The therapeutic effect of C1-inhibitor on gut-derived bacterial translocation after thermal injury

• Published in: Shock (Augusta, Ga.) Ga.), 1998-02, Vol.9 (2), p.101-108
• Main Authors: KHORRAM-SEFAT, R, GOLDMANN, C, RADKE, A, LENNARTZ, A, MOTTAGHY, K, AFIFY, M, KÜPPER, W, KLOSTERHALFEN, B
• Format: Article
• Language: English
• Subjects: Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy; Animals; Bacterial Translocation - drug effects; Biological and medical sciences; Body Weight - drug effects; Burns - complications; Burns - drug therapy; Burns - microbiology; Complement C1 Inactivator Proteins - pharmacology; Complement Membrane Attack Complex; Complement System Proteins - analysis; Digestive System - microbiology; Digestive System - pathology; Edema - drug therapy; Emergency and intensive care: burns; Feces - microbiology; Glycoproteins - analysis; Hemodynamics - drug effects; Intensive care medicine; Kidney - pathology; Liver - pathology; Lung - physiopathology; Lymph Nodes - microbiology; Male; Medical sciences; Skin - injuries; Skin - pathology; Swine; Tetrazolium Salts; Thiazoles
• ISSN: 1073-2322; 1540-0514
• DOI: 10.1097/00024382-199802000-00005

To test the effects of C1-esterase inhibitor in scald burns on bacterial translocation and intestinal damage, standardized deep partial-thickness burns were inflicted on domestic pigs, scalding 30% of the skin surface for 25 s with 75 degrees C hot water. The animals (n = 17; weight 25-35 kg) were divided into three groups: I) the control group (n = 5) without scald burn; II) the group (n = 6) with scald burn; and III) the group with C1-inhibitor (n = 6): scald burn and treatment with C1-inhibitor (C1-INH; BERINERT, Behring, Marburg, Germany). Parameters measured and compared in this model were activity of complement system, hemodynamics, body weight, pathological organ alterations including intestinal lesions, bacterial translocation, and skin damage. C1-INH administration significantly decreased the plasma levels of the specific soluble membrane attack complex (SC5b-9), bacterial translocation, and the degree of intestinal ischemia in the postburn period compared with untreated animals. Moreover, animals treated with C1-INH exhibited a minor degree of organ alterations including damage of the skin and development of edema. The favorable effects of C1-INH may be explained by the protection of the intestinal and dermal microcirculation in the acute phase of thermal injury.