To Understand the Genesis Monocytes and Their Subsets in Post Traumaticsepsis

Abstract

Trauma is the 4th leading cause of death and disability in younger population. The diminished functions of cell mediated defence system of trauma patients has been reported as one of primary cause of immunosuppression occurring during septic shock and multiple organ failure (MOF). Traumatic injury leads to activation of inflammatory at the site of injury which is beneficial for the host. However, if there is over activation of inflammatory response that leads to various complications such as sepsis, septic shock and MOF. During inflammation cytokines are produced by different cells of the body Monocytes, Macrophages, Neutrophils, Endothelial cells, DCs and T-cells. However, monocytes are primary cells which secrets ample amounts of cytokines during inflammation and sepsis. Hence, our present study was focused on the genesis and characterization of monocytes and their subsets. For this study, a total of 30 trauma patients with haemorrhage shock were recruited. Venous blood samples was collected on days 1, 7 and 14 for isolation of serum to estimate the cytokines by ELISA and PBMCs was isolated to measure the circulating level of total monocytes and their subsets (Classical, patrolling and inflammatory) monocytes by flowcytometry. The serum level of cytokines, circulation total monocytes and their subsets were correlated with severity scores (ISS and Shock index) of injury in the Emergency Department and with SOFA score in the ICU. We have observed significantly (p<0.05) elevated serum level of TNF-α and IL-10 in THS patients who had developed sepsis as compared to those who did not developed sepsis. Remarkably, we observed THS patients who recovered from sepsis and survived had significant (p<0.05) reduction in serum level of inflammatory cytokines TNF-α.We observed significantly (p<0.05) higher level of patrolling monocytes (CD14lowCD16+) in THS patients who developed septic shock as compared to other who didn’t. Interestingly, we observed patrolling monocytes showed a negative correlation with severity of sepsis in the ICU.iThe circulating level of classical monocytes(CD14high CD16-)was found comparable in post traumatic sepsis patients as compared to the non-sepsis patients.