Lyophilized plasma reconstituted with ascorbic acid suppresses inflammation and oxidative DNA damage

Philbert Y. Van, Gregory J. Hamilton, Igor V. Kremenevskiy, Chitra Sambasivan, Nicholas J. Spoerke, Jerome A. Differding, Jennifer M. Watters, Martin A. Schreiber

    Research output: Contribution to journalArticle

    22 Scopus citations

    Abstract

    BACKGROUND: Lyophilized plasma (LP) has been shown to be as effective as fresh frozen plasma (FFP) for resuscitation in polytrauma and hemorrhagic shock. LP reconstituted with ascorbic acid is associated with suppression of cytokines when compared with fresh frozen plasma. We aimed to determine the effect of using alternate LP reconstitution acids on physiologic parameters, blood loss, coagulation, oxidative DNA damage, and proinflammatory cytokines in a polytrauma and hemorrhagic shock model. METHODS: Thirty swine were anesthetized, subjected to polytrauma, hemorrhagic shock, and randomized to resuscitation with LP-ascorbic acid (AA), LP-citric acid (CA), or LP-hydrochloric acid (HCL). Physiologic data were continuously monitored, blood loss measured, and serum collected at baseline, 2 hours, and 4 hours for enzyme-linked immunosorbent assays. Measured 8-OH-2′-deoxyguanosine (8-OHdG) was a biomarker of oxidative DNA damage. RESULTS: No differences were observed in physiologic measures, blood loss, or coagulation parameters. Interleukin-6 increased over time for all groups, but at 2 hours, the concentration in AA (median [minimum, maximum]: 113 ng/mL [0, 244]) was lower compared with CA (181 ng/mL [69, 314], p = 0.01) and HCL (192 ng/mL [41, 310], p = 0.03). Comparing 4 hours to baseline, a significant increase in oxidative DNA damage was observed in CA (22.9 ng/mL [16.3, 34.3] vs. 15.6 ng/mL [13.6, 26.7], p = 0.03) and HCL (19.6 ng/mL [15.7, 56.7] vs. 15.8 ng/mL [11.6, 21.4], p = 0.01) but not in AA (17.9 ng/mL [12.6, 26.9] vs. 17.1 ng/mL [11.8, 18.4], p = 0.24). CONCLUSIONS: Resuscitaiton with AA results in decreased interleukin-6 expression and oxidative DNA damage compared with CA and HCL.

    Original languageEnglish (US)
    Pages (from-to)20-25
    Number of pages6
    JournalJournal of Trauma - Injury, Infection and Critical Care
    Volume71
    Issue number1
    DOIs
    StatePublished - Jul 1 2011

    Keywords

    • Ascorbic acid
    • Inflammation
    • Lyophilized plasma
    • Oxidative DNA damage

    ASJC Scopus subject areas

    • Surgery
    • Critical Care and Intensive Care Medicine

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