Organ Cross Talk and its Impact on the Clinical Course in Multiple Trauma and Critical Illness

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Background

Post-traumatic and/or post-surgical inflammation substantially determines the patient’s outcome. Both, detrimental but also regenerative roles of inflammatory mediators have been described in numerous pre-clinical studies and experimental settings. Recently, the communication of different body compartments through which one tissue can affect also distant tissues has gained increasing interest. Due to several observations, this process termed “organ cross-talk” also seems to be of major relevance after multiple trauma (MT) or critical illness (CI). Systemic effects of injuries to different body compartments have been shown to be far greater than the sum of the isolated traumatic insults and posttraumatic dysfunction of primarily unaffected organs has been described. Both observations can contribute to the development of a multiple organ dysfunction syndrome (MODS), which is still one of the most common complications in MT and CI patients who survive the initial insult. Thus, injuries of different body regions are associated with distinct local inflammatory responses, which might accumulate in a systemic inflammatory reaction with potentially harmful consequences even to primarily uninjured organs. However, there is limited knowledge about the pathways and communication patterns and there is no detailed description of the effect on the clinical post-traumatic immunogenicity and of the healing processes. Clarifying these unknown pathomechanistic influences of organ cross-talk on post-injury outcomes might help to indicate and/or monitor disease or injury severity and is probably may also be helpful to optimize therapy.

The aim of this article collection is to provide newest scientific insights on local immunological and cellular reactions and possible communication pathways and pattern between different organs whether they are initially affected or secondary injured. Illuminating tissue-related immunological responses and their effects on remote organs also includes investigation of circulatory responses after MT or during CI in order to draw a comprehensive illustration of what possibly triggers the clinical course of severely injured or critically ill patients.

For this Research Topic, we welcome the submission of experimental and clinical studies, meta-analysis or reviews that focus on:
1. local and systemic immunological reactions after severe trauma and in critically ill patients during their further clinical course.
2. Investigate possible communication pathways between different organs, whether they are initially affected or secondary injured to give detailed information about possible organ cross-talk in the above mentioned population.
3. studies investigating the relevance of biomarkers (e.g., cytokines, extracellular vesicles) as new diagnostic tools but also to monitor clinical progress as well as innovative treatment options focusing on the modification of the immunological response.
4. studies that concentrate on the presentation of new prevention strategies or investigate trauma/critically ill related factors affecting long-term outcome are of major interest.

Keywords: organ crosstalk; polytrauma patients; multiple trauma; critical illness; multiple organ dysfunction syndrome; local immune reactions; systemic immune reaction

Important note: All contributions to this Research Topic must be within the scope of the section and journal to which they are submitted, as defined in their mission statements. Frontiers reserves the right to guide an out-of-scope manuscript to a more suitable section or journal at any stage of peer review.

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