Modulation of types I and II acute phase reactants with insulin-like growth factor-1/binding protein-3 complex in severely burned children.
OBJECTIVE
To determine whether 0.5 mg/kg insulin-like growth factor (IGF)-1/binding protein (IGFBP)-3, given intravenously, effectively alters the acute phase response in severely burned children.


METHODS
Longitudinal trial with each patient serving as their own control.


METHODS
University-affiliated pediatric bum center.


METHODS
Nine children, 15 yrs of age or less, with burns covering >40% of the total body surface area.


METHODS
Standard burn care with early burn wound excision and grafting. Blood sampled at defined time points before and after operative procedures.


RESULTS
Determination of types I and II acute phase reactant proteins, constitutive serum proteins, serum cytokines, serum IGF-1, IGFBP-3, and growth hormone levels. Treatment with IGF-1/BP-3 attenuated increases in type I (complement 3, alpha1-acidglycoprotein) and type II (haptoglobin, alpha1-antitrypsin) acute phase proteins. Further, IGF-1/BP-3 increased constitutive serum protein levels (prealbumin, retinol binding protein, transferrin) and decreased serum IL-6 levels.


CONCLUSIONS
Low-dose IGF-1/BP-3 effectively attenuated the type I and type II hepatic acute phase response, increased serum levels of constitutive proteins, and modulated the hypermetabolic response.
Spies
Marcus
M
Shriners Hospital for Children and Department of Surgery, The University Texas Medical Branch, Galveston 77550, USA.
Wolf
Steven E
SE
Barrow
Robert E
RE
Jeschke
Marc G
MG
Herndon
David N
DN
D000209:Acute-Phase Proteins / Q000378:metabolism*; D002056:Burns / Q000097:blood / Q000188:drug therapy*; D002675:Child, Preschool; D003176:Complement C3 / Q000032:analysis; D016207:Cytokines / Q000097:blood; D005260:Female; D013006:Growth Hormone / Q000097:blood; D006242:Haptoglobins / Q000032:analysis; D006801:Humans; D018972:Insulin-Like Growth Factor Binding Protein 3 / Q000008:administration & dosage* / Q000097:blood; D007334:Insulin-Like Growth Factor I / Q000008:administration & dosage* / Q000032:analysis; D008137:Longitudinal Studies; D008297:Male; D009961:Orosomucoid / Q000032:analysis; D011228:Prealbumin / Q000032:analysis; D012177:Retinol-Binding Proteins / Q000032:analysis; D014168:Transferrin / Q000032:analysis; D000515:alpha 1-Antitrypsin / Q000032:analysis
D000209:Acute-Phase Proteins; D003176:Complement C3; D016207:Cytokines; D006242:Haptoglobins; D018972:Insulin-Like Growth Factor Binding Protein 3; D009961:Orosomucoid; D011228:Prealbumin; D012177:Retinol-Binding Proteins; D014168:Transferrin; D000515:alpha 1-Antitrypsin; D007334:Insulin-Like Growth Factor I; D013006:Growth Hormone