Trauma Patients Clinical Trial
Official title:
Effect of Severe Trauma on Programmed Death Molecule (PD1) and Its Legend (PD1/L1) on T Lymphocytes and Correlation With Mortality
Unlike neuro-endocrine response to trauma; posttraumatic immune alterations are not easily
carried out at bedside. The majority of trials were conducted in the intensive care usually
hours to days post injury.
In this trial the investigators sought assess the immune responses during emergency
department trauma resuscitation by looking at the biomarkers of severe injury by comparing T
lymphocytes and programmed cell death molecules and its relation with mortality.
Trauma is a major healthcare problem with a high mortality rate that might be caused by
immune-suppression.
Trauma initiates an immunosuppressive response which is contributor tocell damage and could
be a marker of multi organ failure and mortality.
Programmed cell death receptor-1 (PD-1) and programmed cell death receptor ligand-1 (PD-L1),
which are co-inhibitory receptor molecules, may participate in trauma-induced
immune-suppression.
Both sterile and infected trauma induce the systemic inflammatory response syndrome (SIRS),
originally defined by pyrexia, tachycardia, hyperventilation and neutrophilia, the latter
responding poorly to pathogens. (10) Accompanying these changes is a decrease in circulating
basophil, eosinophil and natural killer precursors, which further weakens systemic immunity.
Apoptosis (Programmed Cell Death):
Programmed cell-death (PCD) is death of a cell in any form, mediated by an intracellular
program. PCD is carried out in a regulated process, which usually confers advantage during an
organism's life-cycle. Apoptosis and autophagy are both forms of PCD, but necrosis is a
non-physiological process that occurs as a result of infection or injury.
Programmed cell death protein 1 Programmed cell death protein 1, also known as PD-1 and CD
279 (cluster of differentiation 279), is a protein that in humans is encoded by the PDCD1
gene. PD-1 is a cell surface receptor that belongs to the immunoglobulin super family and is
expressed on T cells and pro-B cells. PD-1 binds two ligands, PD-L1 and PD-L2. PD-1,
functioning as an immune checkpoint, plays an important role in down regulating the immune
system by preventing the activation of T-cells, which in turn reduces autoimmunity and
promotes self-tolerance.
Ligands PD-1 has two ligands, PD-L1 and PD-L2, which are members of the B7 family. Several
lines of evidence suggest that PD-1 and its ligands negatively regulate immune responses PD-1
knockout mice have been shown to develop lupus-like glomerulo-nephritis and dilated
cardiomyopathy Triggering PD-1, expressed on monocytes and up-regulated upon monocytes
activation, by its ligand PD-L1 induces IL-10 production which inhibits CD4 T-cell function.
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| Status | Clinical Trial | Phase | |
|---|---|---|---|
| Completed |
NCT02575989 -
Prevention of HYPOthermia in TRAUMa Patients
|
N/A | |
| Withdrawn |
NCT05243420 -
Commonly Used Drug Regimens for Rapid Sequence Intubation (RSI) of Trauma Patients in the Emergency Department
|