Mr Blair Johnson1, Mr Andrew Stevenson1, Ms Helen McGuire2, Mr Matthew Linden1, Ms Fiona Wood1,3, Mr Mark Fear1
1University Of Western Australia, Crawley, Australia, 2University of Sydny, Sydney, Australia, 3Department of Health, Perth, Australia
Epidemiological studies conducted within Australia have demonstrated that survivors of burn injuries are at a long-term risk of developing a range of morbidities. The personal and social burden is significant, with patients demonstrating a risk of increased lengths of hospitalisation. The mechanisms underlying this pattern of disease is not yet understood; however, many of the post-burn morbidities observed could be the result of immune dysfunction.
Children aged 0-3 are at the greatest risk of a burn injury that results in hospitalisation. Most injuries (84%) are non-severe with a total body surface area (TBSA) involvement of <10%. Plasma and PBMCs were collected >3 years after injury from 38 paediatric burn survivors aged <4yo at the time of injury, and from age/sex-matched controls.
Plasma was assessed using a Luminex assay targeting 13 cytokines. TNFa, IL-2, IL-7 and IFNg were all significantly elevated in the burn cohort.
PBMCs from 22 patients and matched controls were stained with a bespoke panel of 40 metal-conjugated antibodies and measured using a Helios mass cytometer. Unsupervised clustering analysis and hierarchical gating strategies were implemented to identify subpopulations that were altered in the burn survivors. Memory T-regulatory cells, Th17 cells, central memory CD8+ T cells, and central memory CD4+ T cells were all generally elevated (0.05 < p < 0.1) in the burn cohort.
This study has demonstrated a lasting change to the immune profile of burn survivors in both the cellular compartment and circulating cytokines. It suggests new avenues for research into post-burn immune suppression and regulation.
Blair has just begun his PhD at the University of Western Australia investigating changes to the immune system and platelet function following burn injury.