A profile of acute-phase proteins after severe burns

Transport proteins and acute-phase proteins, including complement factors C3 and C4, immunoglobulin A (IgA), IgM, albumin (ALB), prealbumin (PAB), transferrin (TRF), ceruloplasmin (CER), haptoglobin (HAG), and alpha antitrypsin (AAT), were examined in 29 patients with severe burns with a total burn surface area (TBSA) ranging from 30% to 97% (mean, 50.03%±21.16%). Samples from each patient were obtained at days 2, 7, 14, and 21 postburn and were analyzed using a 3M 300 special automatic analyzing system (Sanofi, France). A population of normal individuals served as controls. Statistical analyses were performed using multivariate and regression analyses. The postburn values of C3, C4, PAB, ALB, TRF, and CER were significantly lower compared to controls (P>0.01). Slow postburn recovery was observed for C3 and C4, which was negatively correlated with burn severity. TAF, TAB, and ALB values decreased significantly within the first week postburn (P<0.01); TAF, PAB, and ALB values demonstrated a steady recovery between days 14 and 21 postburn. The recovery was negatively correlated to the severity of the burns. IgA and IgM markedly decreased after 2 days postburn (P<0.01). After the initial decrease, the levels of IgM slowly increased, whereas the levels of IgA remained depressed for the first postburn week. The levels of AAT rose significantly throughout the entire study period and were positively correlated with the severity of the burns (P<0.01). This study demonstrates a pattern of certain reactive/acute-phase proteins in the postburn period. It can be concluded that severe burns directly affect the production of serum levels of acute-phase proteins, thereby impairing important physiological functions such as the immune system, protein transportation, metabolism, and repair processes.