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PNAS study reveals why organs fail following massive trauma

Massive trauma, say from a sabertooth tiger attack, meant immediate death for the primitive human. Modern man is more likely to survive severe injury caused by a car crash, gunshot or fall thanks to high-tech emergency medicine. Unfortunately, the body does not know what to do when it survives an injury that would have been fatal until recently in human evolution. Nearly one third of the time, mechanisms in place to protect people from disease misfire seven to ten days after severe injury, causing multiple organ failure. That is one reason why trauma is the leading cause of death for Americans aged 44 and younger.

A nationwide team of researchers is working urgently on the problem of post-trauma immune system and organ failure, and has discovered several new biochemical pathways that play a central role, according to a study published today in the Proceedings of the National Academy of Sciences (PNAS). Inventing new techniques along the way, the team is changing emergency room guidelines, building the foundation for earlier diagnosis of post-trauma organ failure and making possible the design of drugs to reverse it.

Trauma has become a federal research priority because the survival rate has not improved in 10 years. Excitement is growing, however, because new evidence suggests that major diseases involving the immune system share some of the same mechanisms and may be cured by manipulating the same molecules. A protein called programmed cell death 1 (PD1), for example, suggested by the PNAS paper as playing a role in post-trauma organ failure, is also involved in the immune system breakdown leading to AIDS, according to an article in the August edition of Nature.

"Our study proves for the first time that it is possible to identify the genetic and protein changes in specific immune cells that play a significant role in determining whether or not trauma is fatal," said Carol L. Miller-Graziano, Ph.D., professor of Surgery and of Microbiology
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Source:University of Rochester Medical Center


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