Recovery from the hepatic acute phase response in the severely burned and the effects of long-term growth hormone treatment

Background: Administration of growth hormone (GH) to burned children decreases acute phase proteins and increases constitutive proteins when used during the acute hospitalization. Treatment during convalescence has not been examined. Methods: Seventy-six children with total body surface area burned (TBSAB) ≥40% were randomized to either placebo or GH (0.05 mg/kg/day) from discharge to 1 year after burn. Subjects were followed for an additional year. Levels of constitutive proteins and acute phase proteins were measured at discharge and 6, 9, 12, 18, and 24 months. Data are expressed as mean±S.E.M. Results: Albumin and transferrin levels increased during convalescence to the normal range but pre-albumin and retinol binding protein (RBP) levels remained below normal for at least 24 months. Acute phase proteins α1-acid glycoprotein, C-reactive protein, and haptoglobin decreased (P<0.05) but α2-macroglobulin increased from discharge to 6 months. C-3 complement remained elevated for at least 2 years after burn. Changes were similar in both groups with no effect for GH treatment. Conclusion: Some hepatic acute phase and constitutive proteins remain abnormal even 2 years after injury. GH treatment during convalescence has no effect on hepatic acute phase protein changes.