Immunology of Trauma and Transfusion

It was previously thought that immune dysregulation following traumatic injury was the result of initial immune activation followed by a compensating period of suppression. Using samples collected from transfused and non-transfused trauma patients starting with arrival in hospital and tracking for up to a year after injury, we screened for over 40 soluble immune mediators in the circulation and demonstrated that a generally immunosuppressive cytokine milieu develops very early but includes some overlapping production of pro-inflammatory cytokines.

We were also able to look at the impact of transfusion on this immune dysregulation, developing a novel model to separate out the effects of traumatic blood loss and transfusion. This model has since been further adapted to look at the immunomodulatory impact of transfusion of different blood products in various settings.

Selected Publications:

Jackman R.P., Utter, G.H., Muench, M.O., Heitman, J.H., Munz, M.M., Jackman, R.W., Biswas, H., Rivers, R.M., Tobler, L.H., Busch, M.P., Norris, P.J. (2012). “Distinct roles of trauma and transfusion in induction of immune dysregulation post-injury.” Transfusion 52(12): 2533-50. PMC3392528.

Jackman R.P., Utter, G.H., John W Heitman, J.W., Hirschkorn, D.F., Law, J.P., Gefter, N., Busch, M.P., Norris, P.J. (2011). “Effects of Blood Sample Age at Time of Separation on Measured Cytokine Concentrations in Plasma.” Clinical and Vaccine Immunology 18(2):318-326. PMC3067358.

Bloch E.M., Jackman R.P., Lee T.H., Busch, M.P. (2013) Transfusion-associated microchimerism: the hybrid within. Transfus Med Rev 27(1): 10-20.

Jackman R.P. (2013) Immunomodulation in transfused trauma patients. Curr Opin Anaesthesiol 26(2): 196-203.

Danesh, A., Inglis, H.C., Jackman R.P., Wu, S., Deng, X., Muench, M.O., Heitman, J.W., Norris, P.J. (2014) Exosomes from RBC units bind to monocytes and induce pro-inflammatory cytokines, boosting T cell responses in vitro. Blood 123(5):687-96. PMC3630837.