Abstract

Introduction: Extensive soft tissue injury and bone fracture are significant contributors to the initial systemic inflammatory response in multiply injured patients. Systemic inflammation can lead to organ dysfunction remote from the site of traumatic injury. Mechanisms that activate the systemic inflammatory response to soft tissue and bone injury are unknown. Toll-like receptors (TLR) recognize microbial products but also may recognize danger signals released from damaged tissues. We hypothesized that peripheral tissue trauma generates release of danger signals that initiate systemic inflammation and remote organ injury and that this systemic response to a sterile local injury is Toll-like receptor 4 (TLR-4) dependent.

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