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European Journal of Trauma and Emergency Surgery
Published in: European Journal of Trauma and Emergency Surgery 6/2022

Open Access 21-05-2022 | Thoracic Trauma | Original Article

Club cell protein (CC)16 as potential lung injury marker in a porcine 72 h polytrauma model

Authors: Johannes Greven, Jan Tilmann Vollrath, Felix Bläsius, Zhizhen He, Eftychios Bolierakis, Klemens Horst, Philipp Störmann, Aleksander J. Nowak, Marija Simic, Ingo Marzi, Frank Hildebrand, Borna Relja

Published in: European Journal of Trauma and Emergency Surgery | Issue 6/2022

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Abstract

Background

Polytrauma and respiratory tract damage after thoracic trauma cause about 25% of mortality among severely injured patients. Thoracic trauma can lead to the development of severe lung complications such as acute respiratory distress syndrome, and is, therefore, of great interest for monitoring in intensive care units (ICU). In recent years, club cell protein (CC)16 with its antioxidant properties has proven to be a potential outcome-related marker. In this study, we evaluated whether CC16 constitutes as a marker of lung damage in a porcine polytrauma model.

Methods

In a 72 h ICU polytrauma pig model (thoracic trauma, tibial fracture, hemorrhagic shock, liver laceration), blood plasma samples (0, 3, 9, 24, 48, 72 h), BAL samples (72 h) and lung tissue (72 h) were collected. The trauma group (PT) was compared to a sham group. CC16 as a possible biomarker for lung injury in this model, and IL-8 concentrations as known indicator for ongoing inflammation during trauma were determined by ELISA. Histological analysis of ZO-1 and determination of total protein content were used to show barrier disruption and edema formation in lung tissue from the trauma group.

Results

Systemic CC16 levels were significantly increased early after polytrauma compared vs. sham. After 72 h, CC16 concentration was significantly increased in lung tissue as well as in BAL in PT vs. sham. Similarly, IL-8 and total protein content in BAL were significantly increased in PT vs. sham. Evaluation of ZO-1 staining showed significantly lower signal intensity for polytrauma.

Conclusion

The data confirm for the first time in a larger animal polytrauma model that lung damage was indicated by systemic and/or local CC16 response. Thus, early plasma and late BAL CC16 levels might be suitable to be used as markers of lung injury in this polytrauma model.
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Metadata
Title
Club cell protein (CC)16 as potential lung injury marker in a porcine 72 h polytrauma model
Authors
Johannes Greven
Jan Tilmann Vollrath
Felix Bläsius
Zhizhen He
Eftychios Bolierakis
Klemens Horst
Philipp Störmann
Aleksander J. Nowak
Marija Simic
Ingo Marzi
Frank Hildebrand
Borna Relja
Publication date
21-05-2022
Publisher
Springer Berlin Heidelberg
Published in
European Journal of Trauma and Emergency Surgery / Issue 6/2022
Print ISSN: 1863-9933
Electronic ISSN: 1863-9941
DOI
https://doi.org/10.1007/s00068-022-01997-w

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