Background We reported earlier that the cytokine macrophage migration inhibitory factor (MIF) is a potential biomarker in burn injury. In the present study, we investigated the clinical significance in severely burned patients of expression levels the newly discovered MIF family member D-dopachrome tautomerase (DDT or MIF-2) and their common soluble receptor CD74 (sCD74). Methods DDT and sCD74 serum levels were measured 20 severely burned patients and 20 controls. Serum levels were correlated to the abbreviated burn severity index (ABSI) and TBSA followed by receiver operating characteristic (ROC) analysis. Data were supported by gene expression dataset analysis of 31 burn patients and 28 healthy controls. Results CD74 and DDT were increased in burn patients. Furthermore, CD74 and DDT also were elevated in septic non-survivors when compared to survivors. Serum levels of DDT showed a positive correlation with the ABSI and TBSA in the early stage after burn injury, and the predictive character of DDT was strongest at 24 hrs. Serum levels of CD74 only correlated with the ABSI five days post-injury. Conclusions DDT may assist in the monitoring of clinical outcome and prediction of sepsis during the early post-burn period. sCD74 and MIF, by contrast, have limited value as an early predictor of death due to their delayed response to burn injury.

Background Although chemical antiseptics are the most basic measure to control wound infection and frequently come into contact with subcutaneous adipose tissue, no studies have evaluated their toxicity on adipose tissue and its cell fractions. In the present study, the effects of the following antiseptics on adipose-derived stem cells (ASC) were evaluated: Betaisodona® (povidone iodine), Lavasept®/Prontosan® (polyhexanide), Mafenide acetate, and Octenisept® (octenidinedihydrochloride). Methods Human ASCs were harvested from healthy donors. ASC viability was measured after treatment with different concentrations of antiseptics over five days. Furthermore, the effect on the proliferation, adipogenic differentiation, and apoptosis/necrosis of ASCs was analyzed. Finally, the mRNA expression of the stem cell markers CD29, CD34, CD73, CD90, and CD105 was detected. Results Octenisept® and Betaisodona® significantly reduced ASC proliferation and differentiation and led to considerable ASC necrosis. Octenisept® decreased ASC viability at the lowest concentrations tested and all stem cell markers were down-regulated by Octeniseptr® and Betaisodona®. Lavasept® and Prontosan® both led to reduced ASC viability, proliferation, differentiation, and increased apoptosis/necrosis, though the effects were less pronounced than those of Octenisept® and Betaisodona®. ASCs survived treatment with Mafenide acetate even at high concentrations, and Mafenide acetate showed minimal negative effects on their proliferation, adipogenic differentiation, cell death, and stem cell marker expression. Conclusion Mafenide acetate may be regarded as a feasible antiseptic for the treatment of wounds with exposed adipose tissue due to its low ASC toxicity. While Lavasept® and Prontosan® are possible alternatives, Octenisept® and Betaisodona® may only be used in highly diluted solutions.