Mr Blair Johnson1, Mr Andrew Stevenson1, Ms Fiona Wood1,2, Mr Mark Fear1, Mr Matthew Linden1
1University Of Western Australia, Crawley, Australia, 2Department of Health, Perth, Australia
It has been established that burn survivors are at a long-term increased risk of cardiovascular disease, with increased lengths of stay when hospitalised. However, the underlying pathology is poorly understood; this is compounded by a lack of research into non-severe burn injuries (NSBI), which comprise the majority of all burn cases in Australia (84%).
Platelets have an established role in the pathogenesis of cardiovascular diseases. During the acute burn injury circulating pro-thrombotic mediators increase susceptibility to venous thrombosis and pulmonary embolism. It has not been determined whether there is an association with NSBI and altered platelet reactivity that could drive a life-long risk of cardiovascular disease.
Platelet function was assessed in the post-acute period by flow cytometric analysis of platelet activation in mice and humans. Blood was collected from mouse models of NSBI (8% TBSA) and sham controls then incubated with a panel of canonical platelet agonists. Increased reactivity to stimulation of platelet collagen receptor was observed (1.2 fold change from sham). We then followed up in adult humans presenting with a NSBI, collecting blood samples at 2- and 6-weeks post-injury. An increase in circulating monocyte-platelet aggregates was observed without stimulation at 2 weeks, and expression of the fibrinogen-binding site upon stimulation with threshold doses of collagen-related peptide at 2 weeks. Platelet responsiveness to collagen-related peptide showed a trending increase across dosages and time points.
Platelet reactivity has been demonstrated to remain altered after the acute burn injury has resolved. Further research is recommended to establish a causative mechanism.
Blair has just begun his PhD at the University of Western Australia investigating changes to immune profile and platelet function after burn injury.