[Effect of escharectomy during burn shock stage on stress response]

OBJECTIVE

To investigate changes in hormones of plasma and the effect of escharectomy during burn shock stage on early stress response after burn.

METHODS

Sixteen male minipigs were subjected to a 35% TBSA III degree burn injury. The burned minipigs were randomly divided into two groups: escharectomy during burn shock stage group (S group) and escharectomy group after burn shock stage (N group). The sequential changes in plasma levels of insulin, glucagon, cortisol, GH, IGF-I, albumin were analyzed.

RESULTS

The serum concentration of insulin, glucagon, cortisol increased to some degree, whereas the serum concentration of GH, IGF-I decreased obviously after burn. As compared with the N group, no significant difference in the serum concentration of glucagon, cortisol, GH, IGF-I, was observed.

CONCLUSIONS

Escharectomy during burn shock stage could not aggravate stress response after burn.

[The effect of early escheractomy on expression of ICAM-1 and E-selectin mRNA of endothelial cells]

OBJECTIVES

To examine the effect of burned serum on change in endothelial cell ICAM-1 and E-selectin mRNA expression and whether these alterations can be corrected by the means of escharectomy during burn shock period.

METHODS

One hundred and seventy-six Wistar rats with 30% III degree TBSA on back were studied. Endothelial cell ICAM-1 and E-selectin mRNA were tested with the method of RT-PCR.

RESULTS

ICAM-1 and E-selectin expression showed an increase after stimulation by serum of 4 hours post burn, reaching peak levels 168 hours after injury. ICAM-1 and E-selectin expression levels could decrease to baseline within 168 hours in the rats which underwent escharectomy during shock stage, but kept higher than normal in rats without escharectomy or underwent 96 hours post burn.

CONCLUSIONS

These findings suggest that eschar can induce endothelial cells to express adhesion molecule. Early escharectomy is important to prevent adhesion molecule expression and SIRS.

[Role of endothelin and nitric oxide in early gut ischemia]

OBJECTIVE

Inadequate perfusion in splanchnic organs and especially in the gut during acute burn period has been reported in many conventionally "successfully" resuscitated patients, but the mechanisms still remain unclear and its early preventive measures need to be further studied. The aim of this study is to evaluate the role of endothelin and nitric oxide in gut ischemia.

METHODS

Eighteen male pigs were randomly assigned to one of the three groups: group C, a sham burn group that was subjected to all surgical procedures except burn; group B, sustained 30% TBSA cutaneous thermal burn; Group N, NO donor (C87-3754) was given intravenously (0.0125 mg.kg-1.min-1) at the beginning of resuscitation.

RESULTS

In group B, PVF decreased rapidly after burn, and did not recover in the observation period (72 h), ET levels in portal blood and intestinal tissue elevated contrary to the changes in NO. In group N, PVF was higher than in group B.

CONCLUSION

1. Changes in ET and NO may influence the protal blood flow. 2. NO donor was proved to be beneficial in improving GI tissue perfusion by releasing NO.

[Performing escharectomy following "clinical guidelines" in extensively burned patients during burn shock stage]

OBJECTIVE

To verify the practicability of performing escharectomy on extensively burned patients during shock stage following the clinical guidelines only.

METHOD

Sixty-five burn patients with total body surface area(TBSA) over 30% received resuscitation to prevent and treat burn shock without hemodynamic monitoring. Clinical indexes of optimal resuscitation, such as a urine volume 80 to 100 ml/h, heart rate around 100 to 110/min, respiration rate 20 to 24/min, significant alleviation of thirst, sense of nausea and vomiting, clear mentality, Hb < or = 150 g/l and Hct < or = 0.50 were adopted as guidelines, under which thirty-three patients underwent escharectomy and grafting during burn shock stage (group A). For comparison, other 32 patients received escharectomy 96 hr after injury(group B). The incidences of sepsis and MODS were analyzed. Plasma samples from 12 patients in group A and 9 patients in group B were assayed at interval for LPS, TNF, IL-6 and IL-8.

RESULTS

All 33 patients in group A were in stable condition, and the incidence of sepsis was lower (34.4%) than that in group B(56.3%). The incidence of MODS and the mortality of patients in group A was lower than those in group B. Levels of LPS, TNF, IL-6 and IL-8 in plasma were lower in group A as compared with those in group B.

CONCLUSION

The results show that escharectomy could be performed during shock stage under clinical guidelines with reasonable safety.

[Impact of intracellular Na+ concentration alteration on intracellular aerobic glycolysis in skeletal muscles in sepsis]

OBJECTIVE

To evaluate the impact of the changes of the intracellular Na+ concentration on the cellular lactate production of different skeletal muscles in septic rats as compared to that of the normal ones.

METHODS

Using septic model of rats, we established the in vitro muscle incubation system with sufficient oxygen supply as well as the NADH fluoremetric method for the detection of trace amount of lactate in the samples. By using the specific Na+ ionorphor--monensin, the distribution of transmembrane Na+ was under control and the lactate production of the muscle cells were measured.

RESULTS

The intracellular glycolysis was activated by increasing of intracellular Na+ probably because of the mechanism of Na+ pump activation. The sensitivity of muscles to monensin varied according to different muscle fiber composition. The mechanism of the aerobic glycolysis activation in sepsis was identical to the roles of monensin in the cells.

CONCLUSION

The increase of the permeability of Na+ in skeletal muscle cells as well as the increment of the intracellular concentration of Na+ can directly lead to the enhancement of muscular aerobic glycolysis and its mechanism plays a significant role in the enhancement of muscular glycolysis in septic states.

[Preparation of collagen-based materials for wound dressing]

This article addressed the methods to develop collagen-based materials for wound dressing. Fresh frozen bovine tendon was treated with 0.05 M acetic acid at pH 3.2 for 48-72 h, then it was homogenized, filtered, and after the process of adding chondroitin sulphate(8%), it was dbubblized; thus 1.5%-2.5% collagen solution was finally prepared. The solution was lyophilized in prefrozen or un-prefrozen mold. The collagen sponge was crosslinked with 0.25% glutaraldehyde for 24 h. Three other wound dressings were developed by similar method, namely collagen membrane with polyurethane membrane onlay, polyurethane-coated collagen membrane and collagen membrane on gauze. It was demonstrated that the property of frozen bovine tendon was stable, and the prepared collagen sponge contained pores of 50-400 microns in diameter. Some factors influencing pore structure and size in the collagen sponge were discussed. The results of this preliminary study suggested that the collagen could be used as wound dressing.

Recombinant fusion protein and DNA vaccines against foot and mouth disease virus infection in guinea pig and swine

In this study, we provide evidence that a recombinant fusion protein containing beta-galactosidase and a tandem repeat peptide of immunogenic dominant epitope of foot-and-mouth disease virus (FMDV) VP1 protein elicits high levels of neutralizing antibody and protects both guinea pigs and swine against infection. Vaccination with this fusion protein induced a FMDV-specific proliferative T-cell response and a neutralizing antibody response. The immunized guinea pigs and swine were protected against FMD type O virus infection. Two DNA plasmids expressing genes of foot-and-mouth disease were constructed. Both plasmids pBO1 and pCO1 contain a signal sequence of the swine immunoglobulin G (IgG) gene and fusion protein gene of pXZ84. The signal sequence and fusion protein gene were under the control of a metallothionein promoter in the case of the pBO1 plasmid and under the control of a cytomegalovirus immediate early promoter in the case of pCO1 plasmid. When pBO1 and pCO1 were inoculated intramuscularly into guinea pigs, both plasmids elicited a neutralizing antibody response and spleen cell proliferation increased following stimulation with FMDV antigen, but animals were not protected from viral challenge.

[Analysis of factors influencing healing time of burn wounds]

OBJECTIVE

To analyze the factors influencing healing time, length of hospital stay and hospital costs in burn patients.

METHODS

Seven hundred and ninety-one burn patients with principal component analysis were studied retrospectively.

RESULTS

There were some factors that influence healing time, including total area of burn, the area of full-thickness burn, the area of partial-thickness burn, inhalation injury, sepsis, shock, visceral complication, combined injuries, the size of surgical excision, the time of surgical excision, whether or not excision of burn wound was done in shock stage, and use of antibiotic, etc. Further analysis indicated that the patients undergo escharectomy during shock stage had better recovery with lower incidence of visceral complications and sepsis, especially in those with major burn over 30 percent TBSA.

CONCLUSION

To reduce healing time of burn patients, there are many effective methods such as the prevention and treatment of shock, sepsis, visceral complication, and appropriate use of antibiotics. The most important factor to reduce healing time of burn patients is escharectomy as early as possible for major burns.

[Gene expression of lipopolysaccharide receptor CD14 and tumor necrosis factor-alpha in rats after thermal injury]

OBJECTIVE

To investigate changes in lipopolysaccharide receptor CD14 and tumor necrosis factor-alpha (TNF-alpha) gene expression in vital organs, and their significance in the pathogenesis of systemic inflammation after burns.

METHODS

Wistar rats were subjected to a 35 percent full-thickness scald injury, then sacrificed pre-burn, and postburn 12, 24, 48, 72 hours, respectively. Tissue samples from liver, kidney, lung and intestine were collected to measure CD14 and TNF-alpha mRNA expression. Peritoneal macrophages were harvested by peritoneal lavage to determine CD14 mRNA expression.

RESULTS

CD14 mRNA expression increased markedly after thermal injury, peaking at both 12 and 48 hours. Likewise, CD14 mRNA levels were significantly up-regulated in peritoneal macrophages. Gene expression of TNF-alpha elevated markedly in liver, lungs, and kidneys after acute insults. Positive correlation was found between CD14 mRNA and TNF-alpha mRNA in liver, lung, and kidney tissues.

CONCLUSIONS

Thermal injury per se can markedly up-regulate both CD14 and TNF-alpha gene expression in various organs. Excessive CD14 mRNA expression may enhance synthesis and release of TNF-alpha stimulated by endotoxin translocation, and the interaction between CD14 and TNF-alpha may play an important role in mediating multiple organ damage secondary to major burns.

[Biopterin synthesis and GTP cyclohydrolase I mRNA expression in rats following endotoxic shock]

OBJECTIVE

To investigate the potential role of changes in biopterin (tetrahydrobiopterin and more oxidized species) synthesis and GTP cyclohydrolase I (GTP-CHI) mRNA expression in endotoxic shock.

METHODS

SD rats were subjected to endotoxic shock by a bolus injection of lipopolysaccharide (15 mg/kg, i.p.), biopterin and GTP-CHI mRNA levels in liver, kidney, and intestine were determined at 4, 8 hours following endotoxin challenge.

RESULTS

Tissue biopterin levels significantly elevated in liver, kidney, and intestine, with high levels sustaining for 8 hours after endotoxin challenge (P < 0.05, P < 0.01). Similarly, GTP-CHI mRNA induction in various tissues substantially increased within 4 hours compared to normal controls (P < 0.05, P < 0.01). It was also shown that hepatic and renal biopterin levels were positively correlated with glutamic pyruvic transaminase (GPT) and also blood urea nitrogen (BUN) values (both P < 0.01). In addition, treatment with recombinant bactericidal/permeability increasing protein (rBPI(21)) markedly reduced tissue biopterin and GTP-CHI mRNA levels, concomitant with significant decreases in GPT, BUN as well as D-lactate values.

CONCLUSIONS

Biopterin synthesis and release may be involved in the development of endotoxin-induced multiple organ dysfunction, and early use of rBPI(21) is effective to inhibit marked GTP-CHI mRNA expression and biopterin formation following septic shock.

Human T-cell lymphotropic virus types I and II infections in mother-child pairs in Nigeria

A community-based survey to determine the prevalence of human T-cell lymphotropic type I (HTLV-I) and type II (HTLV-II) virus infections in mothers and children in south-western Nigeria was carried out using blood samples collected in 1993. A multistage cluster, random sampling procedure was used to select 460 mother-child pairs (476 children because there were 16 sets of twins) from 14 enumeration areas. A commercially available, whole HTLV-I lysate antigen-based ELISA method was used to screen for HTLV-I and HTLV-II antibodies in the samples. A synthetic peptide antigen-based ELISA was then used to differentiate between antibody reactivity to either HTLV-I or HTLV-II. Reactivity to HTLV-I or HTLV-II antibodies was found in 4.3 per cent (20/460) of mothers and in 1.1 per cent (5/476) of children in both rural and urban communities and all the positive children were males. None of the 16 sets of twins in this study was positive for either HTLV-I or HTLV-II. Also none of the mother-child paired sera tested showed concordance for either HTLV-I or HTLV-II antibody positivity. The lack of concordance between mother and child sera suggests that vertical transmission may not be the major route of transmission of HTLV infection to children in south-western Nigeria. Other modes of transmission, such as the re-use of unsterilized needles for injections and surgical knives in local scarification, which are common practices in the region, need to be investigated as they may prove to be more important than vertical transmission. These findings have important implications for any control programme for diseases that can be spread by the same routes as HTLV infection (the human immunodeficiency viruses, hepatitis B, and hepatitis C infections).

Hair cell protection from aminoglycoside ototoxicity by adenovirus-mediated overexpression of glial cell line-derived neurotrophic factor

Aminoglycosides are commonly used antimicrobial drugs that often have ototoxic side effects. The ototoxicity often involves permanent loss of cochlear hair cells (HCs). Neurotrophic factors have been shown to protect a variety of tissues, including HCs, from toxic trauma. To determine if glial cell line-derived neurotrophic factor (GDNF) can protect cochlear HCs from trauma, we inoculated an adenoviral vector encoding the human GDNF gene into guinea pig cochleae via the round window membrane 4 days prior to injection of aminoglycosides. Control groups showed little or no negative influence of the viral inoculation on cochlear structure and function. In contrast, ears that were inoculated with the GDNF vector had better hearing and fewer missing HCs after exposure to the ototoxins, as compared with controls. Our results demonstrate the feasibility of gene therapy for cochlear application and suggest that virus-mediated overexpression of GDNF may be developed as a valuable prevention against trauma-induced HC death.

Assessment of genetic changes in hepatocellular carcinoma by comparative genomic hybridization analysis: relationship to disease stage, tumor size, and cirrhosis

Hepatocellular carcinoma (HCC) is a common and highly malignant tumor that is prevalent in Southeast Asia. Although the etiological factors associated are now well recognized, the interactions between individual factors and the molecular mechanisms by which they lead to cancer remain unclear. Cytogenetic analysis on HCC has been limited because of poor hepatocyte growth in vitro. The recently developed technique of comparative genomic hybridization (CGH), however, permits screening of the entire genome without the need of cell culture. CGH was applied to the study of genomic aberrations in 67 surgically resected samples of HCC, 3 of adenomatous hyperplasia (AH), and 12 of nontumorous cirrhotic liver surrounding the tumors. All samples were from patients of a racially and etiologically homogeneous population in Southern China, where chronic hepatitis B virus infection is the main etiological factor. CGH analysis of the HCC samples revealed frequent copy number gain of 1q (48/67 cases, 72%), 8q (32/67 cases, 48%), 17q (20/67 cases, 30%), and 20q (25/67 cases, 37%) and common losses on 4q (29/67 cases, 43%), 8p (25/67 cases, 37%), 13q (25/67 cases, 37%), and 16q (20/67 cases, 30%). Our finding of a high incidence of 1q gain strongly suggested this aberration was associated with the development of HCC. Genomic abnormalities were detected in 1 of the 3 AH specimens but absent in all 12 cirrhotic tissues surrounding the tumor. Clinical staging classified 3/67 HCC cases as T1, 53 cases as T2, and 11 cases as T3. No significant difference in the pattern of genomic imbalances was detected between stages T2 and T3. A significant copy number loss of 4q11-q23 was, however, identified in those tumors larger than 3 cm in diameter. Of particular interest was the identification of 8q copy number gain in all 12 cases of HCC that arose in a noncirrhotic liver, compared with only 20/55 cases in HCC arising in a cirrhotic liver. We suggest that 8q over-representation is likely associated with a growth advantage and proliferative stimulation that have encouraged malignant changes in the noncirrhotic human liver.

[Experimental study on the mechanisms of enhancement of aerobic glycolysis of muscles in burns and sepsis--the verification of the existence and the enhancement of the aerobic glycolysis of muscles in early postburn period and sepsis]

OBJECTIVE

To verify if aerobic glycolysis exists in the muscle cells in normal rats and to analyze the changes in aerobic glycolysis in the muscle cells in the early postburn period and in septic states.

METHOD

Using septic model of rats, we established the in vitro muscle incubation system with sufficient oxygen supply as well as the NADH fluoremetric method for the detection of trace amount of lactate in the samples. Extensor digitorium longus (EDL) and soleus muscles which represent two types of muscle fiber were studied.

RESULTS

In the early postburn period as well as in septic states, the lactate production of muscle cells was significantly elevated as compared to the normal controls even though the muscles were incubated in a fully oxygenated media. The levels of aerobic glyoclysis, as well as its changes in postburn period and in septic states, vary depending on the difference in the fiber composition of the muscles.

CONCLUSION

Muscle cells might develop a kind of metabolic enhancement which is referred to as aerobic glycolysis rather than the metabolic defect which results from tissue hypoperfusion and hypoxia in the early postburn period as well as in septic states. This provides us a special insight to elucidate the mechanisms of the metabolic derangement in the early postburn period and in sepsis.

[Study on the cytotoxic and DNA damaging effects in oral mucosal fibroblasts by areca nut extract]

An aqueous areca nut extract (ANE) was tested for its cytotoxic effects on cultured human embryo oral mucosal fibroblasts (HE-OMF) in vitro by using the trypan blue and thiazolyl blue (MTT) assay. The ANE decreases the cell survival rate in a dose-dependent manner (P < 0.05). So was the extract in inducing damage on the cellular DNA of HE-OMF in vitro examined by the nick translation assay. The increase in counts per minute (CPM) values was significant (P < 0.05) for comparing all four concentration groups tested, The results suggests that aqueous ANE is highly cytotoxic and capable to induce DNA damage on cultured HE-OMF. It may have potential carcinogenic effect on the oral mucosal membrane of whom habitually chewing the areca nut frequently for quite a long time. Futher study is required to illustrate the detail process and study the mechanism of these effects.

[The preventing function of garlic on experimental oral precancer and its effect on natural killer cells, T-lymphocytes and interleukin-2]

In order to study the effect and mechanism of garlic on preventing oral precancer, we divided randomly 32 Wistar rats into two groups. The garlic group was painted with garlic solution on the hard palatal mucosae. The control group was applied with distilled water that is equal in quantity. Then, chemical carinogen 4-nitroquinoline 1-oxide (4NQO) was painted on the same sites for both groups, three times weekly. Eight rats were randomly killed in the 10th, 13th week. The hard palatal mucosae were examined with light microscope. Meanwhile, lymphocytes were isolated from the rat spleens. The activation of natural killer (NK) cells and T-lymphocytes, and level of interleukin-2 were determined by radioimmunoassay. The results revealed that garlic effectively prevented oral precancer induced by 4NQO. This effect may be related to the following factors that garlic can improve the activation of NK cells, the function of T-lymphocytes, and the level of IL-2.

Randomised placebo-controlled trial of use of topical recombinant bovine basic fibroblast growth factor for second-degree burns

BACKGROUND

Wound healing is a dynamic process that could be accelerated by growth factors. We investigated the effect of recombinant bovine basic fibroblast growth factor (rbFGF) on burn healing in a randomised placebo-controlled trial.

METHODS

We recruited 600 patients with superficial or deep second-degree burns. Patients received 150 AU/cm2 daily topical rbFGF (n=300) or placebo (n=300) plus vehicle. We assessed healing by photography, punch-biopsy, and clinical examination.

FINDINGS

All patients treated with rbFGF had faster granulation tissue formation and epidermal regeneration than those in the placebo group. Superficial and deep second-degree burns treated with rbFGF healed in a mean of 9.9 (SD 2.5) days and 17.0 (4.6) days, respectively, compared with 12.4 (2.7) and 21.2 (4.9) days (p=0.0008 and p=0.0003, respectively). No adverse effects were seen locally or systemically with rbFGF.

INTERPRETATION

rbFGF effectively decreased healing time and improved healing quality. Clinical benefits would be shorter hospital stays and the patient's skin quickly becoming available for harvesting and grafting.

[The significance of changes in serum soluble lipopolysaccharide receptor CD14 levels in burned patients with multiple organ dysfunction syndrome]

OBJECTIVE

To determine whether an increased soluble lipopolysaccharide receptor CD14 (sCD14) level is associated with the development of multiple organ dysfunction syndrome (MODS) in patients after major burns.

METHOD

22 patients with burns covering more than 70% of body surface area were studied. These patients were divided into two groups according to the occurrence of MODS (MODS group, n = 9; non-MODS group, n = 13). Blood samples were obtained from burned patients. Serum concentrations of sCD14 and tumor necrosis factor (TNF) were determined by sandwich ELISA. Plasma endotoxin was measured using a quantitative chromogenic LAL test.

RESULT

Compared to the healthy volunteers, a significant increase in serum sCD14 levels was observed in 22 patients on day 7 postburn, which remained marked elevation up to 21 days after thermal insult (P < 0.01). The serum sCD14 levels of the MODS group were significantly higher than those of the non-MODS group on days 7, 14, and 21 postburn (P < 0.05). Additionally, the serum sCD14 and endotoxin levels were positively correlated in patients who developed MODs on days 7, 14 and 21 postburn (P < 0.05), whereas no correlation was found between sCD14 and TNF levels at any time point (P > 0.05).

CONCLUSION

Our data suggest that sCD14 elevation is associated with the development of MODS after major burns, and endotoxin release may be involved in the activation of sCD14 under certain pathophysiological conditions.

Ischemia and reperfusion impair the gene expression of endogenous basic fibroblast growth factor (bFGF) in rat skeletal muscles

Our previous studies showed that the amount of endogenous basic fibroblast growth factor (bFGF) was reduced after ischemia and reperfusion insult. One of the mechanisms involved in the decrease of endogenous bFGF is the increased destruction of this growth factor associated with oxygen free radical activation and inflammation. We hypothesized that the wounding also impairs the secretion of bFGF and examined the bFGF gene expression in skeletal muscles after ischemia and reperfusion insult. In this study, a rat leg ischemia (4 h) and reperfusion (24 h) injury model was prepared and the in situ hybridization method and reverse transcriptase polymerase chain reaction technique (RT-PCR) were used to evaluate the bFGF gene expression and its localization in control (normal) and injured rat skeletal muscles. The results showed that the bFGF mRNA expression was localized in the cytoplasm in control skeletal muscle, especially at the periphery inside the cells. According to the intensity of the stain, four main classes of fibers could be identified: strongly, moderately, weakly, and negatively stained fibers. Based on the positive stain, about 82% of the total fibers examined were positive for bFGF mRNA stain. In ischemic or ischemic and reperfused rat skeletal muscles, the localization of bFGF mRNA expression was similar to that in normal skeletal muscles, but only 52% in ischemic muscles and 22% in ischemic and reperfused muscles had positive bFGF mRNA staining. RT-PCR confirmed a significant decrease in bFGF mRNA expression in ischemic and reperfused rat skeletal muscles. These results suggest that the acute ischemia and reperfusion not only induce the destruction of endogenous bFGF molecule, which is stored at the extracellular matrix of the fibers, but also downregulate the bFGF gene expression. The simultaneous dysregulation of endogenous bFGF gene expression and decreased synthesis of bFGF protein suggest a possible role of this growth factor in delayed wound healing.

Regulation of matrix metalloproteinase-9 and inhibition of tumor invasion by the membrane-anchored glycoprotein RECK

A human fibroblast cDNA expression library was screened for cDNA clones giving rise to flat colonies when transfected into v-Ki-ras-transformed NIH 3T3 cells. One such gene, RECK, encodes a membrane-anchored glycoprotein of about 110 kDa with multiple epidermal growth factor-like repeats and serine-protease inhibitor-like domains. While RECK mRNA is expressed in various human tissues and untransformed cells, it is undetectable in tumor-derived cell lines and oncogenically transformed cells. Restored expression of RECK in malignant cells resulted in suppression of invasive activity with concomitant decrease in the secretion of matrix metalloproteinase-9 (MMP-9), a key enzyme involved in tumor invasion and metastasis. Moreover, purified RECK protein was found to bind to, and inhibit the proteolytic activity of, MMP-9. Thus, RECK may link oncogenic signals to tumor invasion and metastasis.

[Effect of TNF-alpha monoclonal antibody on tissue lipopolysaccharide-binding protein mRNA expression in rats after thermal injury]

OBJECTIVE

To explore the effects of tumor necrosis factor-alpha (TNF-alpha) monoclonal antibody (MAb) on tissue TNF-alpha and lipopolysaccharide-binding protein (LBP) mRNA expression, and multiple organ dysfunction in rats after thermal injury.

METHOD

24 male Wistar rats were subjected to a 35% total body surface area full-thickness thermal injury.

RESULT

The tissue TNF-alpha and LBP mRNA expressions of liver, lung, intestine, and kidney were markedly increased (P < 0.05 approximately equal 0.01) after thermal injury. Treatment with TNF-alpha MAb could significantly lower TNF-alpha mRNA expression of lung, intestine and kidney, but had no effect on liver TNF-alpha mRNA expression (P > 0.05). Similarly, the tissue LBP mRNA expression also decreased significantly (36.0% - 72.9%), and returned to normal in lung, intestine and kidney. In addition, biochemical parameters including GPT, TBiL, BUN, CK-MB, and LDH were markedly elevated after thermal injury, and decreased significantly after treatment with TNF-alpha MAb.

CONCLUSION

The increase of tissue TNF-alpha gene expression caused by thermal injury might be associated with a marked elevation of tissue LBP mRNA expression, which could contribute to the development of multiple organ dysfunction. The early use of TNF-alpha MAb seems to be effective in inhibiting significant LBP mRNA expression in various tissues and ameliorating multiple organ damage after major thermal injury.