Leading this project is Ronald G. Tompkins, MD, ScD, director of the Sumner Redstone Burn Center at Massachusetts General Hospital (MGH) and chief of the MGH Trauma Service. "We know that patients recovering from trauma go through a characteristic sequence of physiologic changes involving the immunoinflammatory system," he says. "We want to better understand those changes and, we hope, identify proteomic [protein] and genomic markers that could predict which patients are at greater risk for serious problems."
Inflammation is a common activity of the body?s immune system that occurs in response to infection and injury. Usually a controlled activity that contributes to protecting and healing an injured area, inflammation can run out of control and lead to the life-threatening body-wide infection called sepsis or to multi-organ failure syndrome. Burn and trauma patients are among those at greatest risk for uncontrolled inflammation.
The research group will investigate in great detail how the immune system responds to serious injury, including the contribution of genetic elements. "Every one of us has tiny genetic differences called single nucleotide polymorphisms, most of which have no effect on our health," says Tompkins. "But mutations in genes that are important to the ability to respond to injury could indicate which patients are at greater risk for problems; so we want to identify those genes."
Tompkins adds that the activation or expression of normal genes also may be changed by the body?s response to injury, and discovering those changes and how they relate to recovery is another goal of the research project. The team also hopes to develop standard operating procedures to treat burn and trauma patients and promulgate the use of those procedures in trauma centers across the country.
The grant from the NIGMS, one of the National Institutes of Health, is part of a new effort to support large-scale, multidisciplinary efforts to tackle significant biomedical problems. Reflecting the fact that such programs combine efforts from institutions across the country, the awards are referred to as "glue grants."
The burn/trauma recovery project brings together 45 researchers from institutions including the University of Washington, the University of Texas, the University of Colorado Health Sciences Center, Northwestern University, the University of Florida College of Medicine, Stanford University, Washington University and the University of Alabama at Birmingham. The investigators represent such specialty areas as burn and trauma surgery, critical care medicine, genetics, cell biology, physiology, biostatistics, bioinformatics (the use of computer technology to manage complex biological information) and biomedical engineering. Tompkins' Boston-area team includes a number of MGH researchers and colleagues from Brigham and Women's Hospital and Harvard Medical School.
The Massachusetts General Hospital, established in 1811, is the original and largest teaching hospital of Harvard Medical School. The MGH conducts the largest hospital-based research program in the United States, with an annual research budget of almost $300 million and major research centers in AIDS, the neurosciences, cardiovascular research, cancer, cutaneous biology, transplantation biology and photomedicine. In 1994, the MGH joined with Brigham and Women's Hospital to form Partners HealthCare System, an integrated health care delivery system comprising the two academic medical centers, specialty and community hospitals, a network of physician groups and nonacute and home health services.
MGH website: www.massgeneral.org NIGMS website: www.nigms.nih.gov