Trauma: Immune Deficiency, Immune Suppression, or Just Immune Cell Redistribution?

Abstract

The term “post-traumatic immunodepression” is being frequently used in the contemporary surgical literature. Is there, however, enough scientific evidence for such a term to be used whenever the human body is suffering from trauma? Trauma is a complex set of events comprising acute neurohormonal regulation, reaction to “self” uncovered antigens and subsequently, but not immediately, reaction against invading pathogens. The mechanisms behind the trauma related changes in immune competence are not yet elucidated, but it would be difficult to accept, from an evolutionary point of view, the notion that immune reactions were depressed after trauma when tissue reparative processes develop actively. Our suggestion would be that the changes observed in the early post-traumatic stage (initial 3 days) are not due to the depressed responsiveness of blood mononuclear cells but rather to their depletion from circulation possibly due to redistribution from the blood to the tissues.