Late immune consequences of combat trauma: a review of trauma-related immune dysfunction and potential therapies
| Autor: | Ryan J. Stark, Luke T Krispinsky, Kelly B. Thompson |
|---|---|
| Rok vydání: | 2018 |
| Předmět: |
0301 basic medicine
medicine.medical_specialty Multiple Organ Failure Damage control resuscitation Acute respiratory distress Review Adaptive Immunity Immune Dysfunction Trauma Sepsis Immunomodulation 03 medical and health sciences 0302 clinical medicine Immune system Medicine Humans Intensive care medicine Delayed wound healing lcsh:R5-920 Wound Healing Late onset sepsis lcsh:Military Science business.industry lcsh:U 030208 emergency & critical care medicine General Medicine medicine.disease Immunity Innate Systemic Inflammatory Response Syndrome 3. Good health 030104 developmental biology Military Personnel Immune dysfunction Persistent inflammation-immunosuppression and catabolism syndrome Treatment strategy Wounds and Injuries Compensatory anti-inflammatory response syndrome business lcsh:Medicine (General) |
| Zdroj: | Military Medical Research Military Medical Research, Vol 6, Iss 1, Pp 1-13 (2019) |
| ISSN: | 2054-9369 |
| Popis: | With improvements in personnel and vehicular body armor, robust casualty evacuation capabilities, and damage control resuscitation strategies, more combat casualties are surviving to reach higher levels of care throughout the casualty evacuation system. As such, medical centers are becoming more accustomed to managing the deleterious late consequences of combat trauma related to the dysregulation of the immune system. In this review, we aim to highlight these late consequences and identify areas for future research and therapeutic strategies. Trauma leads to the dysregulation of both the innate and adaptive immune responses, which places the injured at risk for several late consequences, including delayed wound healing, late onset sepsis and infection, multi-organ dysfunction syndrome, and acute respiratory distress syndrome, which are significant for their association with the increased morbidity and mortality of wounded personnel. The mechanisms by which these consequences develop are complex but include an imbalance of the immune system leading to robust inflammatory responses, triggered by the presence of damage-associated molecules and other immune-modifying agents following trauma. Treatment strategies to improve outcomes have been difficult to develop as the immunophenotype of injured personnel following trauma is variable, fluid and difficult to determine. As more information regarding the triggers that lead to immune dysfunction following trauma is elucidated, it may be possible to identify the immunophenotype of injured personnel and provide targeted treatments to reduce the late consequences of trauma, which are known to lead to significant morbidity and mortality. |
| Databáze: | OpenAIRE |
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