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A Study on the Change of Autophagy in Monocytes Following Trauma and It’s Relationship with Glycometabolism and Prognosis

Author: YuJian
Tutor: ZhangLianYang
School: Third Military Medical University
Course: Surgery
Keywords: autophagy trauma monocytes glycometabolism prognosis
CLC: R64
Type: Master's thesis
Year: 2009
Downloads: 67
Quote: 2
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Abstract

ObjectiveAutophagy occurs in all types of eukaryotic cells.In response to starvation, cells digest own cytoplasms to pass through crisis, as is called“cell autophagy”biologically. The body was in the state of hypermetabolism and low-synthesis after trauma,appeared as energy insufficient,while the autophagy was obviously enhanced when the cells were starvated,then it would effect the change of organism’s function,at last ,affect the prognosis of the trauma patients. This research aimed to study the change of monocytes’autophay and the relationships among the change of monocytes’autophagy,trauma severity, glycometabolism after trauma and the prognosis,illuminate the level change rule of monocyte’s autophagy in peripheral blood after trauma,thus provide some new cues for the clinical therapy of trauma patients.Methods1. According to the injury severity score (ISS) or abbreviated injury scale (AIS), all the patients were divided into three groups: mild, moderate and severe trauma groups. There were 21 cases in mild trauma group (multiple injury ISS<16 points or AIS=1～2), 19 in moderate trauma group (16≤ISS<25 or AIS=3) and 11 in severe trauma group (ISS≥25 or AIS≥4). The peripheral blood of three groups was collected at days 1, 3, 5 and 10 after trauma. Peripheral blood monouclear cells were harvested by density gradient centrifugation and adherence sepration, then autophagy was observed by laser confocal microscopy and transmission electron microscope.2. Monocytes were lysed by cell lysate (10 mmol/L Tris-HCl,1% Triton X-100 [pH]=7.5]). After MDC staining, the OD value determined by fluorospectrophotometer (the wavelength of excitation light for 380 nm and the wavelength of emission light for 525 nm).3. The blood sugar level was determined at days 1, 3 and 5 after trauma ,and analyzed the dependability of autophagy and blood sugar.4. Recorded the complications such as infection of all patients,and analyzed the dependability of autophagy and prognostics.Results1. The observation under transmission electron microscope confirmed the existence of autophagy in peripheral blood monouclear cells of trauma patients.It appeared as autophagosome in double membrane near by cell nucleus,round or ellipse,embraced cell-substance or cell organelles.2. The laser confocal microscopic observation showed that the counts of monocyte fluor particles in trauma patients was much higher than in healthy people. And the higher severity of injury begot the more fluorescent parricles and the deeper colour.3. Compared with healthy control group, the OD value (reflect the autophagy level) of trauma patients’monocytes in MDC stainging was significantly increased, with a direct ration to trauma severity. In mild trauma group. the autophagy level of monocyte reached peak at the 5th day; in moderate trauma group, the autophagy level of monocyte reached peak at the 3rd day ;while in severe trauma group, the autophagy level of monocyte reached peak in 24 hours after trauma,with significant difference(P<0.05).4. Compared with the healthy group,the blood sugar was increased after trauma, manifested as hyperglycemia after trauma. Scatterplot and correlation analysis between autophagy level of peripheral blood monouclear cells and blood sugar after trauma,showed that the more severity of hyperpglycemia after trauma was, the more the autophagy level increased, with positive correlation between them (P<0.05) .5. In these data of all 51 trauma cases, there was no death in every group and no complication occurred in the minor injury group; there was one case of wound infection in the moderate injury group; there was one case of wound infection and two cases of pulmonary infection in the severe trauma group, but there was no death. The prognosis of minor injury was much better than the moderate injury and severe injury.Conclusions1. The autophagy level of peripheral blood mononuclear cells increased after trauma, and it had a positive correlation with trauma severity.2. The autophagy level of peripheral blood mononuclear cells had a positive correlation with hyperglycemia after trauma,it may have a closely relationship with the complications,such as infections、SIRS、MODS, etc.

A Study on the Change of Autophagy in Monocytes Following Trauma and It’s Relationship with Glycometabolism and Prognosis

Abstract

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