Recovery from the hepatic acute phase response in the severely burned and the effects of long-term growth hormone treatment.
BACKGROUND
Administration of growth hormone (GH) to burned children decreases acute phase proteins and increases constitutive proteins when used during the acute hospitalization. Treatment during convalescence has not been examined.


METHODS
Seventy-six children with total body surface area burned (TBSAB) >/=40% were randomized to either placebo or GH (0.05 mg/kg/day) from discharge to 1 year after burn. Subjects were followed for an additional year. Levels of constitutive proteins and acute phase proteins were measured at discharge and 6, 9, 12, 18, and 24 months. Data are expressed as mean +/- S.E.M.


RESULTS
Albumin and transferrin levels increased during convalescence to the normal range but pre-albumin and retinol binding protein (RBP) levels remained below normal for at least 24 months. Acute phase proteins alpha(1)-acid glycoprotein, C-reactive protein, and haptoglobin decreased (P < 0.05) but alpha(2)-macroglobulin increased from discharge to 6 months. C-3 complement remained elevated for at least 2 years after burn. Changes were similar in both groups with no effect for GH treatment.


CONCLUSIONS
Some hepatic acute phase and constitutive proteins remain abnormal even 2 years after injury. GH treatment during convalescence has no effect on hepatic acute phase protein changes.
Department of Surgery, The University of Texas Medical Branch and Shriners Hospitals for Children, 815 Market Street, Galveston, TX 77550, USA.
Suchmor
S
Thomas
Steven E
SE
Wolf
David L
DL
Chinkes
David N
DN
Herndon
D000209:Acute-Phase Proteins / Q000378:metabolism*; D000210:Acute-Phase Reaction; D002056:Burns / Q000097:blood / Q000188:drug therapy* / Q000473:pathology; D002648:Child; D005260:Female; D019382:Human Growth Hormone / Q000627:therapeutic use*; D006801:Humans; D008099:Liver / Q000378:metabolism*; D008297:Male; D011228:Prealbumin / Q000378:metabolism; D011994:Recombinant Proteins / Q000627:therapeutic use; D012177:Retinol-Binding Proteins / Q000378:metabolism; D012709:Serum Albumin / Q000378:metabolism; D014168:Transferrin / Q000378:metabolism
D000209:Acute-Phase Proteins; D011228:Prealbumin; D011994:Recombinant Proteins; D012177:Retinol-Binding Proteins; D012709:Serum Albumin; D014168:Transferrin; D019382:Human Growth Hormone