Division of Research, Department of Surgery, University of Cincinnati College of Medicine, Cincinnati, Ohio 45267-0558, USA.
BMC Immunol. 2010 Jan 25;11:4. doi: 10.1186/1471-2172-11-4.
The immune response to trauma has traditionally been modeled to consist of the systemic inflammatory response syndrome (SIRS) followed by the compensatory anti-inflammatory response syndrome (CARS). We investigated these responses in a homogenous cohort of male, severe blunt trauma patients admitted to a University Hospital surgical intensive care unit (SICU). After obtaining consent, peripheral blood was drawn up to 96 hours following injury. The enumeration and functionality of both myeloid and lymphocyte cell populations were determined.
Neutrophil numbers were observed to be elevated in trauma patients as compared to healthy controls. Further, neutrophils isolated from trauma patients had increased raft formation and phospho-Akt. Consistent with this, the neutrophils had increased oxidative burst compared to healthy controls. In direct contrast, blood from trauma patients contained decreased naïve T cell numbers. Upon activation with a T cell specific mitogen, trauma patient T cells produced less IFN-gamma as compared to those from healthy controls. Consistent with these results, upon activation, trauma patient T cells were observed to have decreased T cell receptor mediated signaling.
These results suggest that following trauma, there are concurrent and divergent immunological responses. These consist of a hyper-inflammatory response by the innate arm of the immune system concurrent with a hypo-inflammatory response by the adaptive arm.
传统上，创伤后的免疫反应被建模为全身性炎症反应综合征（SIRS），随后是代偿性抗炎反应综合征（CARS）。我们在一家大学医院外科重症监护病房（SICU）收治的同质男性严重钝器创伤患者队列中研究了这些反应。在获得同意后，在受伤后最多 96 小时内抽取外周血。测定了骨髓细胞和淋巴细胞群体的计数和功能。
与健康对照组相比，创伤患者的中性粒细胞数量升高。此外，从创伤患者中分离出的中性粒细胞形成筏的能力和磷酸化 Akt 增加。与此一致的是，与健康对照组相比，中性粒细胞的氧化爆发增加。与此形成鲜明对比的是，创伤患者的血液中幼稚 T 细胞数量减少。用 T 细胞特异性有丝分裂原激活后，与健康对照组相比，创伤患者的 T 细胞产生的 IFN-γ 较少。与这些结果一致，在激活后，观察到创伤患者的 T 细胞的 T 细胞受体介导的信号转导减少。
这些结果表明，创伤后存在并发和发散的免疫反应。这些反应包括免疫系统先天免疫部分的过度炎症反应，同时伴有适应性免疫部分的低炎症反应。
