Tumor necrosis factor receptor I, II and tumor necrosis factor-α levels in patients with burns

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Objects

The present study was undertaken to examine the relationship between the severity of burns and TNFRI and TNFRII levels in the acute post-burn period and the entire follow-up period.

Materials and methods

Tumor necrosis factor α (TNF-α) and TNF receptor I and II (TNFRI and TNFRII) were studied in 24 burn patients who had a total burn surface area (TBSA) of 50.2± 20.4%. TNFRI and TNFRII were quantified by enzyme-linked immunosorbent assay (ELISA) using a kit (Amersham, Buckinghamshire, UK). TNF-α was quantified by ELISA (Medogenix, Fleurus, Belgium).

Results

Immediately after the injury, both the TNFRI and TNFRII levels correlated significantly with TBSA (r=0.7344, P<0.0001; r=0.6074, P=0.0012). The TNFRI and TNFRII levels immediately after the injury were significantly higher in the 11 patients who later died of their burns than in the 13 patients who survived (0.8± 0.4 ng/ml vs 1.8± 0.7 ng/ml, P=0.0002; 2.3± 1.1 ng/ml vs 4.5± 1.6 ng/ml, P=0.0009). The TNF-α levels immediately after the injury did not differ significantly between the group that survived and the group that died. The TNFRI and TNFRII values for the entire follow-up period also correlated significantly with TBSA. Peak TNFRI and TNFRII levels were significantly higher in the group that died than in the group that survived (6.0± 4.7 ng/ml vs 14.1± 7.8 ng/ml, P=0.0009; 7.0± 5.1 ng/ml vs 16.7± 5.2 ng/ml, P=0.0003).

Conclusion

The TNF-α levels correlated significantly with both the TNFRI and the TNFRII levels. The TNFRI and TNFRII levels thus closely reflected the severity of the burns in both the acute post-burn period and the subsequent follow-up period. In other words, these parameters well reflected the severity and outcome of the burns, irrespective of the presence or absence of accompanying infection.