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Insulin decreases hepatic acute phase protein levels in severely burned children

Xiaowu Wu1, Steven J Thomas, David N Herndon

  • 1Shriners Hospitals for Children and Department of Surgery, the University of Texas Medical Branch, Galveston, Tex 77550, USA.

Surgery
|January 24, 2004
PubMed

Insights

Continuous insulin treatment significantly reduces acute phase proteins in severely burned children. This suggests insulin helps regulate the body's inflammatory response to severe injury.

Area of Science:

  • Biochemistry
  • Endocrinology
  • Pediatric Critical Care

Background:

  • Severe burns trigger a hepatic acute phase response, characterized by altered protein synthesis.
  • The role of insulin in modulating this response post-burn injury remains incompletely understood.

Purpose of the Study:

  • To investigate the effect of continuous insulin treatment on acute phase protein levels in children with severe burns.
  • To determine if insulin can downregulate the hepatic acute phase response following major trauma.

Main Methods:

  • A randomized controlled trial involving 18 pediatric patients with >40% total body surface area burns.
  • Patients received either continuous insulin infusion to maintain euglycemia or no treatment.
  • Plasma levels of various acute phase and hepatic constitutive proteins were measured at multiple time points post-injury.

Main Results:

  • Insulin treatment led to significant reductions in levels of alpha1-acid glycoprotein, C3 complement, alpha2-macroglobulin, and haptoglobin.
  • These decreases were most pronounced at 21 and 28 days post-burn.
  • Hepatic constitutive proteins (prealbumin, transferrin, retinol-binding protein) were also lower in the insulin group by day 21.

Conclusions:

  • Continuous insulin administration effectively decreases acute phase protein levels in severely burned children.
  • Insulin appears to play a role in downregulating the hepatic acute phase response to severe burn injury.
Abstract

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