The Th-17 response and its potential role in post-injury pulmonary complications

Trauma is a leading cause of death and morbidity among all ages and constitutes a major public health problem. This burden is initially directed at stabilizing direct injury, however, post-trauma complications are common and prolong costly ICU stays. Among these complications are acute lung injury (ALI) and acute respiratory distress syndrome (ARDS). While care for these pulmonary complications has now been standardized and prevention continues to improve, the true pathophysiology has not been elucidated. Current evidence suggests that the activation of a pro-inflammatory cascade plays an important role in the pathogenesis of trauma related lung injury. Additionally, there is a novel T-cell response that has been shown to be intricately involved in other non-traumatic lung diseases and multiple inflammatory diseases. With the recent discovery of this novel T-helper subset (Th-17) and the main effector cytokine, IL-17, there is the potential for further categorizing the biologic mechanism leading to ALI and ARDS. By utilizing the discoveries provided by animal models and further investigation into local and systemic cytokine profiles in human trauma victims, the information gained holds promise in the development of unique therapeutic modalities for the treatment and prevention of ARDS following traumatic injury.