Endothelin-1 and prostaglandin E2 levels increase in patients with burns

Endothelin-1 (ET-1), a powerful vasoconstrictor, is a 21 amino acid peptide produced by endothelium. It negatively affects pulmonary, cardiac, hepatic, and renal function. It also constricts bronchial and gut smooth muscle. This peptide also stimulates monocytes to produce prostaglandin E2 (PGE2), tumor necrosis factor, interleukin-6 and 8, and substances that stimulate neutrophil superoxide production. Plasma levels of ET-1 also increase in shock, low flow states, ischemia, and sepsis.

Fourteen patients between the ages of seven and 72 years were admitted to the Bridgeport Hospital Burn Unit and resuscitated with a modified Parkland formula. Plasma was drawn on admission, at 12, 24, and 48 hours. Endothelin-1 and PGE2 were measured by radioimmunoassay.

Endothelin-1 levels increased ten- to 20-fold in all patients. Prostaglandin E2 levels increased five- to 40-fold in all patients. There was no correlation between plasma ET-1 or PGE2 levels with either size of burn, inhalation injury, patient age, organ dysfunction, or survival in this small study of early burn injury.

The increased plasma ET-1 response in patients with burns may have a role in the genesis of the systemic response to burns. This peptide may also activate monocyte production of PGE2 and other mediators of the systemic inflammatory response syndrome. This study was done to measure ET-1 and PGE2 levels in patients with burns greater than 20 percent of the body surface area on admission, at 12, 24, and 48 hours. The correlations between severity of burn, ET-1 levels, and PGE2 production were also assessed.