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Growth hormone attenuates tumor necrosis factor alpha in burned children
M T Chrysopoulo1, M G Jeschke, R J Ramirez
1Shriners Hospitals for Children, Galveston Burns Institute and the Department of Surgery, University of Texas Medical Branch 77550, USA.
Insights
Recombinant human growth hormone (rhGH) significantly reduced elevated tumor necrosis factor alpha (TNF-alpha) levels in pediatric burn patients. This finding supports rhGH's beneficial role in modulating the acute-phase response following severe burns.
Area of Science:
- Biochemistry
- Immunology
- Pediatric Critical Care
Background:
- Recombinant human growth hormone (rhGH) shows promise in positively influencing the acute-phase response.
- Elevated tumor necrosis factor alpha (TNF-alpha) levels are linked to increased multiorgan failure and mortality in burn patients.
Purpose of the Study:
- To investigate if rhGH can reduce elevated TNF-alpha levels in pediatric burn patients.
- To assess the impact of rhGH on inflammatory markers post-burn injury.
Main Methods:
- A randomized controlled trial involving 20 pediatric patients with extensive burns (>40% total body surface area).
- Participants received either rhGH (0.2 mg/kg/day) or a placebo intramuscularly.
- Serum TNF-alpha levels were measured using enzyme-linked immunoassay at baseline, 21, and 42 days post-injury.
Main Results:
- No significant differences in age or burn severity were observed between the rhGH and placebo groups.
- Serum TNF-alpha levels significantly decreased from baseline at 21 and 42 days in the rhGH group (P<.05).
- The placebo group showed no significant reduction in TNF-alpha levels (P=.5).
Conclusions:
- rhGH administration significantly lowers serum TNF-alpha levels in children following burn injury.
- These findings align with the known beneficial effects of rhGH on the acute-phase response.
- rhGH may be a valuable therapeutic agent in managing severe burn injuries.
Background:
Recombinant human growth hormone (rhGH) has been shown to favorably modulate the acute-phase response and may improve the clinical outcome.
Objective:
To examine whether rhGH attenuates the elevated tumor necrosis factor alpha (TNF-alpha) levels that correlate with increased multiorgan failure and mortality in burned adults and children.
Design:
Twenty children with burns of greater than 40% of the total body surface area were randomly divided into 2 groups to receive placebo (n = 10) or rhGH, 0.2 mg/kg per day intramuscularly (n = 10).
Setting:
Pediatric burn hospital.
Main Outcome Measure:
Serum TNF-alpha levels by enzyme-linked immunoassay at baseline (day 0) and at 21 and 42 days after injury. For statistical analysis, we used the Kruskal-Wallis and Friedman tests.
Results:
No significant differences in age (mean +/- SD, 6.2+/-1.6 vs 5.0+/-1.2 years) or percentage of total body surface area burn (mean +/- SD, 65.1%+/-8.2% vs 57.1%+/-5.2%) could be shown between the groups given rhGH and placebo. Baseline TNF-alpha levels were elevated from reference values in both groups. Twenty-one and 42 days after rhGH administration, serum TNF-alpha levels were significantly decreased from those at baseline (P<.05). No significant decrease in TNF-alpha levels was observed in the placebo group (P = .5).
Conclusions:
Recombinant human growth hormone significantly lowers serum TNF-alpha levels after burn injury. This is consistent with the beneficial effect that rhGH has on the acute-phase response.