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Lang E, Abdou H, Edwards J, Patel N, Morrison JJ. State-of-the-Art Review: Sex Hormone Therapy in Trauma-Hemorrhage. Shock 2022; 57:317-326. [PMID: 34618728 DOI: 10.1097/shk.0000000000001871] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
ABSTRACT Trauma-hemorrhage is the leading cause of prehospital and early in-hospital deaths, while also significantly contributing to the later development of multisystem organ dysfunction/failure and sepsis. Common and advanced resuscitative methods would potentially demonstrate benefits in the prehospital setting; however, they face a variety of barriers to application and implementation. Thus, a dialogue around a novel adjunct has arisen, sex hormone therapy. Proposed candidates include estradiol and its derivatives, metoclopramide hydrochloride/prolactin, dehydroepiandrosterone, and flutamide; with each having demonstrated a range of salutary effects in several animal model studies. Several retrospective analyses have observed a gender-based dimorphism in mortality following trauma-hemorrhage, thus suggesting that estrogens contribute to this pattern. Trauma-hemorrhage animal models have shown estrogens offer protective effects to the cardiovascular, pulmonary, hepatic, gastrointestinal, and immune systems. Additionally, a series of survival studies utilizing 17α-ethinylestradiol-3-sulfate, a potent, water-soluble synthetic estrogen, have demonstrated a significant survival benefit and beneficial effects on cardiovascular function. This review presents the findings of retrospective clinical studies, preclinical animal studies, and discusses how and why 17α-ethinylestradiol-3-sulfate should be considered for investigation within a prospective clinical trial.
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Affiliation(s)
- Eric Lang
- R Adams Cowley Shock Trauma Center, University of Maryland Medical System, Baltimore, Maryland
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Coleman JR, Moore EE, Kelher MR, Samuels JM, Cohen MJ, Sauaia A, Banerjee A, Silliman CC, Peltz E. Female platelets have distinct functional activity compared with male platelets: Implications in transfusion practice and treatment of trauma-induced coagulopathy. J Trauma Acute Care Surg 2019; 87:1052-1060. [PMID: 31162329 PMCID: PMC6814522 DOI: 10.1097/ta.0000000000002398] [Citation(s) in RCA: 26] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
BACKGROUND Females are hypercoagulable and have survival benefit in trauma-induced coagulopathy (TIC). The mechanism for this sex-specific hypercoagulability is unknown. Platelets and platelet function are central in providing hemostatic potential and are the largest contributor to clot strength. Ligands (adenosine diphosphate [ADP] and platelet-activating factor [PAF]) bind distinct platelet receptors to potentiate activation and aggregation. We hypothesize that female platelets have a differential response to ADP and PAF, resulting in greater aggregation and activation compared to males, and that estradiol pretreatment of male or female platelets enhances this activity. METHODS Platelets were collected from healthy volunteers: premenopausal/postmenopausal females (≤54 years, >54 years) and similarly aged males. Platelet aggregometry and flow cytometry (fibrinogen binding capacity) were examined. After treatment with ADP or PAF, platelet aggregation was assessed with Chronolog and activation assessed by CD41 receptor surface expression using flow cytometry. Aggregation and activation were again assessed after platelet pretreatment with estradiol. RESULTS Healthy volunteers included 12 premenopausal and 13 postmenopausal females and 18 similarly aged males. Female platelets (combined premenopausal and postmenopausal) had increased aggregation with ADP stimulation, as compared to male platelets. Male and female platelets had differential fibrinogen receptor expression, with female platelets (combined premenopausal and postmenopausal) demonstrating robust activation with ADP versus male platelets with PAF. In the presence of estradiol incubation, male platelets' activation with PAF approximated that of females (combined premenopausal and postmenopausal) and activation with PAF was enhanced in both male and female platelets. CONCLUSION Male and female platelets have differential response to stimuli, suggesting sex-dependent signaling and cellular activation. Female platelets have both increased aggregation and activation potential, and estradiol pretreatment feminizes male platelets to approximate female platelet activation with PAF. These findings offer potential explanation for sex-based differences in hemostatic potential in TIC and question whether donor sex of transfused platelets should be considered in resuscitation. Estradiol may also serve as a novel therapeutic adjunct in TIC.
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Affiliation(s)
- Julia R Coleman
- University of Colorado-Denver, Department of Surgery, 12605 E 16th Ave, Aurora, CO 80045
| | - Ernest E Moore
- Ernest E Moore Shock Trauma Center at Denver Health, Department of Surgery, 777 Bannock St, Denver, CO 80204
| | - Marguerite R Kelher
- University of Colorado-Denver, Department of Surgery, 12605 E 16th Ave, Aurora, CO 80045
- Vitalant Research Institute-Denver, 717 Yosemite St, Denver, CO 80230
| | - Jason M Samuels
- University of Colorado-Denver, Department of Surgery, 12605 E 16th Ave, Aurora, CO 80045
| | - Mitchell J Cohen
- Ernest E Moore Shock Trauma Center at Denver Health, Department of Surgery, 777 Bannock St, Denver, CO 80204
| | - Angela Sauaia
- University of Colorado-Denver, Department of Surgery, 12605 E 16th Ave, Aurora, CO 80045
| | - Anirban Banerjee
- University of Colorado-Denver, Department of Surgery, 12605 E 16th Ave, Aurora, CO 80045
| | - Christopher C Silliman
- University of Colorado-Denver, Department of Surgery, 12605 E 16th Ave, Aurora, CO 80045
- Vitalant Research Institute-Denver, 717 Yosemite St, Denver, CO 80230
| | - Erik Peltz
- University of Colorado-Denver, Department of Surgery, 12605 E 16th Ave, Aurora, CO 80045
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Red blood cells in hemorrhagic shock: a critical role for glutaminolysis in fueling alanine transamination in rats. Blood Adv 2017; 1:1296-1305. [PMID: 29296771 DOI: 10.1182/bloodadvances.2017007187] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2017] [Accepted: 06/02/2017] [Indexed: 02/06/2023] Open
Abstract
Red blood cells (RBCs) are the most abundant host cell in the human body and play a critical role in oxygen transport and systemic metabolic homeostasis. Hypoxic metabolic reprogramming of RBCs in response to high-altitude hypoxia or anaerobic storage in the blood bank has been extensively described. However, little is known about the RBC metabolism following hemorrhagic shock (HS), the most common preventable cause of death in trauma, the global leading cause of total life-years lost. Metabolomics analyses were performed through ultra-high pressure liquid chromatography-mass spectrometry on RBCs from Sprague-Dawley rats undergoing HS (mean arterial pressure [MAP], <30 mm Hg) in comparison with sham rats (MAP, >80 mm Hg). Steady-state measurements were accompanied by metabolic flux analysis upon tracing of in vivo-injected 13C15N-glutamine or inhibition of glutaminolysis using the anticancer drug CB-839. RBC metabolic phenotypes recapitulated the systemic metabolic reprogramming observed in plasma from the same rodent model. Results indicate that shock RBCs rely on glutamine to fuel glutathione (GSH) synthesis and pyruvate transamination, whereas abrogation of glutaminolysis conferred early mortality and exacerbated lactic acidosis and systemic accumulation of succinate, a predictor of mortality in the military and civilian critically ill populations. Glutamine is here identified as an essential amine group donor in HS RBCs, plasma, liver, and lungs, providing additional rationale for the central role glutaminolysis plays in metabolic reprogramming and survival following severe hemorrhage.
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Doucet D, Badami C, Palange D, Bonitz RP, Lu Q, Xu DZ, Kannan KB, Colorado I, Feinman R, Deitch EA. Estrogen receptor hormone agonists limit trauma hemorrhage shock-induced gut and lung injury in rats. PLoS One 2010; 5:e9421. [PMID: 20195535 PMCID: PMC2828476 DOI: 10.1371/journal.pone.0009421] [Citation(s) in RCA: 48] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2009] [Accepted: 02/01/2010] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Acute lung injury (ALI) and the development of the multiple organ dysfunction syndrome (MODS) is a major cause of death in trauma patients. Earlier studies in trauma hemorrhagic shock (T/HS) have documented that splanchnic ischemia leading to gut inflammation and loss of barrier function is an initial triggering event that leads to gut-induced ARDS and MODS. Since sex hormones have been shown to modulate the response to T/HS and proestrous (PE) females are more resistant to T/HS-induced gut and distant organ injury, the goal of our study was to determine the contribution of estrogen receptor (ER)alpha and ERbeta in modulating the protective response of female rats to T/HS-induced gut and lung injury. METHODS/PRINCIPAL FINDINGS The incidence of gut and lung injury was assessed in PE and ovariectomized (OVX) female rats subjected to T/HS or trauma sham shock (T/SS) as well as OVX rats that were administered estradiol (E2) or agonists for ERalpha or ERbeta immediately prior to resuscitation. Marked gut and lung injury was observed in OVX rats subjected to T/HS as compared to PE rats or E2-treated OVX rats subjected to T/HS. Both ERalpha and ERbeta agonists were equally effective in limiting T/HS-induced morphologic villous injury and bacterial translocation, whereas the ERbeta agonist was more effective than the ERalpha agonist in limiting T/HS-induced lung injury as determined by histology, Evan's blue lung permeability, bronchoalevolar fluid/plasma protein ratio and myeloperoxidase levels. Similarly, treatment with either E2 or the ERbeta agonist attenuated the induction of the intestinal iNOS response in OVX rats subjected to T/HS whereas the ERalpha agonist was only partially protective. CONCLUSIONS/SIGNIFICANCE Our study demonstrates that estrogen attenuates T/HS-induced gut and lung injury and that its protective effects are mediated by the activation of ERalpha, ERbeta or both receptors.
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Affiliation(s)
- Danielle Doucet
- Department of Surgery, University of Medicine & Dentistry of New Jersey (UMDNJ)-New Jersey Medical School, Newark, New Jersey, United States of America
| | - Chirag Badami
- Department of Surgery, University of Medicine & Dentistry of New Jersey (UMDNJ)-New Jersey Medical School, Newark, New Jersey, United States of America
| | - David Palange
- Department of Surgery, University of Medicine & Dentistry of New Jersey (UMDNJ)-New Jersey Medical School, Newark, New Jersey, United States of America
| | - R. Paul Bonitz
- Department of Surgery, University of Medicine & Dentistry of New Jersey (UMDNJ)-New Jersey Medical School, Newark, New Jersey, United States of America
| | - Qi Lu
- Department of Surgery, University of Medicine & Dentistry of New Jersey (UMDNJ)-New Jersey Medical School, Newark, New Jersey, United States of America
| | - Da-Zhong Xu
- Department of Surgery, University of Medicine & Dentistry of New Jersey (UMDNJ)-New Jersey Medical School, Newark, New Jersey, United States of America
| | - Kolenkode B. Kannan
- Department of Surgery, University of Medicine & Dentistry of New Jersey (UMDNJ)-New Jersey Medical School, Newark, New Jersey, United States of America
| | - Iriana Colorado
- Department of Surgery, University of Medicine & Dentistry of New Jersey (UMDNJ)-New Jersey Medical School, Newark, New Jersey, United States of America
| | - Rena Feinman
- Department of Surgery, University of Medicine & Dentistry of New Jersey (UMDNJ)-New Jersey Medical School, Newark, New Jersey, United States of America
| | - Edwin A. Deitch
- Department of Surgery, University of Medicine & Dentistry of New Jersey (UMDNJ)-New Jersey Medical School, Newark, New Jersey, United States of America
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Estrogenic hormone modulation abrogates changes in red blood cell deformability and neutrophil activation in trauma hemorrhagic shock. ACTA ACUST UNITED AC 2010; 68:35-41. [PMID: 20065755 DOI: 10.1097/ta.0b013e3181bbbddb] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND Decreased red blood cell (RBC) deformability and activation of neutrophils (polymorphonuclear leukocytes [PMN]) after trauma-hemorrhagic shock (T/HS) have been implicated in the development of multiple organ dysfunction. Experimentally, female animals seemed to be protected from the effects of T/HS, at least in part, because of elevated estrogen levels. Thus, we examined the relative role of estrogen receptor (ER)-alpha and -beta in this protective response. METHODS To accomplish this goal, RBC deformability and neutrophil respiratory burst activity were measured in several groups of hormonally intact or ovariectomized (OVX) female rats subjected to T/HS (laparotomy plus hemorrhage to an MAP of 30 mm Hg to 35 mm Hg for 90 minutes) or trauma-sham shock (T/SS) and 3 hours of reperfusion. These groups included rats receiving vehicle, estradiol, or either an ER-alpha agonist or an ER-beta agonist administered at the end of the shock period just before volume resuscitation. RESULTS RBC deformability and neutrophil activation were similar among all the T/SS groups and were not different from that observed in the non-OVX female rats subjected to T/HS. In contrast, RBC deformability was reduced and neutrophil activation was increased in the OVX, T/HS female rats as compared with the T/SS groups or the non-OVX, T/HS rats. The administration of estrogen to the T/HS, OVX rats returned RBC and neutrophil function to normal. Both the ER-alpha and -beta agonist partially, but not completely, protected the OVX rats from T/HS-induced loss of RBC deformability, whereas only the ER-beta agonist prevented the increase in neutrophil activation. CONCLUSIONS The protective effects of estrogen on T/HS-induced RBC deformability are mediated, at least in part, via activation of both ER-alpha and -beta, whereas ER-beta activation is involved in limiting T/HS-induced neutrophil activation.
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Deitch EA, Xu DZ, Lu Q. Gut lymph hypothesis of early shock and trauma-induced multiple organ dysfunction syndrome: A new look at gut origin sepsis. ACTA ACUST UNITED AC 2009. [DOI: 10.1080/17471060600551772] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
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Trauma-hemorrhagic shock-induced red blood cell damage leads to decreased microcirculatory blood flow*. Crit Care Med 2009; 37:1000-10. [DOI: 10.1097/ccm.0b013e3181962d39] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
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Use of a pediatric cohort to examine gender and sex hormone influences on outcome after trauma. ACTA ACUST UNITED AC 2008; 63:1127-31. [PMID: 17993961 DOI: 10.1097/ta.0b013e318154c1b8] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
BACKGROUND Animal studies suggest that female gender imparts a protective effect on outcome after trauma, and implicate sex hormones as the cause. Human studies have yielded mixed results. These results are confounded by postmenopausal hormone replacement and the difficulty of controlling for pretrauma comorbidities. The pediatric population is a better model to determine the impact of gender and sex hormones on outcome after trauma. METHODS The National Trauma Data Bank was queried for all patients from birth to 20 years of age. Age, gender, Injury Severity Score (ISS), mechanism of injury, mortality, intensive care unit days, and ventilator days were examined. To control for the effect of sex hormones, patients were divided into three groups by age: prepubertal (birth to 8 years), peripubertal (8.1-14.5 years), and postpubertal (14.6-20 years). We calculated survival rates for age group ISS subsets overall and by mechanism of injury. RESULTS The prepubertal and peripubertal age groups had equivalent survival rates between genders across all severities of injury. The sex hormone-containing postpubertal cohort had a significantly improved survival rate for women across all ISS subgroups, and the effect was more pronounced with increasing ISS. This effect was despite a higher mean ISS for women at these greater magnitudes of injury. The cause of this effect could not be explained by mechanism of injury, ventilator days, or intensive care unit days. CONCLUSION Female gender was associated with improved survival rates for patients demonstrating sex hormone production (i.e. postpubescent patients) in a manner that was directly proportional to their severity of injury. No protective effect of gender was seen in the prepubescent or peripubertal age groups.
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Deitch EA, Feketeova E, Lu Q, Zaets S, Berezina TL, Machiedo GW, Hauser CJ, Livingston DH, Xu DZ. RESISTANCE OF THE FEMALE, AS OPPOSED TO THE MALE, INTESTINE TO I/R-MEDIATED INJURY IS ASSOCIATED WITH INCREASED RESISTANCE TO GUT-INDUCED DISTANT ORGAN INJURY. Shock 2008; 29:78-83. [PMID: 17666951 DOI: 10.1097/shk.0b013e318063e98a] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
We tested the hypothesis that the female intestine is more resistant to gut I/R injury than the male intestine by comparing the effects of the isolated pure gut I/R superior mesenteric artery occlusion (SMAO) model on gut morphology and whether SMAO-induced distant organ injury (lung, bone marrow [BM], neutrophils, and red blood cells [RBCs]) would differ between male and proestrus female rats. At 6 or 24 h after SMAO or sham SMAO, gut injury, lung permeability, pulmonary neutrophil sequestration, RBC deformability, and BM RBC and white blood cell progenitor growth were measured, as was the ability of the plasma from these rats to activate naive rat neutrophils. At both 6 and 24 h after SMAO, the female rats had significantly less intestinal injury and reduced gut-induced lung injury, BM suppression, RBC dysfunction, and neutrophil activation than male rats subjected to SMAO. These results indicate that the resistance of proestrus female rats to gut injury and gut-induced distant organ injury is greater than that observed in male rats.
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Affiliation(s)
- Edwin A Deitch
- Department of Surgery, New Jersey Medical School, UMDNJ, Newark, NJ 07103, USA.
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Sifri ZC, Cohen D, Ananthakrishnan P, Wang L, Kaiser VL, Mohr AM, Hauser CJ, Rameshwar P, Deitch EA, Livingston DH. Sex hormones affect bone marrow dysfunction after trauma and hemorrhagic shock. Crit Care Med 2007; 35:864-9. [PMID: 17255869 DOI: 10.1097/01.ccm.0000256839.50053.1d] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVE Bone marrow (BM) dysfunction after trauma and hemorrhagic shock (T/HS) results in a decrease in clonogenic growth of BM progenitors through a plasma-mediated process. Although sex hormones have been shown to modulate some end-organ injury after shock, post-T/HS BM dysfunction has only been studied in male animals. Therefore, the present study examines the effects of sex hormones on post-T/HS BM dysfunction by measuring clonogenic growth of BM progenitors in castrated male rats and in ovariectomized and proestrus female rats. DESIGN Laboratory experiment. SETTING University surgical research laboratory. SUBJECT Castrated and noncastrated male and ovariectomized and proestrus female Sprague-Dawley rats. INTERVENTION All rats were subjected to either T/HS or sham shock with laparotomy (n = 3-5 per group). At 3 hrs after resuscitation, the rats were killed and plasma and BM mononuclear cells from bilateral femurs were harvested. MEASUREMENTS AND MAIN RESULTS BM mononuclear cells were cultured for erythroid burst-forming unit and granulocyte-macrophage colony-forming unit colonies to assess the extent of progenitor BM dysfunction. BM from noncastrated male rats subjected to T/HS demonstrated a significant decrease in granulocyte-macrophage colony-forming unit and erythroid burst-forming unit colony formation compared with BM of all the sham shock groups and with the castrated male and both female rat groups subjected to T/HS. In addition, plasma from noncastrated shocked male rats incubated in vitro with BM cells from unmanipulated male rats caused a significant suppression of BM granulocyte-macrophage colony-forming unit and erythroid burst-forming unit colonies compared with plasma from castrated rats subjected to either sham shock with laparotomy or T/HS. CONCLUSION The profound BM dysfunction observed in noncastrated male rats after T/HS is not observed in proestrus female rats and castrated male rats. In addition, the in vitro plasma-mediated BM suppression present in male rats after T/HS is also lost in castrated male rats. Sex hormones seem to play a significant role in BM dysfunction after T/HS.
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Affiliation(s)
- Ziad C Sifri
- Division of Trauma, Department of Surgery, New Jersey Medical School, Newark, NJ, USA
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Krausz MM, Semenikhina L, Hirsh M. Lactated Ringer’s Solution and Hypertonic Saline Improve Survival in Uncontrolled Hemorrhagic Shock in Female Rats in Metestrus. J Surg Res 2006; 132:23-31. [PMID: 16256136 DOI: 10.1016/j.jss.2005.08.029] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2005] [Revised: 07/27/2005] [Accepted: 08/30/2005] [Indexed: 11/16/2022]
Abstract
BACKGROUND In the present investigation the effect of fluid treatment in uncontrolled hemorrhagic shock after massive splenic injury (MSI) was comparatively studied in male and female rats. MATERIALS AND METHODS The anesthetized animals were randomly divided into three groups: in group 1 MSI was induced in males, in group 2 MSI was induced in females in proestrus, in group 3 MSI was induced in females in metestrus. Each group was divided into four subgroups: a) Sham-operated, b) MSI untreated (UT), c) MSI treated with 40 ml/kg lactated Ringer's solution (RL), and d) MSI treated with 5 ml/kg NaCl 7.5% (HTS). RESULTS Total blood loss (TBL) in groups 1b, 2b, and 3b was 31.7 +/- 3.6%, 33.1 +/- 2.6%, and 36.7 +/- 2.6%, respectively, and mean survival time (MST) was 143.7 +/- 25.3 min, 174.8 +/- 10.4 min, and 67.8 +/- 11.4 min (P < 0.01 versus group 2b), respectively. TBL in groups 1c, 2c, and 3c increased to 52.4 +/- 5.5% (P < 0.02 versus UT), 48.6 +/- 1.6% (P < 0.02 versus UT), and 48.8 +/- 4.1% (P < 0.02 versus UT), respectively, and MST decreased to 126 +/- 19.4 min, (P < 0.05 versus UT), and 136.8 +/- 13.0 min (P < 0.05 versus UT) in groups 1c and 2c, respectively, and increased in group 3c to 120.4 +/- 23.3 min (P < 0.05 versus UT). TBL in groups 1d, 2d, and 3d was 31.3 +/- 4.8%, 38.0 +/- 4.2%, and 40.6 +/- 3.7%, respectively, and MST increased to 198.5 +/- 13.9 min (P < 0.05 versus UT) in group 1d, decreased to 128.4 +/- 17.2 min (P < 0.01) in group 2d, and increased to 102.6 +/- 19.0 min (P < 0.002 versus group 1d) in group 3d. CONCLUSIONS RL infusion significantly increased blood loss in all three groups, reduced survival time in males and female rats in proestrus, but significantly improved survival in females in metestrus. HTS treatment did not alter blood loss in all three groups, but significantly improved survival in females in metestrus and males.
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Affiliation(s)
- Michael M Krausz
- Department of Surgery A and the Laboratory for Shock and Trauma Research, Rambam Medical Center, 31096 Haifa, Israel
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Zaets SB, Berezina TL, Xu DZ, Lu Q, Ricci J, Cohen D, Ananthakrishnan P, Deitch EA, Machiedo GW. Burn-induced red blood cell deformability and shape changes are modulated by sex hormones. Am J Surg 2003; 186:540-6. [PMID: 14599622 DOI: 10.1016/j.amjsurg.2003.07.022] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Abstract
BACKGROUND Burns are known to cause changes in red blood cell (RBC) deformability and resting shape. However, it is unclear whether sex and sex hormones can influence the severity of these alterations. METHODS Red blood cell deformability and shape were examined in proestrus and diestrus female rats, ovariectomized female rats, as well as castrated and non-castrated male rats (6 animals per group) subjected to scald burn. Red blood cell deformability was measured by laser ektacytometry and erythrocyte shape was evaluated by scanning electron microscopy. RESULTS Burn-induced RBC deformability changes (decrease in elongation index) and shape alterations (increase in the percentage of reversibly and irreversibly changed cells) were less severe in proestrus females than in diestrus females or males. Ovariectomized rats demonstrated more severe RBC changes than non-ovariectomized ones. The degree of RBC damage was the same in castrated and non-castrated males. CONCLUSIONS Removal of female sex hormones increases the severity of burn-induced RBC, indicating that female sex hormones protect against burn-induced RBC dysfunction. In contrast, male sex hormones do not appear to modulate burn-induced RBC dysfunction.
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Affiliation(s)
- Sergey B Zaets
- Department of Surgery, MSB G-507, UMDNJ-New Jersey Medical School, 185 South Orange Avenue, Newark, NJ 07107, USA.
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