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Traumatic injury sets off a 'genomic storm' in immune system pathways
Date:12/7/2011

for serious burns, 37 healthy controls and four volunteers treated with a bacterial toxin that produces brief flu-like symptoms.

The genomic changes seen in the trauma and burn patients were essentially the same, with immediate increased expression of pathways involved with inflammation and with the first-response innate immune system along with simultaneous suppression of adaptive immune pathways. Over time these patterns changed only in terms of intensity and duration, which runs counter to a widely accepted theory that the initial pro-inflammatory response would be followed by an anti-inflammatory response that opens the door to complications like sepsis and organ failure. Instead the only differences between patients with and without complications were in the magnitude of gene expression changes and how long they lasted. Even the volunteers who received bacterial toxin, whose symptoms lasted for only 24 hours, had similar changes in 40 percent of the gene pathways that were altered in the seriously injured patients.

"Burn patients may take months to years to recover from their injuries, while trauma patients who are going to recover usually do so within a month. So it was entirely unexpected that gene expression patterns in burns and trauma patients changed in exactly the same directions 91 percent of the time," Tompkins explains. "Also if you consider two patients with identical injuries from a serious auto accident a 20-year old who is ready to go home in a week and a 55-year-old who is still in the ICU and on a ventilator at the same point in time it would be logical to think that the complications suffered by the older patient must have a genome-based difference. But it turns out that the gene expression changes are the same and the only differences is how much they change and how soon they return to normal. There are no new genes or pathways recruited to deal with those serious complications beyond those already involved in the
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Contact: Sue McGreevey
smcgreevey@partners.org
617-724-2764
Massachusetts General Hospital
Source:Eurekalert

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