Altered neutrophil functions in elderly XXXX during a 6-month follow-up period after a hip fracture.

@entity1 @entity32 @entity6722 @entity222 @entity310 @entity73 @entity2938 @entity1110 @entity688 @entity4071 @entity9536 @entity2939 @entity687 @entity224 @entity1292 @entity1366
BACKGROUND: Fracture of the hip (HF) is a significant cause of morbidity and mortality in elderly individuals. HF is an acute stress that triggers a state of @entity32 which may affect immune responses and physical recovery. METHODS: Longitudinal study of the impact of HF on the functions of polymorphonuclear neutrophils (PMNs) in elderly subjects. Data were recorded prior to surgery, 6weeks and 6months later. RESULTS: PMN functions were severely impaired shortly after HF ( @entity6722 , phagocytosis, @entity224 production) but there was a time-related recovery of some PMN functions ( @entity6722 , phagocytosis) over time, except in the case of @entity224 production. Whereas FcyRII ( @entity222 ) expression remained unchanged, FcyRIII ( @entity4071 ) increased from low values before surgery to levels of controls 6months post-surgery. This was also the case for the C5a complement receptor and @entity9536 . @entity2938 and @entity2939 expressions were unchanged. Cytokine and chemokine secretions by stimulated PMN were altered. @entity310 and @entity688 secretions were increased following HF but @entity687 secretion was decreased. @entity73 prior to surgery were related to alterations in PI3K and NF-kB signaling pathways. Recovery of these functions paralleled increased PI3K activity, although @entity224 production remained low. Sustained activation of the NF-kB pathway by @entity310 has been reported to involve upregulation of IKKb kinase activity. Activated IKKb kinase inhibits @entity1366 and results in concomitant downstream inhibition of @entity1110 oxidase complex which can account for sustained impaired production of ROS in HF @entity1 . CONCLUSION: Our data showed that the stress caused by HF negatively affects initial PMN responses shortly after the event and that may negatively influence clinical outcomes such as resolving long-term @entity32 and recovery, as well as explaining susceptibility to @entity1292 .
