School of Pharmacy & Health Sciences, University of the Pacific, Stockton, California, 123 Forest Ave, Pacific Grove, CA 93950, USA.
University Paris Diterot, Paris 7, Chef de Service, Laboratory of Immunology & Histocompatibility, Hospital Saint-Louis, 1 Avenue Claude Vellefaux, 75475 Paris Cedex 10, France.
Med Hypotheses. 2018 Aug;117:7-15. doi: 10.1016/j.mehy.2018.05.012. Epub 2018 May 26.
All traumas suppress the immune system, resulting in higher morbidity and mortality. Infections, poor nutritional status, chronic illness, fatigue, therapies or procedures performed during and after transport also negatively affect the immune system. Large populations are impacted by trauma worldwide and suffer enormous costs in both direct and indirect expenditures from physical, psychological and functional losses. Most therapies and studies of trauma, brain trauma, stroke, immune suppression and their co-morbidities do not address nor discuss methods that promote immune system resuscitation or efficacy to support its role in post-trauma healing and rehabilitation. These omissions present an opportunity for using autologous stored naïve (unexposed to the current trauma and co-morbidities) white blood cell infusions (autologous white blood cell infusion) (AWBCI) to supplement treatment of most traumas, trauma-associated infections, other co-morbidities and immune suppression derived problems in order to improve the global standard of trauma care. We hypothesize to give the traumatized patients back their own immune system that has been 'stored' in some fashion, either cryogenically or just after or during the trauma event [surgery, etc for example]. We emphasize that other treatments should not be replaced - rather we suggest AWBCI as concurrent therapy. We present focused select animal and human studies as proofs of concept to arrive at and support our therapeutic suggestion and hypotheses, flowing historically from donor white blood cell therapy [DLI] to close cohort white blood cell therapy to autologous white blood cell infusion [AWBCI]. We integrate the concept of personalized medicine from an evidence-based framework while maintaining scientific rigor and statistical proof as a basis of our hypotheses.
所有创伤都会抑制免疫系统，导致发病率和死亡率上升。感染、营养状况差、慢性疾病、疲劳、治疗或在运输过程中及之后进行的程序也会对免疫系统产生负面影响。全世界有大量人群受到创伤的影响，在身体、心理和功能丧失方面承受着巨大的直接和间接支出。大多数创伤、脑外伤、中风、免疫抑制及其合并症的治疗和研究都没有解决或讨论促进免疫系统复苏或提高其在创伤后愈合和康复中的作用的方法。这些遗漏为使用自体储存的幼稚（未暴露于当前创伤和合并症）白细胞输注（自体白细胞输注）（AWBCI）提供了机会，以补充治疗大多数创伤、创伤相关感染、其他合并症和免疫抑制相关问题，以提高全球创伤护理标准。我们假设通过某种方式（例如低温保存或创伤事件后或期间）给受创伤的患者回输他们自己的“储存”的免疫系统。我们强调，其他治疗方法不应被替代，而我们建议将 AWBCI 作为联合治疗。我们提出了重点选择的动物和人体研究，作为证明概念的证据，以支持我们的治疗建议和假设，这些研究是从供体白细胞治疗[DLI]到密切队列白细胞治疗到自体白细胞输注[AWBCI]历史上发展而来的。我们从循证框架整合了个性化医学的概念，同时保持科学严谨性和统计证据作为假设的基础。
