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Nazemidashtarjandi S, Muldur S, Supple MD, Ryan CM, Yonker LM, Karabacak MN, Goverman J, Yarmush M, Irimia D. Monocyte Anisocytosis Changes in Patients after Major Burn Injuries. J Burn Care Res 2024:irae088. [PMID: 38783715 DOI: 10.1093/jbcr/irae088] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2024] [Indexed: 05/25/2024]
Abstract
The recovery of patients after severe burns is a long and complex process. Recently, genomic analysis of white blood cells from burn and trauma patients revealed excessive and prolonged innate immune activation in patients with complicated outcomes. However, translating this knowledge into practical biomarkers has not been possible yet. Although several biomarkers for monitoring burn patients have been proposed, their ability to accurately distinguish between inflammation stemming from initial tissue destruction, infections, and organ failure complications is limited. Here, we focused on monocytes, critical innate immune cells in the response to burn injured tissues. We measured the monocyte anisocytosis (quantified as monocyte distribution width, MDW, a recently emerged marker of sepsis) throughout the recovery of patients from the time of burn injury until the end of the hospital stay. We observed that MDW increases in patients during the first week after major burns. Among the patients with major burns who survive, MDW starts decreasing in the second week and normalizes by the end of the hospital stay. The duration of hospital stay appears to be proportional to how fast MDW decreases during the second week after the injury. We also found that MDW decreases significantly in most patients after excision and debridement surgeries but not after allo- and auto-graft surgeries. Moreover, high MDW values correlated with a higher rate of positive microbiology blood culture samples and respiratory infections. These findings underscore the importance of monitoring MDW as a potential biomarker for the risk of complications during burn patient recovery.
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Affiliation(s)
- Saeed Nazemidashtarjandi
- Department of Surgery, Center for Engineering in Medicine, Massachusetts General Hospital, Boston, MA 02129, USA
- Harvard Medical School, Boston, MA 02114, USA
- Shriners Children's Boston, Boston, MA 02114, USA
| | - Sinan Muldur
- Department of Surgery, Center for Engineering in Medicine, Massachusetts General Hospital, Boston, MA 02129, USA
- Department of Pediatrics, Mucosal Immunology and Biology Research Center, Massachusetts General Hospital, Boston, MA 02114, USA
- Department of Surgery, Sumner Redstone Burn Center, Massachusetts General Hospital, MA 02114, USA
| | - Matthew D Supple
- Department of Surgery, Sumner Redstone Burn Center, Massachusetts General Hospital, MA 02114, USA
| | - Collen M Ryan
- Department of Surgery, Sumner Redstone Burn Center, Massachusetts General Hospital, MA 02114, USA
- Harvard Medical School, Boston, MA 02114, USA
- Shriners Children's Boston, Boston, MA 02114, USA
| | - Lael M Yonker
- Department of Pediatrics, Mucosal Immunology and Biology Research Center, Massachusetts General Hospital, Boston, MA 02114, USA
- Harvard Medical School, Boston, MA 02114, USA
| | - Murat N Karabacak
- Department of Surgery, Center for Engineering in Medicine, Massachusetts General Hospital, Boston, MA 02129, USA
- Harvard Medical School, Boston, MA 02114, USA
- Shriners Children's Boston, Boston, MA 02114, USA
| | - Jeremy Goverman
- Department of Surgery, Sumner Redstone Burn Center, Massachusetts General Hospital, MA 02114, USA
- Harvard Medical School, Boston, MA 02114, USA
- Shriners Children's Boston, Boston, MA 02114, USA
| | - Martin Yarmush
- Department of Surgery, Center for Engineering in Medicine, Massachusetts General Hospital, Boston, MA 02129, USA
- Harvard Medical School, Boston, MA 02114, USA
- Shriners Children's Boston, Boston, MA 02114, USA
| | - Daniel Irimia
- Department of Surgery, Center for Engineering in Medicine, Massachusetts General Hospital, Boston, MA 02129, USA
- Harvard Medical School, Boston, MA 02114, USA
- Shriners Children's Boston, Boston, MA 02114, USA
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