Plasma gelsolin is reduced in trauma patients

Tissue injury results in the release of the intracellular protein actin whi ch is cleared from the circulation by the plasma proteins gelsolin and Gc-g lobulin, constituting the Extracellular Actin Scavenger System (EASS). Expe rimental studies have shown that excessive amounts of actin in the circulat ion can lead to a condition resembling multiple organ dysfunction syndrome (MODS), and we have previously demonstrated that the level of Gc-globulin i s decreased after severe trauma. The purpose of the present study was to de termine whether the plasma levels of gelsolin were altered in the early pha se after trauma. Twenty-three consecutive trauma patients were studied. Pla sma samples were assayed for gelsolin by immunonephelometry with polyclonal rabbit antihuman gelsolin prepared in our own laboratory. The median time from injury until the time the first blood sample was taken was 52 min (ran ge 20-110) and the median Injury Severity Score (ISS) was 20 (range 4-50). The gelsolin level on admission was reduced significantly in the trauma pat ients compared with normal controls. The median level was 51 mg/L(7-967) vs . 207 mg/L (151-621), P < 0.0001. There was no correlation between admissio n levels of gelsolin and ISS or survival. This study illustrates that the p lasma concentration of gelsolin is significantly diminished immediately aft er traumatic injury. Further studies are necessary to establish a role for gelsolin or EASS in the development of MODS in trauma patients. The level o f serum or plasma gelsolin can be determined rapidly and accurately using a nephelometric assay.