Increasing Burn Size Dramatically Influences the Immune Response to Burn Injury

Abstract

Increasing total body surface area percentage (%TBSA) following burn injury leads to an increased risk of immune dysfunction, infection, and sepsis, yet the cellular mechanism responsible for this relationship is poorly understood. In this study, we hypothesize that increasing %TBSA burn area correlates with predictable changes in immune gene expression. To test this hypothesis, we analyzed the expression of several gene families important in inflammation and innate immunity in human peripheral blood monocytes following burn injury. We enrolled patients with 9% to 59% TBSA burn injury. We drew an initial peripheral blood sample with 24 hours of burn injury and a follow up blood sample within 10 days of injury. Peripheral blood mononuclear cells (PBMCs) were isolated using Ficoll extraction, cells lysed and mRNA extracted. Total RNA was reverse transcribed and subsequent cDNA used for real-time quantitative PCR analysis of NF-kappaB signaling genes as well as newly described and novel intracellular pathogen receptors genes (CLR). Gene expression was determined by log fold-increase or decrease over baseline. Data compared using chi-square, with significance defined as p<0.05.