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"He who asks is a fool for five minutes, but he who does not ask remains
a fool forever. "
Chinese Proverb
Contents © 2004-2007 Massachusetts
General Hospital |
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Patient and Volunteer Studies
Inflammation and the Host Response
to Injury researchers aim to identify which trauma or burn patients
will go on to develop multi-system organ failure. Scientists sample
whole blood and other available tissues from trauma patients in an effort
to correlate molecular markers with white blood cell behavior,
and ultimately, with patient outcome. Clinical researchers from 13 to
15 participating hospitals nationwide collect blood and tissue
samples from four groups of human subjects: burn patients, trauma patients,
lipopolysaccharide (LPS)-challenged volunteers, and normal volunteers.
Predefined standard operating procedures (SOPs) for sample collection
and sample processing help minimize variation in sample quality
between centers and permit data analysis of the highest quality.
We selected two patient groups and two categories of human
volunteers for these clinical studies because we believe that there
is a critical need to separate responses that are common from responses
that are unique to a particular condition. For the volunteer studies,
researchers administer LPS to study participants according to a
carefully defined protocol. An LPS "challenge" to volunteers
should cause an acute, limited inflammatory process, which we predict
will be very different from the acute inflammatory process provoked
by injury. We anticipate finding common as well as contrasting features
in the proteomic and genomic data gathered from both sets of research
subjects. These findings should distinguish the molecular mechanisms
involved in producing inflammation in each group of patients. Scientists
working under this grant deposit appropriately consented human
studies data into comprehensive databases to help sort and define
the clinical, physiological, cellular, genomic, and outcomes information
from research subjects. Patient confidentiality is strictly maintained through
a stringent data coding system.
Model Validation Studies
 Another
key goal of the research program is to evaluate established models of
burn injury, trauma-hemorrhage, and acute inflammation. Researchers
will examine changes in gene expression patterns and evaluate the cellular
and molecular changes in organs, blood, and other tissues using well-established
models of injury.
Research results from these model validation studies are deposited into a database that will house data on post-injury genomic
and proteomic changes. This database serves as a firm foundation
for comparisons between genomic changes observed in human and murine
studies.
We may discover that the molecular changes occurring after
injury are substantially different between humans and the models used
for validation. This might simply reflect the fact that established
experimental designs have isolated control mechanisms that differ between
murine and human physiology, or that the models only took into account
a single component of the human disease process. The new knowledge we
gain from performing validation studies will have two implications.
Our findings may show that the interpretation of results from these
studies would be applicable only within the context of the limitations
of a particular model. Or, perhaps more importantly, the models used
for validation could now be redesigned to more closely mimic the human
injury phenotype and genotype.
Model validation studies are necessary if the injury research
community is to develop better strategies to prevent the complications
that take the lives of seriously injured patients.
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