Genetic predisposition to pathologic inflammation in trauma patients with respect to the ISS based on data from cooperating centers

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In Germany, trauma has a relevant share in the causes of death, the costs of therapy for acute illness, long-term mortality and subsequent economic costs. Depending on the severity of the trauma, posttraumatic patients develop a systemic inflammatory response syndrome (SIRS), which decisively determines the individual clinical course of the patient. So far, the understanding of the responsible (intra-)cellular regulatory mechanisms remains limited. While various studies within the joint project focus on global patterns of expression and genotyping of chosen candidate genes, the aim of this project is to study familial predisposition based on an epidemiological approach. In order to plan and initiate an epidemiological study adequately, knowledge on risk factors promoting traumatic inflammatory response will be gained during the first part of this project. Selected data from the trauma registry (provided by the German Trauma Society) will be systematically analysed in order to detect influencing variables and to perform subgroup analyses. Parallel to this, a questionnaire to quantify pathologic immune response in first degree relatives of patients shall be developed and evaluated in a pilot study. These parameters need to be taken into account as potential risk factors in the planning of a following case-control study. In this study prospective data on trauma patients will be collected from cooperating centers. Patients will be defined as cases or controls depending on their outcome (multiple organ failure). Family history of pathologic immune response patterns (wound healing disorder, disposition to sepsis, multiple organ failure, etc.) will be studied and compared in cases and controls, respectively.