The Complexity of the Post-Burn Immune Response: An Overview of the Associated Local and Systemic Complications
H. Ibrahim Korkmaz,
Gwendolien Flokstra,
Maaike Waasdorp,
Anouk Pijpe,
Stephan G. Papendorp,
Evelien de Jong,
Thomas Rustemeyer,
Susan Gibbs,
Paul P. M. van Zuijlen
Affiliations
H. Ibrahim Korkmaz
Department of Plastic Reconstructive and Hand Surgery, Amsterdam Movement Sciences (AMS) Institute, Amsterdam UMC, Location VUmc, 1081 HZ Amsterdam, The Netherlands
Gwendolien Flokstra
Department of Molecular Cell Biology and Immunology, Amsterdam Infection and Immunity (AII) Institute, Amsterdam UMC, Location VUmc, 1081 HZ Amsterdam, The Netherlands
Maaike Waasdorp
Department of Molecular Cell Biology and Immunology, Amsterdam Infection and Immunity (AII) Institute, Amsterdam UMC, Location VUmc, 1081 HZ Amsterdam, The Netherlands
Anouk Pijpe
Department of Plastic Reconstructive and Hand Surgery, Amsterdam Movement Sciences (AMS) Institute, Amsterdam UMC, Location VUmc, 1081 HZ Amsterdam, The Netherlands
Stephan G. Papendorp
Burn Center and Department of Plastic and Reconstructive Surgery, Red Cross Hospital, 1942 LE Beverwijk, The Netherlands
Evelien de Jong
Burn Center and Department of Plastic and Reconstructive Surgery, Red Cross Hospital, 1942 LE Beverwijk, The Netherlands
Thomas Rustemeyer
Department of Dermatology, Amsterdam UMC, Location AMC, 1105 AZ Amsterdam, The Netherlands
Susan Gibbs
Department of Molecular Cell Biology and Immunology, Amsterdam Infection and Immunity (AII) Institute, Amsterdam UMC, Location VUmc, 1081 HZ Amsterdam, The Netherlands
Paul P. M. van Zuijlen
Department of Plastic Reconstructive and Hand Surgery, Amsterdam Movement Sciences (AMS) Institute, Amsterdam UMC, Location VUmc, 1081 HZ Amsterdam, The Netherlands
Burn injury induces a complex inflammatory response, both locally and systemically, and is not yet completely unravelled and understood. In order to enable the development of accurate treatment options, it is of paramount importance to fully understand post-burn immunology. Research in the last decades describes insights into the prolonged and excessive inflammatory response that could exist after both severe and milder burn trauma and that this response differs from that of none-burn acute trauma. Persistent activity of complement, acute phase proteins and pro- and anti-inflammatory mediators, changes in lymphocyte activity, activation of the stress response and infiltration of immune cells have all been related to post-burn local and systemic pathology. This “narrative” review explores the current state of knowledge, focusing on both the local and systemic immunology post-burn, and further questions how it is linked to the clinical outcome. Moreover, it illustrates the complexity of post-burn immunology and the existing gaps in knowledge on underlying mechanisms of burn pathology.
