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Growth Hormone Attenuates Tumor Necrosis Factor  in Burned Children
Minas T. Chrysopoulo, MD;
Marc G. Jeschke, MD;
Roque J. Ramirez, MD;
Robert E. Barrow, PhD;
David N. Herndon, MD
Arch Surg. 1999;134:283-286.
Background Recombinant human growth hormone (rhGH) has been shown to favorably modulate the acute-phase response and may improve the clinical outcome.
Objective To examine whether rhGH attenuates the elevated tumor necrosis factor  (TNF-) levels that correlate with increased multiorgan failure and mortality in burned adults and children.
Design Twenty children with burns of greater than 40% of the total body surface area were randomly divided into 2 groups to receive placebo (n=10) or rhGH, 0.2 mg/kg per day intramuscularly (n=10).
Setting Pediatric burn hospital.
Main Outcome Measure Serum TNF- levels by enzyme-linked immunoassay at baseline (day 0) and at 21 and 42 days after injury. For statistical analysis, we used the Kruskal-Wallis and Friedman tests.
Results No significant differences in age (mean ± SD, 6.2 ± 1.6 vs 5.0 ± 1.2 years) or percentage of total body surface area burn (mean ± SD, 65.1% ± 8.2% vs 57.1% ± 5.2%) could be shown between the groups given rhGH and placebo. Baseline TNF- levels were elevated from reference values in both groups. Twenty-one and 42 days after rhGH administration, serum TNF- levels were significantly decreased from those at baseline (P<.05). No significant decrease in TNF- levels was observed in the placebo group (P=.5).
Conclusions Recombinant human growth hormone significantly lowers serum TNF- levels after burn injury. This is consistent with the beneficial effect that rhGH has on the acute-phase response.
From the Shriners Hospitals for Children, Galveston Burns Institute and the Department of Surgery, University of Texas Medical Branch, Galveston.
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