Histomorphometric and biochemical characterization of bone following acute severe burns in children

G. L. Klein, David Herndon, W. G. Goodman, C. B. Langman, W. A. Phillips, I. R. Dickson, R. Eastell, K. E. Naylor, N. A. Maloney, M. Desai, D. Benjamin, A. C. Alfrey

Research output: Contribution to journalArticle

119 Citations (Scopus)

Abstract

Severe burns in adults is associated with an uncoupling of normal remodeling, low bone formation without reduced resorption. The risk of osteopenia that may occur under such circumstances is heightened by our detection in a cross-sectional study of low bone mass in severely burned children. We report here the acute histomorphometric and biochemical response of bone to severe burn injury, as well as bone mass in severely burned children. We enrolled 24 patients ages 5.8 to 17.5 years following burns of 63 ± 16% (SD) body surface area. Serum and urine were collected weekly until iliac crest bone biopsy was obtained 26 ± 10 days postburn. Seventeen of 18 patients, including 5 patients receiving growth hormone treatment to accelerate wound healing, failed to take up doxycycline in trabecular bone, and had no detectable osteoblasts at the osteoid seam, while eroded surface was normal and osteoblasts were documented by staining. Thus, bone formation was virtually absent. There was an eightfold elevation in urinary free cortisol excretion and high serum levels of acute phase reactants and interleukin-1β and -6. Biochemical markers of bone formation, osteocalcin, and type I procollagen propeptide were low, as were resorptive markers urinary pyridinoline and deoxypyridinoline. However, there was no correlation with resorptive surface. Mean age-related z-score for bone mass was -1.06 ± 1.05, 40 days postburn. Immobilization and endogenous corticosteroid production may be the main factors responsible for acutely reduced bone formation while inflammatory cytokines may mediate resorption.

Original languageEnglish (US)
Pages (from-to)455-460
Number of pages6
JournalBone
Volume17
Issue number5
DOIs
StatePublished - 1995

Fingerprint

Burns
Osteogenesis
Bone and Bones
Osteoblasts
Acute-Phase Proteins
Doxycycline
Metabolic Bone Diseases
Body Surface Area
Osteocalcin
Collagen Type I
Serum
Interleukin-1
Immobilization
Wound Healing
Growth Hormone
Hydrocortisone
Interleukin-6
Adrenal Cortex Hormones
Cross-Sectional Studies
Biomarkers

Keywords

  • Bone formation
  • Bone resorption
  • Burn
  • Corticosteroids
  • Immobilization

ASJC Scopus subject areas

  • Physiology
  • Endocrinology, Diabetes and Metabolism
  • Histology
  • Hematology

Cite this

Klein, G. L., Herndon, D., Goodman, W. G., Langman, C. B., Phillips, W. A., Dickson, I. R., ... Alfrey, A. C. (1995). Histomorphometric and biochemical characterization of bone following acute severe burns in children. Bone, 17(5), 455-460. https://doi.org/10.1016/8756-3282(95)00279-1

Histomorphometric and biochemical characterization of bone following acute severe burns in children. / Klein, G. L.; Herndon, David; Goodman, W. G.; Langman, C. B.; Phillips, W. A.; Dickson, I. R.; Eastell, R.; Naylor, K. E.; Maloney, N. A.; Desai, M.; Benjamin, D.; Alfrey, A. C.

In: Bone, Vol. 17, No. 5, 1995, p. 455-460.

Research output: Contribution to journalArticle

Klein, GL, Herndon, D, Goodman, WG, Langman, CB, Phillips, WA, Dickson, IR, Eastell, R, Naylor, KE, Maloney, NA, Desai, M, Benjamin, D & Alfrey, AC 1995, 'Histomorphometric and biochemical characterization of bone following acute severe burns in children', Bone, vol. 17, no. 5, pp. 455-460. https://doi.org/10.1016/8756-3282(95)00279-1
Klein GL, Herndon D, Goodman WG, Langman CB, Phillips WA, Dickson IR et al. Histomorphometric and biochemical characterization of bone following acute severe burns in children. Bone. 1995;17(5):455-460. https://doi.org/10.1016/8756-3282(95)00279-1
Klein, G. L. ; Herndon, David ; Goodman, W. G. ; Langman, C. B. ; Phillips, W. A. ; Dickson, I. R. ; Eastell, R. ; Naylor, K. E. ; Maloney, N. A. ; Desai, M. ; Benjamin, D. ; Alfrey, A. C. / Histomorphometric and biochemical characterization of bone following acute severe burns in children. In: Bone. 1995 ; Vol. 17, No. 5. pp. 455-460.
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AU - Dickson, I. R.

AU - Eastell, R.

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