Burn patients have a reduced life expectancy and are at increased risk of infections and other diseases, long after discharge from hospital for the burn injury itself. These risks exist regardless of burn severity, so understanding the mechanisms behind this is a priority. We have built a strong evidence base using pre-clinical burn models, patient studies and epidemiology to show that the immune system is compromised for many years after a burn. We believe this is the cause of susceptibility to chronic disease seen in children after a burn. However, we still do not fully understand the underlying mechanisms that lead to immune dysfunction after burn, meaning children cannot be treated to reduce these known long-term health impacts.
In a previous study, we found that paediatric burn patients had reduced or absent responses to vaccine antigens (Diptheria, Tetanus, Pertussis), despite receiving their DTaP vaccine >1 year after injury. To further investigate this, we initiated the ongoing CHIP study (Childhood Health & Immunity Post-burn injury), which recruits children with and without a history of burn injury who are scheduled to receive their Year 7 school-based vaccinations, including DTaP. Participants provide blood samples pre-vaccination (Day 0) and at follow-up timepoints; Day 7, Day 28-, and one-year post-vaccination. Preliminary findings from this study indicate that early responses are intact: both burn and control groups show comparable plasmablast expansion at Day 7. However, by Day 28, burn survivors show a significant reduction in tetanus toxoid (TetTox)-specific IgG⁺ memory B cells compared to healthy controls, suggesting a defect in memory formation.
This ongoing study aims to uncover the mechanisms that drive long-term immune dysfunction in paediatric burn survivors; knowledge that will provide the foundation for targeted interventions to support immune recovery, improve vaccine responsiveness, and reduce long-term disease risk in children affected by burn injury.