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Vester H, Huber-Lang MS, Kida Q, et al. The immune response after fracture trauma is different in old compared to young patients. Immun Ageing. 2014;11(1):20doi: 10.1186/s12979-014-0020-x.
Vester, H., Huber-Lang, M. S., Kida, Q., Scola, A., van Griensven, M., Gebhard, F., Nüssler, A. K., & Perl, M. (2014). The immune response after fracture trauma is different in old compared to young patients. Immunity & ageing : I & A, 11(1), 20. https://doi.org/10.1186/s12979-014-0020-x
Vester, Helen, et al. "The immune response after fracture trauma is different in old compared to young patients." Immunity & ageing : I & A vol. 11,1 (2014): 20. doi: https://doi.org/10.1186/s12979-014-0020-x
Vester H, Huber-Lang MS, Kida Q, Scola A, van Griensven M, Gebhard F, Nüssler AK, Perl M. The immune response after fracture trauma is different in old compared to young patients. Immun Ageing. 2014 Dec 11;11(1):20. doi: 10.1186/s12979-014-0020-x. eCollection 2014. PMID: 25620994; PMCID: PMC4305233.
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Immun Ageing. 2014 Dec 11;11(1):20. doi: 10.1186/s12979-014-0020-x. eCollection 2014.

The immune response after fracture trauma is different in old compared to young patients.

Immunity & ageing : I & A

Helen Vester, Markus S Huber-Lang, Qerim Kida, Alexander Scola, Martijn van Griensven, Florian Gebhard, Andreas K Nüssler, Mario Perl

Affiliations

  1. Department of Trauma Surgery, Klinikum rechts der Isar, Technical University Munich, Munich, Germany.
  2. Department of Orthopedic Trauma, Hand-, Plastic-, and Reconstructive Surgery, University Hospital Ulm, Ulm, Germany.
  3. Siegfried Weller Institute for Trauma Research, BG Trauma Center Tübingen, Eberhard Karls University Tübingen, Tübingen, Germany.
  4. Department of Orthopedic Trauma, Hand-, Plastic-, and Reconstructive Surgery, University Hospital Ulm, Ulm, Germany ; BG-Trauma Center Murnau, Prof.-Küntscher-Str. 8, 82418 Murnau, Germany.

PMID: 25620994 PMCID: PMC4305233 DOI: 10.1186/s12979-014-0020-x

Abstract

BACKGROUND: Despite significant medical progress and improved treatment, surgical procedures of proximal femur fractures in older patients are still associated with a high postoperative complication and mortality rate. Recently, several authors investigated the phenomenon of immunoageing, indicating differences in the ageing immune system. The aim of the present multi-center prospective clinical trial was to analyze differences in the posttraumatic immune response of old patients compared to young patients.

METHODS: Blood was collected from young patients (<50 y, n = 20) with long bone fractures (YF), old patients (>70 y, n = 21) with proximal femur fractures (OF) upon clinical admission and within 6 hours after surgery, and two healthy age matched control groups (YH & OH). Serum TRAIL- and cytokine concentrations were analyzed via cytometric bead array, Fas-Ligand and TNF-Receptor-I via ELISA. CD15(+) magnetic bead-isolated neutrophils (PMN) were TUNEL stained.

RESULTS: IL-6 was significantly increased only in OF after trauma and surgery whereas YF patient exhibited a marked decrease of TNF after trauma. Interestingly, a significant increase of GM-CSF serum levels was observed in YF only, whereas OF exhibited a decrease of systemic IFN-γ concentrations after trauma and after surgery. The healthy controls, old and young, had more or less similar inflammation levels. Moreover, TRAIL serum levels were diminished in OF after trauma and even further after surgery whereas in YF this was only observed after the surgical procedure. Fas-L concentrations were reduced only in YF after surgery or trauma. PMN apoptosis was significantly reduced only in YF, indicating activation of the innate immune system.

DISCUSSION: In summary, our data suggest that the posttraumatic immune response is differently regulated in old and young trauma patients. The operative procedure further impacts these differences after trauma. Whether the decreased activation of PMNs and phagocytes along with the observed dysregulation of the posttraumatic inflammatory response contributes to the high perioperative mortality rate of the elderly suffering from a proximal femoral fracture requires further investigation.

Keywords: Apoptosis; Immunoageing; Inflammation; Trauma

References

  1. Arch Surg. 1999 Apr;134(4):421-7 - PubMed
  2. J Clin Immunol. 2000 Jul;20(4):229-39 - PubMed
  3. Bone. 1996 Jan;18(1 Suppl):57S-63S - PubMed
  4. J Gerontol A Biol Sci Med Sci. 1997 Jul;52(4):M201-8 - PubMed
  5. Crit Care Med. 2000 Oct;28(10):3441-8 - PubMed
  6. Immunol Cell Biol. 2004 Aug;82(4):415-20 - PubMed
  7. Immunol Rev. 2005 Jun;205:130-46 - PubMed
  8. J Leukoc Biol. 2000 Jan;67(1):40-5 - PubMed
  9. J Transl Med. 2011 Jul 20;9:113 - PubMed
  10. Immun Ageing. 2011 Oct 01;8:8 - PubMed
  11. Arch Intern Med. 2002 Oct 14;162(18):2053-7 - PubMed
  12. J Gerontol A Biol Sci Med Sci. 1997 Mar;52(2):B93-7 - PubMed
  13. Shock. 2012 Jul;38(1):98-106 - PubMed
  14. Invest Ophthalmol Vis Sci. 2013 Aug 07;54(8):5321-31 - PubMed
  15. Age Ageing. 2012 Jan;41(1):86-92 - PubMed
  16. Eur Cytokine Netw. 2002 Oct-Dec;13(4):389-91 - PubMed
  17. Mech Ageing Dev. 2003 Apr;124(4):487-93 - PubMed
  18. JAMA. 2009 Oct 14;302(14):1573-9 - PubMed
  19. Clin Geriatr Med. 2014 May;30(2):175-81 - PubMed
  20. Crit Care Med. 2005 Dec;33(12 Suppl):S526-9 - PubMed
  21. PLoS One. 2013 Dec 12;8(12):e82204 - PubMed
  22. Aging (Albany NY). 2014 Feb;6(2):131-9 - PubMed
  23. Scand J Trauma Resusc Emerg Med. 2014 Mar 03;22:16 - PubMed
  24. Osteoporos Int. 2009 Oct;20(10):1633-50 - PubMed
  25. Vaccine. 2000 Feb 25;18(16):1596-601 - PubMed
  26. Curr Top Cell Regul. 1997;35:107-21 - PubMed
  27. Eur Cytokine Netw. 2002 Oct-Dec;13(4):392-4 - PubMed
  28. Shock. 2007 Dec;28(6):668-674 - PubMed
  29. Clin Exp Immunol. 1999 Nov;118(2):235-41 - PubMed
  30. J Am Coll Surg. 2007 May;204(5):840-52; discussion 852-3 - PubMed
  31. Cytokine. 2013 Mar;61(3):716-9 - PubMed
  32. Trends Immunol. 2011 Feb;32(2):57-65 - PubMed
  33. Am J Pathol. 2005 Dec;167(6):1545-59 - PubMed
  34. Inflamm Res. 2007 Jan;56(1):38-44 - PubMed
  35. Immunol Res. 2004;30(1):81-94 - PubMed
  36. Oxid Med Cell Longev. 2014;2014:819847 - PubMed
  37. Shock. 2003 Apr;19(4):299-304 - PubMed
  38. Aging (Albany NY). 2009 Jul 14;1(7):652-63 - PubMed
  39. Arch Surg. 2000 Mar;135(3):291-5 - PubMed

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