Biochemical investigations after burning injury: complement system, protease-antiprotease balance and acute-phase reactants.
Seventeen burned patients were investigated--Group I (n=10) with a mean burned area expressed as unit burn standard (UBS) of 69 +/- 24 and Group II (n = 7) with a mean UBS of 23 +/- 8. Blood samples were collected immediately after admission, 6-12 h after injury, during the morning and evening of day 1, and then daily for 2 weeks. This prospective study demonstrated complement activation in vivo in all burned patients, measured by C3d/C3 ratio index which was not related to the extent of the burned surface. A significant protease-antiprotease imbalance, correlated to the severity of burns, was found, leukocyte elastase was increased throughout the observation period, alpha 2-macroglobulin drastically decreased in severely burned patients, and alpha 1-proteinase inhibitor promptly decreased below the normal level in patients with more than 40 UBS. Finally, there was a delayed but then persistent acute-phase reactant protein response involving C-reactive protein, haptoglobin and alpha 1-acid glycoprotein, the concentrations of which reached a plateau on days 6 or 7.
D000209:Acute-Phase Proteins / Q000097:blood*; D000328:Adult; D001798:Blood Proteins; D002056:Burns / Q000097:blood* / Q000201:enzymology / Q000276:immunology; D002097:C-Reactive Protein / Q000032:analysis; D003167:Complement Activation; D003176:Complement C3 / Q000032:analysis; D015933:Complement C3d; D003182:Complement C5 / Q000032:analysis; D015936:Complement C5a; D003165:Complement System Proteins / Q000032:analysis*; D005260:Female; D006801:Humans; D007962:Leukocytes / Q000201:enzymology; D008297:Male; D008875:Middle Aged; D010196:Pancreatic Elastase / Q000097:blood; D010447:Peptide Hydrolases / Q000097:blood*; D011446:Prospective Studies; D011480:Protease Inhibitors / Q000097:blood*; D000515:alpha 1-Antitrypsin; D000511:alpha-Macroglobulins / Q000032:analysis
D000209:Acute-Phase Proteins; D001798:Blood Proteins; D003176:Complement C3; D003182:Complement C5; D011480:Protease Inhibitors; D000515:alpha 1-Antitrypsin; D000511:alpha-Macroglobulins; D015933:Complement C3d; D015936:Complement C5a; D003165:Complement System Proteins; D002097:C-Reactive Protein; D010447:Peptide Hydrolases; D010196:Pancreatic Elastase