Determining how a service member’s immune system will respond to injury before an injury happens is difficult reports the Naval Medical Research Unit at San Antonio.
Navy researchers are using sophisticated models of trauma and hemorrhage to predict outcomes using baseline immune-typing. Simple tests already clinically available are being evaluated for their utility in predicting both injury outcomes and responses to therapy.
By using samples no greater than a few hundred microliters of blood obtained during routine and non-invasive in-processing procedures, researchers are able to immune type an individual based on their white blood cells ability to respond to a naturally occurring stimulus in the laboratory.
The results, which can vary from one individual to another can stratify patients according to immuno-type. Those individuals identified as high responders show an increased risk for inflammation and damaging pathology in response to trauma and would require aggressive therapy.
On the other hand, low responders may be able to avoid unneeded aggressive intervention which itself may be injurious. This means that wounded warriors would be able to receive the appropriate triage and personalized application of therapy when treated for their injury.
The Navy understands the need to transition expensive and complex fixed facilities into operationally deployable settings. That is why in addition to using commercially available hospital diagnostics to immune-type individuals, the Navy is also repurposing equipment to make these tests logistically possible in emergency medicine settings such as when service members are in a combat environment.
One of the primary immuno-typing tests is an assay for white blood cell activity that is performed with a hospital flow cytometer. The typically large 350 pound flow cytometers are well suited for a fixed hospital setting. However, in the combat theater, the equipment is bulky, expensive, and immobile.
The Navy is now able to deliver a much smaller (15 pound) and less expensive microplate reader. By using the repurposed and easily portable microplate reader it is possible to bring immune-typing a step closer to becoming practical in a combat environment.
Go to www.med.navy/sites/nmrc/Pages/namrusa.htm for more information.