PLOS Science Wednesday: We’re Karim, Martin and Tim, trauma surgeons who
edited and contributed research to the new PLOS Medicine Special Issue
on traumatic injury – Ask Us Anything!
Abstract
I am Karim Brohi, a trauma surgeon and director of the Centre for Trauma
Sciences at Barts Health and Queen Mary University & London. The Centre
for Trauma Sciences has a broad research into all areas of trauma care.
My research especially focuses on how the body responds to critical
injury and how this understanding can lead to new survivors. And I’m
Martin Schreiber, MD, the Chief of the Division of Trauma, Critical Care
& Acute Care Surgery at Oregon Health & Science University. I am the
head of the Trauma Research Laboratory at OHSU and we focus on
resuscitation, novel blood transfusion strategies and cellular therapies
in trauma. We (Karim and Martin) recently co-edited the PLOS Medicine
Special Issue on Trauma. In the collection we also published a paper on
how the body’s immune system responds to critical injury in the first 2
hours after injury. This is a difficult time window to study in trauma
but we found it holds very specific signatures of how the body responds
in the early activation of inflammation (which is the first stage of
healing). We also found that some patients had a different response in
certain cell death and survival pathways that were associated with them
developing organ failure later in their clinical course. Organ failure
is a common complication of trauma patients with a high associated death
rate in its own right. It appears this immediate post-injury period is
critical to understanding the response to trauma and therefore is likely
to be a critical period for interventions that may improve survival and
reduce complications. And I’m Tim Billiar, Chair of the Surgery
Department at the University of Pittsburgh and current President of the
SHOCK Society, USA. My research focuses on how trauma, which induces a
sudden and massive activation of the immune system, leads to an abnormal
immune response in some individuals. This is important because this
dysregulated immune response after severe injury has been linked to
dysfunction of organs such as the lungs and an increased susceptibility
to infections. My colleagues and I (Tim) recently published a
perspectives article titled “Time for Trauma Immunology” in PLOS
Medicine as well as the results of a study in humans and mice titled
“IL33 Mediated ILC2 Activation and Neutrophil IL5 production in the
Lung Response After Severe Trauma: A Reverse Translation Study from and
Human Cohort to a Mouse Trauma Model” in the same journal. In the
perspectives piece we make the argument that trauma should be viewed
like many other major disease processes that result from a dysregulated
immune response (e.g. autoimmunity); as a specialized area under the
broader field of immunology. We posit that this way of looking at trauma
would bring the tools and expertise of the rapidly advancing field of
immunology to the study of severe injury. In our experimental study, we
reverse translate observations made in a large cohort of injured humans
into mice genetically engineered to study the IL33-Innate Lymphocyte
Cell type 2 axis. We show that an immune pathway discovered for its role
in allergic airway diseases appears to contribute to acute lung injury
after trauma. This study supports the idea that the study of trauma is
ripe for sophisticated immunologic studies based on observations made in
injured humans. We will be answering your questions at 1pm ET – Ask Us
Anything!