PMID- 10674617
OWN - NLM
STAT- MEDLINE
DCOM- 20000309
LR  - 20190514
IS  - 0003-4932 (Print)
IS  - 1528-1140 (Electronic)
IS  - 0003-4932 (Linking)
VI  - 231
IP  - 2
DP  - 2000 Feb
TI  - Insulinlike growth factor I plus insulinlike growth factor binding protein 3 
      attenuates the proinflammatory acute phase response in severely burned children.
PG  - 246-52
AB  - OBJECTIVE: To determine the effect of insulinlike growth factor I (IGF-I) in 
      combination with its principal binding protein (IGFBP-3) on the hepatic acute 
      phase response in severely burned children. SUMMARY BACKGROUND DATA: The hepatic 
      acute phase response is a cascade of events initiated to restore homeostasis 
      after trauma. A prolonged response, however, may contribute to multiple organ 
      failure, hypermetabolism, complications, and death. METHODS: Twenty-two children 
      with a mean total body surface area (TBSA) burn of 57 +/- 3% were given a 
      continuous infusion of 1 to 4 mg/kg/day IGF-I/BP-3 for 5 days after wound 
      excision and grafting. Eight children with a TBSA burn of 54 +/- 4% were given 
      saline as controls. Before and 5 days after excision and grafting, blood samples 
      were taken for serum hepatic constitutive protein, acute phase protein, and 
      proinflammatory cytokine analysis. RESULTS: Serum IGF-I levels in burned children 
      given the IGF-I/BP-3 complex increased from 113 +/- 15 to 458 +/- 40 ng/mL and 
      IGFBP-3 levels increased from 1.8 +/- 0.2 to 3.1 +/- 0.3 ng/mL. Levels of serum 
      constitutive hepatic proteins (prealbumin, retinol-binding protein, and 
      transferrin) increased with IGF-I/BP-3, whereas levels of type I acute phase 
      proteins (C-reactive protein, alpha1-acid glycoprotein, and complement C-3) 
      decreased when compared with controls. The complex had no effect on type II acute 
      phase proteins. Tumor necrosis factor-alpha (TNF-alpha) and interleukin-1beta 
      (IL-1beta) levels decreased with IGF-I/BP-3 compared with controls, with no 
      effect on interleukin-6. CONCLUSION: Severely burned children receiving 
      IGF-I/BP-3 showed a decrease in IL-1beta and TNF-alpha followed by a decrease in 
      type I acute phase proteins that was associated with a concomitant increase in 
      constitutive hepatic proteins. Attenuating the proinflammatory acute phase with 
      IGF-1/BP-3 response may prevent multiple organ failure and improve clinical 
      outcomes after thermal injury without any detectable adverse side effects.
FAU - Jeschke, M G
AU  - Jeschke MG
AD  - Shriners Hospital for Children and the Department of Surgery, University of Texas 
      Medical Branch, Galveston 77550, USA.
FAU - Barrow, R E
AU  - Barrow RE
FAU - Herndon, D N
AU  - Herndon DN
LA  - eng
GR  - R01 GM056687/GM/NIGMS NIH HHS/United States
GR  - 1 RO1-GM56687-01/GM/NIGMS NIH HHS/United States
GR  - 5 T32 GM 0825607/GM/NIGMS NIH HHS/United States
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
PT  - Research Support, U.S. Gov't, P.H.S.
PL  - United States
TA  - Ann Surg
JT  - Annals of surgery
JID - 0372354
RN  - 0 (Insulin-Like Growth Factor Binding Protein 3)
RN  - 0 (Recombinant Proteins)
RN  - 67763-96-6 (Insulin-Like Growth Factor I)
SB  - IM
MH  - Acute-Phase Reaction/blood/etiology/*prevention & control
MH  - Burns/blood/*complications
MH  - Child
MH  - Female
MH  - Humans
MH  - Infusions, Intravenous
MH  - Insulin-Like Growth Factor Binding Protein 3/*therapeutic use
MH  - Insulin-Like Growth Factor I/*therapeutic use
MH  - Liver/physiopathology
MH  - Male
MH  - Multiple Organ Failure/prevention & control
MH  - Recombinant Proteins/therapeutic use
PMC - PMC1420993
EDAT- 2000/02/16 09:00
MHDA- 2000/03/11 09:00
PMCR- 2000/08/01
CRDT- 2000/02/16 09:00
PHST- 2000/02/16 09:00 [pubmed]
PHST- 2000/03/11 09:00 [medline]
PHST- 2000/02/16 09:00 [entrez]
PHST- 2000/08/01 00:00 [pmc-release]
AID - 0000658-200002000-00014 [pii]
AID - 10.1097/00000658-200002000-00014 [doi]
PST - ppublish
SO  - Ann Surg. 2000 Feb;231(2):246-52. doi: 10.1097/00000658-200002000-00014.