A severe
burn leads to hypermetabolism and catabolism resulting in compromised function and structural changes of essential organs. The release of
cytokines has been implicated in this hypermetabolic response. The severity of the hypermetabolic response following
burn injury increases with age, as does the mortality rate. Due to the relationship between the hypermetabolic and inflammatory responses, we sought to compare the plasma
cytokine profiles following a severe
burn in adults and in children. We enrolled 25 adults and 24 children who survived a flame
burn covering more than 20% of total body surface area (TBSA). The concentrations of 22
cytokines were measured using the Linco multiplex array system (St. Charles, MO, USA). Large perturbations in the expression of pro- and anti-inflammatory
cytokines were seen following thermal injury. During the first week following
burn injury, IFN-gamma,
IL-10,
IL-17,
IL-4,
IL-6, and
IL-8 were detected at significantly higher levels in adults compared with children, P < 0.05. Significant differences were measured during the second week post-
burn for IL-1beta (higher in children) and
IL-5 (higher in adults), P < 0.05.
IL-18 was more abundant in children compared with adults during the third week post-
burn, P < 0.05. Between post-
burn d 21 and d 66, IL-1alpha was detected at higher concentrations in pediatric compared with adult patients, P < 0.05. Only
GM-CSF expression was significantly different at all time points; it was detected at lower levels in pediatric patients, P < 0.05. Eotaxin,
G-CSF,
IL-13,
IL-15, IP-10, MCP-1, and
MIP-1alpha were detected at significantly different concentrations in adult compared with pediatric patients at multiple time points, P < 0.05. There were no differences in
IL-12,
IL-2,
IL-7, or TNF levels in adult compared with pediatric
burn patients at any of these time points. Following severe flame
burns, the
cytokine profiles in pediatric patients differ compared with those in adult patients, which may provide insight with respect to the higher morbidity rate in adults. Furthermore, the dramatic discrepancies observed in plasma
cytokine detection between children and adults suggest that these two patient populations may benefit from different therapeutic interventions to achieve attenuation of the post-
burn inflammatory response.