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
DOI: https://doi.org/10.15407/fz67.06.032
Abstract
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.
Keywords:
thermal trauma; immunological reactivity; systemic inflammatory response syndrome; compensatory anti-inflammatory response; cytokines.
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