فهرست نشریات علمی دسترسی آزاد ایران

Background and Objectives: Immune components, as an important prognostic tool for evaluating clinical risk in combination with other parameters. This study aims to systematically review the role of immune components, including pro- and anti-inflammatory cytokines, sex hormones, age and race in the response to treatment in trauma patients.   Methods: For conducting this study, articles published between 1990 and 2019 and indexed in PubMed, Google Scholar, Scopus, and Web of Science were recovered. Forty articles which directly addressed the issue of this study were contained in the final analysis. There were conflicted findings regarding the role of immune components on the response to treatment in trauma patients.   Results: The findings of this study demonstrated that an imbalance between pro-inflammatory cytokines, interleukin (IL)-1, IL-6, tumor necrosis factor-alpha (TNF-α), and anti-inflammatory cytokines, including IL-10, and tumor growth factor-beta (TGF-β), could lead to several complications. These complications included delayed wound healing, sepsis, multi-organ dysfunction syndrome, and acute respiratory distress syndrome. Moreover, The present study found that 17 β-estradiol, a female sex hormone, modulated inflammatory responses during trauma by suppressing IL-1, IL-6, and TNF-α and reducing the proliferation of T helper 1 (Th1) cells. Notably, the serum levels of inflammatory cytokines were found to be higher in Black trauma patients than in White cases. Additionally, advancing age was associated with the attenuation of both innate and adaptive immune components, leading to an increased mortality rate among trauma patients.   Conclusion: The findings suggested that sex hormones, older age, and race could dysregulate immune responses during the treatment of trauma patients. This dysregulation primarily occurred through a reciprocal shift in the pro- and anti-inflammatory mediators.