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ORIGINAL RESEARCH ARTICLE

Posttraumatic Inflammation Is a Complex Response Based on the Pathological Expression of the Nervous, Immune, and Endocrine Functional Systems

M. A. Aller^*, J. L. Arias, M. P. Nava and J. Arias^*,1

^* Surgery I Department, Medical School, Complutense University of Madrid, Madrid, Spain; Psychobiology Laboratory, Psychology School, University of Oviedo, Principado de Asturias, Spain; and Physiology Department, Biological Sciences Faculty, Complutense University of Madrid, Madrid Spain

To whom requests for reprints should be addressed at ¹ Cátedra de Cirugía, Facultad de Medicina, Universidad Complutense de Madrid, Pza. Ramón y Cajal s/n, 28040 Madrid, Spain. E-mail: jariasp{at}med.ucm.es

The successive phases that make up both the local and systemic posttraumatic acute inflammatory response could represent the expression of three concatenated pathological or ‘‘primitive’’ functional systems with trophic properties: the nervous, immune, and endocrine ones. The nervous functional system would play an important role in the phenomenon of ischemia-reperfusion, which would be represented by nutrition by diffusion that is either anaerobic (ischemia) or with defective use of oxygen (reperfusion) and, thus, with a limited energy requirement. The immune functional system would be represented by the infiltration of the tissues by inflammatory cells and bacteria, which would become mediators in providing nutrition to the injured tissues. Although the use of oxygen would still be defective, hypermetabolism and fever would occur. In these inflammatory response phases, the lymphatic is the most important circulation. The endocrine functional system would be the most specialized and would have high energy requirements because it would be represented by the blood capillary-mediated nutrition. Highly specialized epithelial cells would already possess a perfected oxidative metabolism. The successive expression of these three functional systems during embryonic development and also during the evolutionary development of our species could explain why the inflammatory response is a ubiquitous mechanism that is common to multiple diseases, because it is an integrator of the ontogeny and phylogeny.

Key Words: posttraumatic inflammatory response • trophic • neuro-immune-endocrine system

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