The role and therapeutic potential of gut microbiome in severe burn

Abstract

Severe burn is a serious acute trauma that can lead to significant complications such as sepsis, multiple organ failure, and high mortality worldwide. The gut microbiome, the largest microbial reservoir in the human body, plays a significant role in this pathogenic process. Intestinal dysbiosis and disruption of the intestinal mucosal barrier are common after severe burn, leading to bacterial translocation to the bloodstream and other organs of the body, which is associated with many subsequent severe complications. The progression of some intestinal diseases can be improved by modulating the composition of gut microbiota and the levels of its metabolites, which also provides a promising direction for post-burn treatment. In this article, we summarised the studies describing changes in the gut microbiome after severe burn, as well as changes in the function of the intestinal mucosal barrier. Additionally, we presented the potential and challenges of microbial therapy, which may provide microbial therapy strategies for severe burn.

Enteral Resuscitation: A Field-Expedient Treatment Strategy for Burn Shock during Wartime and in Other Austere Settings

“…This increase in intestinal permeability has also been seen in burn-injured patients and correlates with burn size [41,42]. There is also evidence of pathological shifts and general collapse of the intestinal microbiome with early proliferation of more pathogenic bacterial species (e.g., Gram-negative rods, yeasts), which leads to further mucosal barrier immune dysfunction [43][44][45][46].…”

“…These starches would be fermented by gut bacteria into short-chain fatty acids (SCFA) that would be absorbed in the colon by active cotransport with sodium-a process similar to the way glucose is absorbed in the small intestine [109]. SCFA are also important inflammatory mediators in the gut and have been shown to improve barrier function [43]. Other groups focusing specifically on burn and trauma resuscitation have examined the addition of pyruvate to EResus formulas with promising results in animal models [102][103][104][105][106]110].…”

Systemic immune response of burns from the acute to chronic phase

“…Disruption of the bacterial flora in the intestinal tract is called dysbiosis, 104 and attempts such as symbiotic and fecal transplantation may be useful in curing this condition. 105 …”

In silico analysis of intestinal microbial instability and symptomatic markers in mice during the acute phase of severe burns

“…Not only do we know little about the changing characteristics of gut microbes during the acute phase, but there is an even greater lack of in-depth exploration of which are the key microbes associated with acute phase symptoms and what role they may play in disease progression. Accurate answers to these questions, which can be corroborated by studies in humans [ 11 ], may help to explain the origin and subsequent development of infections, as well as to infer the prognosis of burn patients [ 12 , 13 ]. Once the differences between the different samples are known, it means that their characteristics can be extracted.…”