Role of biological modifiers regulating the immune response after trauma.
Trauma induces a profound immunological dysfunction. This is characterised by an early state of hyperinflammation, followed by a phase of immunosuppression with increased susceptibility to infection and multiple organ failure. Therapeutic strategies directed at restoring immune homeostasis after traumatic injuries have largely failed in translation from "bench to bedside". The present review illustrates the role of biological modifiers of the posttraumatic immune response by portraying different modalities of therapeutic immune modulation. The emphasis is placed on anti-inflammatory (steroids) and immune-stimulatory (interferon) pharmacological strategies and modified resuscitative strategies, as well as more unconventional immunomodulatory approaches, such as immunonutrition.
Department of Orthopaedic Surgery, Denver Health Medical Center, University of Colorado School of Medicine, 777 Bannock Street, Denver, CO 80204, USA.
Philip F
PF
Stahel
Wade R
WR
Smith
Ernest E
EE
Moore
D000305:Adrenal Cortex Hormones / Q000627:therapeutic use*; D000893:Anti-Inflammatory Agents / Q000627:therapeutic use; D000998:Antiviral Agents / Q000627:therapeutic use; D016207:Cytokines / Q000276:immunology; D006801:Humans; D007108:Immune Tolerance / Q000276:immunology*; D007155:Immunologic Factors / Q000627:therapeutic use*; D007249:Inflammation / Q000276:immunology*; D007372:Interferons / Q000627:therapeutic use; D009104:Multiple Trauma / Q000150:complications / Q000276:immunology*
D000305:Adrenal Cortex Hormones; D000893:Anti-Inflammatory Agents; D000998:Antiviral Agents; D016207:Cytokines; D007155:Immunologic Factors; D007372:Interferons