Thioredoxin in Post-Injury Sepsis And Ards

Trauma is one of the leading causes of mortality worldwide, resulting in a great global burden of disability and mortality [1, 2]. Approximately half of all trauma deaths occur during the first hours due to traumatic brain injury or massive bleeding. Later deaths are due to, for example, sepsis or multiple organ failure [3]. Independent risk factors for post-injury sepsis are still somewhat poorly defined. Injury Severity Score (ISS), male gender, age, low Glasgow Coma Scale (GCS) and massive blood transfusion have been suggested as risk factors [4]. Thioredoxin (TRX) is thought to have important anti-oxidant properties but it also functions as an endogenous anti-inflammatory mediator [5]. The link between high plasma levels of TRX and sepsis has been studied previously, although with conflicting evidence [5, 6]. TRX-levels in trauma patients and the possible correlation to secondary complications such as post-injury sepsis and acute respiratory distress syndrome (ARDS) have to our knowledge not been studied previously.