SHOCK 2001-Meeting Highlights/ YoungInvestigatorCompetition-Travel Awards/ ShockSocietyPresidentialRun/SHOCK2002-BigSky/Sponsors/

Dear Colleagues:

On behalf of the Shock Society, I would like to express my thanks to all of you for your willingness to serve either as presenters (moderators/ speakers/oral and/or poster presenters) or as active audience participants in the recent 24^th Annual Shock Society meeting held last month at Marco Island, Florida.

Based on the numbers from our registration (over 450), some personal feedback and my own subjective observation of audience participation within the various symposia, workshops, plenary sessions, mini-symposia and poster sessions held, it appears you all helped make this a highly successful scientific meeting for the Shock Society. This was the largest national (North American) meeting we have ever held and approached the attendance of the conjoined 4^th International Congress/22^nd Shock Conference held in Philadelphia 2 years ago.

Many thanks also go to the Shock Society Council, the Program, Awards/Honors, and the Developmental Committees, as well as Shock Meeting Management whose efforts brought together a scientifically exciting meeting in a beautiful venue in southern Florida. Approximately 285 papers were accepted for either poster or oral (65) presentations. 26 keynote lectures were given in the various workshops/ symposia / late breaking paper. We also worked very hard to "youthanize" the voice of our society in almost all phases of the program, so as to recognize the rising scientists among our membership. And it was heartening to see what great jobs you all did in your respective roles. The science presented was top-rate, thought provoking and I believe the excitement it engendered within membership will carry us well into the next year as we all go forward in our own work.

Clearly that was indicated by the quality of this years' Young Investigator Competition. Five competitors made it a very difficult task for the judges on the awards panel. The winner was Cheryl Croft's presentation on "Activation of Stress-Responsive Pathways by the Sympathetic Nervous System in Burn Trauma". Edwin Deitch’s Award Committee also had the challenge of selecting "Travel Awardees" from an exceptional field of candidates. Lest anyone think the posters were of less quality, of the 15 Travel awards given (outside 5 of those given to the Young Investigator Competitors), over half these went to folks with papers in the poster session.

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Zakaria Tawadrous, MD - University of Pittsburgh Medical Center, Pittsburgh, PA (Paper 80)

Thomas R. Bernik, MD - North Shore University Hospital, Manhesset, NY (Paper 81)

Ming-Hui Fan, MD - University of Michigan, Ann Arbor, MI (Paper 82)

Cheryl Croft, PhD - UT Southwestern Medical Center, Dallas, TX (Paper 83)

Justin T. Sambol, MD - UMDNJ-Newark, Newark, NJ (Paper 84)

Grace Y. Song, BA – Brown University School of Medicine, Providence, RI (Paper 182)

Markus W. Knoferl, MD - University of Alabama at Birmingham, Birmingham, AL (Paper 256)

David Gourlay, MD - University of Washington, Seattle, WA (Paper 97)

Joseph Cuschieri, MD - University of Washington, Seattle, WA (Paper 260)

Elliott S. Cohen, MD - Rush Medical College, Chicago, IL (Paper 263)

Casey M. Calkins, MD - University of Colorado HSC, Denver, CO (Paper 273)

Michael E. Kelly, MD - University of Tennessee, Memphis, TN (Paper 277)

Saraswati D. Dayal, MD – UMDNJ-Newark, Newark, NJ (Paper 132)

Christian Schneider, MD – University of Alabama at Birmingham, Birmingham, AL (Paper 150)

Stefan M. Nitsch, MD – Ludwig-Maximilians University, Munich, GERMANY (Paper 158)

Kaushal J. Shah, MD - University of Maryland School of Medicine, Baltimore, MD (Paper 175)

Jochim F. Kuebler, MD – University of Alabama at Birmingham, Birmingham, AL (Paper 187)

Amy M. Liese, BS – UMDNJ-Newark, Newark, NJ (Paper 202)

Christopher D. Raeburn MD – University of Colorado HSC, Denver, CO (Paper 216)

Yong Song, MD - University of Colorado HSC, Denver, CO (Paper 251)

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In the opening workshop on Modeling in Shock and Trauma research, Edwin Deitch over-viewed what we need to consider when choosing/interpreting or applying a model to emulate the critically ill patient. While Martin Schwacha and Heinz Redl summarized considerations, which need to be made in modeling shock and sepsis in small and large animals, respectively. Carl Hauser emphasized the importance of utilizing materials derived from shock and traumatized patients as opposed to conjecture from normal human peripheral blood sampling or cell line science while Stephen Lowry overviewed advantages and limitations of studying aspects of the septic response in human volunteers.

In the 1^st Symposia, on Necrosis, Apoptosis, Necrapoptosis, (moderated by Richard Hotchkiss and Alfred Ayala), Basilla Zingarelli nicely overviewed recent studies accessing the capacity of peroxy-nitrite to serve as an inducer of necrotic as well as apoptotic changes contributing to the pathology of hypotensive and ischemic injury. Craig Coopersmith overviewed the role of the anti-apoptotic protein Bcl-2's role in maintaining gut integrity, while Chun-Shiang Chung summarized recent observations of the divergent nature of the regulation of the lymphoid systems apoptotic response in shock and sepsis via Bcl-2, steriods, FasL and caspase activation. The ability of caspases to regulate movement of cells towards an apoptotic as opposed to a necrotic state was reviewed by James Klostergaard. John Leamasters provided us with an elegant anatomical description of mitochondria’s capacity to regulate these apoptotic and/or necrotic mechanisms, touching on the roles of ATP, cytochrome C release and caspase 9 activation.

William Cheadle provided an overview of the changing face of bacterial infection in the critically ill patient population in today’s intensive care unit, to lead off Symposia 2's discussion of Triggering mechanisms which drive the innate response [pro-inflammatory] in shock and sepsis. Polly Matzinger then provided us with a discussion of how the immune system actually perceives "danger (infection/injury)" through antigen presenting cells binding of TLR ligands from bacteria, fungi and viruses, recognition of HSP cell surface expression, necrotic cell death, etc. and how these serve as a third "alarm signal" in host immune system activation. Matthew Fenton followed Polly’s presentation with a detailed discussion of how cells of the immune system use TLR-4 and TLR-2 proteins and their down stream signaling pathways to regulate the innate immune response to bacterial pathogens. While James Thomas illustrated that the TLR family members can also serve to alter the responses of non-immune cells involved in regulating the cardiovascular response in thermal injury. The session was then concluded by Jim Lederer’s synthesis of ways in which components, such as T-cells, of injured/shocked host’s adaptive response can alter the innate/pro-inflammatory response. In so doing, varying survival to septic/bacterial challenges.

A number of concepts concerning how shock and septic challenge induce injury of the gastrointestinal tract and the liver were overviewed in Symposia 3. Inge Bauer reviewed how activation of HO-1 might be a central player in the induction of liver injury following ischemic or hypotensive insult. Henri Ford brought to us some recent findings on NO driven processes underpinning apoptotic-necrotic injury encountered in the mucosal layer of the intestine of septic animals. Alternatively, Bill Watson described how dysregulation of neutrophil functions such as respiratory capacity and apoptosis served to contribute to gastrointestinal inflammatory processes. And, Walter Biffl described how the release of lipid mediators such as PAF from the gut during shock or trauma could serve to drive distal organ injury, e.g., the lungs, via neutrophil priming.

The last workshop on Resuscitative Therapies in Shock (moderated by Peter Safar & Wolfgang Junger) touched on recent experimental data and its potential for application in the traumatized patient. The discussion was initiated by Jane Shelby’s overview of the experimental application of endocrine agents such as DHEA and melatonin as adjuvants to resuscitative therapy. Brian Harbrecht reviewed the experimental findings concerning the role of NO in the pathology of hypotensive shock and the possibilities of specific inhibition of iNOS as an approach in resuscitation. Recent findings concerning the mechanisms of the salutary effects of hypertonic salines in resuscitated animal shock models and the current status of this agent's use clinically, were overviewed by Raul Coimbra. The session was closed by a provocative discussion of the experimental and potential clinical applications of induced hypothermia and reanimation of the shocked patient by Samuel Tischerman.

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Our president, James Holcroft provided us with superlative examples of mentorship and its significance to the Society in his presidential address. While John Siegel gave us a unique insight into how power and politics during the renaissance shaped the evolution of art and anatomy in his after-dinner presentation.

Brett Girior also provided us with the most recent news on the completed and ongoing clinical trails with activated protein C. A theme, which will be addressed in greater detail in a symposium, planned for next year’s program at Big Sky, MT.

Dan Remick and I were also excited to see the enthusiastic response to the "Young Investigator Research Forum". This was an experimental format designed to specifically encourage "young" (relative to their scientific training) investigator’s active participation during oral presentations, which will be repeated next year by popular demand.

It was also clear from the many tanned faces that a number of you were also fortunate enough to enjoy the leisure components that the Marco Island site provided. We were happy to see many ongoing mini-conferences/reunions in halls, lounges, by the pool and beaches of the resort.

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Mark Clemens also brought many of us together for the 19^th Annual Shock Society Presidential "Beach" Run. He indicated that this was the largest run to date. Congratulations to all of you who were willing to cut through the 6AM, 75° F heat and 90% humidity. Also, a big thanks to Bethli Clemens and the marshals for the organizational help. Remember to practice for next year's "20^th" Annual Presidential Run in Big Sky where it will be "higher" and "dryer".

We were also fortunate to have had the unrestricted educational support from 3 major sponsors, 3 other/minor sponsors, as well as an exhibitor, which were critical to defraying significant expenses of various aspects of this year’s meeting. They are listed below:

Pharmacia  

Lilly

Baxter

Cubist Pharmaceuticals

Merck Research Laboratories

Hycult Biotechnology b.v.

In closing, it was a privilege getting to meet and work with so many of you to make this into a scientifically exciting and successful meeting for the Society. Your interest and participation indicates to me and the Society that the annual meeting remains not only an important event to the membership but is a place in which you are anxious to present your best science.

(NOTE: If your not already a member, consider joining the Shock Society today)

Best wishes and we hope to see you all again next year at "25^th"Annual Conference on Shock in Big Sky, Montana (June 8-11, 2002; check this site for update SHOCK 2002 meeting information.)

Sincerely,

Al Ayala, Ph.D.

Immediate-Past Scientific Committee Program Chairman – SHOCK 2001