Polimorfismo genético en el paciente crítico (I). Aspectos generales, inflamación y sepsis

Diagnosis and treatment in the intensive Care Unit (ICU) is still difficult. This is caused, in part, by the complicated nature of critical illnes coupled with the frequent inability of ICU patients to communicate. Recent advances in biotechnology and sequencing of human genome offer interesting opportunities to increase our understanding of critical illness and injury. The purpose of this manuscript is to review the role of genetic polymorphism in critical care. We revised the literature (Medline) from 1995 through 2002. Over the past decade, with the advances of molecular technologies, our understanding of the complex genetic traits has expanded exponentially. From the identification of single gene disorders to multigenic adquired pathology, the fundamental genetic contributions of these diseases are unquestionable. The immune response to injury involves a complex pattern of primary, secondary, and tertiary humoral and cellular responses. In this system, the role of the genetic background in the inflammatory responses is determined by genetic variabilities in endogenous mediators that constitute the pathways of inflammation. Genomic information my be used to identify groups of patients with a high risk of developing severe sepsis and multiple organ dysfunction and determining which patients will benefit from immunomodulatory strategies.