CHANGES IN SERUM TUMOR-NECROSIS-FACTOR-ALPHA IN BURNED PATIENTS

Dynamic tumour necrosis factor-alpha (TNF-alpha) changes in serial ser um samples of 10 burned patients were analysed in this study. The tota l body surface areas (TBSA) of the burn injury were from 30 to 85 per cent. Among these 10 patients, five recovered and another five died wi th proved sepsis. On admission which was about 5-13 h postburn, eight of the 10 patients showed their serum TNF-alpha levels to be higher th an the mean serum TNF-alpha value of five healthy laboratory personnel . Furthermore, an initial peak serum TNF-alpha response which could be detected within 2.5 days after burn injury has also been observed. Ho wever, significant differences in both the serum TNF-alpha values on a dmission, as well as the first peak serum TNF-alpha levels, were not f ound (P >0.05) between patients with TBSA of greater or less than 50 p er cent and patients who survived or died from burn injury. In the sur vivors, serum TNF-alpha stayed at low levels, while it increased marke dly in four of the five non-survivors with proven sepsis starting at a bout 1 week postburn. A significant difference in the maximum serum TN F-alpha levels (P <0.05) was detected between patients who recovered a nd died from the thermal injury. In conclusion, great increases in ser um TNF-alpha levels have been detected in burned patients with the occ urrence of bacterial infection postburn. It is suggested that strategi es for the inhibition of TNF-alpha production or in the neutralization of TNF-alpha activity should also be considered in the better treatme nt of burned patients. (C) 1997 Elsevier Science Ltd for ISBI.