title: Cytokine response to burn injury: relationship with protein metabolism.
abstract: Plasma levels of interleukin 1 beta (IL-1 beta), tumor necrosis factor alpha (TNF alpha), interleukin 6 (IL-6), and markers of protein metabolism were determined in 12 burn patients throughout the healing period (day 2 to 21 post-injury) to determine the pattern of variations in plasma cytokine concentration. To establish the relationship between cytokine production and the nutritional status a wide range of severity standpoints (burn surface area ranging from 9% to 82%) was chosen. Interleukin 6 levels were increased in all patients throughout the study period; maximum concentrations (615 +/- 198 pg/mL) were reached on day 4 and correlated (p < 0.01) with the extent of burn injury. Tumor necrosis factor alpha levels were also elevated; they were significantly higher on day 7 in the patients who developed sepsis than in the other patients (67 +/- 21 pg/mL vs. 20 +/- 7 pg/mL; p < 0.05) but did not correlate with the extent of burn injury. Interleukin 1 beta was rarely detected. Cortisolemia on day 7 was inversely correlated with levels of TNF alpha but not with those of IL-6. Interleukin 6 levels correlated positively with protein turnover (phenylalaninemia) and catabolism (3-methylhistidine/creatinine ratio) and negatively with levels of fibronectin and transthyretin. Our data indicate that the systemic cytokine response to burn injury is mainly represented by IL-6. These data also support the hypothesis that IL-6 is a key mediator of the variations in protein metabolism following burn injury.
authors.affiliation: Lab Biochimie A, Hôpital Saint Antoine, Paris, France.
authors.forename: J P
authors.initials: JP
authors.lastname: de Bandt
authors.forename: S
authors.initials: S
authors.lastname: Chollet-Martin
authors.forename: A
authors.initials: A
authors.lastname: Hernvann
authors.forename: N
authors.initials: N
authors.lastname: Lioret
authors.forename: L D
authors.initials: LD
authors.lastname: du Roure
authors.forename: S K
authors.initials: SK
authors.lastname: Lim
authors.forename: M
authors.initials: M
authors.lastname: Vaubourdolle
authors.forename: J
authors.initials: J
authors.lastname: Guechot
authors.forename: R
authors.initials: R
authors.lastname: Saizy
authors.forename: J
authors.initials: J
authors.lastname: Giboudeau
mesh_terms: D000328:Adult; D000368:Aged; D002056:Burns / Q000097:blood*; D016207:Cytokines / Q000097:blood*; D005260:Female; D006801:Humans; D007375:Interleukin-1 / Q000097:blood; D015850:Interleukin-6 / Q000097:blood; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D013997:Time Factors; D014409:Tumor Necrosis Factor-alpha / Q000378:metabolism
chemical_list: D016207:Cytokines; D007375:Interleukin-1; D015850:Interleukin-6; D014409:Tumor Necrosis Factor-alpha