Inflammatory response to the ischaemia–reperfusion insult in the liver after major tissue trauma

Abstract

Background Polytrauma is often accompanied by ischaemia–reperfusion injury to tissues and organs, and the resulting series of immune inflammatory reactions are a major cause of death in patients. The liver is one of the largest organs in the body, a characteristic that makes it the most vulnerable organ after multiple injuries. In addition, the liver is an important digestive organ that secretes a variety of inflammatory mediators involved in local as well as systemic immune inflammatory responses. Therefore, this review considers the main features of post-traumatic liver injury, focusing on the immuno-pathophysiological changes, the interactions between liver organs, and the principles of treatment deduced. Methods We focus on the local as well as systemic immune response involving the liver after multiple injuries, with emphasis on the pathophysiological mechanisms. Results An overview of the mechanisms underlying the pathophysiology of local as well as systemic immune responses involving the liver after multiple injuries, the latest research findings, and the current mainstream therapeutic approaches. Conclusion Cross-reactivity between various organs and cascade amplification effects are among the main causes of systemic immune inflammatory responses after multiple injuries. For the time being, the pathophysiological mechanisms underlying this interaction remain unclear. Future work will continue to focus on identifying potential signalling pathways as well as target genes and intervening at the right time points to prevent more severe immune inflammatory responses and promote better and faster recovery of the patient.

Dilation of the Infarct-Related Coronary Artery to Reduce the Incidence of the No-Reflow Phenomenon in STEMI Patients

“…Реперфузионное повреждение миокарда. Выполнение успешного ЧКВ способствует достаточно быстрому восстановлению антеградного кровоснабжения в ИСКА после различной по времени продолжительности ишемического периода [12][13][14].…”

The intersection of coagulation activation and inflammation after injury: What you need to know

“…The result is an activation of multiple inflammatory cascades, dramatically amplifying and producing a wide range of inflammatory mediators. 97 Continued resuscitation may lead to recovery, whereas the continued inflammatory process may lead to multiple organ failure and progression to persistent inflammation, immunosuppression, and catabolism syndrome, with resultant prolonged chronic critical illness. 98 After injury and hemorrhage, resuscitation seeks to replete lost intravascular volume and correct anemia, acidosis, and coagulopathy.…”

“…The severity of the inflammatory response after hemorrhage is likely due to a profound ischemic injury during hemorrhage, followed by reperfusion injury during the resuscitation phase, leading to widespread activation of the immune system, endothelial cells, and end organs (Supplemental Digital Content, Supplementary Data 1, http://links.lww.com/TA/D397). The result is an activation of multiple inflammatory cascades, dramatically amplifying and producing a wide range of inflammatory mediators 97 . Continued resuscitation may lead to recovery, whereas the continued inflammatory process may lead to multiple organ failure and progression to persistent inflammation, immunosuppression, and catabolism syndrome, with resultant prolonged chronic critical illness 98 …”