Circulating endothelial cells (CECs) are increased in sickle cell disease, myocardial infarction, and acute lung injury. The purpose of this study was to determine whether CECs are a prognosticating marker for the development of pneumonia in burn patients with/without inhalation injury in addition to their relationship to proinflammatory cytokines. There were 24 patients: 6 with inhalation injury, 5 with burn only,and 13 with burn plus inhalation injury. CECs were measured by anchored cytometry (Clarient ChromaVision, San Juan Capistrano, CA). In addition, plasma levels of tumor necrosis factor-α, interferon-γ, and interleukins (IL)-10, IL-6, IL-4, and IL-2 were compared with CEC levels. Patients with inhalation injury had a significant (P < .001) paucity of CECs compared with the thermally injured with inhalation. There was a statistically significant increase in inteferon-γ, tumor necrosis factor-α, and IL-6, IL-4, and IL-2 compared with control patients (P < .01), with a concomitant increase in the number of CECs. The numbers of CEC levels did not prognosticate which patients would develop pneumonia. Burn patients with/without inhalation injury had concurrent increase in CECs and proinflammatory cytokines during the acute phase of injury.
From the *Department of Trauma, Sumner L. Koch Burn Center, John H. Stroger, Jr. Hospital of Cook County, Chicago, Illinois; † Clarient ChromaVision Systems, San Juan Capistrano, California; ‡Department of Medicine, Division of Pulmonary and Critical Care Medicine, Rush University Medical Center, Chicago, Illinois; ¶Department of Surgery, University of Iowa Hospitals, Iowa City, Iowa; and ||Department of Inflammation, Pfizer Global Research and Development, Ann Arbor, Michigan.
Address correspondence to Areta Kowal-Vern, MD, Sumner L. Koch Burn Center, Department of Trauma, John H. Stroger, Jr. Hospital of Cook County, 1901 W. Harrison Street, Chicago, Illinois 60612.
Supported by the Rush-Cook County Collaborative Research Fund, a program of the Rush-Cook County Affiliation Research Committee, on behalf of Rush College of Medicine and John H. Stroger, Jr. (nee Cook County) Hospital. Dr. Suresh Ramasubban received the 2003 Clinical Research Trainee Award from the Chest Foundation.