Evidence map›Paper›PMID 41552959›Full record

ArticleUnited European gastroenterology journal2026

Remote Pancreatic Response to Severe Polytrauma Correlates With Clinical Outcome.

Rebecca Halbgebauer, Lisa Wohlgemuth, Jonas Wrba, Sonja Braumüller, Enes Kumral, Ludmila Lupu, Clara Morgenstern, Lucas Bettac, Sebastian Wiese, Benjamin Mayer and 8 more

Abstract read
In one paragraph

Article in United European gastroenterology journal, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed.

  1. Review
  2. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

18 authors.

Rebecca HalbgebauerInstitute of Clinical and Experimental Trauma Immunology (ITI), Ulm University Medical Center, Ulm, Germany.ORCID https://orcid.org/0000-0001-8060-2076
Lisa WohlgemuthInstitute of Clinical and Experimental Trauma Immunology (ITI), Ulm University Medical Center, Ulm, Germany.ORCID https://orcid.org/0000-0001-5795-812X
Jonas WrbaInstitute of Clinical and Experimental Trauma Immunology (ITI), Ulm University Medical Center, Ulm, Germany.
Sonja BraumüllerInstitute of Clinical and Experimental Trauma Immunology (ITI), Ulm University Medical Center, Ulm, Germany.
Enes KumralInstitute of Clinical and Experimental Trauma Immunology (ITI), Ulm University Medical Center, Ulm, Germany.
Ludmila LupuInstitute of Clinical and Experimental Trauma Immunology (ITI), Ulm University Medical Center, Ulm, Germany.
Clara MorgensternInstitute of Molecular Oncology and Stem Cell Biology, Ulm University Medical Center, Ulm, Germany.
Lucas BettacInternal Medicine I, Ulm University Medical Center, Ulm, Germany.
Sebastian WieseCore Unit of Mass Spectrometry and Proteomics, Ulm University Medical Center, Ulm, Germany.
Benjamin MayerInstitute for Epidemiology and Medical Biometry, Ulm University, Ulm, Germany.
Paolo CinelliDepartment of Traumatology, Universitaetsspital Zurich, Zurich, Switzerland.
Daniel RittirschInstitute of Clinical and Experimental Trauma Immunology (ITI), Ulm University Medical Center, Ulm, Germany.
Hans-Christoph PapeDepartment of Traumatology, Universitaetsspital Zurich, Zurich, Switzerland.
Francesco RoselliDepartment of Neurology, Ulm University Medical Center, Ulm, Germany.
Thomas SeufferleinInternal Medicine I, Ulm University Medical Center, Ulm, Germany.
Alexander KlegerInstitute of Molecular Oncology and Stem Cell Biology, Ulm University Medical Center, Ulm, Germany.ORCID https://orcid.org/0000-0003-0592-5232
Markus BreunigInstitute of Molecular Oncology and Stem Cell Biology, Ulm University Medical Center, Ulm, Germany.
Markus Huber-LangInstitute of Clinical and Experimental Trauma Immunology (ITI), Ulm University Medical Center, Ulm, Germany.

Funding

Baden-Württemberg Stiftung ISF-015 CrossIngPanCDeutsche Forschungsgemeinschaft KL 2544/13-1Deutsche Forschungsgemeinschaft K.L. 2544/6-1Deutsche Forschungsgemeinschaft Project-ID 251293561 - SFB 1149Deutsche Forschungsgemeinschaft U1-FOR5417, project number 465409392Else Kröner-Fresenius-Stiftung 2022_EKEA.89Medizinische Fakultät, Universität Ulm Baustein program
6 · The paper itself

Abstract

backgroundAcute pancreatic injury can result from blunt or sharp force trauma, often leading to serious complications. While direct pancreatic trauma is associated with high rates of infection, organ failure, and mortality, little is known about the pancreas as a potential secondary target and remote trauma organ and thereby as a booster of systemic injury.

methodsWe employed a murine model of multiple trauma and hemorrhagic shock in which the pancreas was deliberately spared from the direct trauma impact. Four hours post-trauma, we determined systemic and local inflammatory responses, pancreatic tissue damage, pancreatic lipase (Pnlip in mice), and protease activity, and conducted proteomic profiling of the pancreas. For clinical translation, we performed a post hoc analysis of severely injured polytrauma patients, focusing on acute pancreatic involvement and its association with clinical parameters.

resultsSevere trauma in mice induced rapid systemic inflammation and significantly elevated plasma levels of Pnlip. Notably, pancreatic edema formation was observed in a subset of polytraumatized mice, accompanied by increased activity of matrix metalloproteinases Mmp2 and Mmp9. Proteomic analysis revealed an enrichment of inflammatory and cellular stress pathways in pancreatic tissue. Similarly, in polytraumatized patients, plasma pancreatic lipase (PNLIP in humans) and trypsin concentrations were elevated during the early posttraumatic period and correlated with injury patterns, systemic inflammation, coagulopathy, endotheliopathy, organ failure, and time in hospitals and intensive care units.

conclusionOur findings highlight the pancreas as a novel remote responder to severe tissue trauma, even in the absence of direct injury. This widely overlooked dimension of trauma pathophysiology has potential clinical implications. However, further research is essential (i) to unravel the mechanisms driving remote pancreatic enzyme release and (ii) to prove the causality between the pancreatic response and observed clinical parameters.

Indexed as

Multiple TraumaPancreasShock, HemorrhagicAdultAnimalsDisease Models, AnimalFemaleHumansLipaseMaleMiceMice, Inbred C57BLProteomicsTrypsinLipaseTrypsinorgan dysfunctionpancreaspolytraumashock

Identifiers

PMID41552959
PMCPMC12814208

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LicenceCC BY-NC-ND
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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.