Plasma cytokines after thermal injury and their relationship to infection

Objective: The relationship of plasma cytokine levels to infection, core temperature, and to one another in patients with thermal injury was examined. Summary Background Data: The response to infection has been associated with cytokines such as interleukin 1β (IL1β), interleukin 6 (IL6), and tumor necrosis factor α (TNFα), and these cytokines have been studied in various inflammatory diseases. The authors previously reported that patients with thermal injury have elevated IL1β and IL6 plasma levels and that these cytokines may play different roles in the response to thermal injury. Methods: IL1β, IL6, and TNFα were measured by enzyme-linked immunosorbent assay (ELISA) in serial samples of plasma from 27 patients. Results: IL6 and TNFα levels were increased in severely infected patients as compared to patients who remained free of infection, and the IL6 level was higher in infected patients who died than those who survived. There was no apparent relationship between IL1β levels and infection. IL6 and IL1β were positively correlated with core temperature. The correlations between IL6 and IL1β, between IL6 and TNFα, and between TNFaα and IL1β were significant. Conclusions: These results suggest that IL6 and TNFα play a role in the response of burned patients to infection.