Interleukin-6 and its relation to the humoral immune response and clinical parameters in burned patients.
The cytokine interleukin-6, which has been shown to be increased in patients with burn injuries, is produced by activated monocytes and endothelial cells and has many in vitro activities, including stimulation of acute-phase protein synthesis in hepatocytes, immunoglobulin synthesis in B lymphocytes, and stimulation of growth of megakaryocytes. In 13 patients with a mean of 31% full-thickness burns, we studied the relation of serum interleukin-6 to clinical parameters and parameters of the acute-phase response and immunoglobulin production. Interleukin-6 was already elevated within hours after the injury was sustained, and it remained elevated for several weeks. All components of the acute-phase response were observed: fever, tachycardia, leukocytosis with an associated left shift, elevation of C-reactive protein and alpha 1-antitrypsin, and a decrease in albumin levels. In the second week after burn injury, immunoglobulin M levels peaked, followed by a prolonged elevation of immunoglobulin G levels. Thrombocyte counts initially decreased and rebounded to supranormal levels after 2 weeks. Interleukin-6 levels were positively correlated with acute-phase responses. We believe that the production of interleukin-6 induces the synthesis of acute-phase proteins. High interleukin-6 levels may also be an etiologic factor in the marked immunoglobulin response observed. Likewise, the relation between the megakaryocyte-promoting activity of interleukin-6 and the rebound thrombocytosis requires further investigation.
Nijsten
M W
MW
Central Laboratory, The Netherlands Red Cross Blood Transfusion Service, Groningen.
Hack
C E
CE
Helle
M
M
ten Duis
H J
HJ
Klasen
H J
HJ
Aarden
L A
LA
D000328:Adult; D000917:Antibody Formation; D015415:Biomarkers / Q000097:blood; D001798:Blood Proteins / Q000032:analysis; D001831:Body Temperature; D002056:Burns / Q000097:blood / Q000276:immunology / Q000503:physiopathology*; D002097:C-Reactive Protein / Q000032:analysis; D003167:Complement Activation; D003181:Complement C4 / Q000032:analysis; D003165:Complement System Proteins / Q000032:analysis; D005260:Female; D006339:Heart Rate; D006454:Hemoglobins / Q000032:analysis; D006801:Humans; D007074:Immunoglobulin G / Q000032:analysis; D007075:Immunoglobulin M / Q000032:analysis; D015850:Interleukin-6 / Q000097:blood*; D007958:Leukocyte Count; D008297:Male; D008954:Models, Biological; D010976:Platelet Count; D013997:Time Factors; D000515:alpha 1-Antitrypsin / Q000032:analysis
D015415:Biomarkers; D001798:Blood Proteins; D003181:Complement C4; D006454:Hemoglobins; D007074:Immunoglobulin G; D007075:Immunoglobulin M; D015850:Interleukin-6; D000515:alpha 1-Antitrypsin; D003165:Complement System Proteins; D002097:C-Reactive Protein