T-helper cell polarisation following severe polytrauma

Conference poster


Torrance, H., Brohi, K., Warnes, G., Owen, H., Hinds, C., Pennington, D. and O'Dwyer, M. 2015. T-helper cell polarisation following severe polytrauma. ESICM LIVES 2015: 28th Annual Congress of European Society of Intensive Care Medicine. Berlin, Germany 03 - 07 Oct 2015 Springer Open. https://doi.org/10.1186/2197-425X-3-S1-A848
TypeConference poster
TitleT-helper cell polarisation following severe polytrauma
AuthorsTorrance, H., Brohi, K., Warnes, G., Owen, H., Hinds, C., Pennington, D. and O'Dwyer, M.
Abstract

Introduction
Severe polytrauma induces an immunosuppressive response and is associated with a very high incidence of nosocomial infections. Previous studies have inferred that this detrimental immune response results from polarisation of the T helper (Th) response towards an anti-inflammatory, TH2 dominated, response at the expense of a bactericidal, Th1 response [1].
Objectives
1) To define alterations in TH cell subsets following severe blunt polytrauma.
Methods
Patients presenting to the emergency department within 2 hours of severe polytrauma were eligible if intubated either at the scene or in ED. Isolated head injuries and those not expected to survive 24 hours were excluded. EDTA anti-coagulated blood was drawn at 0hr (within 2 hours of injury), at 24 and 72hrs. Samples were immediately lysed, washed, stained and analysed using a standardised human 8-colour TH 1, 2 & 17 panel [2] on an LSR II flow cytometer. A paired white cell count differential was obtained at each sampling point. Patients were followed until discharge or death. Data were analysed using non-parametric statistics, with results presented as median and IQR.
Results
15 consecutive severe polytrauma patients requiring Intensive Care Unit (ICU) admission were recruited. Demographic and clinical data are outlined in Figure 1. Twelve (80%) lymphocytosis (3.3x109/L, 2.5 - 4.4x109/L) (Figyre 2A). At 72 hours leukocytes had fallen (P < 0.01, figure 2A) such that 6 (54%) of those surviving were lymphopenic (0.9x109/L, 0.6 - 1.2x109/L). Circulating CD4+ (P = 0.01; Figure 2B) and CD4+CD25+ (P < 0.05) lymphocytes increased over 72 hours. When expressed as a percentage of total circulating lymphocytes no significant change in the proportions of the TH 1, 2 & 17 subpopulations was detected (Figure 2C-E).
Conclusions
Severe polytrauma patients swiftly become lymphopenic. Although a failure to normalise this during the ICU stay correlates with higher mortality [3] our study of TH cell subtypes demonstrates no evidence of a switch to a detrimental anti-inflammatory TH2 subtype at the expense of the potentially protective bactericidal TH1 subtype.

ConferenceESICM LIVES 2015: 28th Annual Congress of European Society of Intensive Care Medicine
Proceedings TitleIntensive Care Medicine Experimental
ISSN2197-425X
PublisherSpringer Open
Publication dates
Print01 Oct 2015
Publication process dates
Deposited14 Jun 2016
Accepted01 Oct 2015
Output statusPublished
Publisher's version
License
Copyright Statement

Full text: © Torrance et al.; 2015
This article is published under license to BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Additional information

Published in meeting abstract book as: Torrance et al.: T-helper cell polarisation following
severe polytrauma. Intensive Care Medicine Experimental 2015 3(Suppl 1): A848

Digital Object Identifier (DOI)https://doi.org/10.1186/2197-425X-3-S1-A848
LanguageEnglish
Book titleIntensive Care Medicine Experimental 2015 3(Suppl 1)
Permalink -

https://repository.mdx.ac.uk/item/86746

  • 41
    total views
  • 6
    total downloads
  • 2
    views this month
  • 0
    downloads this month

Export as

Related outputs

The efficacy of gemcitabine and docetaxel chemotherapy for the treatment of relapsed and refractory osteosarcoma: a systematic review and pre‐clinical study
Low, K., Foulkes, P., Hills, F., Roberts, H. and Stordal, B. 2024. The efficacy of gemcitabine and docetaxel chemotherapy for the treatment of relapsed and refractory osteosarcoma: a systematic review and pre‐clinical study. Cancer Medicine. 13 (18). https://doi.org/10.1002/cam4.70248
Identifying fibroblast growth factor receptor 3 as a mediator of periosteal osteochondral differentiation through the construction of microRNA-based interaction networks
Wells, L., Roberts, H., Luyten, F. and Roberts, S. 2023. Identifying fibroblast growth factor receptor 3 as a mediator of periosteal osteochondral differentiation through the construction of microRNA-based interaction networks. Biology. 12 (11). https://doi.org/10.3390/biology12111381
A machine learning‑based image segmentation method to quantify in vitro osteoclast culture endpoints
Davies, B.K., Hibbert, A.P., Roberts, S.J., Roberts, H., Tickner, J.C., Holdsworth, G., Arnett, T.R. and Orriss, I.R. 2023. A machine learning‑based image segmentation method to quantify in vitro osteoclast culture endpoints. Calcified Tissue International and Musculoskeletal Research. 113 (4), p. 437–448.
Establishment and characterization of single and triple‐agent resistant osteosarcoma cell lines
Low, K., Hills, F., Roberts, H. and Stordal, B. 2023. Establishment and characterization of single and triple‐agent resistant osteosarcoma cell lines. Advanced Biology. 7 (2). https://doi.org/10.1002/adbi.202200194
Overcoming chemoresistance in osteosarcoma: the role of autophagy in cell death or survival following chemotherapy
Rosa, G., Burczynska, B., Stordal, B. and Roberts, H. 2018. Overcoming chemoresistance in osteosarcoma: the role of autophagy in cell death or survival following chemotherapy. Research Degrees Students' Summer Conference. Middlesex University, London, UK 04 Sep 2018
Optimisation of a selection strategy for drug resistance osteosarcoma cell lines
Low, K., Hills, F., Roberts, H. and Stordal, B. 2018. Optimisation of a selection strategy for drug resistance osteosarcoma cell lines. Research Degrees Students' Summer Conference. Middlesex University, London, UK 04 Sep 2018
Mechanisms of apoptosis and autophagy in chemoresistant ovarian cancer cells
Bennacer, A., Roberts, H. and Stordal, B. 2018. Mechanisms of apoptosis and autophagy in chemoresistant ovarian cancer cells. Research Degrees Students' Summer Conference. Middlesex University, London, UK 04 Sep 2018
Overcoming chemoresistance in osteosarcoma: the role of autophagy in cell death or survival following chemotherapy
Rosa, G., Burczynska, B., Stordal, B. and Roberts, H. 2018. Overcoming chemoresistance in osteosarcoma: the role of autophagy in cell death or survival following chemotherapy. 2018 NCRI Cancer Conference. Glasgow, Scotland 04 - 06 Nov 2018
Optimisation of a selection strategy for drug resistance osteosarcoma cell lines
Low, K., Hills, F., Roberts, H. and Stordal, B. 2019. Optimisation of a selection strategy for drug resistance osteosarcoma cell lines. 2019 NCRI Cancer Conference. Glasgow, UK 03 - 05 Nov 2019
The role of autophagy in canine osteosarcoma chemoresistance and metastasis
Kulatheepan, Y., Baines, S., Meeson, R. and Roberts, H. 2022. The role of autophagy in canine osteosarcoma chemoresistance and metastasis. 26th Annual Technological Advances in Science, Medicine and Engineering Conference 2022. Virtual 27 - 28 Aug 2022
ATR inhibition increases sensitivity of a highly aggressive osteosarcoma cell line to cisplatin treatment
Pereira, J., Roberts, S. and Roberts, H. 2022. ATR inhibition increases sensitivity of a highly aggressive osteosarcoma cell line to cisplatin treatment. Research Students' Summer Conference. Middlesex University, Lonon, UK 22 - 23 Jun 2022
Migratory bodies express markers of tumour initiating cells and may represent an early stage of osteosarcoma sarcosphere initiation and metastasis
Paternina Martinez, D., Roberts, S. and Roberts, H. 2022. Migratory bodies express markers of tumour initiating cells and may represent an early stage of osteosarcoma sarcosphere initiation and metastasis. Research Students' Summer Conference. Middlesex University, Lonon, UK 22 - 23 Jun 2022
CRISPR/Cas9-mediated ATG7 knockout results in enhanced osteosarcoma chemosensitivity
Pears, A. and Roberts, H. 2022. CRISPR/Cas9-mediated ATG7 knockout results in enhanced osteosarcoma chemosensitivity. Bone Research Society Annual Conference. Manchester Metropolitan University, Manchester, UK 06 - 08 Jul 2022
ATR inhibition increases sensitivity of a highly aggressive osteosarcoma cell line to cisplatin treatment
Pereira, J., Roberts, S. and Roberts, H. 2022. ATR inhibition increases sensitivity of a highly aggressive osteosarcoma cell line to cisplatin treatment. Bone Research Society Annual Conference. Manchester Metropolitan University, Manchester, UK 06 - 08 Jul 2022
Migratory bodies express markers of tumour initiating cells and may represent an early stage of osteosarcoma sarcosphere initiation and metastasis
Paternina Martinez, D., Roberts, S. and Roberts, H. 2022. Migratory bodies express markers of tumour initiating cells and may represent an early stage of osteosarcoma sarcosphere initiation and metastasis. Bone Research Society Annual Conference. Manchester Metropolitan University, Manchester, UK 06 - 08 Jul 2022
Intentionality for inclusivity - the journey at Middlesex University
Roberts, H., Punev, I., Allardyce, D., Kyprianou, A., Appiah, S., Megeney, A., Calin, A., Gallacher, D. and Mill, R. 2022. Intentionality for inclusivity - the journey at Middlesex University. McGraw Hill.
Decellularised cartilage ECM culture coatings drive rapid and robust chondrogenic differentiation of human periosteal cells
Vas, W., Shah, M., Roberts, H. and Roberts, S. 2022. Decellularised cartilage ECM culture coatings drive rapid and robust chondrogenic differentiation of human periosteal cells. Bioengineering. 9 (5). https://doi.org/10.3390/bioengineering9050203
Guidelines for the use and interpretation of assays for monitoring autophagy (4th edition)
Klionsky, D., Roberts, H. and et al. 2021. Guidelines for the use and interpretation of assays for monitoring autophagy (4th edition). Autophagy. 17 (1), pp. 1-382. https://doi.org/10.1080/15548627.2020.1797280
Mapping human serum induced gene networks as a basis for the creation of biomimetic periosteum for bone repair
Al Hosni, R., Shah, M., Cheema, U., Roberts, H., Luyten, F. and Roberts, S. 2020. Mapping human serum induced gene networks as a basis for the creation of biomimetic periosteum for bone repair. Cytotherapy. 22 (8), pp. 424-435.
The combination of curcumin and doxorubicin shows a selective cytotoxic effect on acute myeloid leukaemia cell line
Hasan, N., Roberts, H., Ghali, L. and Appiah, S. 2018. The combination of curcumin and doxorubicin shows a selective cytotoxic effect on acute myeloid leukaemia cell line. NCRI Cancer Conference (2018). Glasgow, Scotland 04 - 06 Nov 2018
MicroRNA profiles are associated with lymphocyte count after a major traumatic injury: a potential role for immunometabolism?
Jones, T., Torrance, H., Roberts, H., Brohi, K., Barnes, M., Knight, J., Hinds, C., Ackland, G. and O'Dwyer, M. 2018. MicroRNA profiles are associated with lymphocyte count after a major traumatic injury: a potential role for immunometabolism? British Journal of Anaesthesia Research Forum. Royal College of Anaesthetists, London 30 - 31 May 2018 Elsevier. pp. e23-e24 https://doi.org/10.1016/j.bja.2018.05.027
Phytochemical modulation of apoptosis and autophagy: strategies to overcome chemoresistance in leukaemic stem cells in the bone marrow microenvironment
Owen, H., Appiah, S., Hasan, N., Ghali, L., Elayat, G. and Bell, C. 2017. Phytochemical modulation of apoptosis and autophagy: strategies to overcome chemoresistance in leukaemic stem cells in the bone marrow microenvironment. in: Zeng, B. and Zhao, K. (ed.) Neurobiology of Chinese Herb Medicine Elsevier.
Biomimetic strategies for fracture repair: engineering the cell microenvironment for directed tissue formation
Vas, W., Shah, M., Al Hosni, R., Owen, H. and Roberts, S. 2017. Biomimetic strategies for fracture repair: engineering the cell microenvironment for directed tissue formation. Journal of Tissue Engineering. 8, pp. 1-14. https://doi.org/10.1177/2041731417704791
Granulocyte macrophage colony-stimulating factor and interferon gamma act through different mechanisms in reversing post-operative immune suppression
Longbottom, E., Torrance, H., Owen, H., Hinds, C., Pearse, R. and O'Dywer, M. 2016. Granulocyte macrophage colony-stimulating factor and interferon gamma act through different mechanisms in reversing post-operative immune suppression. ESICM LIVES 2016: 29th Annual Congress of European Society of Intensive Care Medicine. Milan, Italy 01 - 05 Oct 2016 Springer. https://doi.org/10.1186/s40635-016-0098-x
Systemic inflammatory response syndrome after major abdominal surgery predicted by early upregulation of TLR4 and TLR5
Lahiri, R., Derwa, Y., Bashir, Z., Giles, E., Torrance, H., Owen, H., O'Dwyer, M., O'Brien, A., Stagg, A., Bhattacharya, S., Foster, G. and Alazawi, W. 2016. Systemic inflammatory response syndrome after major abdominal surgery predicted by early upregulation of TLR4 and TLR5. Annals of Surgery. 263 (5), pp. 1028-1037. https://doi.org/10.1097/SLA.0000000000001248
Features of postoperative immune suppression are reversible with interferon gamma and independent of interleukin-6 pathways
Longbottom, E., Torrance, H., Owen, H., Fragkou, P., Hinds, C., Pearse, R. and O'Dwyer, M. 2016. Features of postoperative immune suppression are reversible with interferon gamma and independent of interleukin-6 pathways. Annals of Surgery. 264 (2), pp. 370-377. https://doi.org/10.1097/SLA.0000000000001484
Association between early postoperatively elevated TLR-4 & TLR-5 gene expression and late nosocomial infection in elective high-risk hepato-pancreato-biliary (HPB) surgery
Pirmadjid, N., Torrance, H., Owen, H., Alazawi, W. and O'Dwyer, M. 2015. Association between early postoperatively elevated TLR-4 & TLR-5 gene expression and late nosocomial infection in elective high-risk hepato-pancreato-biliary (HPB) surgery. 2015 International Surgical Congress of the Association of Surgeons of Great Britain and Ireland. Manchester, UK 22 - 24 Apr 2015 Oxford University Press (OUP).
Post-operative immune suppression is reversible with interferon gamma and independent of IL-6 pathways
Longbottom, E., Torrance, H., Owen, H., Hinds, C., Pearse, R. and O'Dwyer, M. 2015. Post-operative immune suppression is reversible with interferon gamma and independent of IL-6 pathways. ESICM LIVES 2015: 28th Annual Congress of European Society of Intensive Care Medicine. Berlin, Germany 03 - 07 Oct 2015 Springer Open. https://doi.org/10.1186/2197-425X-3-S1-A820
The role of micrornas in the development of hospital acquired infection in polytrauma patients
Owen, H., Torrance, H., Barnes, M., Brohi, K., Knight, J., Hinds, C. and O'Dwyer, M. 2015. The role of micrornas in the development of hospital acquired infection in polytrauma patients. ESICM LIVES 2015: 28th Annual Congress of European Society of Intensive Care Medicine. Berlin, Germany 03 - 07 Oct 2015 Springer Open. https://doi.org/10.1186/2197-425X-3-S1-A35
Changes in gene expression following trauma are related to the age of transfused packed red blood cells
Torrance, H., Vivian, M., Brohi, K., Prowle, J., Pearse, R., Owen, H., Hinds, C. and O'Dwyer, M. 2015. Changes in gene expression following trauma are related to the age of transfused packed red blood cells. Journal of Trauma and Acute Care Surgery. 78 (3), pp. 535-542. https://doi.org/10.1097/TA.0000000000000534
The perioperative immune response
O'Dwyer, M., Owen, H. and Torrance, H. 2015. The perioperative immune response. Current Opinion in Critical Care. 21 (4), pp. 336-342. https://doi.org/10.1097/MCC.0000000000000213
Critical illness-induced bone loss is related to deficient autophagy and histone hypomethylation
Owen, H., Vanhees, I., Gunst, J., Van Cromphaut, S. and Van den Berghe, G. 2015. Critical illness-induced bone loss is related to deficient autophagy and histone hypomethylation. Intensive Care Medicine Experimental. 3. https://doi.org/10.1186/s40635-015-0052-3
Epigenetic regulatory pathways involving microRNAs may modulate the host immune response following major trauma
Owen, H., Torrance, H., Jones, T., Pearse, R., Hinds, C., Brohi, K. and O'Dwyer, M. 2015. Epigenetic regulatory pathways involving microRNAs may modulate the host immune response following major trauma. Journal of Trauma and Acute Care Surgery. 79 (5), pp. 766-772. https://doi.org/10.1097/TA.0000000000000850
Humanized culture of periosteal progenitors in allogeneic serum enhances osteogenic differentiation and in vivo bone formation
Roberts, S., Owen, H., Tam, W., Solie, L., Van Cromphaut, S., Van den Berghe, G. and Luyten, F. 2014. Humanized culture of periosteal progenitors in allogeneic serum enhances osteogenic differentiation and in vivo bone formation. Stem Cells Translational Medicine. 3 (2), pp. 218-28. https://doi.org/10.5966/sctm.2012-0137
Perioperative blood transfusion is associated with a gene transcription profile characteristic of immunosuppression: a prospective cohort study
Fragkou, P., Torrance, H., Pearse, R., Ackland, G., Prowle, J., Owen, H., Hinds, C. and O'Dwyer, M. 2014. Perioperative blood transfusion is associated with a gene transcription profile characteristic of immunosuppression: a prospective cohort study. Critical Care. 18 (5). https://doi.org/10.1186/s13054-014-0541-x
Enhanced immunoreceptor tyrosine-based activation motif signaling is related to pathological bone resorption during critical illness
Vanhees, I., Gunst, J., Janssens, T., Wauters, A., Van Herck, E., Van Cromphaut, S., Van den Berghe, G. and Owen, H. 2013. Enhanced immunoreceptor tyrosine-based activation motif signaling is related to pathological bone resorption during critical illness. Hormone and Metabolic Research. 45 (12), pp. 862-9. https://doi.org/10.1055/s-0033-1351290
Critical illness-related bone loss is associated with osteoclastic and angiogenic abnormalities
Owen, H., Vanhees, I., Solie, L., Roberts, S., Wauters, A., Luyten, F., Van Cromphaut, S. and Van den Berghe, G. 2012. Critical illness-related bone loss is associated with osteoclastic and angiogenic abnormalities. Journal of Bone and Mineral Research. 27 (7), pp. 1541-1552. https://doi.org/10.1002/jbmr.1612
Hypermethylation of CpG islands and shores around specific microRNAs and mirtrons is associated with the phenotype and presence of bladder cancer
Dudziec, E., Miah, S., Choudhry, H., Owen, H., Blizard, S., Glover, M., Hamdy, F. and Catto, J. 2011. Hypermethylation of CpG islands and shores around specific microRNAs and mirtrons is associated with the phenotype and presence of bladder cancer. Clinical Cancer Research. 17 (6), pp. 1287-1296. https://doi.org/10.1158/1078-0432.CCR-10-2017
Low frequency of epigenetic events in urothelial tumours from young patients
Catto, J., Owen, H., Giedl, J., Wild, P., Fine, S., Epstein, J., Humphrey, P., Dehner, L., Amin, M., Blaszyk, H., Hughes, D., Hartmann, A. and Stoehr, R. 2010. Low frequency of epigenetic events in urothelial tumours from young patients. European Urology Supplements. 9 (2), pp. 260-261. https://doi.org/10.1016/S1569-9056(10)60798-1
Low frequency of epigenetic events in urothelial tumors in young patients
Owen, H., Giedl, J., Wild, P., Fine, S., Humphrey, P., Dehner, L., Amin, M., Epstein, J., Blaszyk, H., Hughes, D., Hartmann, A., Stoehr, R. and Catto, J. 2010. Low frequency of epigenetic events in urothelial tumors in young patients. The Journal of Urology. 184 (2), pp. 459-463. https://doi.org/10.1016/j.juro.2010.03.131
Chondrocyte p21(WAF1/CIP1) expression is increased by dexamethasone but does not contribute to dexamethasone-induced growth retardation in vivo
Owen, H., Ahmed, S. and Farquharson, C. 2009. Chondrocyte p21(WAF1/CIP1) expression is increased by dexamethasone but does not contribute to dexamethasone-induced growth retardation in vivo. Calcified Tissue International and Musculoskeletal Research. 85 (4), pp. 326-334. https://doi.org/10.1007/s00223-009-9276-0
Distinct microRNA alterations characterize high- and low-grade bladder cancer
Catto, J., Miah, S., Owen, H., Bryant, H., Myers, K., Dudziec, E., Larré, S., Milo, M., Rehman, I., Rosario, D., Di Martino, E., Knowles, M., Meuth, M., Harris, A. and Hamdy, F. 2009. Distinct microRNA alterations characterize high- and low-grade bladder cancer. Cancer Research. 69 (21), pp. 8472-8481. https://doi.org/10.1158/0008-5472.CAN-09-0744
Dexamethasone-induced expression of the glucocorticoid response gene lipocalin 2 in chondrocytes
Owen, H., Roberts, S., Ahmed, S. and Farquharson, C. 2008. Dexamethasone-induced expression of the glucocorticoid response gene lipocalin 2 in chondrocytes. American Journal of Physiology - Endocrinology and Metabolism. 294 (6), pp. E1023-E1034. https://doi.org/10.1152/ajpendo.00586.2007
Identification of a novel splice variant of the haloacid dehalogenase: PHOSPHO1
Roberts, S., Owen, H. and Farquharson, C. 2008. Identification of a novel splice variant of the haloacid dehalogenase: PHOSPHO1. Biochemical and Biophysical Research Communications. 371 (4), pp. 872-876. https://doi.org/10.1016/j.bbrc.2008.04.163
Identification and functional involvement of lipocalin 2 in glucocorticoid-induced growth retardation
Owen, H., Ahmed, S. and Farquharson, C. 2007. Identification and functional involvement of lipocalin 2 in glucocorticoid-induced growth retardation. 29th Annual Meeting of the American Society for Bone and Mineral Research. Honolulu, HI 16 - 19 Sep 2007 Wiley.
The role of P21CIP1/WAF1 in glucocorticoid induced growth retardation
Owen, H., Ahmed, S. and Farquharson, C. 2007. The role of P21CIP1/WAF1 in glucocorticoid induced growth retardation. 2007 Annual Meeting of the Bone Research Society. Southampton, UK 03 - 05 Jul 2007 Wiley.
Identification of lipocalin 2, a novel glucocorticoid responsive gene in growth plate chondrocytes
Owen, H., Ahmed, S. and Farquharson, C. 2007. Identification of lipocalin 2, a novel glucocorticoid responsive gene in growth plate chondrocytes. 2007 Annual Meeting of the Bone Research Society. Southampton, UK 03 - 05 Jul 2007 Wiley.
The growth plate sparing effects of the selective glucocorticoid receptor modulator, AL-438
Owen, H., Miner, J., Ahmed, S. and Farquharson, C. 2007. The growth plate sparing effects of the selective glucocorticoid receptor modulator, AL-438. Molecular and Cellular Endocrinology. 264 (1-2), pp. 164-70. https://doi.org/10.1016/j.mce.2006.11.006
Glucocorticoids stimulate p21 expression in growth plate chondrocytes
Owen, H., Ahmed, S. and Farquharson, C. 2006. Glucocorticoids stimulate p21 expression in growth plate chondrocytes. 2006 Annual Meeting of the Bone Research Society. Southampton, UK 05 - 06 Jul 2006 Wiley.
Glucocorticoids induce lipocalin 2 gene expression in growth plate chondrocytes.
Owen, H., Ahmed, S. and Farquharson, C. 2006. Glucocorticoids induce lipocalin 2 gene expression in growth plate chondrocytes. 28th Annual Meeting of the American Society for Bone and Mineral Research. Philadelphia, PA 15 - 19 Sep 2006 Wiley.
The role of the 11 beta HSD shuttle in modulating the effects of proinflammatory cytokines on the growth plate
MacRae, V., Owen, H., Ahmed, S. and Farquharson, C. 2006. The role of the 11 beta HSD shuttle in modulating the effects of proinflammatory cytokines on the growth plate. 28th Annual Meeting of the American Society for Bone and Mineral Research. Philadelphia, PA 15 - 19 Sep 2006 Wiley.