THE THERAPEUTIC EFFECT OF C1-INHIBITOR ON GUT-DERIVED BACTERIAL TRANSLOCATION AFTER THERMAL-INJURY

To test the effects of C1-esterase inhibitor in scald burns on bacteri al translocation and intestinal damage, standardized deep partial-thic kness burns were inflicted on domestic pigs, scalding 30% of the skin surface for 25 s with 75 degrees C hot water. The animals (n = 17; wei ght 25-35 kg) were divided into three groups: I) the control group (n = 5) without scald burn; II) the group (n = 6) with scald burn; and II I) the group with C1-inhibitor (n = 6): scald burn and treatment with C1-inhibitor (C1-INH; Berinert(R), Behring, Marburg, Germany). Paramet ers measured and compared in this model were activity of complement sy stem, hemodynamics, body weight, pathological organ alterations includ ing intestinal lesions, bacterial translocation, and skin damage. C1-I NH administration significantly decreased the plasma levels of the spe cific soluble membrane attack complex (SC5b-9), bacterial translocatio n, and the degree of intestinal ischemia in the postburn period compar ed with untreated animals. Moreover, animals treated with C1-INH exhib ited a minor degree of organ alterations including damage of the skin and development of edema. The favorable effects of C1-INH may be expla ined by the protection of the intestinal and dermal microcirculation i n the acute phase of thermal injury.