FEATURES OF THE IMMUNE RESPONSE FORMATION TO THERMAL TRAUMA
O.M. Lynnyk1,2, O.I. Osadcha2, H.P. Kozynets1,2, I.R. Yanchiy3, O.O. Shmatova2, G.M. Boiarska2
- Shupyk National Healthcare University of Ukraine, Kyiv, Ukraine
- Institute of Haematology and Transfusiology of NAMS of Ukraine, Kyiv, Ukraine
- Komisarenko Institute of Endocrinology and Metabolism of Ukraine, Kyiv, Ukraine
To study the effect of thermal trauma on the immune response
formation, 43 patients aged 16 to 58 with body surface
area of burns 20-60% were examined. The neutrophilic
granulocytes (NG) and monocytes functional activity, the
content of myeloperoxidase and substances with a positive
reaction to Schiff’s periodic acid (PAS- stained substances),
the cytokines content were determined: interleukin-1β
(IL-1β), IL-2, IL-4, IL- 6, tumor necrosis factor-α (TNF-α).
Thermal damage caused changes in the immune response,
which were characterized by a pro-inflammatory phase in
which innate immunity cells (neutrophilic granulocytes,
monocytes) acquired high functional activity, producing
a higher content of proinflammatory cytokines. On the
2-3rd day after the burn injury in the peripheral blood, the
interleukin-1β (IL-1β) content was 133.5 ± 21.1 pg/ml, the
tumor necrosis factor α (TNF-α) content was 265 ± 115.5
pg/ml, which exceeded the reference values by 5.1 and 10.9
times, respectively. The content of IL-6 on the 2-3rd day
was 85.30 ± 13.10 pg/ml. Also a concomitant syndrome of
compensatory anti-inflammatory response developed with
increasing production of anti-inflammatory IL-4: on the
2-3rd day after burn injury, its content was 268.5 pg/ml,
exceeding the reference values by 8.2 times. The content
of anti-inflammatory IL-10 was decreased. This suggests
that anti-inflammatory cytokines do not compensate for the
high content of pro-inflammatory factors. On the 7th-8th
day after the burn injury, there was a tendency to further
increase the content of pro-inflammatory cytokines IL-
1β and TNF-α to 148.0 ± 27.0, and 281.2 ± 146.7 pg/ml,
respectively, while the content of IL-6 on the 7-8th day
was 131.0 ± 11.1 pg/ml, the anti-inflammatory cytokine
IL-10 increased slightly, and the content of IL-4 decreased.
These changes in the early period of burn disease dynamics,
as well as reduced activity of myeloperoxidase and PAS-
stained substances NG, point for a functional deficiency of NG, reduced enzymatic activity and cells energy resources
decompensation. These changes could clinically lead to
SIRS progression and multiorgan dysfunction.
thermal trauma; immunological reactivity; systemic inflammatory response syndrome; compensatory anti-inflammatory response; cytokines.
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