Journal of Emergencies, Trauma, and Shock
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Year : 2016  |  Volume : 9  |  Issue : 2  |  Page : 51-52
Hematopoietic stem cells: Can it be a therapeutic option for the hematopoietic failure in patients with trauma-hemorrhagic shock?

1 Department of Emergency Medicine, Jai Prakash Narayan Apex Trauma Centre, AIIMS, New Delhi, India
2 Department of Emergency Medicine, University of Florida Jacksonville Healthcare, Inc., Jacksonville, FL, USA

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Date of Submission18-Dec-2015
Date of Acceptance23-Dec-2015
Date of Web Publication31-Mar-2016

How to cite this article:
Kumar M, Bhoi S, Galwankar S. Hematopoietic stem cells: Can it be a therapeutic option for the hematopoietic failure in patients with trauma-hemorrhagic shock?. J Emerg Trauma Shock 2016;9:51-2

How to cite this URL:
Kumar M, Bhoi S, Galwankar S. Hematopoietic stem cells: Can it be a therapeutic option for the hematopoietic failure in patients with trauma-hemorrhagic shock?. J Emerg Trauma Shock [serial online] 2016 [cited 2022 Jul 6];9:51-2. Available from:

Hemorrhagic shock (HS) is the third major cause of death in trauma [1] with a limited therapeutic option. Fluid, blood component, and control of hemorrhage have been the cornerstone of management. Previous studies reported that resuscitation with fluids and blood products induces reperfusion ischemia due to the production of reactive oxygen species and activation of immune cells.[2] Hematopoietic failure and bone marrow (BM) dysfunction have been observed in experimental animals and human following shock and injury.[3],[4] Impairment of hematopoietic progenitor cells (HPCs) is clinically associated with persistent anemia and patients are susceptible to infection, sepsis, and multiple organ failure.[3],[4],[5]

HS induces excessive production of inflammatory cytokines which leads to HPCs apoptosis.[4],[5] Robinson et al. reported that tumor necrosis factor-α binds to the receptor on BM, which activates caspase-8 leading to apoptosis in severe trauma.[5] Maturation of erythroid progenitor cells was inhibited by interleukin 1 (IL-1), IL-6, IL-8, and transforming growth factor-β in severe trauma.[4],[5] BM dysfunction is also associated with mobilization of HPCs into the peripheral blood from BM following severe trauma and animal model.[6]

Hematopoietic stem cells (HSCs) are blood cells that differentiate into the myeloid and lymphoid lineage. BM-derived stem and progenitor cells have a capacity for self-renewal, differentiation, survival, migration, and proliferation. Their mobilization is regulated by an extrinsic and intrinsic signal provided by their microenvironment. BM HPCs are thought to be located within specific stromal niches. This specific microenvironment provides soluble factors and cellular interaction required for HPCs proliferation and differentiation. HPCs may move from one niche to another. HSCs can be isolated from the pelvis, femur, sternum, umbilical cord blood, and peripheral blood. Human HSCs are characterized by expression of surface markers of CD34+, CD59+, Thy1/CD90+, CD38lo/−, C-kit/CD117+, lin .[7],[8],[9]

HSCs transplantation has been used as an adjunct treatment of BM failure, hemoglobinopathies, and immune system disorders.[9],[10],[11] Li et al. study showed that human hematopoietic stem/progenitor cells (HSPCs) promoted the kidney repair and regeneration using an established ischemia-reperfusion injury model in mice.[12] Human CD34+ cells and HSPCs promoted vasculogenesis and osteogenesis in stroke and bone injury.[13] However, the experience of HSCs transplantation in trauma is limited. Authors feel HSCs transplantation may be explored as a therapeutic option in various research models of trauma/HS.

   References Top

El Sayad M, Noureddine H. Recent advances of hemorrhage management in severe trauma. Emerg Med Int 2014;2014:638956.  Back to cited text no. 1
Finfer S, Liu B, Taylor C, Bellomo R, Billot L, Cook D, et al. Resuscitation fluid use in critically ill adults: An international cross-sectional study in 391 intensive care units. Crit Care 2010;14:R185.  Back to cited text no. 2
Sifri ZC, Kaiser VL, Ananthakrishnan P, Wang L, Mohr AM, Hauser CJ, et al. Bone marrow failure in male rats following trauma/hemorrhagic shock (T/HS) is mediated by mesenteric lymph and modulated by castration. Shock 2006;25:12-6.  Back to cited text no. 3
Livingston DH, Anjaria D, Wu J, Hauser CJ, Chang V, Deitch EA, et al. Bone marrow failure following severe injury in humans. Ann Surg 2003;238:748-53.  Back to cited text no. 4
Robinson Y, Hostmann A, Matenov A, Ertel W, Oberholzer A. Erythropoiesis in multiply injured patients. J Trauma 2006;61:1285-91.  Back to cited text no. 5
Badami CD, Livingston DH, Sifri ZC, Caputo FJ, Bonilla L, Mohr AM, et al. Hematopoietic progenitor cells mobilize to the site of injury after trauma and hemorrhagic shock in rats. J Trauma 2007;63:596-600.  Back to cited text no. 6
Gurudutta GU, Satija NK, Singh VK, Verma YK, Gupta P, Tripathi RP. Stem cell therapy: A novel and futuristic treatment modality for disaster injuries. Indian J Med Res 2012;135:15-25.  Back to cited text no. 7
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Hoggatt J, Pelus LM. Mobilization of hematopoietic stem cells from the bone marrow niche to the blood compartment. Stem Cell Res Ther 2011;2:13.  Back to cited text no. 8
Atkins HL, Muraro PA, van Laar JM, Pavletic SZ. Autologous hematopoietic stem cell transplantation for autoimmune disease – Is it now ready for prime time? Biol Blood Marrow Transplant 2012;18 1 Suppl: S177-83.  Back to cited text no. 9
Daikeler T, Kump E, Stern M, Hügle T, Hij A, Haeuserman P, et al. Autologous hematopoietic stem cell transplantation reverses skin fibrosis but does not change skin vessel density in patients with systemic sclerosis. Pathol Biol (Paris) 2015;63:164-8.  Back to cited text no. 10
Yesilipek MA. Hematopoietic stem cell transplantation in children. Turk Pediatri Ars 2014;49:91-8.  Back to cited text no. 11
Li B, Cohen A, Hudson TE, Motlagh D, Amrani DL, Duffield JS. Mobilized human hematopoietic stem/progenitor cells promote kidney repair after ischemia/reperfusion injury. Circulation 2010;121:2211-20.  Back to cited text no. 12
Matsumoto T, Kawamoto A, Kuroda R, Ishikawa M, Mifune Y, Iwasaki H, et al. Therapeutic potential of vasculogenesis and osteogenesis promoted by peripheral blood CD34-positive cells for functional bone healing. Am J Pathol 2006;169:1440-57.  Back to cited text no. 13

Correspondence Address:
Sanjeev Bhoi
Department of Emergency Medicine, Jai Prakash Narayan Apex Trauma Centre, AIIMS, New Delhi
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/0974-2700.179458

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This article has been cited by
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[Pubmed] | [DOI]


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