Early Transcriptomic Response to Burn Injury: Severe Burns Are Associated With Immune Pathway Shutdown
Year: 2021
Type: article
Study design: Observational Study
Abstract: Burn injury induces a systemic hyperinflammatory response with detrimental side effects. Studies have described the biochemical changes induced by severe burns, but the transcriptome response is not well characterized. The goal of this work is to characterize the blood transcriptome after burn injury. Burn patients presenting to a regional center between 2012 and 2017 were prospectively enrolled. Blood was collected on admission and at predetermined time points (hours 2, 4, 8, 12, and 24). RNA was isolated and transcript levels were measured with a gene expression microarray. To identify differentially regulated genes (false-discovery rate ≤0.1) by burn injury severity, patients were grouped by TBSA above or below 20% and statistically enriched pathways were identified. Sixty-eight patients were analyzed, most patients were male with a median age of 41 (interquartile range, 30.5-58.5) years, and TBSA of 20% (11%-34%). Thirty-five patients had % TBSA injury ≥20%, and this group experienced greater mortality (26% vs 3%, P = .008). Comparative analysis of genes from patients with </≥20% TBSA revealed 1505, 613, 380, 63, 1357, and 954 differentially expressed genes at hours 0, 2, 4, 8, 12, and 24, respectively. Pathway analysis revealed an initial up-regulation in several immune/inflammatory pathways within the ≥20% TBSA groups followed by shutdown. Severe burn injury is associated with an early proinflammatory immune response followed by shutdown of these pathways. Examination of the immunoinflammatory response to burn injury through differential gene regulation and associated immune pathways by injury severity may identify mechanistic targets for future intervention.
Source: Journal of Burn Care & Research
DOI: 10.1093/jbcr/irab217
Authors: John W Keyloun, Ross Campbell, Bonnie C Carney, Ruoting Yang, Stacy-Ann Miller, Leanne Detwiler, Aarti Gautam, Lauren T Moffatt, Rasha Hammamieh, Marti Jett, Jeffrey W Shupp, SYSCOT study group, Melissa M McLawhorn, Rachael A Callcut, Mitchell J Cohen, Linda R Petzold, Jeffrey D Varner, Maria Cristina Bravo, Kathleen E Brummel-Ziedins, Kalev Freeman, Kenneth G Mann, Thomas Orfeo, Anthony E Pusateri
Language: English
Subfield: Epidemiology
Field: Medicine
Domain: Health Sciences
Open Access status: green
OpenAlex ID: W3214636661