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The Immune and Inflammatory Response to Major Traumatic Injury

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Blast Injury Science and Engineering

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Abstract

Two opposing clinical syndromes characterise the immune and inflammatory response to major trauma. Defined by immune activation and raised circulating levels of pro-inflammatory cytokines, a systemic inflammatory response syndrome (SIRS) is accompanied by a counteracting compensatory anti-inflammatory response syndrome (CARS), which is characterised by peripheral immune suppression and elevated circulating concentrations of anti-inflammatory cytokines. With it becoming increasingly recognised that it is the magnitude and/or duration of the SIRS:CARS response that influences a patient’s clinical course, the field of trauma immunology is starting to focus upon understanding the mechanisms that underpin both the initiation and maintenance of the post-trauma immune response in an effort to improve patient outcome. Thus, the purpose of this chapter is to provide a summary of these emerging areas of research that are combining the results of both basic science and clinical-based studies to (1) further our understanding at the molecular level of how traumatic injury promotes systemic inflammation, (2) determine whether novel therapeutic strategies aimed at restoring immune homeostasis can reduce the incidence of secondary complications amongst hospitalised trauma patients and (3) establish whether features of the SIRS:CARS responses can serve as prognostic indicators of patient outcome.

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Authors and Affiliations

  1. Institute of Inflammation and Ageing, University of Birmingham, Birmingham, UK

    Jon Hazeldine

  2. National Institute for Health Research Surgical Reconstruction and Microbiology Research Centre, University Hospital Birmingham, Birmingham, UK

    Jon Hazeldine

  3. Royal Centre for Defence Medicine, Birmingham, UK

    Mark Foster

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  1. Jon Hazeldine
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  2. Mark Foster
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Correspondence to Mark Foster .

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Editors and Affiliations

  1. Department of Bioengineering and Centre for Blast Injury Studies, Imperial College London, London, UK

    Anthony M. J. Bull

  2. Department of Bioengineering and Centre for Blast Injury Studies, Imperial College London, Surrey, UK

    Jon Clasper

  3. Centre for Blast Injury Studies, Imperial College London, London, UK

    Peter F. Mahoney

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Hazeldine, J., Foster, M. (2022). The Immune and Inflammatory Response to Major Traumatic Injury. In: Bull, A.M.J., Clasper, J., Mahoney, P.F. (eds) Blast Injury Science and Engineering. Springer, Cham. https://doi.org/10.1007/978-3-031-10355-1_13

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  • DOI: https://doi.org/10.1007/978-3-031-10355-1_13

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