Citation

Posluszny JA, Muthumalaiappan K, Kini AR, Szilagyi A, He LK, Li Y, Gamelli RL, Shankar R. J. Trauma 2011; 71(5): 1288-1296.

Affiliation

Loyola University Medical Center (J.A.P., K.M., A.S., L.K.H., R.L.G., R.S.), Burn and Shock Trauma Institute, Maywood, Illinois; Department of Surgery (J.A.P.), Case Western Reserve University School of Medicine, Cleveland, Ohio; Department of Pathology (A.K., Y.L.), Loyola University Medical Center, Maywood, Illinois.

Copyright

(Copyright © 2011, Lippincott Williams and Wilkins)

DOI

10.1097/TA.0b013e31822e2803

PMID

22071930

PMCID

PMC3217199

Abstract

BACKGROUND: : Anemia in burn patients is due to surgical blood loss and anemia of critical illness. Because the commitment paradigm of common bone marrow progenitors dictates the production of erythroid, myeloid, and lymphoid cells, we hypothesized that skewed bone marrow lineage commitment decreases red cell production and causes anemia after a burn injury. METHODS: : After anesthesia, B6D2F1 mice received a 15% total body surface area dorsal scald burn. The sham group did not receive scald burn. Femoral bone marrow was harvested on 2, 5, 7, 14, and 21 postburn days (PBD). Total bone marrow cells were labeled with specific antibodies to erythroid (CD71/Ter119), myeloid (CD11b), and lymphoid (CD19) lineages and analyzed by flow cytometry. To test whether erythropoietin (EPO) could increase red blood cell production, EPO was administered to sham and burn animals and their reticulocyte response was measured on PBD 2 and PBD 7. RESULTS: : Burn injury reduced the erythroid cells of the bone marrow from 35% in sham to 17% by PBD 5 and remained at similar level until PBD 21. Myeloid cells, however, increased from 42% in sham to 60% on PBD 5 and 77% on PBD 21. Burn injury reduced reticulocyte counts on PBD 2 and PBD 7 indicating that the erythroid compartment is severely depleted. This depleted compartment, however, responded to EPO but was not sufficient to change red cell production. CONCLUSION: : Burn injury skews the bone marrow hematopoietic commitment away from erythroid and toward myeloid cells. Shrinkage of the erythroid compartment contributes to resistance to EPO and the anemia of critical illness.

Language: en