Sterile post-traumatic immunosuppression

Area of Science:

• Immunology
• Trauma Medicine
• Surgical Complications

Background:

• Major trauma initiates localized inflammation followed by immunosuppression.
• This post-traumatic immunosuppression (PTI) involves complex cellular and molecular interactions.
• PTI contributes to significant post-surgical mortality and complications like infections.

Purpose of the Study:

• To review the immune system's response to sterile trauma.
• To clarify the immunological changes contributing to post-traumatic immunosuppression (PTI).
• To integrate various responsive modalities into a comprehensive scheme of PTI.

Main Methods:

• Literature review of immune responses following sterile trauma.
• Analysis of cellular and soluble mediator contributions to PTI.
• Integration of findings to explain systemic immunosuppression post-trauma.

Main Results:

• Local inflammatory events after trauma lead to systemic immunosuppression (PTI).
• Complex interactions of immune cells (macrophages, dendritic cells, neutrophils, monocytes) and mediators (cytokines, chemokines) drive PTI.
• Factors like hemorrhage, blood transfusion, and immunesenescence exacerbate PTI.

Conclusions:

• Understanding the immunological contributions to PTI is crucial for improving patient outcomes.
• Further research is needed to resolve controversies surrounding systemic immunological changes post-trauma.
• This review aims to provide a clearer understanding of PTI's mechanisms and implications.