High-Level Expression of Toll-Like Receptors on Dendritic Cells in Adult Patients with Burns on ≥90% of Total Body Surface Area (TBSA).
BACKGROUND As a serious clinical problem, severe burn injury disturbs the immune system, resulting in progressive suppression of immune response. TLRs are associated with immune system activation, but the effect of TLRs levels on circulating cDCs of severe burn injury patients has not been fully assessed. MATERIAL AND METHODS Ten patients with total body surface area (TBSA) burned >90% admitted to our institution were enrolled in this study. We analyzed TLR2, TLR4, and TLR9 expression on the circulating cDCs by using multicolor flow cytometric analysis in patients at 14 days to 28 days after burn injury according to mortality, and We also assessed Demographics, clinical outcomes, organ function, and inflammatory and acute-phase responses. RESULTS No difference in TBSA, sex, age, or number of operations before the first 14 days after injury were observed between surviving and non-surviving burn patients. The levels of TLR2, TLR4, and TLR9 in circulating cDCs were significantly and consistently elevated in all patients compared to age-matched healthy volunteers, and survivors exhibited higher TLR2 and TLR4 values than non-survivors. Of the survivors, TLR2 and TLR4 levels were higher at 28 days than at 14 days after injury, while the difference in TLR9 levels was not significant. TLR2 levels of non-survivors at 28 days after injury decreased, and the TLR4 and TLR9 levels showed no significant difference. CONCLUSIONS TLRs levels in circulating cDCs are highly activated in severe burn injury patients up to 28 days after injury. The low expression of TLR2 in cDCs may be useful as a potential marker predicting the poor prognosis of severe burn patients.
Department of Anesthesiology and Intensive Care, Changhai Hospital, Second Military Medical University, Shanghai, China (mainland).
Xu
X
Zhang
Department of Anesthesiology and Intensive Care, Changhai Hospital, Second Military Medical University, Shanghai, China (mainland).
Na
N
Li
Department of Anesthesiology and Intensive Care, Changhai Hospital, Second Military Medical University, Shanghai, China (mainland).
Yan
Y
Meng
Department of Anesthesiology and Intensive Care, Changhai Hospital, Second Military Medical University, Shanghai, China (mainland).
Renjing
R
Zhang
Department of Anesthesiology and Intensive Care, Changhai Hospital, Second Military Medical University, Shanghai, China (mainland).
Jinjun
J
Bian
Department of Anesthesiology and Intensive Care, Changhai Hospital, Second Military Medical University, Shanghai, China (mainland).
Ying
Y
Yao
Department of Anesthesiology and Intensive Care, Changhai Hospital, Second Military Medical University, Shanghai, China (mainland).
Jinbao
J
Li
Department of Anesthesiology and Intensive Care, Changhai Hospital, Second Military Medical University, Shanghai, China (mainland).
Xiaoming
X
Deng
Ann Burns Fire Disasters. 2007 Dec 31;20(4):199-202
21991097
Am J Crit Care. 2010 Nov;19(6):e81-7
21041189
Nat Rev Immunol. 2014 Aug;14(8):546-58
25060580
Burns. 2010 Sep;36(6):773-9
20074860
Int J Clin Exp Med. 2012;5(2):136-44
22567174
J Immunol. 1999 Apr 1;162(7):3749-52
10201887
Immunity. 2011 May 27;34(5):637-50
21616434
Crit Care. 2010;14(5):R188
20958968
Cell Mol Life Sci. 2010 Apr;67(8):1315-29
20087752
J Leukoc Biol. 2009 May;85(5):862-70
19228816
J Trauma. 2006 Sep;61(3):616-23; discussion 623
16966997
Curr Opin Microbiol. 2002 Feb;5(1):62-9
11834371
Crit Care Med. 2014 Sep;42(9):2029-36
24851744
Cell Immunol. 2006 Jul;242(1):9-22
17045255
Cell Immunol. 2011;268(1):29-36
21345420
Crit Care. 2013 Jan 18;17(1):406
23331487
Immunol Rev. 2012 Nov;250(1):216-29
23046132
Indian J Plast Surg. 2010 Sep;43(Suppl):S29-36
21321653
Nat Immunol. 2001 Aug;2(8):675-80
11477402
J Immunol. 2003 Aug 1;171(3):1473-83
12874240