Endogenous Opioids in Wound-Site Neutrophils of Sternotomy Patients 英文参考文献.docVIP

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Endogenous Opioids in Wound-Site Neutrophils of Sternotomy Patients 英文参考文献.doc

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Endogenous Opioids in Wound-Site Neutrophils of Sternotomy Patients 英文参考文献

EndogenousOpioidsinWound-SiteNeutrophilsof SternotomyPatients HamdyAwad1,MotazAbas1,HaythamElgharably2,RaviTripathi1,TykieTheofilos1,SujathaBhandary1, ChittoorSai-Sudhakar2,ChandanK.Sen2,SashwatiRoy2* 1Comprehensive Wound Center and Davis Heart and Lung Research Institute, Department of Anesthesiology, Wexner Medical Center at the Ohio State University, Columbus,Ohio,UnitedStatesofAmerica,2ComprehensiveWoundCenterandDavisHeartandLungResearchInstitute,DepartmentofSurgery,WexnerMedicalCenter attheOhioStateUniversity,Columbus,Ohio,UnitedStatesofAmerica Abstract Background: Postoperative pain management is a critical aspect of patient care. The inflammatory state of the post- sternotomysurgicalwoundsensitizesnerveendings,causingpain.Unrelievedorimproperlymanagedpaincompromises woundhealing.Peripheralopioidreceptorsplayamajorroleinanalgesia,particularlyunderinflammatoryconditionswhere both opioid receptor expression and efficacy are increased. Leukocytic opioid peptides include b-endorphin (END), met- enkephalin(ENK),anddynorphin-A(DYN),withENDandENKbeingpredominant. Methodology/PrincipalFindings:Thisworkrepresentsthefirststudyofinflammatorycellscollectedfrompost-sternotomy woundsofpatientsundergoingcardiacsurgery includingcoronaryarterybypass grafting (CABG).Woundfluid (WF)and cellswerecollectedfromsternalwoundsusingaJPBlakedrainat24,48,and72hourspoststernumclosure.Anti-CD15 staining and flow cytometry revealed that polymorphonuclear neutrophils (PMN) are the predominant cells present in wound fluid collected post-surgery. Compared to peripheral blood (PB) derived PMN, significant increases in CD177+/ CD66b+PMNwereobservedsuggestingactivationofwound-sitePMN.Suchactivationwasassociatedwithhigherlevelsof opioid peptide expression in PMN derived from WF. Indeed, increased level of opioid peptides in sternal wound environmentwasnoted72hpost-surgery.WedemonstratethatWFcontainsfactorsthatcansignificantlyinducePOMC transcriptioninhumanPMNs.IL-10andIL-4wereabundantin W