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Related Concept Videos

Acute Inflammation III: Local and Systemic Effects01:25

Acute Inflammation III: Local and Systemic Effects

Acute inflammation produces a coordinated set of local and systemic changes that limit injury, eliminate pathogens, and initiate repair. These responses arise within minutes of infection, trauma, or chemical insult and are driven by vascular alterations and leukocyte-derived mediators. When the stimulus resolves, the reaction typically abates within days.Local EffectsAt the site of injury, arteriolar vasodilation increases blood flow, resulting in redness and warmth. Simultaneously, increased...
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An inflammatory response is a localized, nonspecific immune reaction that occurs when a tissue is injured. It is characterized by redness, swelling, heat, and pain, which are commonly called the cardinal signs and symptoms of inflammation. Inflammation can sometimes result in a loss of function.
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Immunomodulation in polytrauma and polymicrobial sepsis - where do we stand?

Claudia Neunaber1, Christian Zeckey, Hagen Andruszkow

  • 1Trauma Department, Hannover Medical School, Hannover, Germany. neunaber.claudia@mh-hannover.de

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Multiple trauma patients face sepsis and organ dysfunction despite better survival. Immune responses, including sex hormones and novel agents like H₂S, are key to developing new treatments for better outcomes.

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Area of Science:

  • Immunology
  • Trauma Surgery
  • Critical Care Medicine

Background:

  • Mortality in multiple trauma patients has decreased, but sepsis and multiple organ dysfunction syndrome (MODS) remain significant challenges.
  • The balance between pro-inflammatory (Systemic Inflammatory Response Syndrome, SIRS) and anti-inflammatory (Compensatory Anti-inflammatory Response Syndrome, CARS) responses dictates patient outcomes.
  • Gender dimorphism in immune response and potential protective effects of sex hormones have been observed.

Purpose of the Study:

  • To explore the role of immune response modulation in post-traumatic complications.
  • To investigate potential therapeutic targets, including sex hormones and novel agents, for sepsis and MODS in trauma patients.

Main Methods:

  • Review of existing experimental and clinical studies on immune responses after multiple trauma and sepsis.
  • Analysis of the impact of sex hormones, androgen receptor blockade, and dihydrotestosterone (DHT) synthesis inhibition.
  • Examination of the modulation of Toll Like Receptor (TLR) pathways and the roles of hydrogen sulfide (H₂S) and substance P.

Main Results:

  • Female sex hormones and precursors like androstenediol show protective effects.
  • Androgen receptor blockade and DHT synthesis inhibition may benefit immune response.
  • Modulation of TLR pathways by MALP-2, and the pro-inflammatory roles of H₂S and substance P are significant.

Conclusions:

  • Immune response balance is critical in managing post-traumatic sepsis and MODS.
  • Sex hormones, TLR pathway modulators, H₂S, and substance P represent potential therapeutic avenues.
  • Further research into these agents could lead to improved treatment strategies for trauma patients with sepsis.