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The relationship between dysfunction of cell-mediated immunity and prognosis in severely burned patients

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Author:
No author available
Journal Title:
CHINESE CRITICAL CARE MEDICINE
Issue:
9
DOI:
10.3321/j.issn:1003-0603.2008.09.002
Key Word:
烧伤;人白细胞DR抗原;T淋巴细胞;免疫功能;预后;burn;human leukocyte antigen-DR;T lymphocyte;immune function;prognosis

Abstract: Objective To investigate the relationship between dysfunction of cell-mediated immunity and prognosis in severely burned patients. Methods Twenty-six patients with total burn surface area larger than 70% total body surface area (TBSA) were included in the present study, and they were divided into non-survival group (14 cases) and survival group (12 cases). Eleven healthy volunteers served as controls.The blood samples were collected on days 1, 3, 7, 14 postburn, the human leukocyte antigen-DR (HLA-DR) bound on CD14+ mononuclear cell surface of burned patients was quantified by flow cytometry (using monoclonal antibody, QuantiBRITETM anti-HLA-DR PE/anti-monocyte PerCP-Cy5.5). The ability of T lymphocyte proliferation was determined by thiazolyl blue (MTT) method, and interleukin-2 (IL-2) release was measured by enzyme-linked immunosorbent assay (ELISA). Results Compared to the survival group, the T lymphocyte proliferative activity (0.739±0.299 vs. 0.320±0.237) and IL-2 release [(11.02±2.50) ng/L vs. (8.21±2.63) ng/L] in non-survival group were significantly decreased on postburn day 14 (P<0.01 and P<0.05). The expression of HLA-DR on CD14+ mononuclear cell surface was persistently decreased in non-survivors, while it markedly elevated in survivors after 14 days postburn (P<0.01).Conclusion The cellular immune function is consistently suppresed in severely burned patients. Sequential monitoring of T lymphocyte proliferation, IL-2 release, and the amount of HLA-DR on CD14+mononuclear cell surface might be of clinical prognostic significance in patients with massive burn injury.

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