title: Current views on the mechanisms of immune responses to trauma and infection.
abstract: According to the World Health Organization, post-traumatic mortality rates are still very high and show an increasing tendency. Disorders of innate immune response that may increase the risk of serious complications play a key role in the immunological system response to trauma and infection. The mechanism of these disorders is multifactorial and is still poorly understood. The changing concepts of systemic inflammatory response syndrome (SIRS) and compensatory anti-inflammatory response syndrome (CARS) early inflammatory response, presented in this work, have been extended to genetic studies. Overexpression of genes and increased production of immune response mediators are among the main causes of multiple organ dysfunction syndrome (MODS). Changes in gene expression detected early after injury precede the occurrence of subsequent complications with a typical clinical picture. Rapid depletion of energy resources leads to immunosuppression and persistent inflammation and immune suppression catabolism syndrome (PICS). Early diagnosis of immune disorders and appropriate nutritional therapy can significantly reduce the incidence of complications, length of hospital stay, and mortality. The study presents the development of knowledge and current views explaining the mechanisms of the immune response to trauma and infection.
authors.affiliation: Department of Emergency Medicine, Medical University of Warsaw, Warsaw, Poland ; Department of Disaster Medicine, Medical University of Warsaw, Warsaw, Poland.
authors.forename: Aneta Małgorzata
authors.initials: AM
authors.lastname: Binkowska
authors.affiliation: Department of Emergency Medicine, Medical University of Warsaw, Warsaw, Poland.
authors.forename: Grzegorz
authors.initials: G
authors.lastname: Michalak
authors.affiliation: Department of Immunology, Biochemistry, and Nutrition, Medical University of Warsaw, Warsaw, Poland ; Department of Surgical Research and Transplantology, Medical Research Centre, Polish Academy of Sciences, Warsaw, Poland.
authors.forename: Robert
authors.initials: R
authors.lastname: Słotwiński
keywords: CARS; MODS; PICS; SIRS; innate immune response; sepsis