title: Transient endotoxemia during burn wound revision causes leukocyte beta 2 integrin up-regulation and cytokine release.
abstract: After severe burns, a wound revision is often done to remove devitalized tissue and minimize bacterial growth. After such revision, the patient may show signs of sepsis. In a group of burned patients we found a transient endotoxemia, and a subsequent leukocyte activation, monitored as increased expression of the beta 2-integrin CD11b, after such wound revision. In most patients we could detect elevated levels of plasma TNF-alpha before the operation, with no increases in these levels after the operation. Plasma levels of IL-6 were elevated in all patients and increased after the wound revision in all patients. They also had elevated plasma levels of soluble E-selectin, indicating systemic inflammation. The close relation between endotoxin levels and CD11b expression, and lack of evidence for additional production of TNF-alpha, suggests that up-regulation of the beta 2 adhesion protein during wound revision is mainly caused by endotoxin interaction with the leukocyte.
authors.affiliation: Department of Clinical Immunology, University Hospital, Linköping, Sweden.
authors.forename: O
authors.initials: O
authors.lastname: Ljunghusen
authors.forename: S
authors.initials: S
authors.lastname: Berg
authors.forename: J
authors.initials: J
authors.lastname: Hed
authors.forename: J
authors.initials: J
authors.lastname: Lundahl
authors.forename: H
authors.initials: H
authors.lastname: Nettelblad
authors.forename: F
authors.initials: F
authors.lastname: Sjögren
authors.forename: O
authors.initials: O
authors.lastname: Stendahl
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D002056:Burns / Q000150:complications* / Q000601:surgery; D018821:CD18 Antigens / Q000096:biosynthesis*; D002448:Cell Adhesion; D018925:Chemokines / Q000378:metabolism*; D003167:Complement Activation; D003646:Debridement / Q000009:adverse effects*; D019040:E-Selectin / Q000097:blood*; D004731:Endotoxins / Q000097:blood*; D005260:Female; D006801:Humans; D007962:Leukocytes / Q000378:metabolism*; D016177:Macrophage-1 Antigen / Q000096:biosynthesis*; D008297:Male; D008875:Middle Aged; D018746:Systemic Inflammatory Response Syndrome / Q000209:etiology* / Q000378:metabolism; D014409:Tumor Necrosis Factor-alpha / Q000032:analysis; D015854:Up-Regulation
chemical_list: D018821:CD18 Antigens; D018925:Chemokines; D019040:E-Selectin; D004731:Endotoxins; D016177:Macrophage-1 Antigen; D014409:Tumor Necrosis Factor-alpha