ANALYSIS OF PERIPHERAL BLOOD LYMPHOCYTES IN BURNS OF VARYING DEGREES IN THE ASSESSMENT OF IMMMUNE SUPPRESSION
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 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 andsignificantly 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 wassignificantly lower in severe burns compared to mild burns; significantly lower in moderateburns 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 immunosuppresion, compared to smaller %TBSA and partial-thickness burns.
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