ANALYSIS OF PERIPHERAL BLOOD LYMPHOCYTES IN BURNS OF VARYING DEGREES IN THE ASSESSMENT OF IMMMUNE SUPPRESSION

Introduction: Burn, depending on the degree of severity and depth, induces significant pathophysiological  response of the body. Our study is the  prospective study  for  assessment of  T lymphocyte  immunological changes in patients with burns, with different degrees of  %TBSA  and depth of burns. Research objectives : Objectives of this study were to assess %CD3+Ly, % CD4+Ly,  %CD8+Ly, %CD3+HLA-DR+Ly, %CD4+Ly /CD8+Ly), of burned body with different   %TBSA degrees, different depth burns and to establish predictive value of of immune suppression  these  parameters. Patients and methods: According  to %TBSA, patients were classified into three groups:  mild  burns with TBSA% 25% to 40%  (30 patients).  According to the depth of burns, patients were classified into two groups, partial-thickness burns, (39 patients), and full-thickness burns (51 patients). We followed laboratory  parameters :  % CD3+Ly , % CD3+ CD4+Ly,  % CD3+CD8+Ly,  % CD3+HLA-DR+Ly, CD4 / CD8 (%) lymphocytes (on    day 7th and on   day 14th). Results: Percentage of CD3+ lymphocytes was significantly lower in severe  burns compared to the moderate  heavy  burns  andsignificantly lower compared to the mild  burns . Percentage of CD3+CD4+ lymphocytes was significantly lower in severe burns   compared to moderate  heavy burns   and  in relation to  mild burns  (results on day 14th );  also  are lower in moderate severe burn compared  to  mild burns. On day 14th, the% CD4 / CD8 ratio was not significantly lower in the severe burns versus the moderate  burns. On day 14th, the  % CD4 / CD8 ratio wassignificantly lower in severe burns compared to mild burns; significantly lower in moderateburns  compared  to  mild  burns. % CD3+HLA-DR + cells was significantly lower   in severe   burn and moderately  severe  burns  compared to the mild burns  on day 7th, and also on day 14th .  Full- thickness burns have significantly lower  %CD3+lymphocytes, %CD3+CD4+ lymphocytes,  %CD3+HLA-DR+ lymphocytes, ratio of % CD4/CD8 lymphocytes compared to partial-thickness burns  . Conclusions : Peripheral blood T lymphocytes are one of the key indicators of immunosuppression of patients with burns of different % TBSA and different degrees of burn depth.   Larger %TBSA and full- thickness burns injected stronger systemic immunosuppresion,   compared to smaller %TBSA and partial-thickness burns.