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Perturbed Mononuclear Phagocyte System in Severely Burned and Septic Patients

Xiu, Fangming; Jeschke, Marc G.

doi: 10.1097/SHK.0b013e318299f774
Clinical Aspects
Editor's Choice

ABSTRACT Burn is one of the most common and devastating forms of trauma. Major burn injury disturbs the immune system, resulting in marked alterations in bone marrow hematopoiesis and a progressive suppression of the immune response, which are thought to contribute to increased susceptibility to secondary infections and the development of sepsis. Immunosuppression in patients with severe burn and sepsis leads to high morbidity and mortality in these patients. mononuclear phagocytes system (MPS) is a critical component of the innate immune response and plays key roles in burn immunity. These phagocytes are the first cellular responders to severe burn injury after acute disruption of the skin barrier. They are not only able to internalize and digest bacteria and dead cells and scavenge toxic compounds produced by metabolism, but also able to initiate an adaptive immune response. Severe burn and sepsis profoundly inhibit the functions of dendritic cells, monocytes, and macrophages. Adoptive transfer of MPS or stem cells to patients with severe burn and sepsis that aim to restore MPS function is promising. A better understanding of the roles played by MPS in the pathophysiology of severe burn and sepsis will guarantee a more rational and effective immunotherapy of patients with severe burn and sepsis.

Sunnybrook Health Science Centre and University of Toronto, Toronto, Ontario, Canada

Received 14 Mar 2013; first review completed 29 Mar 2013; accepted in final form 2 May 2013

Address reprint requests to Marc G. Jeschke, PhD, MD, Ross Tilley Burn Center, Sunnybrook Health Sciences Centre and University of Toronto, 2075 Bayview Ave., Toronto, Ontario M4N 3M5, Canada. E-mail: marc.jeschke@sunnybrook.ca.

This study was supported by Canadian Institutes of Health Research grant 123336; CFI Leader’s Opportunity Fund: project 25407 NIH RO1 GM087285-01; and Physicians’ Services Incorporated Foundation–Health Research Grant Program.

No competing financial interests exist. F.X. and M.G.J. have no disclosures.

© 2013 by the Shock Society