Danger associated molecular patterns, complements, and other novel biomarkers in trauma patient management

Polytrauma is one of the leading causes of death in the first four decades of life and for all ages in the United States. Despite the improvements and advanced management of initial lifesaving medical and surgical interventions, there is an increase in mortality due to sepsis and systemic inflammatory immune response (SIRS) leading to multiorgan failure. This might be attributed to chronic inflammation and immunoparesis, at a later time, contributing to increased risk of infection and complications of immune response and sepsis. SIRS in posttraumatic patients is mediated by damage-associated molecular patterns, including high mobility group box 1 and heat shock proteins, released after trauma leading to the activation of the complement system and inflammatory pathways. Early diagnosis and intervention may improve clinical outcomes. Studies have discussed various biomarkers for early diagnosis of sepsis and SIRS; however, no definitive biomarker or panel of biomarkers has been established to date in posttrauma patients. Thus, there is a need of investigating newer biomarkers and in-depth research, and large-scale well-organized clinical trials are warranted to elucidate newer biomarkers and targets of therapeutic importance.