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

在德国，创伤在死亡原因、急性疾病治疗费用、长期死亡率和随后的经济费用中占有相当大的份额。根据创伤的严重程度，创伤后患者会出现系统性炎症反应综合征（SIRS），这决定性地决定了患者的个体临床病程。到目前为止，对细胞内调控机制的理解仍然有限。虽然联合项目中的各种研究侧重于所选候选基因的全球表达模式和基因分型，但该项目的目的是基于流行病学方法研究家族易感性。为了充分规划和启动一项流行病学研究，在该项目的第一部分将获得有关促进创伤性炎症反应的危险因素的知识。将系统分析创伤登记处（由德国创伤学会提供）的选定数据，以便发现影响变量并进行亚组分析。与此同时，应制定一份调查问卷，量化患者一级亲属的病理性免疫反应，并在一项试点研究中进行评估。在规划后续病例对照研究时，需要将这些参数作为潜在风险因素加以考虑。本研究将从合作中心收集创伤患者的前瞻性数据。患者将根据其结果（多器官衰竭）被定义为病例或对照。病理性免疫反应模式的家族史（伤口愈合障碍、败血症倾向、多器官功能衰竭等）将分别在病例和对照组中进行研究和比较。

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.