Abstract
Background
Erythropoietic dysfunction after trauma and critical illness is associated with anemia,
persistent inflammation, increased hematopoietic progenitor cell mobilization from
the bone marrow, and reduced erythroid progenitor growth. Yet the duration and reversibility
of these postinjury bone marrow changes remain unknown. This study sought to determine
whether removal of chronic postinjury stress could induce improvements in erythroid
progenitor growth.
Methods
Sprague-Dawley rats (n = 8–11/group) were assigned to the following: naïve, lung contusion and hemorrhagic
shock, lung contusion and hemorrhagic shock plus daily chronic stress for 7 days followed
by 7 days of routine handling to allow recovery (lung contusion and hemorrhagic shock +
chronic stress 7), or lung contusion and hemorrhagic shock plus chronic stress for
14 days (lung contusion and hemorrhagic shock + chronic stress 14). Circulating CD117+CD71+ erythroid progenitors were detected by flow cytometry. Rodents were killed on day
14, and bone marrow erythroid progenitor growth and erythroid transcription factors
were assessed. Differences were assessed by analysis of variance (P < .05).
Results
Compared to lung contusion and hemorrhagic shock + chronic stress 14, lung contusion
and hemorrhagic shock + chronic stress 7 rodents had improved hemoglobin (8% ± 10%
increase vs 6% ± 10% decrease) with fewer mobilized erythroid progenitors (898 × vs
1,524 cells), lower granulocyte-colony stimulating factor levels (3.1 ± 1.1 × pg/mL
vs 5.9 ± 1.8 pg/mL), and improved erythroid progenitor growth. Cessation of stress
had no impact on erythroid transcription factors GATA-1, GATA-2, LMO2, or KLF1.
Conclusion
Improvements in erythroid progenitor growth and reduced hematopoietic progenitor cell
mobilization were seen 7 days after cessation of chronic stress and were associated
with an improvement in hemoglobin. Early bone marrow erythropoietic functional recovery
may result from resolution of hematopoietic progenitor mobilization rather than upregulation
of pro-erythroid transcription factors. This study suggests that postinjury anemia
is reversible and has the potential to improve with the cessation of stress.
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Article info
Publication history
Published online: June 04, 2022
Accepted:
April 29,
2022
Footnotes
These findings were presented at the 2022 Academic Surgical Congress on February 3, 2022, in Lake Buena Vista, FL.
Identification
Copyright
© 2022 Elsevier Inc. All rights reserved.
