Endotoxemia and complement activation after severe burn injuries--effects on leukocytes, soluble selectins, and inflammatory cytokines.
In this study we followed the development of an inflammatory response in a group of patients the first week after a burn injury. We detected elevated plasma endotoxin levels, on at least one occasion, in 6 of 8 patients. No endotoxin was detected in the two patients with the lowest total burned surface area (< or = 30%). We found evidence of complement activation as increased C3a levels, in parallel with a production of inflammatory cytokines (TNF-alpha, IL-6). The TNF-alpha levels increased significantly during the observation period, while the IL-6 levels were elevated already at admission, and remained so. Elevated levels of soluble E-selectin were detected, indicating endothelial cell activation. Despite the inflammatory response and a loss of inflammatory cells during the first days of the monitoring period, we found no evidence of cellular activation measured as increased expression of beta 2 integrin CD11b, nor increased plasma levels of soluble L-selectin.
Ljunghusen
O
O
Department of Clinical Immunology, Karolinska Hospital, Stockholm, Sweden.
Lundahl
J
J
Nettelblad
H
H
Nilsson
B
B
Sjögren
F
F
Stendahl
O
O
D000293:Adolescent; D000328:Adult; D000368:Aged; D002056:Burns / Q000097:blood* / Q000150:complications; D003167:Complement Activation; D015926:Complement C3a / Q000031:analogs & derivatives / Q000378:metabolism; D019040:E-Selectin / Q000097:blood; D019446:Endotoxemia / Q000097:blood* / Q000209:etiology; D006801:Humans; D015850:Interleukin-6 / Q000097:blood; D019041:L-Selectin / Q000097:blood; D007958:Leukocyte Count; D016177:Macrophage-1 Antigen / Q000097:blood; D008875:Middle Aged; D014409:Tumor Necrosis Factor-alpha / Q000378:metabolism
D019040:E-Selectin; D015850:Interleukin-6; D016177:Macrophage-1 Antigen; D014409:Tumor Necrosis Factor-alpha; C044541:complement C3a, des-Arg-(77)-; D019041:L-Selectin; D015926:Complement C3a