Finlay LD, Conway Morris A, Deane AM, Wood AJ. Neutrophil kinetics and function after major trauma: A systematic review. World J Crit Care Med 2021; 10(5): 260-277 [PMID: 34616661 DOI: 10.5492/wjccm.v10.i5.260]
Corresponding Author of This Article
Alexander JT Wood, MBBS, PhD, Doctor, Intensive Care Unit, Royal Melbourne Hospital, Intensive Care Unit Offices Level 5, B Block Royal Melbourne Hospital 300 Grattan Street, Parkville 3052, Victoria, Australia. alex.wood1@unimelb.edu.au
Research Domain of This Article
Critical Care Medicine
Article-Type of This Article
Systematic Reviews
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Crit Care Med. Sep 9, 2021; 10(5): 260-277 Published online Sep 9, 2021. doi: 10.5492/wjccm.v10.i5.260
Neutrophil kinetics and function after major trauma: A systematic review
Liam DB Finlay, Andrew Conway Morris, Adam M Deane, Alexander JT Wood
Liam DB Finlay, Melbourne Medical School, University of Melbourne, Melbourne 3052, Victoria, Australia
Andrew Conway Morris, Department of Medicine, University of Cambridge, Cambridge 01223, United Kingdom
Adam M Deane, Alexander JT Wood, Centre for Integrated Critical Care, University of Melbourne, Parkville 3052, Victoria, Australia
Adam M Deane, Alexander JT Wood, Intensive Care Unit, Royal Melbourne Hospital, Parkville 3052, Victoria, Australia
Author contributions: Finlay LDB and Wood AJT screened and analysed included studies and wrote the manuscript; Conway Morris A and Deane AM assisted with critical review and editing of the manuscript; all authors have read and approved the final manuscript.
Supported bythe Clinical Research Career Development Fellowship from the Wellcome Trust, No. WT 205214/Z/16/Z; the MRC Clinician Scientist Fellowship, No. MR/V006118/1; and the Career Development Fellowship from the National Health and Medical Research Council of Australia, No. APP1141870.
Conflict-of-interest statement: There are no conflicts of interest to declare.
PRISMA 2009 Checklist statement: The guidelines of the PRISMA 2009 Statement have been adopted.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Alexander JT Wood, MBBS, PhD, Doctor, Intensive Care Unit, Royal Melbourne Hospital, Intensive Care Unit Offices Level 5, B Block Royal Melbourne Hospital 300 Grattan Street, Parkville 3052, Victoria, Australia. alex.wood1@unimelb.edu.au
Received: February 21, 2021 Peer-review started: February 21, 2021 First decision: May 13, 2021 Revised: June 22, 2021 Accepted: July 27, 2021 Article in press: July 27, 2021 Published online: September 9, 2021 Processing time: 200 Days and 3.3 Hours
ARTICLE HIGHLIGHTS
Research background
Neutrophils play an important role in immune dysfunction after major traumatic injury and alterations in this cell type are associated with the development of complications including organ failure and secondary infection. The kinetics of neutrophil dysfunction in the context of trauma is not completely understood and may have important implications for therapy.
Research motivation
Developing a granular and nuanced understanding of neutrophil kinetics and changes after trauma is necessary if key associations with disease and therapeutic targets are to be identified.
Research objectives
This review aimed to provide an overview of established aspects of neutrophil immunophenotypes in trauma, with special attention to factors which may hold prognostic value.
Research methods
This study was a systematic review of the PubMed, Ovid Medline and Embase databases for all papers on neutrophil kinetics or function after major trauma (injury severity score > 12) in adults (≥ 18 years) since 1990.
Research results
Key findings include a notable increase in immature (CD16dim/CD62Lbright) neutrophils poorly responsive to subsequent bacterial stimuli which may confer susceptibility to bacteraemia. Highly inflammatory neutrophils which express adhesion markers and chemoattractant receptors such as CD11b and CXCR2 extravasate into end organs where they may damage host tissues and cause organ dysfunction.
Research conclusions
Neutrophil dysfunction after major trauma is complex and changes over time. Several stereotyped changes have been observed in multiple studies, as discussed above. Immunophenotyping of multiple cell types combined with clinical and laboratory data may yield endotypes likely to respond to different therapies.
Research perspectives
Areas of ongoing research include integration of multiple markers of immune dysfunction, enrichment strategies for clinical trials of immunomodulatory agents and the assessment of live cells in tissues rather than the circulation.
