Objective: To determine whether an increased soluble lipopolysaccharide receptor CD14 (sCD14) level is associated with the development of multiple organ dysfunction syndrome (MODS) in patients after major burns.
Method: 22 patients with burns covering more than 70% of body surface area were studied. These patients were divided into two groups according to the occurrence of MODS (MODS group, n = 9; non-MODS group, n = 13). Blood samples were obtained from burned patients. Serum concentrations of sCD14 and tumor necrosis factor (TNF) were determined by sandwich ELISA. Plasma endotoxin was measured using a quantitative chromogenic LAL test.
Result: Compared to the healthy volunteers, a significant increase in serum sCD14 levels was observed in 22 patients on day 7 postburn, which remained marked elevation up to 21 days after thermal insult (P < 0.01). The serum sCD14 levels of the MODS group were significantly higher than those of the non-MODS group on days 7, 14, and 21 postburn (P < 0.05). Additionally, the serum sCD14 and endotoxin levels were positively correlated in patients who developed MODs on days 7, 14 and 21 postburn (P < 0.05), whereas no correlation was found between sCD14 and TNF levels at any time point (P > 0.05).
Conclusion: Our data suggest that sCD14 elevation is associated with the development of MODS after major burns, and endotoxin release may be involved in the activation of sCD14 under certain pathophysiological conditions.