Suppressive serum, suppressor lymphocytes, and death from burns

Area of Science:

• Immunology
• Burn Medicine
• Infectious Disease

Background:

• Major thermal burns are associated with impaired immune responses.
• Suppressor lymphocytes and immunosuppressive serum factors may compromise host resistance to bacterial infections in burn wounds.
• The clinical significance of these immune alterations is not well understood.

Purpose of the Study:

• To investigate the relationship between immunosuppressive serum factors, circulating suppressor lymphocytes, and clinical outcomes in patients with major thermal burns.
• To determine the clinical importance of impaired immune reactivity following severe burns.

Main Methods:

• Studied 18 patients with full-thickness burns of varying severity.
• Assessed the presence of non-specific immunosuppressive serum and circulating suppressor lymphocytes.
• Correlated clinical course with immune findings, including the phytohemagglutinin (PHA) response of lymphocytes.

Main Results:

• Immunosuppressive serum factors were detected early in 15 of 18 patients.
• Systemic infection developed in 13 patients with immunosuppressive serum.
• Severe depression of the PHA response in peripheral blood lymphocytes was less common but strongly associated with mortality.
• No patients without severe PHA response depression died.

Conclusions:

• Immunosuppressive serum factors are common in burn patients and associated with systemic infection.
• Severe depression of lymphocyte PHA response is a critical indicator of poor prognosis and mortality in burn patients.
• Nonadherent leukocytes from burn patients can suppress normal lymphocyte PHA responses, indicating the presence of suppressor cells.