Burn Immune System Responses

In life, expect the unexpected. In science, expect the unaccepted.

Contrary to expectations, a recent study on morbidity and mortality in burn patients showed that those who died from their burns had a lower inflammatory response in their lungs than patients who survived.

Understanding early pulmonary immune dysfunction may improved therapies in burn care.

Christopher S. Davis, MD, a general surgery resident at Loyola University Hospital Researchers and his colleagues followed 60 burn patients at the Loyola University Hospital Burn Center, whose severity of inhalation injury was categorized into one of five grades (0, 1, 2, 3, and 4). Zero equals the absence of visible injury.

As expected, patients with the worst combined burn-and-smoke-inhalation injuries required more time on the ventilator, longer stays in the hospital, and in the intensive care unit. Older and more seriously injured patients also had a greater likelihood of death. 

However, it was the immune system findings that  were unexpected. Researchers measured concentrations of 28 immune system modulators, which are proteins produced by white blood cells that recruit other white blood cells to the injured area to mount an protective inflammatory response.

Previous studies showed that sicker patients usually have more active inflammatory responses, but in this case, the results showed that patients who died had less modulators, and therefore, a lower immune response.

Dr. Davis hypothesized that age, genetics, and differing health status at the time of injury may all have contributed to the unexpected findings, and noted that the inflammatory and immune response to injury remains incompletely understood and requires additional studies.