INTERLEUKIN-2 AND INTERLEUKIN-6 IN RELATION TO BURN WOUND SIZE IN THEACUTE-PHASE OF THERMAL-INJURY

Thermal injury induces significant physiologic responses of acute infl ammation, acute phase reaction and cell repair and growth, mediated by interleukins, cytokines and growth factors. To determine the relative role of interleukin-2 (IL-2) and interleukin-6 (IL-6) in the acute ph ase of thermal injury, 60 patients (47 men and 13 women, with average age of 37 years [1.5 to 70.0 years]) were analyzed within the first 36 hours and at five to seven days postoperatively. The patient populati on was categorized by percent burn (2 or 3, or both, degrees): less th an 20 percent, n=22; 20 to 40 percent, n=18, and greater than 40 perce nt, n=20. The average percent burn was 32 percent (range 4 to 95 perce nt). The mechanism of injury was by flame (25 instances), explosion an d flame (19 instances), scald (12 instances), electric (three instance s) or chemical (one instance). Twelve patients had an associated inhal ation injury; 14 patients had sepsis syndrome. The overall mortality r ate was 13 percent. Within 36 hours of onset of injury, IL-6 and IL-2 levels increased in proportion to the severity of the burn wound size. IL-2 levels were significantly elevated in the 20 to 40 percent burn group as compared with the greater than 40 percent group and patients in a control group (p<0.0001). IL-6 levels increased with burn wound s ize and were significant only in the greater than 40 percent group (p< 0.0007). Any physiologic modulation of the thermal injury by biologic modifiers must be adapted to the extent of burn wound size and phase o f injury: acute, recovery or reparative for optimal benefit and result s.