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Mediators Affecting IL2 Function in Burn Immunosuppression

  • B. G. Sparkes
  • J. A. Teodorczyk-Injeyan
  • W. J. Peters
  • R. E. Falk
Conference paper
Part of the NATO ASI Series book series (NSSA, volume 139)

Abstract

Thermal injury induces the most complex array of physiological dysfunction known. Extensive research effort has led to an understanding of some of the changes occurring following a major burn, yet early pathological changes have been documented to be different from those of later phases and great difficulties have arisen in determining cause-and-effect relationships in these changes. For example, intensive first treatment using specific, systemic and local therapy successfully delays mortality in the early phase of very severe burns but has little relationship to the outcome. This was observed where burn victims, treated early, survived initially in greater numbers than those devoid of early treatment (48% greater at day 4, 32% at day 12), whereas the difference was only 7.3% at 2 months1. The fatal outcome of the late phase is ascribed to multiple organ system failure (MOSF) but not always to concomitant sepsis, for often bacteria cannot be detected in up to half the patients who die2.Where sepsis had been well controlled and was not confirmed at death, it had been surmised that infection was not the primary cause of death. In this situation, devitalized tissue and/or circulating endotoxin have been thought to perpetuate some mediator-induced response which lead to MOSF2. Evidence in animal models suggests, however, that endotoxic shock and burn shock are two different pathologies. Whereas endotoxin mediates its effects through lipid peroxidation via the production of oxygen free radicals, and catalase and superoxide dismutase can reverse these effects, burn shock is not protected by these enzymes3. Thus endotoxin, when present, may not be the main mediator of late death in burns.

Keywords

Peripheral Blood Mononuclear Cell Thermal Injury Mixed Lymphocyte Reaction Multiple Organ System Failure Normal Peripheral Blood Mononuclear Cell 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

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Copyright information

© Plenum Press, New York 1987

Authors and Affiliations

  • B. G. Sparkes
    • 1
  • J. A. Teodorczyk-Injeyan
    • 2
  • W. J. Peters
    • 3
  • R. E. Falk
    • 2
  1. 1.The Defence & Civil Institute of Environmental Medicine DownsviewOntarioCanada
  2. 2.Department of SurgeryUniversity of TorontoCanada
  3. 3.The Ross Tilley Burn CentreWellesley HospitalTorontoCanada

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