Postinjury multiple organ failure is the net result of the dysfunctional immune response to injury characterized by an early hyperactive innate system. Acute lung injury (ALI) is the first clinical manifestation of organ failure, followed by renal and hepatic dysfunction. The gut has been invoked as the "motor of MOF", and mesenteric lymph is recognized as the mechanistic link between splanchnic ischemia and distant organ dysfunction. But the specific mediators remain to be defined. Current evidence suggests the lipid fraction of post-shock mesenteric lymph (PSML) is central in the etiology of ALI. Specifically, our recent work indicates that 5-lipoxygenase (5-LO) products are essential, but proteins may have an important role. Elucidating these mediators is critical In translating our current knowledge to new therapeutic strategies at the bedside. Our specific research aims (abbreviated) are: 1) to determine if 5-lipoxygenase activity is necessary for PSML to provoke acute lung injury by examining a) mesenteric lymph diversion (MLD) in rats, b) pretreatment of rats with 5-LO inhibitors, c) knock out mice, d) 5-LO metabolites in BALF and pleural fluid of severely injured patients with ALI / ARDS;2) to determine if T/HS activates 5-LO in the gut, thereby producing metabolites in PSML that mediate ALI by a) infusing rat PSML into naive rats from donor rats, pretreatedt with 5-LO inhibitors, monitoring for increases in 5-LO metabolites and ALI, b) incubating PMNs, HMVECs, alveolar macrophages, and type II pneumocytes with PSML and LTB4/ LTC4 receptor antagonists to produce proinflammatory activation, c) examining 5-LO metabolites in PSML following T/HS in rats, d) examining 5-LO metabolites in the mesenteric lymph of severely injured patients;and 3) to determine if T/HS activates 5-lipoxygenase in the lung by a) infusing isotope labeled (d8)AA into MLD T/HS rat lung to generate (d8)LTB{4}and produce ALI, b) cross-transfusing PSML from T/HS rats, pretreated with a PLA{2} inhibitor (to eliminate AA) or 5-LO inhibitor, into naive rats and measuring 5-LO metabolites in BALF and assessing for ALI, c) locating 5-LO pathway components in the lung versus infiltrating hematological cells (PMNs and platelets) following T/HS +/- MLD, d) determining if elevated alpha-enolase, elevated major urinary protein, or the depletion of antiproteases in PSML stimulates 5-LO activity in cultured PMNs, HMVECs, alveolar macrophages and type II pneumocytes, e) proteomics analysis of human lymph to identify relevant lipid carriers and 5-LO activators.

Agency
National Institute of Health (NIH)
Institute
National Institute of General Medical Sciences (NIGMS)
Type
Specialized Center (P50)
Project #
5P50GM049222-20
Application #
8678939
Study Section
Special Emphasis Panel (ZGM1-PPBC-5)
Project Start
Project End
Budget Start
2014-06-01
Budget End
2015-05-31
Support Year
20
Fiscal Year
2014
Total Cost
$507,211
Indirect Cost
$131,358
Name
University of Colorado Denver
Department
Type
DUNS #
041096314
City
Aurora
State
CO
Country
United States
Zip Code
80045
Brown, Joshua B; Cohen, Mitchell J; Minei, Joseph P et al. (2015) Pretrauma center red blood cell transfusion is associated with reduced mortality and coagulopathy in severely injured patients with blunt trauma. Ann Surg 261:997-1005
Stahel, Philip F; Moore, Ernest E (2014) Peer review for biomedical publications: we can improve the system. BMC Med 12:179
Silliman, C C; Bercovitz, R S; Khan, S Y et al. (2014) Antibodies to the HLA-A2 antigen prime neutrophils and serve as the second event in an in vitro model of transfusion-related acute lung injury. Vox Sang 107:76-82
Chin, Theresa L; Moore, Ernest E; Moore, Hunter B et al. (2014) A principal component analysis of postinjury viscoelastic assays: clotting factor depletion versus fibrinolysis. Surgery 156:570-7
Wohlauer, M; Kobeiter, H; Desgranges, P et al. (2014) Inferior Mesenteric Artery Stenting as a Novel Treatment for Chronic Mesenteric Ischemia in Patients with an Occluded Superior Mesenteric Artery and Celiac Trunk. Eur J Vasc Endovasc Surg 27:e21-e23
Stringham, John R; Moore, Ernest E; Gamboni, Fabia et al. (2014) Mesenteric lymph diversion abrogates 5-lipoxygenase activation in the kidney following trauma and hemorrhagic shock. J Trauma Acute Care Surg 76:1214-21
Jones, Edward L; Stovall, Robert T; Jones, Teresa S et al. (2014) Intra-abdominal injury following blunt trauma becomes clinically apparent within 9 hours. J Trauma Acute Care Surg 76:1020-3
Dzieciatkowska, Monika; D'Alessandro, Angelo; Moore, Ernest E et al. (2014) Lymph is not a plasma ultrafiltrate: a proteomic analysis of injured patients. Shock 42:485-98
Gonzalez, E; Moore, E E; Moore, H B et al. (2014) Trauma-Induced Coagulopathy: An Institution's 35 Year Perspective on Practice and Research. Scand J Surg 103:89-103
Moore, Ernest E; Chin, Theresa L; Chapman, Michael C et al. (2014) Plasma first in the field for postinjury hemorrhagic shock. Shock 41 Suppl 1:35-8

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