Estrogen as a safe therapeutic adjunct in reducing the inflammatory
storm in Trauma hemorrhagic shock patients
Abstract
Trauma is a major cause of morbidity and mortality throughout the world.
Alarmingly the mortality rate, owing to multiple causes with or without
sepsis, is now reported to cross the value of 50%. The preliminary
study was conducted in humans to investigate the 1) safety of estrogen
therapy following trauma hemorrhage 2) Does estrogen reduced the
inflammatory storms caused due to trauma 3) Does estrogen affects the
survival of THS patients and prevent the advancement of
sepsis-associated problems. 40, THS patients and 20 healthy controls
were recruited. THS patients were divided into experimental groups and
placebo controls based on the estrogen administration in the ED. Serum
level of cytokines and immune cells were measured at different time
points on days 0, 3, 7, and 14 in both groups of THS patients. Patients
receiving intravenous estrogen beside standard of care as per ATLS
guidelines did not develop any major or minor adverse events and showed
favorable clinical outcomes during their course of stay in the ED and
ICU. The levels of T regulatory cells, monocytes, and systemic cytokines
were significantly reduced in THS patients who received estrogen. Again,
THS patients who received estrogen recovered early, do not have side
effects and showed a balanced inflammatory response. In conclusion, this
preliminary study showed that intravenous estrogen therapy is safe and
overcame the problem of inflammatory insults caused due to trauma
hemorrhagic shock. It may protect from sepsis-associated complications
among THS patients.