Immune Diagnostics and Immunotherapy of Burn Sepsis

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The paper analyzes the literature data and authors’ proper experience in the study of immunopathogenesis and immunodiagnosis of burn sepsis. It argues the issues of effective use of immunocorrection in the complex treatment of severely burned patients.
Diagnosis of sepsis after severe burn injury is challenging due to the overlap of signs and clinical manifestations of the hypermetabolic reaction of thermal injury and sepsis. The systemic inflammatory response caused by burns can mimic manifestations of sepsis and complicate its early diagnosis. Considering this, modern immunodiagnostics can serve as an effective tool in identifying damaged key immune markers in burns, determining the severity of immune status disorders in burn disease and the risk of developing septic complications for timely immunocorrection and providing appropriate complex therapy for patients with extensive burns.
However, the problem of immunocorrective therapy in severely burned patients remains extremely relevant, debatable and not fully resolved. It is a personalized approach based on immune analysis and clinical recommendations for the complex treatment of burn injury that should be applied in the immunotherapy of burn sepsis to improve the clinical outcomes and, possibly, prevent the development of sepsis in patients with severe burn injury.

Sobre autores

Maria Kozlova

A.V. Vishnevsky National Medical Research Center of Surgery

Email: mnkozlova@rambler.ru
ORCID ID: 0000-0002-0554-7094
Código SPIN: 7631-8050

PhD, Leading Researcher at the Burn Center 

Rússia, Moscow, 27 B. Serpukhovskaya street, 117997

Vladimir Zemskov

A.V. Vishnevsky National Medical Research Center of Surgery

Email: arturrego@yandex.ru
ORCID ID: 0000-0002-8867-5349
Código SPIN: 7754-0336

MD, Professor, Chief Researcher of the Clinical Diagnostic Laboratory

Rússia, Moscow, 27 B. Serpukhovskaya street, 117997

Andrey Alekseev

A.V. Vishnevsky National Medical Research Center of Surgery

Autor responsável pela correspondência
Email: alexseev@ixv.ru
ORCID ID: 0000-0001-6675-4794
Código SPIN: 4803-3939

MD, Professor, Deputy Director

Rússia, Moscow, 27 B. Serpukhovskaya street, 117997

Bibliografia

  1. World Health Organization. Burns. 2018. Dostupno po: https://www.who.int/en/news-room/fact-sheets/detail/burns. Ssylka aktivna na 01.04.2023.
  2. Revishvili ASh, Olovyannii VE, Sajin VP, Anischenko MA, Kuznecov AV, Mironova NL, Shelina NV. Khirurgicheskaya pomoshh' v Rossijskoj Federacii. М. 2021; 180. (in Russ.)
  3. Dasari H, Kumar A, Sharma BR. Burns septicemia: the leading cause of burn mortality. J Punjab Acad Forensic Med Toxicol. 2008; 8: 2: 10–16.
  4. Sharma BR, Harish D, Singh VP, Bangar S. Septicemia as a cause of death in burns: an autopsy study. Burns. 2006; 32: 5: 545–549.
  5. D’Avignon LC, Hogan BK, Murray CK, Loo FL, Hospenthal DR, Cancio LC, Kim SH, Renz EM, Barillo D, Holcomb JB, Wade CE, Wolf SE. Contribution of bacterial and viral infections to attributable mortality in patients with severe burns: an autopsy series. Burns. 2010; 36: 6: 773–779. doi: 10.1016/j.burns.2009.11.007
  6. Dellinger RP, Carlet JM, Masur H, Gerlach H, Calandra T, Cohen J, Gea-Banacloche J, Keh D, Marshall JC, Parker MM, Ramsay G, Zimmerman JL, Vincent J-L, Levy MM; Surviving Sepsis Campaign Management Guidelines Committee. Surviving sepsis guidelines for severe sepsis and septic shock. Crit Care Med. 2004; 32: 858–873.
  7. Dellinger RP, Levy MM, Rhodes A, Annane D, Gerlach H, Opal SM, Sevransky JE, Sprung CL, Douglas IS, Jaeschke R, Osborn TM, Nunnally ME, Townsend SR, Reinhart K, Kleinpell RM, Angus DC, Deutschman CS, Machado FR, Rubenfeld GD, Webb S, Beale RJ, Vincent J-L, Moreno R; Surviving Sepsis Campaign Guidelines Committee including The Pediatric Subgroup. Surviving sepsis campaign: International guidelines for management of severe sepsis and septic shock, 2012. Intensive Care Med. 2013; 39: 165–228.
  8. Evans L, Rhodes A, Alhazzani W, Antonelli M, Coopersmith CM, French C, Machado FR, Mcintyre L, Ostermann M, Prescott HC, Schorr C, Simpson S, Wiersinga WJ, Alshamsi F, Angus DC, Arabi Y, Azevedo L, Beale R, Beilman G, Belley-Cote E, Burry L, Cecconi M, Centofanti J, Yataco AC, Waele JD, Dellinger RP, Doi K, Du B, Estenssoro E, Ferrer R, Gomersall C, Hodgson C, Møller MH, Iwashyna T, Jacob S, Kleinpell R, Klompas M, Koh Y, Kumar A, Kwizera A, Lobo S, Masur H, McGloughlin S, Mehta S, MehtaY, Mer M, Nunnally M, Oczkowski S, Osborn T, Papathanassoglou E, Perner A, Puskarich M, Roberts J, Schweickert W, Seckel M, Sevransky J, Sprung CL, Welte T, Zimmerman J, Levy M. Surviving Sepsis Campaign: International Guidelines for Management of Sepsis and Septic Shock, 2021. Intensive Care Med. 2021; Nov; 47: 11: 1181-1247.
  9. Singer M, Deutschman CS, Seymour CW, Shankar-Hari M, Annane D, Bauer M, Bellomo R, Bernard GR, Chiche J-D, Coopersmith CM, Hotchkiss RS, Levy MM, Marshall JC, Martin GS, Opal SM, Rubenfeld GD, Poll T, Vincent J-L, Angus DC. The Third International Consensus Definitions for Sepsis and Septic Shock (Sepsis-3). JAMA. 2016; 315: 801–810. doi: 10.1001/jama.2016.0287
  10. Seymour CW, Liu VX, Iwashyna TJ, Brunkhorst FM, Rea TD, Scherag A, Rubenfeld G, Kahn JM, Shankar-Hari M, Singer M, Deutschman CS, Escobar GJ, Angus DC. Assessment of Clinical Criteria for Sepsis: For the Third International Consensus Definitions for Sepsis and Septic Shock (Sepsis-3). JAMA. 2016; 315: 762–774. doi: 10.1001/jama.2016.0288
  11. Shankar-Hari M, Phillips GS, Levy LM, Seymour CW, Liu VX, Deutschman CS, Angus DC, Rubenfeld GD, Singer M; Sepsis Definitions Task Force. Developing a New Definition and Assessing New Clinical Criteria for Septic Shock: For the Third International Consensus Definitions for Sepsis and Septic Shock (Sepsis-3). JAMA. 2016;315:775–787. doi: 10.1001/jama.2016.0289
  12. Greenhalgh DG. Sepsis in the burn patient: a different problem than sepsis in the general population. Burns Trauma. 2017; Aug; 8: 5: 23.
  13. McConnell KW, Coopersmith CM. Organ failure avoidance and mitigation strategies in surgery. Surg Clin N Am. 2012; 92: 307–319.
  14. O’Sullivan ST, O’Connor TP. Immunosuppression following thermal injury: the pathogenesis of immunodysfunction. Br J Plast Surg. 1997; 50: 8: 615–623.
  15. Girardot T, Rimmele T, Venet F, Monneret G. Apoptosis-induced lymphopenia in sepsis and other severe injuries. Apoptosis. 2017; 22: 2: 295–305. doi: 10.1007/s10495-016-1325-3
  16. Bone RC. Sir Isaac Newton, sepsis, SIRS, and CARS. Crit Care Med. 1996; 24:1125–1128. doi: 10.1097/00003246-199607000-00010
  17. Hotchkiss RS, Karl IE. The pathophysiology and treatment of sepsis. N Engl J Med. 2003; 348: 138–150. doi: 10.1056/NEJMra021333
  18. Nast-Kolb DM, Aufmkolk M, Rucholt S, Obertacke U, Waydhas C. Multiple organ failure. Still a major cause of morbidity but not mortality in blunt multiple trauma. J Trauma. 2001; 51: 835–841.
  19. Keel M, Trentz O. Pathophysiology of polytrauma. Injury. 2005; 36: 691–709.
  20. Xiao W, Mindronos MN, Seok J, Cuschieri J, Cuenca AG, Gao H, Hayden DL, Hennessy L, Moore EE, Minei JP, Bankey PE, Johnson JL, Sperry J, Nathens AB, Billiar TR, West MA, Brownstein BH, Mason PH, Baker HV, Finnerty CC, Jeschke MG, López MC, Klein MB, Gamelli RL, Gibran NS, Arnoldo B, Xu W, Zhang Y, Calvano SE, Grace P McDonald-Smith GP, Schoenfeld DA, Storey JD, Cobb JP, Warren HS, Moldawer LL, Herndon DN, Lowry SF, Maier RV, Davis RW, Tompkins RG; Inflammation and Host Response to Injury Large-Scale Collaborative Research Program. A genomic storm in critically injured humans. J Exp Med. 2011; 208: 2581–2590.
  21. Boomer JS, To K, Chang KC, Takasu O, Osborne DF, Walton AH, Bricker TL, Jarman SD, Kreisel D, Krupnick AS, Srivastava A, Swanson PE, Green JM, Hotchkiss RS. Immunosuppression in patients who die of sepsis and multiple organ failure. JAMA. 2011; 306: 2594–2605. doi: 10.1001/jama.2011.1829
  22. Hotchkiss RS, Monneret G, Payen D. Sepsis-induced immunosuppression: from cellular dysfunctions to immunotherapy. Nature Rev Immunol. 2013;13: 862–874. doi: 10.1038/nri3552
  23. Lamas D. Chronic critical illness. N Engl J Med. 2014; 370: 175–177.
  24. Kahn JM, Le T, Angus DC, Cox CE, Hough CL, White DB, Yende S, Carson SS; ProVent Study Group Investigators. The epidemiology of chronic critical illness in the United States. Crit Care Med. 2015; 43: 282–287. doi: 10.1097/CCM.0000000000000710
  25. Mira JC, Gentile LF, Mathias J, Efron PA, Brakenridge SC, Mohr AM, Moore FA, Moldawer LL. Sepsis pathophysiology, chronic critical illness, and the persistent inflammatory-immunosuppression and catabolism syndrome. Crit Care Med. 2017; 45: 253–262.
  26. Flajnik MF, Kasahara M. Origin and evolution of the adaptive immune system: Genetic events and selective pressures. Nature Rev Genet. 2010;1 1: 47–59. doi: 10.1038/nrg2703
  27. Litman GW, Rast JP, Fugmann SD. The origins of vertebrate adaptive immunity. Nature Rev Immunol. 2010; 10: 543–553.
  28. Ebert G. Immunity by equilibrium. Nature Rev Immunol. 2016; 16: 524–32.
  29. Pober JS, Sessa WC. Evolving functions of endothelial cells in inflammation. Nature Rev Immunol. 2007; 7: 803–15.
  30. Komarova YA, Kruse K, Mehta D, Mali AB. Protein interactions at endothelial junctions and signaling mechanisms regulating endothelial permeability. Circ Res. 2017; 120: 179–206.
  31. Kaur A, Sethi GK, Goyal RK, Kaur A, Kaur R, Dhir SK, Gupta H. Thrombocytopenia in paediatric ICU: Incidence, transfusion requirement and role as prognostic indicator. J Clin Diagnost Res. 2015; 9: 5–7. doi: 10.7860/JCDR/2015/14590.6921
  32. Du Clos TW. C-reactive protein and the immune response. Sci Med. 2002; 8: 108–117. doi: 10.3109/07853890009011772
  33. Lopez ON, Cambiaso-Daniel J, Branski LK, Norbury WB, Herndon DN. Predicting and managing sepsis in burn patients: current perspectives. Ther Clin Risk Manag. 2017 Aug 29; 13: 1107-1117.
  34. Ferrer R, Martin-Loeches I, Phillips G, Osborn TM, Townsend S, Dellinger RP, Artigas А, Schorr C, Levy MM. Empiric antibiotic treatment reduces mortality in severe sepsis and septic shock from the first hour: Results from a guideline-based performance improvement program. Crit Care Med. 2014; 42: 1749–1755.
  35. Kaukonen K-M, Bailey M, Suzuki S, Pilcher D, Bellomo R. Mortality related to severe sepsis and septic shock among critically ill patients in Australia and New Zealand, 2000-2012. JAMA. 2014; 311: 1308–1316.
  36. Greenhalgh DG, Saffle JR, Holmes JH, IV, Gamelli R, Palmieri TL, Horton JW, Tompkins RG, Traber DL, Mozingo DW, Deitch ЕA, Goodwin CW, Herndon DN, Gallagher JJ, Sanford AP, Jeng JC, Ahrenholz DH, Neely AN, O'Mara MS, Wolf SE, Purdue GF, Garner WL, Yowler СJ, Latenser BA. American Burn Association Consensus Conference to define sepsis and infection in burns. J Burn Care Res. 2007; 28: 776–790
  37. Alekseev AA. Ozhogovyj sepsis: diagnostika, profilaktika, lechenie. Dissertaciya doktora med. nauk. М. 1993; 233. (in Russ.)
  38. Alekseev AA, Krutikov MG, Yakovlev VP. Ozhogovaya infekciya. Etiologiya, patogenez, diagnostika, profilaktika i lechenie. M.: Vuzovskaya kniga. 2010; 416. (in Russ.)
  39. Pruitt BA, Polk HC. Burns and soft tissues. Infection and the surgical patient. Churchill Livingstone. 1982; 4: 113-131.
  40. Zemskov VM, Alekseev AA, Kozlova MN, Shishkina NS, Gnatenko DA, Zemskov AM, Bahov NI. Immune diagnostics of septic complications in burns. Biology bulletin reviews. 2016; 6: 4: 344-354.
  41. Shapiro NI, Trzeciak S, Hollander JE. Birkhahn R, Otero R, Osborn TM, Moretti E, Nguyen HВ, Gunnerson KJ, Milzman D, Gaieski DF, Goyal M, Cairns CB, Ngo L, Riverset EP. A prospective multicenter derivation of a biomarker panel to assess risk of organ dysfunction, shock, and death in emergency department patients with suspected sepsis. Crit. Care Med. 2009; 37: 1: 96-104.
  42. Bozza FA, Salluh JI, Japiassu AM, Soares M, Assis EF, Gomes RN, Bozza MT, Castro-Faria-Neto HC, Bozza PT. Cytokine profiles as markers of disease severity in sepsis: A multiplex analysis. Crit Care. 2007; 11(2): R49. doi: 10.1186/cc5783
  43. Kofoed K, Andersen O, Kronborg G, Tvede M, Petersen J, Eugen-Olsen J, Larsen K. Use of plasma C-reactive protein, procalcitonin, neutrophils, macrophage migration inhibitory factor, soluble urokinase-type plasminogen activator receptor, and soluble triggering receptor expressed on myeloid cells-1 in combination to diagnose infections: a prospective study. Crit Care. 2007; 11(2): R38. doi: 10.1186/cc5723
  44. Kolker II. Immunologicheskie aspekty ozhogovoj bolezni. III Vsesoyuznaya konferentsiya «Sovremennye sredstva pervoj pomoshchi i metody lecheniya ozhogovoj bolezni». 1986; 191-193. (in Russ.)
  45. Belockii SM. Snastina TI. Filyukova OB. Microbial factor in chemiluminescence of peripheral blood neutrophils in patients with purulent surgical infection. Zhurnal mikrobiologija, jepidemiologija i immunologija. 1988; 8: 87-90. (in Russ.)
  46. Belockii SM. Snastina TI. The role of the opsonophagocytic system in the pathogenesis of sepsis. Terapevticheskij arhiv. 1988; 5: 97-99. (in Russ.)
  47. Karelin AA, Alekseev AA, Globa AG, Demidova VS, Cvetkov VO. Enzymatic production of superoxide by polymorphonuclear human leukocytes in burn disease. Voprosy medicinskoj himii. 1988; 34: 5: 107-110. (in Russ.)
  48. Sergel OS, Morozov SS. K voprosu o znachenii pri ozhogovoj bolezni testov mestnoj kletochnoj giperchuvstvitel'nosti. III Vsesoyuznaya konferentsiya «Sovremennye sredstva pervoj pomoshchi i metody lecheniya ozhogovoj bolezni». 1986; 204-206. (in Russ.)
  49. Krutikov MG. Infektsiya u obozhzhennykh: etiologiya, patogenez, diagnostika, profilaktika i lechenie. Dissertatsiya doktora med. nauk. M. 2005; 371. (in Russ.)
  50. Ushakova T.A. Adaptivnye reaktsii u tyazhelo obozhzhennykh v usloviyakh intensivnoj terapii. Dissertatsiya doktora med. nauk. M. 2008; 268. (in Russ.)
  51. Alekseev AA, Ushakova TA, Krutikov MG, Bobrovnikov AE. Тhe sepsis markers in diagnostic of adaptive inflammation under burn trauma. Lechenie i profilaktika. 2015; 2: 14: 84-91. (in Russ.)
  52. Pivovarova LP, Ariskina OB, Assur MV, Gujda OG, Kladukhina NA, Lopiyuva MP, Osipova IV, Sorokina EV, Razumova TV, Shlyk IV, Stupak GV. Immunotherapy of sepsis in patients with severe burn injury. Meditsinskaya immunologiya. 1999; 1: 3-4: 126-127. (in Russ.)
  53. Zemskov VM, Kozlova MN, Barsukov AA, Shishkina NS, Zemskov AM, Alekseev AA, Demidova VS. Тhe study of limphoid and phagocytic cells of different phenotypes in burn desease. Rossijskij allergologicheskij zhurnal. 2017; 14: S1: 64-66. (in Russ.)
  54. Kozlova MN, Zemskov VM, Barsukov AA, Shishkina NS, Demidova VS, Alekseev AA. Immunological monitoring of infectious complications in severely burned patients. Laboratornaja sluzhba. 2017; 3: 6: 30. (in Russ.)
  55. Kozlova MN, Zemskov VM, Alekseev AA, Barsukov AA, Shishkina NS, Demidova VS. Features of immune status and immunocorrection in burn disease. Rossijskij allergologicheskij zhurnal. 2019; 16: 1: 76-79. (in Russ.)
  56. Zemskov VM, Alekseev AA, Gnatenko DA, Kozlova MN, Shishkina NS, Zemskov AM, Zhegalova IV, Bleykhman DA, Bahov NI, Suchkov SV. Composite Biomarker Panel as a Highly Informative and Reliable Tool for Predicting Septic Complications. Jacobs Journal of Biomarkers. 2016; 2(1): 016: 1-10.
  57. Optimizacija diagnostiki i lechenija gnojno-vospalitel'nyh zabolevanij (innovacionnye tehnologii). Pod red. Revishvili ASh, Zemskova VM, Zemskova AM. Sankt-Peterburg: SpecLit. 2020; 319. (in Russ.)
  58. Zemskov VM, Alekseev AA, Kozlova MN, Barsukov AA, Solov'eva MS, Ahmadov MA. Izmenenija immunnogo statusa pacientov pri ozhogovoj travme. III Syezd kombustiologov. 2010; 76-78. (in Russ.)
  59. Zemskov VM, Alekseev AA, Krutikov MG, Lagvilava MG, Kozlova MN, Barsukov AA, Solov'eva MS, Ahmadov MA. Changes of the immune status at suffered from burns, including at mass accidents. Vestnik eksperimental'noj i klinicheskoj khirurgii. 2013; 6: 1: 9-18. (in Russ.)
  60. Zemskov VM, Barsukov AA, Gnatenko DA, Shishkina NS, Kulikova AN, Kozlova MN. Fundamental and applied aspects of analysis of the oxygen metabolisms of phagocytic cells. Biology bulletin reviews. 2014; 4: 2: 101-111.
  61. Zemskov VM, Alekseev AA, Kozlova MN, Shishkina NS, Gnatenko DA, Zemskov AM, Bahov NI. Immune diagnostics of septic complications in burns. Uspehi sovremennoj biologii.2015; 135: 6: 531-541. (in Russ.)
  62. Alekseev AA, Bobrovnikov AE, Bogdanov VV. Meaning of innovative technologies for improvement of results in treating burned patients. Medical alphabet. 2020; 13: 44–47. (in Russ.)
  63. Alekseev AA, Salahiddinov KZ, Gavriljuk BK, Tjurnikov JuI. Complex treatment of deep burns on basis of surgical necrectomies and modern biotechnological methods. Annaly hirurgii. 2012; 6: 41-45. (in Russ.)
  64. Klinicheskie rekomendacii: «Ozhogi termicheskie i himicheskie. Ozhogi solnechnye. Ozhogi dyhatel'nyh putej». 2021. Dostupno po: https://cr.minzdrav.gov.ru/recomend/687_1. Ssylka aktivna na 01.04.2023. (in Russ.)
  65. Durandy A, Kaveri SV, Kuijpers TW, Basta M, Miescher S, Ravetch JV, Rieben R. Intravenous immunoglobulins-understanding properties and mechanisms. Clin. Exp. Immunol. 2009; 158: 1: 2-13. doi: 10.1111/j.1365-2249.2009.04022.x
  66. Smith KG, Clatworthy MR. FcγRIIB in autoimmunity and infection: evolutionary and therapeutic implications. Nature Reviews Immunology. 2010; 674: 10: 328-343.
  67. Latysheva TV. Principles of replacement therapy with intravenous immunoglobulins. Citokiny i vospalenie. 2005; 4: 3: 58 – 62. (in Russ.)
  68. Kozlova MN, Zemskov VM, Shishkina NS, Barsukov AA, Demidova VS, Alekseev AA. Personalized algorithm of immunocorrection with intravenous immunoglobulins for preventing and treating complications of burn disease by comprehensively analyzing immune status. Rossijskij immunologicheskij zhurnal. 2020; 23: 4: 523-528. doi: 10.46235/1028-7221-459-PAO (in Russ.)
  69. Sewell WA, Jolles S. Immunomodulatory action of intravenous immunoglobulin. Immunology. 2002; 107: 4: 387-393. doi: 10.1046/j.1365-2567.2002.01545.x
  70. Takei S, Arora YK, Walker SM. Intravenous immunoglobulin contains specific antibodies inhibitory to activation of T cells by staphylococcal toxin superantigens. J. Clin. Invest. 1993; 91: 2: 602-607.
  71. Lutz HU, Stammler P, Jelezarova E, Nater M, Späth PJ. High doses of immunoglobulin G attenuate immune aggregate-mediated complement activation by enhancing physiologic cleavage of C3b in C3bn-IgG complexes. Blood.1996; 88: 184-193.
  72. Zemskov VM, Alekseev AA, Kozlova MN, Shishkina NS, Bleykhman DA, Zemskov AM, Suchkov SV. Changes in the immune system depending on the stage of burn disease and the area of thermal destruction. Immunoglobin replacement therapy with gabriglobin. International Journal of Recent Scientific Research. 2017; 8: 2: 15653-15662.
  73. Latysheva TV, Setdikova NH. New domestic immunoglobulin G - gabriglobin in the complex therapy of patients with common variable immunodeficiency. Vestnik Rossijskoj voenno-medicinskoj akademii. 2005; 1: 41-43. (in Russ.)
  74. Ljutov VA, Aleshkin VA, Donjush EK, Zajakina LB, Mostovskaja EV, Sokolov DV. Gabriglobin-IgG - possibilities and efficiency of clinical application. Lechenie i profilaktika. 2016; 4: 20: 74-80. (in Russ.)
  75. Zemskov VM, Alekseev AA, Kozlova MN, Barsukov AA, Solov'eva MS, Ahmadov MA. Study of the clinical and immunological efficacy of immunoreplacement therapy with gabriglobin in the treatment of burn disease and its complications. RMZh. 2012; 5: 216-222. (in Russ.)
  76. Alekseev AA, Zemskov VM, Kozlova MN, Krutikov MG, Barsukov AA, Solov'eva MS, Ahmadov MA. The use of Gabriglobin for the prevention and treatment of sepsis in severely burned patients. Skoraja medicinskaja pomoshh'. 2011; 3: 4-7. (in Russ.)

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