Toll-like receptor activation as a biomarker in traumatically injured patients
dc.contributor.author | Darrabie, Marcus D | |
dc.contributor.author | Cheeseman, Jennifer | |
dc.contributor.author | Limkakeng, Alexander T | |
dc.contributor.author | Borawski, Joseph | |
dc.contributor.author | Sullenger, Bruce A | |
dc.contributor.author | Elster, Eric A | |
dc.contributor.author | Kirk, Allan D | |
dc.contributor.author | Lee, Jaewoo | |
dc.date.accessioned | 2018-08-01T23:14:12Z | |
dc.date.available | 2018-08-01T23:14:12Z | |
dc.date.issued | 2018-11-01 | |
dc.date.updated | 2018-08-01T23:14:11Z | |
dc.description.abstract | © 2018 Elsevier Inc. Background: Surgical insult and trauma have been shown to cause dysregulation of the immune and inflammatory responses. Interaction of damage-associated molecular patterns (DAMPs) with toll-like receptors (TLRs) initiates innate immune response and systemic inflammatory responses. Given that surgical patients produce high levels of circulating damage-associated molecular patterns, we hypothesized that plasma-activated TLR activity would be correlated to injury status and could be used to predict pathological conditions involving tissue injury. Methods: An observational study was performed using samples from a single-institution prospective tissue and data repository from a Level-1 trauma center. In vitro TLR 2, 3, 4, and 9 activation was determined in a TLR reporter assay after isolation of plasma from peripheral blood. We determined correlations between plasma-activated TLR activity and clinical course measures of severity. Results: Eighteen patients were enrolled (median Injury Severity Score 15 [interquartile range 10, 23.5]). Trauma resulted in significant elevation in circulation high mobility group box 1 as well as increase of plasma-activated TLR activation (2.8-5.4-fold) compared to healthy controls. There was no correlation between circulating high mobility group box 1 and trauma morbidity; however, the plasma-activated TLR activity was correlated with acute physiology and chronic health evaluation II scores (R square = 0.24-0.38, P < 0.05). Patients who received blood products demonstrated significant increases in the levels of plasma-activated TLRs 2, 3, 4, and 9 and had a trend toward developing systemic inflammatory response syndrome. Conclusions: Further studies examining TLR modulation and signaling in surgical patients may assist in predictive risk modeling and reduction in morbidity and mortality. | |
dc.identifier.issn | 0022-4804 | |
dc.identifier.issn | 1095-8673 | |
dc.identifier.uri | ||
dc.publisher | Elsevier BV | |
dc.relation.ispartof | Journal of Surgical Research | |
dc.relation.isversionof | 10.1016/j.jss.2018.05.059 | |
dc.title | Toll-like receptor activation as a biomarker in traumatically injured patients | |
dc.type | Journal article | |
duke.contributor.orcid | Limkakeng, Alexander T|0000-0002-9822-5595 | |
duke.contributor.orcid | Kirk, Allan D|0000-0003-2004-5962 | |
duke.contributor.orcid | Lee, Jaewoo|0000-0003-3760-1806 | |
pubs.begin-page | 270 | |
pubs.end-page | 277 | |
pubs.organisational-group | School of Medicine | |
pubs.organisational-group | Duke | |
pubs.organisational-group | Surgery, Emergency Medicine | |
pubs.organisational-group | Surgery | |
pubs.organisational-group | Clinical Science Departments | |
pubs.organisational-group | Duke Cancer Institute | |
pubs.organisational-group | Institutes and Centers | |
pubs.organisational-group | Molecular Genetics and Microbiology | |
pubs.organisational-group | Basic Science Departments | |
pubs.organisational-group | Pharmacology & Cancer Biology | |
pubs.organisational-group | Surgery, Surgical Sciences | |
pubs.organisational-group | Immunology | |
pubs.organisational-group | Pediatrics | |
pubs.organisational-group | Surgery, Abdominal Transplant Surgery | |
pubs.publication-status | Accepted | |
pubs.volume | 231 |
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