title: The association between the Th-17 immune response and pulmonary complications in a trauma ICU population.
abstract: BACKGROUND
  The overall immunopathology of the T-helper cell (Th)-17 immune response has been implicated in various inflammatory diseases including pulmonary inflammation; however its potential role in acute respiratory distress syndrome (ARDS) is not defined. This study aimed to evaluate the Th-17 response in bronchoalveolar lavage fluid (BALF) and blood and from trauma patients with pulmonary complications.
  
  
  METHODS
  A total of 21 severely injured intensive care unit (ICU) subjects, who were mechanically ventilated and undergoing bronchoscopy, were enrolled. BALF and blood were collected and analyzed for Th-1 (interferon [IFN]γ), Th-2 (interleukin [IL]-4, -10), Th-17 (IL-17A, -17F, -22, 23) and pro-inflammatory (IL-1β, IL-6, tumor necrosis factor [TNF]α) cytokine levels.
  
  
  RESULTS
  Significant levels of the Th-17 cytokines IL-17A, -17F and -21 and IL-6 (which can be classified as a Th-17 cytokine) were observed in the BALF of all subjects. There were no significant differences in Th-17 cytokines between those subjects with ARDS and those without, with the exception of plasma and BALF IL-6, which was markedly greater in ARDS subjects, as compared with controls and non-ARDS subjects.
  
  
  CONCLUSIONS
  Trauma patients with pulmonary complications exhibited a significant Th-17 response in the lung and blood, suggesting that this pro-inflammatory milieu may be a contributing factor to such complications.
authors.affiliation: Department of Surgery, The University of Texas Health Science Center at San Antonio, TX 78229, United States.
authors.forename: Travis L
authors.initials: TL
authors.lastname: Holloway
authors.affiliation: Department of Surgery, The University of Texas Health Science Center at San Antonio, TX 78229, United States.
authors.forename: Meenakshi
authors.initials: M
authors.lastname: Rani
authors.affiliation: US Army Institute of Surgical Research, Fort Sam Houston, TX 78234, United States.
authors.forename: Andrew P
authors.initials: AP
authors.lastname: Cap
authors.affiliation: Department of Surgery, The University of Texas Health Science Center at San Antonio, TX 78229, United States.
authors.forename: Ronald M
authors.initials: RM
authors.lastname: Stewart
authors.affiliation: Department of Surgery, The University of Texas Health Science Center at San Antonio, TX 78229, United States; US Army Institute of Surgical Research, Fort Sam Houston, TX 78234, United States. Electronic address: schwacha@uthscsa.edu.
authors.forename: Martin G
authors.initials: MG
authors.lastname: Schwacha
mesh_terms: D000328:Adult; D001992:Bronchoalveolar Lavage Fluid; D016022:Case-Control Studies; D016207:Cytokines / Q000097:blood / Q000378:metabolism; D005260:Female; D006801:Humans; D007362:Intensive Care Units; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012128:Respiratory Distress Syndrome / Q000150:complications* / Q000276:immunology; D058504:Th17 Cells / Q000276:immunology*; D014947:Wounds and Injuries / Q000150:complications* / Q000276:immunology; D055815:Young Adult
chemical_list: D016207:Cytokines
keywords: Acute lung injury; Acute respiratory distress syndrome; IL-17; Inflammation; Injury