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.

National Institute of Health (NIH)
National Institute of General Medical Sciences (NIGMS)
Research Project (R01)
Project #
Application #
Study Section
Special Emphasis Panel (ZRG1-SBIB-E (02))
Program Officer
Somers, Scott D
Project Start
Project End
Budget Start
Budget End
Support Year
Fiscal Year
Total Cost
Indirect Cost
University of Alabama Birmingham
Schools of Medicine
United States
Zip Code
Angele, Martin K; Pratschke, Sebastian; Hubbard, William J et al. (2014) Gender differences in sepsis: cardiovascular and immunological aspects. Virulence 5:12-9
Osuchowski, Marcin F; Remick, Daniel G; Lederer, James A et al. (2014) Abandon the mouse research ship? Not just yet! Shock 41:463-75
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
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
Chaudry, I H; Bland, K I (2009) Cellular mechanisms of injury after major trauma. Br J Surg 96:1097-8
Yu, Huang-Ping; Chaudry, Irshad H (2009) The role of estrogen and receptor agonists in maintaining organ function after trauma-hemorrhage. Shock 31:227-37
Yang, Shaolong; Hu, Shunhua; Chen, Jianguo et al. (2009) Mechanism of hepatoprotection in proestrus female rats following trauma-hemorrhage: heme oxygenase-1-derived normalization of hepatic inflammatory responses. J Leukoc Biol 85:1015-26

Showing the most recent 10 out of 107 publications