Immune status disorders in patients with severe burns associated with negative outcome

Objective: to analyze the indices of immune cells in the blood and the level of proinflammatory cytokines in recovered and deceased patients with severe burns. Material and methods. The study included 45 burn victims with burns covering more than 30% of the body surface area (33 recovered, 12 deceased).The number of immune blood cells (neutrophils, lymphocytes, monocytes) and cytokine levels: tumor necrosis factor α (TNF-α), interleukin 12 (IL-12), monocyte chemoattractant protein-1 (MCP-1) were determined. Samples were taken on days 1, 3, 7, 15, 30 and 45 after the injury. Results. At all control points, an increase in the level of the studied cytokines was observed; on days 1–7, higher levels of TNFα – 0.6 (0.2; 101.0) pg/ml, 8.8 (0.25; 59.0) pg/ml and MCP-1 – 387.5 (147.9; 447.9) pg/ml, 306.8 (154.1; 1210.0) pg/ml were noted, and on days 30–45 – IL-12 – 102.2 (76.3; 148.7) pg/ml, 151.9 (83.5; 162.6) pg/ml. Higher levels of IL-12 and an increase in the number of lymphocytes on days 7–15 from the moment of injury (1.07±0.07; 1.19±0.05) were observed in patients with favorable outcome, and relatively low levels of IL-12 – 27.2 (9.6; 44.5) pg/ml, 32.1 (28.2; 50.7) pg/ml, and high levels of TNF-α – 8.8 (0.25; 59) pg/ml, 15.2 (0.5; 28.6) pg/ml) and neutrophils (7.67±0.49×109/l; 7.27±0.53×109/l) throughout all stages were more common in the deceased. Conclusion. In patients with severe burns, there is suppression of the parameters of the specific link of immunity (IL-12, the number of lymphocytes), with an increase in the non-specific link (neutrophils, TNF-α). The degree of disturbances depends on the severity and outcome of the injury.