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

Crit Care Med. 2002 Jan;30(1):83-8. doi: 10.1097/00003246-200201000-00013.

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 bum 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, alpha1-acidglycoprotein) and type II (haptoglobin, alpha1-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.

Publication types

  • Research Support, Non-U.S. Gov't
  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Acute-Phase Proteins / metabolism*
  • Burns / blood
  • Burns / drug therapy*
  • Child, Preschool
  • Complement C3 / analysis
  • Cytokines / blood
  • Female
  • Growth Hormone / blood
  • Haptoglobins / analysis
  • Humans
  • Insulin-Like Growth Factor Binding Protein 3 / administration & dosage*
  • Insulin-Like Growth Factor Binding Protein 3 / blood
  • Insulin-Like Growth Factor I / administration & dosage*
  • Insulin-Like Growth Factor I / analysis
  • Longitudinal Studies
  • Male
  • Orosomucoid / analysis
  • Prealbumin / analysis
  • Retinol-Binding Proteins / analysis
  • Transferrin / analysis
  • alpha 1-Antitrypsin / analysis

Substances

  • Acute-Phase Proteins
  • Complement C3
  • Cytokines
  • Haptoglobins
  • Insulin-Like Growth Factor Binding Protein 3
  • Orosomucoid
  • Prealbumin
  • Retinol-Binding Proteins
  • Transferrin
  • alpha 1-Antitrypsin
  • Insulin-Like Growth Factor I
  • Growth Hormone