess the role of monocytic cytokines in the development of complications in patients, having isolated diapheseal fracture of femur as compared to those having diapheseal fracture of femur along with ISS score >15.MethodologyPatients were divided into to two groups: in first group, only those patients who had isolated femur fracture were included (named as ‘Group A’). In the second groups patients having femur fracture along with ISS >15 at the time of admission (named as ‘Group B’), were included. The study used flowcytometry based intracellular cytokine assay to circumvent the problem associated with extracellular cytokine assay.Results and ConclusionA total of 20 patients aged between 20 and 55 years, presenting to the emergency department within 24 h of injury were enrolled in Group ‘A’ and ‘B’ as per criteria mentioned above. Intracellular expression of cytokines in isolated femur fracture tends to normalize towards healthy control in the late phase of trauma. Elevated levels of IL-8 and IL-6 levels in late phase (Day 10) of trauma. IL-8 and IL-6 may increases to compensate the higher levels of IL-1β. The effect of cytokines on the severity of injury was observed. This complex action of immune cells and proinflammatory cytokines were seen in initial and later stage of trauma.
Keywords:Femur fracture  Polytrauma  Monocytes  TNF-α  IL-6  IL-8 and IL-1β
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