Modulation of types I and II acute phase reactants with insulin-like growth factor-1/binding protein-3 complex in severely burned children

Marcus Spies, Steven E. Wolf, Robert E. Barrow, Marc G. Jeschke, David N. Herndon

Research output: Contribution to journalArticle

58 Citations (Scopus)

Abstract

Objective: To determine whether 0.5 mg/kg insulin-like growth factor (IGF)-1/binding protein (IGFBP)-3, given intravenously, effectively alters the acute phase response in severely burned children. Design: Longitudinal trial with each patient serving as their own control. Setting: University-affiliated pediatric burn center. Patients: Nine children, 15 yrs of age or less, with burns covering >40% of the total body surface area. Interventions: Standard burn care with early burn wound excision and grafting. Blood sampled at defined time points before and after operative procedures. Measurements and Results: Determination of types I and II acute phase reactant proteins, constitutive serum proteins, serum cytokines, serum IGF-1, IGFBP-3, and growth hormone levels. Treatment with IGF-1/BP-3 attenuated increases in type I (complement 3, α1-acidglycoprotein) and type II (haptoglobin, α1-antitrypsin) acute phase proteins. Further, IGF-1/BP-3 increased constitutive serum protein levels (prealbumin, retinol binding protein, transferrin) and decreased serum IL-6 levels. Conclusions: Low-dose IGF-1/BP-3 effectively attenuated the type I and type II hepatic acute phase response, increased serum levels of constitutive proteins, and modulated the hypermetabolic response.

Original languageEnglish (US)
Pages (from-to)83-88
Number of pages6
JournalCritical Care Medicine
Volume30
Issue number1
StatePublished - 2002

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Insulin-Like Growth Factor Binding Protein 3
Acute-Phase Proteins
Somatomedins
Acute-Phase Reaction
Serum
Blood Proteins
Complement C1
Burn Units
Retinol-Binding Proteins
Complement C3
Prealbumin
Haptoglobins
Body Surface Area
Operative Surgical Procedures
Transferrin
Insulin-Like Growth Factor I
Burns
Growth Hormone
Interleukin-6
Pediatrics

Keywords

  • Acute phase proteins
  • Acute phase response
  • Constitutive serum proteins
  • Inflammatory cytokines
  • Insulin-like growth factor binding protein-3
  • Insulin-like growth factor-1
  • Low-dose insulin-like growth factor-1/binding protein-3
  • Pediatric burns
  • Pharmacological modulation
  • Severe burns

ASJC Scopus subject areas

  • Critical Care and Intensive Care Medicine

Cite this

Modulation of types I and II acute phase reactants with insulin-like growth factor-1/binding protein-3 complex in severely burned children. / Spies, Marcus; Wolf, Steven E.; Barrow, Robert E.; Jeschke, Marc G.; Herndon, David N.

In: Critical Care Medicine, Vol. 30, No. 1, 2002, p. 83-88.

Research output: Contribution to journalArticle

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AB - Objective: To determine whether 0.5 mg/kg insulin-like growth factor (IGF)-1/binding protein (IGFBP)-3, given intravenously, effectively alters the acute phase response in severely burned children. Design: Longitudinal trial with each patient serving as their own control. Setting: University-affiliated pediatric burn center. Patients: Nine children, 15 yrs of age or less, with burns covering >40% of the total body surface area. Interventions: Standard burn care with early burn wound excision and grafting. Blood sampled at defined time points before and after operative procedures. Measurements and Results: Determination of types I and II acute phase reactant proteins, constitutive serum proteins, serum cytokines, serum IGF-1, IGFBP-3, and growth hormone levels. Treatment with IGF-1/BP-3 attenuated increases in type I (complement 3, α1-acidglycoprotein) and type II (haptoglobin, α1-antitrypsin) acute phase proteins. Further, IGF-1/BP-3 increased constitutive serum protein levels (prealbumin, retinol binding protein, transferrin) and decreased serum IL-6 levels. Conclusions: Low-dose IGF-1/BP-3 effectively attenuated the type I and type II hepatic acute phase response, increased serum levels of constitutive proteins, and modulated the hypermetabolic response.

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