Plasma tumor necrosis factor-α, its soluble receptors and interleukin-1β levels in critically burned patients

Levels of plasma TNF-α, interleukin-1β (IL-1β), soluble TNF-receptor I (sTNF-R I) and soluble TNF-receptor II (sTNF-R II) were determined in 16 critically burned patients. Seven of the 16 patients showed hypovolemic shock (shock group), 9 with sepsis (sepsis group), 8 with multiple organ dysfunction syndrome (MODS group) and 6 of them died (non-survival group). Plasma TNF-α, sTNF-R I and R II were significantly higher in the shock group, the MODS group and the non-survival group than each of the control groups. TNF-α and sTNF-Rs increased gradually in the MODS group and the non-survival group from 1 to 5 days postburn. TNF-α, sTNF-R I and R II correlated positively with Gorisʹ multiple organ failure score. Molecular sTNF-Rs/TNF-α ratios were lower in the sepsis group than in the non-sepsis group. These results suggest that circulating TNF and soluble TNF receptors system play an important role in the development of burn shock and MODS; high molecular ratios of endogenous sTNF-Rs might not reduce the morbidity of MODS and the mortality in critically burned patients.