Fig. 1.

Adipose tissue as a modulator of systemic post-traumatic responses. After a severe traumatic insult, a plethora of factors is released into systemic circulation, many of which are also secreted by adipose tissue. Traumatized adipose tissue releases procoagulant mediators such as tissue factor (TF) and plasminogen activator inhibitor 1 (PAI-1), facilitating thrombotic events. Furthermore, various proinflammatory mediators such as interleukin (IL-) 1β, IL-6, IL-8, tumor necrosis factor (TNF), monocyte chemoattractant protein-1 (MCP-1) and high mobility group box 1 protein (HMGB1) are liberated. Together with free fatty acids (FFA), they elicit various effects such as insulin resistance and immune cell activation, and compromise physiological functions of various remote organs. The adipokine adiponectin might exert systemic anti-inflammatory effects. Leptin was recently described as a prognostic marker of multiple organ failure in critically ill patients. ARDS acute respiratory distress syndrome, ASC adipose stromal cell