Immunological approaches and therapy in burns (Review)

Abstract

Burns have become an important public health problem in the last two decades, with just over a quarter of a million deaths annually. Major burns are accompanied by a strong inflammatory response, which will most often lead to systemic response inflammatory syndrome, followed by sepsis and finally induce multiple organ failure. The main mechanism involved in wound healing after burns is the inflammatory process, characterized by the recruitment of myeloid and T cells and by the involvement of numerous cytokines, chemokines, complement fractions, as well as various growth factors. Inflammasomes, protein-based cytosolic complexes, activated during metabolic stress or infection, play a role in modulating and improving the defense capacity of the innate immune system. Nucleotide-binding domain and leucine-rich repeat protein 3 (NLRP3) inflammasome has been studied predominantly and several hypotheses have been issued. Restoring the balance between the pro-inflammatory response and the anti-inflammatory activity is the key element to effective therapy in burns. Severe burns require nutritional support and pharmacotherapy not only for burn area but for different pathological complications of burn injury. In-depth research is required to find new ways to modulate the defense capacity, to prevent the complications of abnormal immune response and to treat burn injuries efficiently. Contents 1. Introduction 2. Burns and host immune response 3. The involvement of inflammasomes in burn and host immune response 4. Burns and the therapy 5. Conclusions

Burn Ointment Promotes Cutaneous Wound Healing by Modulating the PI3K/AKT/mTOR Signaling Pathway

“…After a while, the cytokine initiates an inflammatory cascade reaction to remove necrotic tissues and cells ( Zelova and Hosek, 2013 ). However, overactive inflammation can cause systemic inflammatory response syndrome and immune dysfunction in patients, which will endanger their lives ( Boldeanu et al, 2020 ). Therefore, anti-inflammatory treatments are essential for burn wound healing processes.…”

Innate Immune System Response to Burn Damage—Focus on Cytokine Alteration

“…A burn is considered to be damage to the skin due to the action of heat, corrosive chemicals, electric current, solar UV rays, radiation (X-ray, UV and other extreme radiation factors), and depending on the degree, the burn can reach deeper tissues or organs [ 1 , 2 , 3 ]. The most common are thermal burns, followed by electrical and chemical burns.…”

“…In turn, India experiences over two million burns annually, and this may be a significant underestimation [ 4 ]. According to the World Health Organization, there are approximately 300,000 burn deaths annually [ 2 ], and according to the American Burn Association data, in America in 2012, the total annual number of burn-related deaths was approximately 3400 [ 5 ]. Burns are the third leading cause of death in children aged 5 to 9 [ 6 ].…”

Obstruction of the formation of granulation tissue leads to delayed wound healing after scald burn injury in mice

“…Also, fibroplasia and angiogenesis occur concurrently in a compactly orchestrated manner, in order to form the extracellular matrix and granulation tissue [ 8 ] . Although fibroblasts play a key role in wound healing by secreting collagen and fibronectin to create temporary scaffolds promoting wound repair, the aberrant proliferation of fibroblasts and the excessive synthesis of collagen leads to the formation of hypertrophic scars, which greatly compromise the healing quality [ 5 , 9 ] . In addition, collagen type I and type III are excessively synthesized in the scar area during the process of wound repair, leaving a poorly organized dense collagen-rich matrix that is often highly contracted by myofibroblasts [ 10 ] .…”