New approach for studying traumatic injury

October 28, 2002

In the first national effort of its kind, researchers around the country are collaborating to study the body's response to critical illness and traumatic injuries such as motor vehicle accidents, gunshot wounds and burns.

Washington University School of Medicine in St. Louis is one of the primary institutions involved in the project, called "Inflammation and the Host Response," which is supported by a five-year glue grant, a new type of funding from the National Institute of General Medical Sciences (NIGMS) for large-scale, multidisciplinary pursuits. The NIGMS anticipates spending $37 million on the project.

After severe trauma or stress, the body's natural defense mechanisms can trigger an often-fatal cascade of events that ends in a series of organ failures. As a result, critical illness and injury account for eight percent of deaths in the United States each year, typically taking the lives of young, otherwise healthy individuals.

"This project represents the first ever NIH-sponsored. coordindated national effort in injury and critical-care research," says J. Perren Cobb, M.D., associate professor of surgery and principal investigator of the School of Medicine team. "We are now combining the expertise and resources of investigators across the country to efficiently address this complex medical condition."

Cobb described the problem and the research effort to solve it during the 40th annual New Horizons in Science Briefing, sponsored by the Council for the Advancement of Science Writing, held Oct. 27-30, at Washington University in St. Louis.

Though early treatment for severely injured trauma patients has improved dramatically since the introduction of advanced trauma life support in 1979, there is no evidence-based regimen of care once the ill or injured are transferred to the intensive care unit (ICU), says Cobb. As a result, the mortality rate of ICU patients has barely improved in the past two decades. Without a better understanding of how the body responds to critical injury, he doubts the situation will change.

"We may actually be making things worse by trying to intervene during the body's natural, adaptive response," he explains.

The group of 19 medical centers will compile an extensive database including demographic, genomic and physiologic information about patients with traumatic injuries. In the process, they plan to develop standard operating procedures for burn and trauma patients and to develop clinically relevant animal models.

Washington University and Stanford University are leading the genomics component of the project, which is working to identify the functions and relationships of genes expressed during critical illness and injury.

"Our ultimate goal," says Cobb, "is to understand, model and predict how an individual will respond to a given injury and thereby help physicians choose the best treatment for each patient."
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Questions

Contact: Darrell E. Ward, assc. director for research communications, Washington University School of Medicine, 314-286-0122; wardd@msnotes.wustl.edu ; or Joni Westerhouse,Washington University School of Medicine, 314-286-0120; westerhousej@msnotes.wustl.edu.

Washington University in St. Louis

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