Neutrophil heterogeneity and its role in infectious complications after severe trauma.
Immune response
Infection
Neutrophil
Trauma
Journal
World journal of emergency surgery : WJES
ISSN: 1749-7922
Titre abrégé: World J Emerg Surg
Pays: England
ID NLM: 101266603
Informations de publication
Date de publication:
2019
2019
Historique:
received:
26
04
2019
accepted:
13
05
2019
entrez:
6
6
2019
pubmed:
6
6
2019
medline:
27
9
2019
Statut:
epublish
Résumé
Trauma leads to a complex inflammatory cascade that induces both immune activation and a refractory immune state in parallel. Although both components are deemed necessary for recovery, the balance is tight and easily lost. Losing the balance can lead to life-threatening infectious complications as well as long-term immunosuppression with recurrent infections. Neutrophils are known to play a key role in these processes. Therefore, this review focuses on neutrophil characteristics and function after trauma and how these features can be used to identify trauma patients at risk for infectious complications. Distinct neutrophil subtypes exist that play their own role in the recovery and/or development of infectious complications after trauma. Furthermore, the refractory immune state is related to the risk of infectious complications. These findings change the initial concepts of the immune response after trauma and give rise to new biomarkers for monitoring and predicting inflammatory complications in severely injured patients. For early recognition of patients at risk, the immune system should be monitored. Several neutrophil biomarkers show promising results and analysis of these markers has become accessible to such extent that they can be used for point-of-care decision making after trauma.
Sections du résumé
Background
Trauma leads to a complex inflammatory cascade that induces both immune activation and a refractory immune state in parallel. Although both components are deemed necessary for recovery, the balance is tight and easily lost. Losing the balance can lead to life-threatening infectious complications as well as long-term immunosuppression with recurrent infections. Neutrophils are known to play a key role in these processes. Therefore, this review focuses on neutrophil characteristics and function after trauma and how these features can be used to identify trauma patients at risk for infectious complications.
Results
Distinct neutrophil subtypes exist that play their own role in the recovery and/or development of infectious complications after trauma. Furthermore, the refractory immune state is related to the risk of infectious complications. These findings change the initial concepts of the immune response after trauma and give rise to new biomarkers for monitoring and predicting inflammatory complications in severely injured patients.
Conclusion
For early recognition of patients at risk, the immune system should be monitored. Several neutrophil biomarkers show promising results and analysis of these markers has become accessible to such extent that they can be used for point-of-care decision making after trauma.
Identifiants
pubmed: 31164913
doi: 10.1186/s13017-019-0244-3
pii: 244
pmc: PMC6542247
doi:
Substances chimiques
Integrin alpha4beta1
0
Types de publication
Journal Article
Review
Langues
eng
Sous-ensembles de citation
IM
Pagination
24Déclaration de conflit d'intérêts
Competing interestsAll authors declare that they have no competing interests.
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