Reduction of Plasma Gelsolin Levels Correlates with Development of Multiple Organ Dysfunction Syndrome and Fatal Outcome in Burn Patients

Abstract

BackgroundDepletion of the circulating actin-binding protein, plasma gelsolin (pGSN) has been described in critically ill surgical patients. We hypothesized that the extent of pGSN reduction might correlate with different outcome of burn patients. The study was performed to evaluate the prognostic implications of pGSN levels on the development of multiple organ dysfunction syndrome (MODS) and fatal outcome in a group of severely burn patients.Methods and Findings95 patients were included, and they were divided into three groups with different burn area: group I (n = 33), group II (n = 32) and group III (n = 30). According to whether there was development of MODS or not, patients were divided into MODS group (n = 28) and none-MODS group (n = 67); then the patients with MODS were further divided into non-survivor group (n = 17) and survivor group (n = 11). The peripheral blood samples were collected on postburn days (PBD) 1, 3, 7, 14, and 21. The levels of pGSN were determined and T cells were procured from the blood. The contents of cytokines (IL-2, IL-4 and IFN-γ) released by T cells were also measured. The related factors of prognosis were analyzed by using multivariate logistic regression analysis. The results showed that pGSN concentrations, as well as the levels of IL-2 and IFN-γ, decreased markedly on PBD 1–21, whereas, the levels of IL-4 increased markedly in all burn groups as compared with normal controls (P<0.05 or P<0.01), and there were obviously differences between group I and group III (P<0.05 or P<0.01). The similar results were found in MODS patients and the non-survivor group as compared with those without MODS and the survival group on days 3–21 postburn (P<0.05 or P<0.01). Moreover, as the pGSN levels decreased, the incidence of septic complication as well as MODS remarkably increased.ConclusionspGSN levels appear to be an early prognostic marker in patients suffering from major burns.

Dysregulation of the actin scavenging system and inhibition of DNase activity following severe thermal injury

“…Levels of both proteins decreased for up to 21 days after injury in the present study. Decreased levels of gelsolin and VDBP have also been reported in a number of disease pathologies associated with tissue damage, and have been suggested to be good prognostic markers of outcome/organ damage following severe trauma. Of note, the initial reduction in VDBP and gelsolin levels occurred before the onset of sepsis and MOF in the present cohort.…”

Effects of Shen-Fu Injection on the Expression of T-Cell-Specific Transcription Factors T-bet/Gata-3 in Porcine Postresuscitation Lung Injury

“…Protective immunity is dependent on the proper balance of Th1 and Th2 cells [8]. Alterations in the correct balance of Th1/Th2 cells are associated with a series of immune and inflammatory diseases, such as burn or trauma, acute myocardial infarction, heart failure, and severe sepsis [9–13]. …”

Successful treatment of severe burn patients with multiple organ dysfunction syndrome: A case report

“…In that case, we must resolutely and decisively provide adequate drainage of wound infection, remove necrotic tissue as early as possible, and cover the wound in a timely manner. [20] (3) Early application of enteral nutrition for prevention of intestinal bacteria and endotoxin translocation. [21] Recent studies further indicate that the gut, as the body's largest "bacteria reservoir" and "endotoxin reservoir", is involved in in the pathophysiology of SIRS and MODS process for its unique physiological environment in the body.…”