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Patients diagnosed with traumatic hemorrhagic shock and requiring transfusion in the emergency department were selected as the patients group. Gene expressions were analyzed using quantitative real-time PCR analysis in total RNA samples and serum levels of NOS3 and ADORA3 were detected using ELISA measurements.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      In patients with multiple trauma, adenosine A3 receptor\n                      <jats:italic>(ADORA3)<\/jats:italic>\n                      gene expression showed a significant increase at discharge when compared to healthy controls (\n                      <jats:italic>P<\/jats:italic>\n                      \u2009&lt;\u20090.05). However, serum levels of ADORA3 showed significant decreases at all stages (i.e. at admission, at 24\u00a0h, and at discharge) of patients. Although no significant changes were detected in\n                      <jats:italic>NOS3<\/jats:italic>\n                      gene expression, marked decreases in serum NOS3 levels were observed at admission and at 24\u00a0h in multiple trauma patients (\n                      <jats:italic>P<\/jats:italic>\n                      \u2009&lt;\u20090.05).\n                      <jats:italic>ADORA3<\/jats:italic>\n                      and\n                      <jats:italic>NOS3<\/jats:italic>\n                      gene expressions were found to be significantly diminished in nonsurvivors.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>\n                      The study emphasizes the importance of\n                      <jats:italic>ADORA3<\/jats:italic>\n                      and\n                      <jats:italic>NOS3<\/jats:italic>\n                      gene expressions in influencing shock progression in multiple trauma patients. The increase in\n                      <jats:italic>ADORA3<\/jats:italic>\n                      gene expression may play a role in restoring vascular reactivity after traumatic shock. Decreased serum NOS3 and ADORA3 levels can contribute to the shock progression in the pathophysiology of multiple trauma.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1007\/s00068-025-02853-3","type":"journal-article","created":{"date-parts":[[2025,4,8]],"date-time":"2025-04-08T17:28:41Z","timestamp":1744133321000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Role of adenosine A3 receptor and endothelial nitric oxide synthase in patients with traumatic hemorrhagic shock"],"prefix":"10.1007","volume":"51","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0192-6345","authenticated-orcid":false,"given":"Yasin","family":"\u00d6zta\u015f","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8459-2116","authenticated-orcid":false,"given":"Yusuf Ertu\u011frul","family":"Aslan","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5644-5442","authenticated-orcid":false,"given":"Elif Funda","family":"\u015eener","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0829-8625","authenticated-orcid":false,"given":"Halime","family":"Dana","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1297-9167","authenticated-orcid":false,"given":"Emre","family":"Tu\u011fhan","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1604-9565","authenticated-orcid":false,"given":"Nurullah","family":"G\u00fcnay","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9994-8541","authenticated-orcid":false,"given":"Abdullah Tuncay","family":"Demiry\u00fcrek","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"297","published-online":{"date-parts":[[2025,4,8]]},"reference":[{"issue":"5","key":"2853_CR1","doi-asserted-by":"publisher","first-page":"780","DOI":"10.1097\/ta.0000000000000453","volume":"77","author":"H-C Pape","year":"2014","unstructured":"Pape H-C, Lefering R, Butcher N, Peitzman A, Leenen L, Marzi I, et al. 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