ArticleIntensive care medicine2016
Plasma levels of danger-associated molecular patterns are associated with immune suppression in trauma patients.
Article in Intensive care medicine, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 98 papers, 2 of them syntheses that pooled it.
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Who cites it
98 citing papers in PubMed, 2 syntheses or guidelines pooled it, 182 citations in OpenAlex.
- Pooled it
- The role of total cell-free DNA in predicting outcomes among trauma patients in the intensive care unit: a systematic review.Critical care (London, England) · 2017Pooled it
- The immunomodulatory effect of sugammadex in vitro and after total hip arthroplasty : A randomised controlled pilot and retrospective cohort study.European journal of anaesthesiology · 2025Trial
- Concurrent Immune Suppression and Hyperinflammation in Patients With Community-Acquired Pneumonia.Frontiers in immunology · 2020Trial
- Hallmarks of the multidimensional immune response to trauma in humans.Nature immunology · 2026Review
- Multimodal prehabilitation and perioperative immune function in patients undergoing abdominal cancer surgery.The British journal of surgery · 2026Article
- Article
- Immune function in paediatric trauma patients: a prospective explorative cohort study.Frontiers in immunology · 2026Article
- The impact of traumatic injury on the respiratory system; a narrative review of injury-associated and clinically-induced mechanisms of trauma-associated pneumonia.Frontiers in medicine · 2026Review
- Postoperative innate immune function after minimally invasive transcervical esophagectomy (MICE) versus minimally invasive transthoracic esophagectomy (MIE).Journal of thoracic disease · 2025Article
- Acute kidney injury and postoperative delirium.Journal of biomedical research · 2025Article
- Integrated multi omics and machine learning reveal mitochondrial immunometabolic networks in sepsis associated encephalopathy.Scientific reports · 2025Article
- Bacterial translocation to mesenteric lymph nodes fueling surgical site infections: evidence, technical challenges and future directions.Journal of translational medicine · 2025Review
- Exploratory Study of CD10Scandinavian journal of immunology · 2025Article
- Absolute lymphocyte count trajectory predicts clinical outcome in severely injured patients.European journal of trauma and emergency surgery : official publication of the European Trauma Society · 2025Article
- Polytrauma impairs fracture healing accompanied by increased persistence of innate inflammatory stimuli and reduced adaptive response.Journal of orthopaedic research : official publication of the Orthopaedic Research Society · 2025Article
- The effect of general versus spinal anesthesia on perioperative innate immune function in patients undergoing total hip arthroplasty.BMC anesthesiology · 2025Article
- Reassessing sepsis research: new clues for old players and new players for an old symptom to improve patient outcomes.EXCLI journal · 2025Review
- DAMP-driven trained immunity: metabolic and epigenetic reprogramming in critical illness and chronic inflammation.Frontiers in immunology · 2025Review
- Early Elevation of Monocytic-to-Polymorphonuclear Myeloid-Derived Suppressor Cells Ratio in Critical Illness is Associated with Favorable Clinical Outcomes.Journal of inflammation research · 2025Article
38 more citing papers are in PubMed but not listed here.
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Authors and funding
9 authors at 3 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
purposeDanger-associated molecular patterns (DAMPs) released of trauma could contribute to an immune suppressed state that renders patients vulnerable towards nosocomial infections. We investigated DAMP release in trauma patients, starting in the prehospital phase, and assessed its relationship with immune suppression and nosocomial infections.
methodsBlood was obtained from 166 adult trauma patients at the trauma scene, emergency room (ER), and serially afterwards. Circulating levels of DAMPs and cytokines were determined. Immune suppression was investigated by determination of HLA-DRA gene expression and ex vivo lipopolysaccharide-stimulated cytokine production.
resultsCompared with healthy controls, plasma levels of nuclear DNA (nDNA) and heat shock protein-70 (HSP70) but not mitochondrial DNA were profoundly increased immediately following trauma and remained elevated for 10 days. Plasma cytokines were increased at the ER, and levels of anti-inflammatory IL-10 but not of pro-inflammatory cytokines peaked at this early time-point. HLA-DRA expression was attenuated directly after trauma and did not recover during the follow-up period. Plasma nDNA (r = -0.24, p = 0.006) and HSP70 (r = -0.38, p < 0.0001) levels correlated negatively with HLA-DRA expression. Ex vivo cytokine production revealed an anti-inflammatory phenotype already at the trauma scene which persisted in the following days, characterized by attenuated TNF-α and IL-6, and increased IL-10 production. Finally, higher concentrations of nDNA and a further decrease of HLA-DRA expression were associated with infections.
conclusionsPlasma levels of DAMPs are associated with immune suppression, which is apparent within minutes/hours following trauma. Furthermore, aggravated immune suppression during the initial phase following trauma is associated with increased susceptibility towards infections.
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