Investigation of Inflammation and Oxidative Stress Markers in Sepsis and Burn Injury

Besides injury to the skin, severe burn trauma may initiate pathophysiological processes and changes affecting the entire organism. Metabolic processes activated by stress and pain, and neuro-hormonal changes result in hyper-metabolism and consequently, a catabolic metabolism. The activation of the immune system causes a release of a large amount of inflammatory mediators. Pro-inflammatory cytokines play a key role in initiating SIRS. SIRS results in a life-threatening condition by causing multiple organ failure or dysfunction that pose a great challenge in terms of treatment and thus, necessitate special intensive therapy. Changes in surface markers accompanying leukocyte activation and migration show a characteristic pattern and play an important role in the initiation and development of the inflammatory reaction following burn injury. At present, hundreds of specific CD markers are known. They are known to be involved in immune processes, cellular connections and tissue differentiation. Adhesion molecules CD11a, CD11b, CD18 and CD49d have a significant role in leukocyte attachment and recruitment. CD14 a is a recognising molecule bound to the surface of monocytes and macrophages. Only few human data are available in the literature in connection with CD markers after burn trauma

Insulin Therapy of Nondiabetic Septic Patients Is Predicted by para

Hydroxyl radical converts Phe to para-, meta-, and ortho-Tyr (p-Tyr, m-Tyr, o-Tyr), while Phe is converted enzymatically to p-Tyr in the kidney and could serve as substrate for gluconeogenesis. Pathological isoforms m- and o-Tyr are supposed to be involved in development of hormone resistances. Role of Phe and the three Tyr isoforms in influencing insulin need was examined in 25 nondiabetic septic patients. Daily insulin dose (DID) and insulin-glucose product (IGP) were calculated. Serum and urinary levels of Phe and Tyr isoforms were determined using a rpHPLC-method. Urinary m-Tyr/p-Tyr ratio was higher in patients with DID and IGP over median compared to those below median (P=0.005 and P=0.01, resp.). Urinary m-Tyr and m-Tyr/p-Tyr ratio showed positive correlation with DID (P=0.009 and P=0.023, resp.) and with IGP (P=0.004 and P=0.008, resp.). Serum Phe was a negative predictor, while serum p-Tyr/Phe ratio was positive predictor of both DID and IGP. Urinary m-Tyr and urinary m-Tyr/p-Tyr, o-Tyr/p-Tyr, and (m-Tyr+o-Tyr)/p-Tyr ratios were positive predictors of both DID and IGP. Phe and Tyr isoforms have a predictive role in carbohydrate metabolism of nondiabetic septic patients. Phe may serve as substrate for renal gluconeogenesis via enzymatically produced p-Tyr, while hydroxyl radical derived Phe products may interfere with insulin action