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Immune function predicts infection risk among child trauma patients
Date:7/9/2014

healthy children responded normally when exposed to LPS, producing high levels of TNF-alpha. Samples from the patients with critical injuries all showed at least a moderate decrease in the production of the cytokine. However, the children who went on to develop an infection showed a much more severe and persistent drop in immune function following injury.

"It's as if we put the blood cells on a treadmill, forcing them to work in the test tube by exposing them to LPS, and then we measure how much TNF-alpha they are capable of making," Dr. Hall says. While the findings strongly suggest that infection risk is associated with immune system function after critical injury, they don't offer any answers about what's causing the malfunction. Dr. Hall's team is studying that question now.

The research also highlighted another interesting issue that may affect the immune response in critical illness. The team found that patients who received a transfusion of blood that had been stored for more than two weeks prior to transfusion had a lower level of TNF-alpha production than kids whose transfused blood was less than two weeks old, regardless of the severity of their original injury. This supports a study published by the same group in 2012 in Transfusion that found the same immunosuppressive effect in a human cell culture model.

Dr. Hall plans to look into this further through his work with a multi-institutional effort called The Pediatric Critical Care Blood Research Network (BloodNet) that is studying, among other things, what impact blood transfusions have on immune function.

"There's a whole line of research in which we're involved that is dedicated to understanding the effects of transfusion in critical illness," he says. "It's not clear yet if blood transfusions are immunosuppressive, but our work so far suggests that blood becomes more immunosuppressive the longer it sits on the shelf."

Yet another element to the recentl
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Contact: Gina Bericchia
MediaRelations@NationwideChildrens.org
614-355-0495
Nationwide Children's Hospital
Source:Eurekalert

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