Burn Injury Leads to Increased Long-Term Susceptibility to Respiratory Infection in both Mouse Models and Population Studies.
Vanessa S FearJames H BoydSuzanne ReaFiona M WoodJanine M DukeMark W FearPublished in: PloS one (2017)
The burn injured cohort contained 14893 adult patients from 1980-2012 after removal of those patients with evidence of smoke inhalation or injury to the respiratory tract. During the study follow-up study a total of 2,884 and 2,625 respiratory infection hospital admissions for the burn and uninjured cohorts, respectively, were identified. After adjusting for covariates, the burn cohort experienced significantly elevated admission rates for influenza and viral pneumonia (IRR, 95%CI: 1.73, 1.27-2.36), bacterial pneumonia (IRR, 95%CI: 2.05, 1.85-2.27) and for other types of upper and lower respiratory infections (IRR, 95% CI: 2.38, 2.09-2.71). In the mouse study an increased viral titre was observed after burn injury, accompanied by a reduced CD8 response and increased NK and NKT cells in the draining lymph nodes. This data suggests burn patients are at long-term increased risk of infection due to sustained modulation of the immune response.
Keyphrases
- respiratory tract
- wound healing
- immune response
- lymph node
- end stage renal disease
- sars cov
- emergency department
- chronic kidney disease
- intensive care unit
- mouse model
- induced apoptosis
- dendritic cells
- peritoneal dialysis
- cell cycle arrest
- electronic health record
- cell death
- toll like receptor
- deep learning
- sentinel lymph node
- acute respiratory distress syndrome