People who are personally injured in a car accident know that one of the main procedures that emergency medical staff perform when treating victims throughout the process is preventing infection. This is particularly important for victims with open wounds and burns. However, medical experts have even found that patients without open wounds are in serious danger.
While victims are in the hospital it seems that they were still susceptible to infection and other illnesses regardless of the fact that the patient is in a sterile facility. Some assumed that the infections and other illnesses were due to proximity and environment (i.e lots of sick patients nearby), but new research suggests that a lowered immune response is caused by the personal injury itself.
These findings could potentially make the liability for an illness that might threaten the life of the victim suffered directly after an injury accident fall on the shoulders of the negligent party that caused the accident.
Post-Accident Genomic Immune System Research
The research was conducted by a collaborative program involving investigators from 20 academic research centers from around the United States, and appears in the December Journal of Experimental Medicine.This important study was supported by a grant from the National Institute of General Medical Sciences (NIGMS) at the National Institutes of Health.
Researchers found that traumatic personal injuries and major burns, set off what they called a “genomic storm” in human immune cells. The trauma resulted in altering 80% of the cells’ normal gene expression patterns. This has a major effect on the immune system.
They discovered that the genomic response to personal injury was essentially the same regardless of the patient’s individual genetic background. The genomic response in the immune system was also present whether the injury was caused by major tr
auma or serious burns, or if recovery is rapid or complicated.
“When this project was organized more than a decade ago, the question was raised whether responses would differ so much from person to person that no patterns would appear,” said Ronald G. Tompkins, MD, ScD, director of the Sumner Redstone Burn Center at Massachusetts General Hospital (MGH) and principal investigator of the study. “It is amazing how similar our responses to injuries like serious burns or trauma actually are.”
The Inflammation and Host Response to Injury Consortium was created in 2001 to study how our bodies react to personal injuries and burns and what factors set off excessive, uncontrolled inflammation that can lead to the overwhelming body-wide infection called sepsis or to multi-organ dysfunction syndrome, a life-threatening failure of vital systems.
Blood samples were taken from 167 patients being treated for severe trauma at seven U.S. hospitals within 12 hours of the injury and several times during the next 28 days after the injury. The research team analyzed whole-genome expression patterns in white blood cells. Gene expression pattern changes were tracked and compared with samples from 133 patients treated for serious burns, 37 healthy controls and four volunteers treated with a bacterial toxin that produces brief flu-like symptoms.
The genomic changes in almost all trauma and burn patients in the study began with inflammation and with the first-response innate immune system accompanied by simultaneous suppression of adaptive immune pathways. Through the 28 day study period, these patterns changed only by intensity and duration.
Potentially New Personal Injury Treatments
These findings fly in the face of widely accepted theories that the initial “pro-inflammatory” response in patient is soon 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 medical complications due to their personal injuries were in the levels of gene expression changes and the duration of those changes. Even the volunteers who received bacterial toxin, whose symptoms lasted for only 24 hours, had similar changes in 40% of the gene pathways that were altered in the seriously injured patients.
This expression could last longer in burn patients, who may take months to years to recover from their injuries. Trauma patients, on the other hand, usually recover a month or two. So researchers said that it was entirely unexpected that gene expression patterns in burns and trauma patients changed in exactly the same directions 91% of the time.
“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,” Tompkins said. “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 body’s basic response to serious injury.
This knowledge allows the medical community to begin to design therapies to promote improvement in patients who would otherwise have complicated recoveries. It would also researchers to determine whether measuring genomic changes soon after injury can help them predict which patients will recover well and which will need more intesive treatment delivered in ICUs. This extra treatment can sometimes be harmful to the patient and could now be avoided unless they truly need it.
“The scientists have now created a detailed picture of the genomic aspects of this response, and among their findings are some surprises about the role of inflammation that could point to new strategies for treatment,” said Scott Somers, PhD, of the NIGMS.
Washington Personal Injury Lawyer
This is exciting for patients because with this knowledge they have a whole new understanding of the effects of traumatic personal injuries and burns suffered in automobile accidents that will allow first responders and trauma care workers make proper recommendations for patient care.
Phillips Law Firm is a law firm with a substantial track record of success Personal Injury Litigation. We take the time to fully assess the injured party’s case in order to assure that the victim receives the compensation they deserve. Call our Personal Injury Attorneys today for a free consultation.
