Damage- and pathogen-associated molecular patterns play differential roles in late mortality after critical illness.

Published online

Journal Article

Multiple organ failure (MOF) is the leading cause of late mortality and morbidity in patients who are admitted to intensive care units (ICUs). However, there is an epidemiologic discrepancy in the mechanism of underlying immunologic derangement dependent on etiology between sepsis and trauma patients in MOF. We hypothesized that damage-associated molecular patterns (DAMPs) and pathogen-associated molecular patterns (PAMPs), while both involved in the development of MOF, contribute differently to the systemic innate immune derangement and coagulopathic changes. We found that DAMPs not only produce weaker innate immune activation than counterpart PAMPs, but also induce less TLR signal desensitization, contribute to less innate immune cell death, and propagate more robust systemic coagulopathic effects than PAMPs. This differential contribution to MOF provides further insight into the contributing factors to late mortality in critically ill trauma and sepsis patients. These findings will help to better prognosticate patients at risk of MOF and may provide future therapeutic molecular targets in this disease process.

Full Text

Duke Authors

Cited Authors

  • Eppensteiner, J; Kwun, J; Scheuermann, U; Barbas, A; Limkakeng, AT; Kuchibhatla, M; Elster, EA; Kirk, AD; Lee, J

Published Date

  • August 22, 2019

Published In

Volume / Issue

  • 4 / 16

PubMed ID

  • 31434802

Pubmed Central ID

  • 31434802

Electronic International Standard Serial Number (EISSN)

  • 2379-3708

Digital Object Identifier (DOI)

  • 10.1172/jci.insight.127925

Language

  • eng

Conference Location

  • United States