Limits...
Exposure to 100% Oxygen Abolishes the Impairment of Fracture Healing after Thoracic Trauma.

Kemmler J, Bindl R, McCook O, Wagner F, Gröger M, Wagner K, Scheuerle A, Radermacher P, Ignatius A - PLoS ONE (2015)

Bottom Line: Inflammatory cytokines and markers of oxidative/nitrosative stress were measured in plasma, lung and fracture hematoma.Short-term exposure to 100% oxygen in the acute post-traumatic phase significantly attenuated systemic and local inflammatory responses and improved fracture healing without provoking toxic side effects, suggesting that hyperoxia could induce anti-inflammatory and pro-regenerative effects after severe injury.These results suggest that breathing of 100% oxygen in the acute post-traumatic phase might reduce the risk of poorly healing fractures in severely injured patients.

View Article: PubMed Central - PubMed

Affiliation: Institute of Orthopaedic Research and Biomechanics, Center of Musculoskeletal Research, University of Ulm, Ulm, Germany.

ABSTRACT
In polytrauma patients a thoracic trauma is one of the most critical injuries and an important trigger of post-traumatic inflammation. About 50% of patients with thoracic trauma are additionally affected by bone fractures. The risk for fracture malunion is considerably increased in such patients, the pathomechanisms being poorly understood. Thoracic trauma causes regional alveolar hypoxia and, subsequently, hypoxemia, which in turn triggers local and systemic inflammation. Therefore, we aimed to unravel the role of oxygen in impaired bone regeneration after thoracic trauma. We hypothesized that short-term breathing of 100% oxygen in the early post-traumatic phase ameliorates inflammation and improves bone regeneration. Mice underwent a femur osteotomy alone or combined with blunt chest trauma 100% oxygen was administered immediately after trauma for two separate 3 hour intervals. Arterial blood gas tensions, microcirculatory perfusion and oxygenation were assessed at 3, 9 and 24 hours after injury. Inflammatory cytokines and markers of oxidative/nitrosative stress were measured in plasma, lung and fracture hematoma. Bone healing was assessed on day 7, 14 and 21. Thoracic trauma induced pulmonary and systemic inflammation and impaired bone healing. Short-term exposure to 100% oxygen in the acute post-traumatic phase significantly attenuated systemic and local inflammatory responses and improved fracture healing without provoking toxic side effects, suggesting that hyperoxia could induce anti-inflammatory and pro-regenerative effects after severe injury. These results suggest that breathing of 100% oxygen in the acute post-traumatic phase might reduce the risk of poorly healing fractures in severely injured patients.

No MeSH data available.


Related in: MedlinePlus

Immunohistological stainings of fractured femurs for markers of inflammation, nitrosative stress and vascularization.Left panels are representative slides of mice with isolated fracture, middle panels of animals with additional TXT, and right panels of mice with fracture, TXT and O2 treatment. Images indicate cortical bone proximal to the fracture gap and periosteal callus, macrophage staining show the marrow cavity. (A-C) Neutrophil staining 3 days post-injury, (D-F) macrophage staining on day 7, (G-L) IL-6 and IL-10 staining on day 7, and (M-R) nitrotyrosine and PECAM-1 staining on day 14. Scale bars: 100 μm.
© Copyright Policy
Related In: Results  -  Collection

License
getmorefigures.php?uid=PMC4492600&req=5

pone.0131194.g004: Immunohistological stainings of fractured femurs for markers of inflammation, nitrosative stress and vascularization.Left panels are representative slides of mice with isolated fracture, middle panels of animals with additional TXT, and right panels of mice with fracture, TXT and O2 treatment. Images indicate cortical bone proximal to the fracture gap and periosteal callus, macrophage staining show the marrow cavity. (A-C) Neutrophil staining 3 days post-injury, (D-F) macrophage staining on day 7, (G-L) IL-6 and IL-10 staining on day 7, and (M-R) nitrotyrosine and PECAM-1 staining on day 14. Scale bars: 100 μm.

Mentions: Histomorphometry showed delayed endochondral ossification at 14 days in the normoxia thoracic trauma group, demonstrated in larger amounts of cartilage (Fig 3A and 3D; S1 Fig). After 21 days we did not detect histological intergroup differences in the amounts of cartilage or bone anymore (Fig 3B). Fracture calli were additionally analysed by immunohistochemistry on days 1, 3, 7 and 14 (Fig 4). In all groups, neutrophils were mainly found on day 1 and 3, while on day 7 their number had markedly decreased. After 3 days neutrophil numbers were increased in mice with thoracic trauma (Fig 4A and 4B). Thoracic trauma did not affect macrophage infiltration on day 3, high numbers were found in the marrow cavity on day 7, with no effect of chest trauma (Fig 4D and 4E). Positive IL-6 and IL-10 staining was evident on day 1, 3 and 7 without intergroup differences (Fig 4G–4L). Nitrotyrosine and PECAM-1 stainings examined on days 1, 7 and 14 did not show any intergroup differences either (Fig 4M–4R).


Exposure to 100% Oxygen Abolishes the Impairment of Fracture Healing after Thoracic Trauma.

Kemmler J, Bindl R, McCook O, Wagner F, Gröger M, Wagner K, Scheuerle A, Radermacher P, Ignatius A - PLoS ONE (2015)

Immunohistological stainings of fractured femurs for markers of inflammation, nitrosative stress and vascularization.Left panels are representative slides of mice with isolated fracture, middle panels of animals with additional TXT, and right panels of mice with fracture, TXT and O2 treatment. Images indicate cortical bone proximal to the fracture gap and periosteal callus, macrophage staining show the marrow cavity. (A-C) Neutrophil staining 3 days post-injury, (D-F) macrophage staining on day 7, (G-L) IL-6 and IL-10 staining on day 7, and (M-R) nitrotyrosine and PECAM-1 staining on day 14. Scale bars: 100 μm.
© Copyright Policy
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4492600&req=5

pone.0131194.g004: Immunohistological stainings of fractured femurs for markers of inflammation, nitrosative stress and vascularization.Left panels are representative slides of mice with isolated fracture, middle panels of animals with additional TXT, and right panels of mice with fracture, TXT and O2 treatment. Images indicate cortical bone proximal to the fracture gap and periosteal callus, macrophage staining show the marrow cavity. (A-C) Neutrophil staining 3 days post-injury, (D-F) macrophage staining on day 7, (G-L) IL-6 and IL-10 staining on day 7, and (M-R) nitrotyrosine and PECAM-1 staining on day 14. Scale bars: 100 μm.
Mentions: Histomorphometry showed delayed endochondral ossification at 14 days in the normoxia thoracic trauma group, demonstrated in larger amounts of cartilage (Fig 3A and 3D; S1 Fig). After 21 days we did not detect histological intergroup differences in the amounts of cartilage or bone anymore (Fig 3B). Fracture calli were additionally analysed by immunohistochemistry on days 1, 3, 7 and 14 (Fig 4). In all groups, neutrophils were mainly found on day 1 and 3, while on day 7 their number had markedly decreased. After 3 days neutrophil numbers were increased in mice with thoracic trauma (Fig 4A and 4B). Thoracic trauma did not affect macrophage infiltration on day 3, high numbers were found in the marrow cavity on day 7, with no effect of chest trauma (Fig 4D and 4E). Positive IL-6 and IL-10 staining was evident on day 1, 3 and 7 without intergroup differences (Fig 4G–4L). Nitrotyrosine and PECAM-1 stainings examined on days 1, 7 and 14 did not show any intergroup differences either (Fig 4M–4R).

Bottom Line: Inflammatory cytokines and markers of oxidative/nitrosative stress were measured in plasma, lung and fracture hematoma.Short-term exposure to 100% oxygen in the acute post-traumatic phase significantly attenuated systemic and local inflammatory responses and improved fracture healing without provoking toxic side effects, suggesting that hyperoxia could induce anti-inflammatory and pro-regenerative effects after severe injury.These results suggest that breathing of 100% oxygen in the acute post-traumatic phase might reduce the risk of poorly healing fractures in severely injured patients.

View Article: PubMed Central - PubMed

Affiliation: Institute of Orthopaedic Research and Biomechanics, Center of Musculoskeletal Research, University of Ulm, Ulm, Germany.

ABSTRACT
In polytrauma patients a thoracic trauma is one of the most critical injuries and an important trigger of post-traumatic inflammation. About 50% of patients with thoracic trauma are additionally affected by bone fractures. The risk for fracture malunion is considerably increased in such patients, the pathomechanisms being poorly understood. Thoracic trauma causes regional alveolar hypoxia and, subsequently, hypoxemia, which in turn triggers local and systemic inflammation. Therefore, we aimed to unravel the role of oxygen in impaired bone regeneration after thoracic trauma. We hypothesized that short-term breathing of 100% oxygen in the early post-traumatic phase ameliorates inflammation and improves bone regeneration. Mice underwent a femur osteotomy alone or combined with blunt chest trauma 100% oxygen was administered immediately after trauma for two separate 3 hour intervals. Arterial blood gas tensions, microcirculatory perfusion and oxygenation were assessed at 3, 9 and 24 hours after injury. Inflammatory cytokines and markers of oxidative/nitrosative stress were measured in plasma, lung and fracture hematoma. Bone healing was assessed on day 7, 14 and 21. Thoracic trauma induced pulmonary and systemic inflammation and impaired bone healing. Short-term exposure to 100% oxygen in the acute post-traumatic phase significantly attenuated systemic and local inflammatory responses and improved fracture healing without provoking toxic side effects, suggesting that hyperoxia could induce anti-inflammatory and pro-regenerative effects after severe injury. These results suggest that breathing of 100% oxygen in the acute post-traumatic phase might reduce the risk of poorly healing fractures in severely injured patients.

No MeSH data available.


Related in: MedlinePlus