Soluble cytokine receptors sTNFR I and sTNFR II, receptor antagonist IL-1ra, and anti-inflammatory cytokines IL-10 and IL-13 in the pathogenesis of systemic inflammatory response syndrome in the course of burns in children.

BACKGROUND: This is a prospective clinical study focusing on cytokine inhibitors (sTNFR I, sTNFR II, IL-1ra) and anti-inflammatory cytokines (IL-10, IL-13) following burn injury in children. The aim of the study was to evaluate the prognostic values of the selected cytokine-related molecules.

MATERIAL/METHODS: Fifty-one patients (29 burned children and 22 controls) admitted to the Department of Pediatric Surgery and Oncology were included in this study. Serum sTNFR I, sTNFR II, IL-1ra, IL-10, IL-13, and CRP concentrations were evaluated twice using ELISA, the first determination being performed within 6-24 hrs after the burn and the second following completion of treatment and normalization of the CRP level.

RESULTS: With the exception of IL-13, significantly higher cytokine and cytokine inhibitor levels were observed within 6-24 hours after burn compared with controls (p<0.05). Moreover, a significant attenuation of the burn-induced increases in sTNFR I, sTNFR II, IL-1ra, and IL-10 concentrations was recorded after burn therapy (p<0.05). TNF-alpha soluble receptor levels correlated significantly with serum CRP concentrations. Similarly, the levels of sTNFR I, sTNFR II, and IL-1ra significantly correlated with TBSA of the burned children.

CONCLUSIONS: The results confirm the involvement of these markers in the pathogenesis of SIRS in this clinical entity. Their monitoring simultaneously with CRP level allows evaluating the generalized inflammatory response and may clinically support diagnostic and prognostic methods.