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Cytokine expression profile over time in severely burned pediatric patients
Celeste C Finnerty1, David N Herndon, Rene Przkora
1Galveston Burns Unit and Department of Surgery, Shriners Hospital for Children University of Texas Medical Branch, Galveston, TX 77550, USA.
Insights
Severe burns in children trigger significant changes in cytokine profiles, with most elevations peaking in the first week. These cytokine levels decrease over five weeks but remain higher than normal, suggesting a therapeutic window.
Area of Science:
- Immunology
- Pediatric Burn Care
- Cytokine Signaling
Background:
- Severe burns induce hypermetabolism and catabolism, impacting organ function.
- Cytokine release is a key factor in the hypermetabolic response post-burn.
Purpose of the Study:
- To compare cytokine expression profiles in severely burned children (without infection/inhalation injury) to healthy children.
- To identify specific cytokine patterns associated with severe burns in pediatric patients.
Main Methods:
- Utilized the Bio-Plex suspension array system to quantify 17 different cytokines.
- Compared cytokine levels in 19 burned children against 14 non-burned, non-infected children.
Main Results:
- Fifteen cytokines (pro- and anti-inflammatory) significantly increased within the first week post-burn.
- Granulocyte-macrophage colony-stimulating factor elevated in the second week.
- Sixteen cytokines showed significant alterations compared to controls; levels decreased over 5 weeks but remained elevated.
Conclusions:
- Severe burns in children elicit a distinct cytokine expression profile.
- Elevated cytokine levels during the first week post-burn may present a therapeutic intervention window.
- Cytokine levels normalize gradually but persist above baseline levels for at least five weeks.
Abstract:
A severe burn leads to hypermetabolism and catabolism resulting in compromised function and structure of essential organs. The massive release of cytokines is implicated in this hypermetabolic response. The aim of the present study was to compare cytokine expression profiles from severely burned children without signs of infections or inhalation injury (n = 19) to the cytokine profiles from normal, noninfected, nonburned children (n = 14). The Bio-Plex suspension array system was used to measure the concentration of 17 cytokines. The expression of proinflammatory and anti-inflammatory cytokines was maximal during the first week after thermal injury. Significant increases were measured for 15 mediators during the first week after thermal injury: interleukin (IL) 1beta, IL-2, IL-4, IL-5, IL-6, IL-7, IL-8, IL-10, IL-12 p70, IL-13, IL-17, interferon gamma, monocyte chemoattractant protein 1, macrophage inflammatory protein 1beta, and granulocyte colony-stimulating factor (P < 0.05). Granulocyte-macrophage colony-stimulating factor was significantly increased during the second week after burn (P < 0.05). Within 5 weeks, the serum concentrations of most cytokines decreased, approaching normal levels. When compared with the cytokine levels measured in normal children, a total of 16 cytokines were significantly altered (P < 0.05). After severe burn, a specific cytokine expression profile is observed in patients without complications such as inhalation injury or sepsis. The cytokine concentrations decrease during 5 weeks after burn but remain elevated over nonburned values. Furthermore, the elevation in most serum cytokine levels during the first week after burn may indicate a potential window of opportunity for therapeutic intervention.
