ENDOTOXEMIA AND COMPLEMENT ACTIVATION AFTER SEVERE BURN INJURIES - EFFECTS ON LEUKOCYTES, SOLUBLE SELECTINS, AND INFLAMMATORY CYTOKINES

In this study we followed the development of an inflammatory response in a group of patients the first week after a burn in July. We detecte d elevated plasma endotoxin levels, on at least one occasion, in 6 of 8 patients. No endotoxin was detected in the two patients with the low est total burned surface area (less than or equal to 30%). We found ev idence of complement activation as increased C3a levels, in parallel w ith a production of inflammatory cytokines (TNF-alpha, IL-6). The TNF- alpha levels increased significantly during the observation period, wh ile the IL-6 levels were elevated already at admission, and remained s o. Elevated levels of soluble E-selectin were detected, indicating end othelial cell activation. Despite the inflammatory response and a loss of inflammatory cells during the first days of the monitoring period, we found no evidence of cellular activation measured as increased exp ression of beta 2 integrin CD11b, nor increased plasma levels of solub le L-selectin.