Analysis of peripheral blood lymphocytes in burns of varying degrees in the assessment of immune suppression

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Introduction: Burn, depending on the degree of severity and depth, induces significant pathophysiological response of the body. Our study is the prospective study for assessment of T lymphocyte immunological changes in patients with burns, with different degrees of %TBSA and depth of burns. Research objectives: Objectives of this study were to assess %CD3+Ly, %CD4+Ly, %CD8+Ly, %CD3+ HLA-DR+Ly, %CD4+Ly /CD8+Ly), of burned body with different %TBSA degrees, different depth burns and to establish predictive value of immune suppression these parameters. Patients and methods: According to %TBSA, patients were classified into three groups: mild burns with TBSA% < 15% (30 patients), group of medium burns with %TBSA from 15%-25% (30 patients) and group with %TBSA > 25% to 40% (30 patients). According to the depth of burns, patients were classified into two groups, partial-thickness burns, (39 patients), and full-thickness burns (51 patients). We followed laboratory parameters: % CD3+Ly, % CD3+ CD4+Ly, % CD3+CD8+Ly, % CD3+HLA-DR+Ly, CD4 / CD8 (%) lymphocytes (on day 7th and on day 14th). Results: Percentage of CD3+ lymphocytes was significantly lower in severe burns compared to the moderate-heavy burns and significantly lower compared to the mild burns. Percentage of CD3+CD4+ lymphocytes was significantly lower in severe burns compared to moderate-heavy burns and in relation to mild burns (results on day 14th); also are lower in moderate-severe burn compared to mild burns. On day 14th, the% CD4 / CD8 ratio was not significantly lower in the severe burns versus the moderate burns. On day 14th, the % CD4 / CD8 ratio was significantly lower in severe burns compared to mild burns; significantly lower in moderate burns compared to mild burns. % CD3+HLA -DR + cells was significantly lower in severe burn and moderately severe burns compared to the mild burns on day 7th, and also on day 14th. Full-thickness burns have significantly lower %CD3+lymphocytes, %CD3 +CD4+ lymphocytes, %CD3+HLA-DR+ lymphocytes, ratio of % CD4/CD8 lymphocytes compared to partial-thickness burns. Conclusions: Peripheral blood T lymphocytes are one of the key indicators of immunosuppression of patients with burns of different % TBSA and different degrees of burn depth. Larger %TBSA and full-thickness burns injected stronger systemic immunosuppression, compared to smaller %TBSA and partial-thickness burns

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