{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,27]],"date-time":"2026-08-27T07:17:58Z","timestamp":1787815078367,"version":"build-2784847793"},"reference-count":29,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2026,8,26]],"date-time":"2026-08-26T00:00:00Z","timestamp":1787702400000},"content-version":"vor","delay-in-days":237,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,1,1]],"date-time":"2026-01-01T00:00:00Z","timestamp":1767225600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Journal of Immunology Research"],"published-print":{"date-parts":[[2026,1]]},"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Infections are frequent in critically ill patients with earthquake\u2010associated crush injury (CI) and contribute to poor outcomes, yet the immune pathways underlying posttrauma susceptibility remain poorly defined. We investigated longitudinal changes in damage\u2010associated molecular pattern (DAMP)\/PAMP sensing and downstream inflammatory programs in CI patients requiring intensive care.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Nineteen CI patients admitted to the ICU after the February 6, 2023 Kahramanmara\u015f earthquake and 18 age\u2010 and sex\u2010matched healthy controls were enrolled. Peripheral blood was collected on hospital days 7 and 21. DAMP\/PAMP receptor expression was assessed by flow cytometry and RT\u2010qPCR, and pathway activation was evaluated by phospho\u2010flow (pSTING, pIRF3, pNF\u2010\u03baB, and p\u2010cJun) in gated lymphocytes and monocytes. Plasma cytokines\/alarmins and select DAMPs were quantified by multiplex enzyme\u2010linked immunosorbent assay (ELISA)\/assays.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>CI patients demonstrated broad remodeling of nucleic acid\u2010sensing programs, including reduced expression of TLR7, STING, and IRF7, with a discordant signaling pattern characterized by increased IRF3 phosphorylation, transiently reduced pSTING, and sustained reduction of p\u2010cJun, while NF\u2010\u03baB activation remained comparatively stable. In plasma, IL\u201033 and IFN\u2010\u03b12 were reduced on Day 7, and type 3 immunity\u2010associated cytokines IL\u201023 and IL\u201017A were significantly decreased by Day 21, consistent with impaired antimicrobial barrier\u2010supporting responses. Circulating DAMPs were dynamically altered, with increased S100A9 and HMGB1 and decreased ATP following injury.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Earthquake\u2010associated CI is associated with dynamic DAMP release and dysregulated innate sensing accompanied by suppression of antiviral and type 3 immune cytokine programs. These immune alterations may contribute to heightened vulnerability to secondary infections in critically ill CI patients.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1155\/jimr\/7908547","type":"journal-article","created":{"date-parts":[[2026,8,27]],"date-time":"2026-08-27T06:25:06Z","timestamp":1787811906000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Impaired Antiviral and Type 3 Immune Responses in Crush Injury Patients With Earthquake\u2010Related Trauma"],"prefix":"10.1155","volume":"2026","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4496-9473","authenticated-orcid":false,"given":"Recep Civan","family":"Yuksel","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2047-2967","authenticated-orcid":false,"given":"Busra 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