LOW CERULOPLASMIN LEVELS DURING RECOVERY FROM MAJOR BURN INJURY - INFLUENCE OF OPEN WOUND SIZE AND COPPER SUPPLEMENTATION

Copper (Cu) status is often judged by the plasma level of its chief tr ansport protein, ceruloplasmin (Cp). Only copper deficiency and heredi ty are known to decrease circulating Cp. Cp is an acute-phase responsi ve protein in trauma and it is also induced by Cu supplementation. Des pite this, plasma concentrations of Cp remain low during the acute rec overy from major burn injury. The high provision of vitamin C typicall y used in burn patients may influence these observations when an indir ect oxidase activity assay is used. We employed a radial immunodiffusi on (RID) assay specific for the Cp protein as well as an indirect oxid ase assay for Cp in a series of 11 burned children who were supplement ed with both Cu and vitamin C, either enterally or parenterally. Our f indings confirm that low Cp is a characteristic of the acute recovery from major burns. The oxidase assay is shown to be valid for very low Cp levels even during high vitamin C provision. When these data are co mbined with our previously reported series, a strong relationship betw een the size of the open wound area and the amount of circulating Cp i s demonstrated. Copper supplementation by either the enteral or parent eral routes is only marginally successful in restoring Cp toward norma l levels.