Article
Systemic Lipocalin-2 concentrations are increased in burn patients
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Published: | January 12, 2016 |
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Patients suffering from burn injuries are in apparent danger and require complex and challenging treatment. The systemic immune response after burn trauma is characterized by a primary pro-inflammatory phase followed by secondary immunosuppression. Lipocalin-2 (neutrophil gelatinase-associated lipocalin, LCN2) functions as an acute-phase protein. Various cytokines, growth factors and the activation of Toll-like receptors lead to the up-regulation of LCN2 expression. We hypothesized that LCN2 might be involved in the secondary cascade following burn injury and therefore analyzed LCN2 serum levels in burn patients in a time dependent manner.
We recruited 32 burn patients admitted to our burn intensive care unit (ICU) with a TBSA > 10% and over the age of 18 and compared them to 8 healthy statistically comparable volunteers. Serum concentrations of LCN2 were measured at the day of admission, daily within the first week and weekly thereafter until discharge. Of the included patients, 6 patients (18.75%) had a fatal outcome. Serum levels of LCN2 were significantly increased in burn patients compared to healthy volunteers at all observed time points (d0: 213574pg/ml vs. 64929pg/ml, p<0.001; d1: 210816pg/ml vs. 64147pg/ml, p<0.001; p<0.01 on all other time points). Burn patients with fatal outcome had significant higher serum levels on day 1 after admission (308642pg/ml vs. 199077pg/ml, p<0.05). The predictive value for mortality of LCN2 serum values was determined using ROC curve analysis. We found an area under the curve (AUC) of 0.713 on the day of admission and 0.880 on day 1.
Data obtained from this study suggest involvement of LCN2 in secondary mechanisms present after severe burn injuries. Serum levels of LCN2 were shown to be of prognostic value for outcome of burn patients. Further studies investigating the potential role and clinical practicability of this marker are warranted.