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Could improve prediction of patient outcomes, lead to tailored treatmentsWhen it comes to inflammation, too much of a good thing can be deadly. In some severely injured patients, this normal healing process can develop into a lethal, whole-body response, including bloodstream infection (sepsis) and multiple organ failure. How and why inflammation turns from healing to harming is still mysterious, so doctors can't accurately predict how each injured patient will fare.

To address these issues, scientists have produced the genomic equivalent of a time-lapse movie, tracking the activity of thousands of genes through the course of body-wide inflammation. The research appears in the August 31 advanced online issue of Nature.

"This work represents a major step in understanding inflammation in severely injured or burned patients. We hope this knowledge eventually will help physicians better predict patient outcomes and tailor treatments accordingly," said Jeremy M. Berg, Ph.D., director of the National Institute of General Medical Sciences (NIGMS), the component of the National Institutes of Health that funded the research.

The study is the result of a collaborative effort funded by an NIGMS "glue grant." Glue grants bring together scientists from diverse fields--in this case surgery, critical care medicine, genomics, bioinformatics, immunology and computational biology--to solve major, complex problems in biomedical science that no single laboratory could address on its own.

To identify all the genes involved in responding to critical injury, the Inflammation and the Host Response to Injury glue grant team injected healthy volunteers with bacterial endotoxin. This molecule causes body-wide inflammation similar to sepsis, with one important difference--it is well-defined and lasts only 24 hours. By comparing the changes in gene activity caused by endotoxin exposure with those caused by trauma, the researchers hope to identify the molecular m
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