Genetics and trauma: Coded for injury

Trauma is rarely thought to have a genetic link, but scientists are starting to look at how genes make some people more likely to take risks and impact reactions to physical stress and recovery.

By Victoria Stagg Elliott, amednews staff. March 4, 2002.

In the movie "Unbreakable," Samuel L. Jackson plays a man who is exactly the opposite of the title -- with a long history of broken bones related to osteogenesis imperfecta. He can't even walk down a flight of stairs without shattering his leg. But Bruce Willis, his counterpart, is invulnerable. He walks away from a devastating train wreck that kills everyone else on board.

It's only a movie. But the story line brings up a perplexing question: Why is it that some people always seem to bounce, while others break?

The notion that genetics may play even a small role in how people respond to trauma is not without controversy.

Francis S. Collins, MD, PhD, director of the National Human Genome Research Institute, actually maintains that trauma is the only medical condition not affected by genetics.

"If you're walking down the street and somebody seven floors up drops a brick on your head, it was probably not your genes that played a role in that outcome," said Dr. Collins during an interview last year.

"Maybe the person on the roof was the risk-taker or maybe your bone fragility made it a really bad fracture, but at a certain level having a brick dropped on your head from seven stories up is going to cause trauma in anybody."

But more and more, scientists are starting to explore the issue -- and search for factors beyond fate and good or bad luck to explain different outcomes by different patients. Those researchers talk about genes for risk-taking, depression and harm avoidance that put people in situations where they are more likely to get injured. They also talk about genes for bone density and skin fragility; genes for repair and infection-fighting capacity; and genes for multisystemic organ failure. [...]

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