[Immunological aspects of trauma]

Injury breaks anatomical barriers of the body and leads to cell and tissue destruction. In response to trauma, repair and defense mechanisms, involved in tissue repair, wound healing, and prevention of infection, are induced. The magnitude of the trauma-induced response depends on the patient's overall condition and the severity of the injury. Minor injury usually elicits a local reaction, while severe trauma is associated with a systemic host response. In any case, the character of the response is very complex and involves the activation of crucial systems: (immunological, neural, and endocrine. The influence of different types of injury on immune response has been of interest to scientists for many years. Several studies have shown disturbances in innate and adaptive immune response as a consequence of burns, accident trauma, and surgical operation. It is generally accepted that major surgery often leads to severe immunosuppression, usually lasting for several days after injury and characterized by impaired cell-mediated immune response. Both clinical and experimental studies have demonstrated that one of the main causes of surgery-induced suppression of cellular immunity might be a shift in the T helper 1 TH1/TH2 pattern and type-1/type-2 cytokine secretion towards a TH2 response. The type and extent of the body's immune response to injury depends not only on functional changes of immune cells. An appropriate distribution of immune cells among different tissues and organs of the body is also required for proper function of the immune system.