title: Reduction of plasma gelsolin levels correlates with development of multiple organ dysfunction syndrome and fatal outcome in burn patients.
abstract: BACKGROUND
  Depletion of the circulating actin-binding protein, plasma gelsolin (pGSN) has been described in critically ill surgical patients. We hypothesized that the extent of pGSN reduction might correlate with different outcome of burn patients. The study was performed to evaluate the prognostic implications of pGSN levels on the development of multiple organ dysfunction syndrome (MODS) and fatal outcome in a group of severely burn patients.
  
  
  RESULTS
  95 patients were included, and they were divided into three groups with different burn area: group I (n = 33), group II (n = 32) and group III (n = 30). According to whether there was development of MODS or not, patients were divided into MODS group (n = 28) and none-MODS group (n = 67); then the patients with MODS were further divided into non-survivor group (n = 17) and survivor group (n = 11). The peripheral blood samples were collected on postburn days (PBD) 1, 3, 7, 14, and 21. The levels of pGSN were determined and T cells were procured from the blood. The contents of cytokines (IL-2, IL-4 and IFN-γ) released by T cells were also measured. The related factors of prognosis were analyzed by using multivariate logistic regression analysis. The results showed that pGSN concentrations, as well as the levels of IL-2 and IFN-γ, decreased markedly on PBD 1-21, whereas, the levels of IL-4 increased markedly in all burn groups as compared with normal controls (P<0.05 or P<0.01), and there were obviously differences between group I and group III (P<0.05 or P<0.01). The similar results were found in MODS patients and the non-survivor group as compared with those without MODS and the survival group on days 3-21 postburn (P<0.05 or P<0.01). Moreover, as the pGSN levels decreased, the incidence of septic complication as well as MODS remarkably increased.
  
  
  CONCLUSIONS
  pGSN levels appear to be an early prognostic marker in patients suffering from major burns.
authors: Department of Microbiology and Immunology, Burns Institute, First Hospital Affiliated to the Chinese PLA General Hospital, Beijing, People's Republic of China.
authors: Li-feng
authors: LF
authors: Huang
authors: Yong-ming
authors: YM
authors: Yao
authors: Jin-feng
authors: JF
authors: Li
authors: Ning
authors: N
authors: Dong
authors: Chen
authors: C
authors: Liu
authors: Yan
authors: Y
authors: Yu
authors: Li-xin
authors: LX
authors: He
authors: Zhi-yong
authors: ZY
authors: Sheng
mesh_terms: D000328:Adult; D002056:Burns / Q000097:blood* / Q000150:complications*; D016022:Case-Control Studies; D004797:Enzyme-Linked Immunosorbent Assay; D005260:Female; D018260:Gelsolin / Q000097:blood*; D006801:Humans; D007376:Interleukin-2 / Q000097:blood; D015847:Interleukin-4 / Q000097:blood; D008297:Male; D009102:Multiple Organ Failure / Q000097:blood / Q000209:etiology* / Q000401:mortality*; D011379:Prognosis; D015996:Survival Rate; D013601:T-Lymphocytes / Q000378:metabolism
chemical_list: D018260:Gelsolin; D007376:Interleukin-2; D015847:Interleukin-4