Plasma tumor necrosis factor-alpha, its soluble receptors and interleukin-1 beta levels in critically burned patients

Levels of plasma TNF-alpha, interleukin-1 beta (IL-1 beta), soluble TNF-rec eptor I (sTNF-R I) and soluble TNF-receptor II (sTNF-R II) were determined in 16 critically burned patients. Seven of the 16 patients showed hypovolem ic shock (shock group), 9 with sepsis (sepsis group), 8 with multiple organ dysfunction syndrome (MODS group) and 6 of them died (non-survival group). plasma TNF-alpha, sTNF-R I and R II were significantly higher in the shock group, the MODS group and the non-survival group than each of the control groups. TNF-alpha and sTNF-Rs increased gradually in the MODS group and the non-survival group from 1 to 5 days postburn. TNF-alpha, sTNF-R I and R II correlated positively with Goris' multiple organ failure score. Molecular sTNF-Rs/TNF-alpha ratios were lower in the sepsis group than in the non-sep sis group. These results suggest that circulating TNF and soluble TNF recep tors system play an important role in the development of burn shock and MOD S; high molecular ratios of endogenous sTNF-Rs might not reduce the morbidi ty of MODS and the mortality in critically burned patients. (C) 1998 Elsevi er Science Ltd for ISBI. All rights reserved.