[Changes in plasma levels of LPS, TNFalpha and IL-6 in burn patients with severe infection treated with Imipenem or Cefoperazone].
OBJECTIVE
To observe the changes in plasma levels of lipopolysaccharide (LPS), tumor necrosis factor alpha (TNF-alpha) and interleukin-6 (IL-6) in burn patients with severe infection treated with Imipenem or Cefoperazone.


METHODS
Thirteen severe burn patients infected with gram negative bacilli were enrolled in the study in which 7 were treated with IPM and 6 with CPZ. Venous blood samples were harvested before and 2, 12, 24, 48 and 72 hours after the use of antibiotic for the determination of the plasma levels of LPS, TNF-alpha and IL-6, and correlative analysis was carried out among all the factors in regard to their changes.


RESULTS
The plasma levels of LPS in both groups were elevated 2 hours after the injection of either antibiotic, but it was more obvious in patients with CPZ when compared with that before treatment (13.95 +/- 5.44 pg/ml), and the levels were much higher than that after IPM (P < 0.05). The plasma LPS level declined thereafter. The plasma TNF-alpha level in CPZ group was 0.86 +/- 0.16 ng/ml at 2 hours after the use of antibiotic, and it was much higher than that before the use of the drug, and it was higher compared with IPM group. (P < 0.01). But there was no change in the plasma IL-6 level in all the patients at all the time points before and after the use of either drug. The plasma TNF-alpha levels in the two groups were positively correlated with the plasma levels of LPS and IL-6.


CONCLUSIONS
The release of LPS and TNF-alpha from bacteria could be induced by the administration of different kinds of antibiotics in the management of burn patients infected by gram negative bacilli in different releasing amounts. And the TNF-alpha production was correlated with the release of LPS and IL-6.
Institute of Burn Research, Southwest Hospital, State Key Laboratory of Trauma, Burn and Combined Injury, The Third Military Medical University, Chongqing 400038, P. R. China.
Hui-Min
HM
Wang
Wen-Feng
WF
Cao
Yi-Zhi
YZ
Peng
Guang-Xia
GX
Xiao
Xiao-Yuan
XY
Yang
D002056:Burns / Q000097:blood*; D002438:Cefoperazone / Q000627:therapeutic use*; D005260:Female; D016905:Gram-Negative Bacterial Infections / Q000097:blood* / Q000188:drug therapy; D006801:Humans; D015378:Imipenem / Q000627:therapeutic use*; D015850:Interleukin-6 / Q000097:blood*; D008070:Lipopolysaccharides / Q000097:blood*; D008297:Male; D014409:Tumor Necrosis Factor-alpha / Q000032:analysis*
D015850:Interleukin-6; D008070:Lipopolysaccharides; D014409:Tumor Necrosis Factor-alpha; D015378:Imipenem; D002438:Cefoperazone