Our studies demonstrate that the functions of various organs are markedly depressed in males, but not in proestrus females (with high estrogen [E2] levels) after trauma-hemorrhage and resuscitation (T-H). Moreover, estrogen receptor (ER) but not androgen receptor (AR) expression in cardiomyocytes from males was significantly decreased after T-H. Administration of E2 after T-H in males normalized cardiomyocyte ER and cardiac functions. Furthermore, administration of AR antagonist flutamide in males after T-H normalized cardiac E2 levels, ER levels, mitochondrial ATP levels, and cardiac functions. We hypothesize that the prevailing hormonal milieu in proestrus females helps maintain ER expression in cells of organs and thus preserves organ blood flow, prevents regional hypoxia, maintains mitochondrial ATP production and organ functions. The proposed studies will determine: a) the extent to which ER expression is decreased in cells and mitochondria of various organs in males and females in different stages of the estrus cycle and if the decreased ER is associated with altered mitochondrial ATP levels/organ functions;b) if E2 normalizes ER expression in all cells/organs, and restores organ functions after T-H;c) if cell-based therapy, i.e., administration of genetically modified bone marrow mesenchymal stem cells (MSC) to over-express ER will upregulate ERs in cells and improve organ function after T-H even in the absence of exogenous E2. Since regional hypoxia occurs after T-H in males, it is expected to produce endoplasmic reticulum (EPR) stress. We expect an inverse relationship between EPR stress and ER levels and E2 administration should alleviate EPR stress and normalize ER levels after T-H. Studies will also determine alterations in pro- and anti-apoptotic factors in various cells, mitochondrial ATP and free radical production following T-H in males and females, and whether E2 treatment normalizes these parameters and restores cell/organ functions after T-H. Since MSC therapy after T-H is expected to accelerate recovery of organs, we will determine if the combination of E2 and MSC therapy is more effective in improving cell/organ function and reducing mortality from subsequent sepsis. The integration of cell and organ functions using E2, cell-based therapy and other state-of-the-art cellular/molecular techniques, should identify novel mechanism(s) by which ERs regulate organ effector responses after T-H. The findings should facilitate the development and application of gender-specific therapy for preventing cardiovascular and other organ dysfunction and thus reducing morbidity and mortality from subsequent sepsis in male and female trauma victims.

Public Health Relevance

We will examine the mechanisms by which the use of female sex hormones after trauma will improve cell and organ functions and decrease the lethality from infectious complications. We will use state-of-the-art molecular techniques and cell-based therapy to delineate the mechanisms involved in injury pathogenesis. The funding will help to develop gender-specific therapy. Such therapy should prevent organ dysfunction after injury and reduce morbidity and mortality from subsequent sepsis in male and female trauma victims.

Agency
National Institute of Health (NIH)
Institute
National Institute of General Medical Sciences (NIGMS)
Type
Research Project (R01)
Project #
5R01GM039519-25
Application #
8018986
Study Section
Special Emphasis Panel (ZRG1-SBIB-E (02))
Program Officer
Somers, Scott D
Project Start
1988-02-01
Project End
2013-07-31
Budget Start
2011-02-01
Budget End
2012-07-31
Support Year
25
Fiscal Year
2011
Total Cost
$394,658
Indirect Cost
Name
University of Alabama Birmingham
Department
Surgery
Type
Schools of Medicine
DUNS #
063690705
City
Birmingham
State
AL
Country
United States
Zip Code
35294
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Jian, Bixi; Yang, Shaolong; Chaudry, Irshad H et al. (2014) Resveratrol restores sirtuin 1 (SIRT1) activity and pyruvate dehydrogenase kinase 1 (PDK1) expression after hemorrhagic injury in a rat model. Mol Med 20:10-6
Angele, Martin K; Pratschke, Sebastian; Hubbard, William J et al. (2014) Gender differences in sepsis: cardiovascular and immunological aspects. Virulence 5:12-9
Jian, Bixi; Yang, Shaolong; Chaudry, Irshad H et al. (2012) Resveratrol improves cardiac contractility following trauma-hemorrhage by modulating Sirt1. Mol Med 18:209-14
Kawasaki, Takashi; Chaudry, Irshad H (2012) The effects of estrogen on various organs: therapeutic approach for sepsis, trauma, and reperfusion injury. Part 2: liver, intestine, spleen, and kidney. J Anesth 26:892-9
Kawasaki, Takashi; Chaudry, Irshad H (2012) The effects of estrogen on various organs: therapeutic approach for sepsis, trauma, and reperfusion injury. Part 1: central nervous system, lung, and heart. J Anesth 26:883-91
Angele, Martin K; Pratschke, Sebastian; Chaudry, Irshad H (2012) Does gender influence outcomes in critically ill patients? Crit Care 16:129
Jian, Bixi; Yang, Shaolong; Chen, Dongquan et al. (2011) Influence of aging and hemorrhage injury on Sirt1 expression: possible role of myc-Sirt1 regulation in mitochondrial function. Biochim Biophys Acta 1812:1446-51
Jian, Bixi; Yang, Shaolong; Chen, Dongquan et al. (2011) Aging influences cardiac mitochondrial gene expression and cardiovascular function following hemorrhage injury. Mol Med 17:542-9
Akabori, Hiroya; Moeinpour, Fariba; Bland, Kirby I et al. (2010) Mechanism of the anti-inflammatory effect Of 17beta-estradiol on brain following trauma-hemorrhage. Shock 33:43-8

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