Abstract
The severity of an initial burn injury is critical for determining the treatment plan and prognosis of burn patients. Here, we measured serum neutrophil gelatinase-associated lipocalin (NGAL) levels to determine whether NGAL can be used as a biomarker for severity of burn injuries. A study of the demographic, clinical, and laboratory markers for various organ damage was performed at Bestian Burn Center (n = 10 healthy people, n = 31 patients). NGAL and organ damage marker levels were measured in 31 patients with severe burns within 2 - 3 days following their admission to the intensive care unit. Serum NGAL level of the expired patients was 788.5 (685.0 - 998.0) pg/mL, whereas that of the discharged patients was 421.2 (356.2 - 480.6) pg/mL, showing that the initial serum NGAL level can be used to estimate mortality. We also determined the correlation between serum NGAL level and the currently used severity markers (total body surface area burned and abbreviated burn severity index) and confirmed that serum NGAL level could be used as a severity marker. We also found that serum NGAL level was correlated with damage of organs such as the liver, kidney, heart, and respiratory organs in patients with severe burns.
Highlights
neutrophil gelatinase-associated lipocalin (NGAL) and organ damage marker levels were measured in 31 patients with severe burns within 2 - 3 days following their admission to the intensive care unit
We determined the correlation between serum NGAL level and the currently used severity markers and confirmed that serum NGAL level could be used as a severity marker
The results showed that TBSA, ABSI, and serum NGAL level were higher in the expired patients than in the discharged patients
Summary
The acute-phase response begins at the injured sites where the circulatory plasma protein level changes when a soluble mediator is released, which in turn induces a metabolic and inflammatory response in organs [1]. The secretion of NGAL is activated by lactoferrin and vitamin B12, and its expression increases in epithelial cells in the inflammatory state. NGAL is secreted mainly from neutrophils as well as various organs including the kidney, liver, lung, and bronchus. NGAL has antibacterial effects, playing a critical role in early bacterial infection [3] [4] [5]. The toll-like receptor stimulates the transcription, translation, and secretion of NGAL. Secreted NGAL isolates the siderophore, including iron, which in turn inhibits bacterial growth [6]. NGAL is known to help control homeostasis in various diseases in addition to inflammation [7] [8], body temperature [9], and plasma glucose levels [10]
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