title: Innate danger signals in acute injury: From bench to bedside.
abstract: The description of the systemic inflammatory response syndrome (SIRS) as a reaction to numerous insults marked a turning point in the understanding of acute critical states, which are intensive care basic cases. This concept highlighted the final inflammatory response features whichever the injury mechanism is: infectious, or non-infectious such as extensive burns, traumas, major surgery or acute pancreatitis. In these cases of severe non-infectious insult, many endogenous mediators are released. Like infectious agents components, they can activate the immune system (via common signaling pathways) and initiate an inflammatory response. They are danger signals or alarmins. These molecules generally play an intracellular physiological role and acquire new functions when released in extracellular space. Many progresses brought new information on these molecules and on their function in infectious and non-infectious inflammation. These danger signals can be used as biomarkers and provide new pathophysiological and therapeutic approaches, particularly for immune dysfunctions occurring after an acute injury. We present herein the danger model, the main danger signals and the clinical consequences.
authors.affiliation: Burn Intensive Care Unit, centre hospitalier Saint-Joseph-Saint-Luc, 20, quai Claude-Bernard, 69007 Lyon, France; EAM 4174 « Hemostasis, inflammation and sepsis », hospices civils de Lyon, université Claude-Bernard Lyon I, 69008 Lyon, France. Electronic address: mfontaine@ch-stjoseph-stluc-lyon.fr.
authors.forename: Mathieu
authors.initials: M
authors.lastname: Fontaine
authors.affiliation: EAM 4174 « Hemostasis, inflammation and sepsis », hospices civils de Lyon, université Claude-Bernard Lyon I, 69008 Lyon, France; Intensive Care Unit, centre hospitalier Lyon Sud, 165, chemin du Grand-Revoyet, 69495 Pierre-Bénite cedex, France.
authors.forename: Alain
authors.initials: A
authors.lastname: Lepape
authors.affiliation: EAM 4174 « Hemostasis, inflammation and sepsis », hospices civils de Lyon, université Claude-Bernard Lyon I, 69008 Lyon, France; Intensive Care Unit, centre hospitalier Lyon Sud, 165, chemin du Grand-Revoyet, 69495 Pierre-Bénite cedex, France.
authors.forename: Vincent
authors.initials: V
authors.lastname: Piriou
authors.affiliation: EAM 4174 « Hemostasis, inflammation and sepsis », hospices civils de Lyon, université Claude-Bernard Lyon I, 69008 Lyon, France; Immunology Laboratory, hôpital Édouard-Herriot, hospices civils de Lyon, 5, place d'Arsonval, 69437 Lyon cedex 03, France.
authors.forename: Fabienne
authors.initials: F
authors.lastname: Venet
authors.affiliation: Intensive Care Unit, centre hospitalier Lyon Sud, 165, chemin du Grand-Revoyet, 69495 Pierre-Bénite cedex, France.
authors.forename: Arnaud
authors.initials: A
authors.lastname: Friggeri
mesh_terms: D015415:Biomarkers; D006801:Humans; D007107:Immune System; D012772:Shock, Septic / Q000503:physiopathology / Q000628:therapy; D018746:Systemic Inflammatory Response Syndrome / Q000175:diagnosis* / Q000503:physiopathology*; D014947:Wounds and Injuries / Q000503:physiopathology / Q000628:therapy*
chemical_list: D015415:Biomarkers
keywords: Alarmins; Danger-associated molecular patterns; HMGB1; S100A9; Septic shock; Trauma