{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,19]],"date-time":"2026-06-19T10:51:36Z","timestamp":1781866296527,"version":"3.54.5"},"reference-count":16,"publisher":"Scientific Scholar","content-domain":{"domain":["nmji.in"],"crossmark-restriction":true},"short-container-title":["NMJI"],"abstract":"<jats:sec id=\"st1\">\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Severe trauma and injury may be associated with the release of inflammatory cytokines and the presence of circulating cell-free DNA (cfDNA). cfDNA is released by tissue damage, cell death, or dying cells in trauma haemorrhagic shock (T\/HS) patients. However, the source and mechanism of release of cfDNA in T\/HS is not well understood. Neutrophil extra-cellular traps (NETs) are the most common source of cfDNA, released by activated neutrophils during the process of NETosis. We aimed to determine the levels of cfDNA following T\/HS at different time points after injury.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"st2\">\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A prospective cohort study was done at Jai Prakash Narayan Apex Trauma Centre, All India Institute of Medical Sciences, New Delhi, India, with three groups: T\/HS patients, trauma victims without haemorrhagic shock (TVWHS), and healthy controls. Peripheral blood samples were collected and analysed for circulating cfDNA, protein C, myeloperoxidase (MPO, a marker of neutrophil activation), citrullinated histone H3 (a marker of NETosis), cyclophilin, and caspase-cleaved CK18 on hospital admission and follow-up days 3 and 7.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"st3\">\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>A total of 60 patients were included, 20 each of T\/HS, TVWHS patients and controls. The mean age was 32 years; 10% were women, and 90% were men, and mortality was 35% at 15 days. Circulating cfDNA were elevated in T\/HS when compared to TVWHS and controls. Moreover, serum levels of MPO, CK18, and H3Cit were significantly elevated in T\/HS patients.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"st4\">\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Our study suggests that elevated circulating levels of cfDNA are present in T\/HS patients.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.25259\/nmji_347_2024","type":"journal-article","created":{"date-parts":[[2026,6,8]],"date-time":"2026-06-08T06:49:58Z","timestamp":1780901398000},"page":"239-242","update-policy":"https:\/\/doi.org\/10.25259\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Pattern of circulating cell-free DNA in trauma haemorrhagic shock"],"prefix":"10.25259","volume":"39","author":[{"given":"MANOJ","family":"KUMAR","sequence":"first","affiliation":[{"name":"Department of Microbiology, Sukh Sagar Medical College and Hospital, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"SANJEEV","family":"BHOI","sequence":"additional","affiliation":[{"name":"Department of Emergency Medicine, Jai Prakash Narayan Apex Trauma Centre, All India Institute of Medical Sciences, New Delhi, India"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"10894","published-online":{"date-parts":[[2026,6,8]]},"reference":[{"key":"10.25259\/NMJI_347_2024\/ref-1","doi-asserted-by":"publisher","first-page":"119","DOI":"10.4103\/2229-5151.190654","article-title":"Bone marrow hematopoietic stem cells behavior with or without growth factors in trauma hemorrhagic shock","volume":"6","author":"Kumar","year":"2016","journal-title":"Int J Crit Illn Inj Sci"},{"key":"10.25259\/NMJI_347_2024\/ref-2","doi-asserted-by":"publisher","first-page":"29","DOI":"10.1186\/s40635-019-0251-4","article-title":"Comparison of the source and prognostic utility of cfDNA in trauma and sepsis","volume":"7","author":"Jackson 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