Trauma is danger
- PDF / 1,486,926 Bytes
- 10 Pages / 595.276 x 793.701 pts Page_size
- 35 Downloads / 170 Views
REVIEW
Open Access
Trauma is danger Paul F Hwang1,2,3, Nancy Porterfield1, Dylan Pannell4,5, Thomas A Davis1 and Eric A Elster1,2,3*
Abstract Background: Trauma is one of the leading causes of death in young adult patients. Many pre-clinical and clinical studies attempt to investigate the immunological pathways involved, however the true mediators remain to be elucidated. Herein, we attempt to describe the immunologic response to systemic trauma in the context of the Danger model. Data Sources: A literature search using PubMed was used to identify pertinent articles describing the Danger model in relation to trauma. Conclusions: Our knowledge of Danger signals in relation to traumatic injury is still limited. Danger/alarmin signals are the most proximal molecules in the immune response that have many possibilities for effector function in the innate and acquired immune systems. Having a full understanding of these molecules and their pathways would give us the ability to intervene at such an early stage and may prove to be more effective in blunting the postinjury inflammatory response unlike previously failed cytokine experiments.
Introduction The immune system has two effector arms, innate and adaptive, which mediate the response to pathogens and injury. The innate system is a non-specific response while the adaptive system is pathogen and antigen specific. This system has evolved to respond appropriately to pathogen or injury, but may be maladaptive in the setting of overwhelming injury as seen in complex traumatic war wounds or multisystem civilian trauma. In the setting of severe traumatic injury, the immune system is overwhelmed by the massive release of endogenous signals from injured tissue. Once systemically activated, the immune system reacts against the host, potentiating tissue damage and leading to organ failure [1]. In this situation, the immunologic response to injury, not the actual injury itself, leads to undue morbidity, and in some cases mortality. While immune mediated responses have classically been thought to center on self and non-self interactions and thereby neglect most traumatic injuries, the Danger model abandons this classical concept [2]. The Danger model theorizes that the immune system’s primary driving force is the need to detect and protect against danger and does not discriminate between self and non-self * Correspondence: [email protected] 1 Regenerative Medicine Department, Naval Medical Research Center, Silver Spring, MD USA Full list of author information is available at the end of the article
[2]. This concept states that the mechanism by which a cell dies governs whether the immune response is initiated. Therefore, tissue damage or an injury or endogenous signals of cell distress can trigger both an innate and adaptive response only if it causes danger, a noncontrolled and abnormal cell death process unlike apoptosis. In the absence of danger, host tissues remain healthy or undergo apoptotic death and are scavenged, and no immune response occurs. In contrast, wh
Data Loading...
