The Role of Vitamin E in Thermal Burn Injuries, Infection, and Sepsis: A Review

Abstract

Thermal burn injuries are still a serious public health concern in the United States, due to the initial insult and resulting co-morbidities. Burned patients are increasingly susceptible to colonization by endogenous and exogenous micro-organisms after having lost skin, which acts as the primary protective barrier to environmental contaminants. Furthermore, the onset of additional pathophysiologies, specifically sepsis, becomes more likely in burned patients compared to other injuries. Despite improvements in the early care of burn patients, infections, and sepsis, these pathophysiologies remain major causes of morbidity and mortality and warrant further investigation of potential therapies. Vitamin E may be one such therapy. We aimed to identify publications of studies that evaluated the effectiveness of vitamin E as it pertains to thermal burn injuries, infection, and sepsis. Several investigations ranging from in vitro bench work to clinical studies have examined the impact on, or influence of, vitamin E in vitro, in vivo, and in the clinical setting. To the benefit of subjects it has been shown that enteral or parenteral vitamin E supplementation can prevent, mitigate, and even reverse the effects of thermal burn injuries, infection, and sepsis. Therefore, a large scale prospective observational study to assess the potential benefits of vitamin E supplementation in patients is warranted and could result in clinical care practice paradigm changes.

Exploring the role of antioxidants in sepsis-associated oxidative stress: a comprehensive review

“…The adenosine triphosphate to oxygen (ATP:O) ratios in liver mitochondria of rats subjected to LPS and PepG treatment were found to be lower compared to the control group. Conversely, mice treated with MitoVitE exhibited ATP:O ratios that were comparable to those observed in the control group (Lowes et al, 2013;Thompson et al, 2022). Elevated levels of liver damage indicators, specifically alanine aminotransferase (ALT) and aspartate aminotransferase (AST) activity, as well as renal damage indicated by increased creatinine levels, were observed in rats subjected to LPS/PepG treatment, in comparison to the control group.…”

“…Subsequent to the administration of LPS/peptidoglycan (PepG) to elicit sepsis, when rats were subjected to the administration of MitoVitE ( Lowes et al., 2013 ; Thompson et al., 2022 ), a mortality rate of 25% was observed among the cohort of rats exclusively administered LPS/PepG while, no instances of mortality were recorded within the groups subjected to the MitoVitE- treatment regimen. The adenosine triphosphate to oxygen (ATP:O) ratios in liver mitochondria of rats subjected to LPS and PepG treatment were found to be lower compared to the control group.…”

A burns and COVID-19 shared stress responding gene network deciphers CD1C-CD141-DCs as the key cellular components in septic prognosis

“…It is known that the incidence of sepsis in burn patients, typically resulting from infection, is higher (8%–42.5%) than trauma (2.4%–16.9%) or even critical care patients (19%–38%) (Thompson, Zuniga, Sousse, Christy and Gurney 2022). Burn injuries can also increase a patient's susceptibility to infection by compromising their metabolic and immunological defenses (Jeschke, van Baar, Choudhry, Chung, Gibran and Logsetty 2020; Mulder, Koenen, Vlig, Joosten, de Vries and Boekema 2022).…”

A burns and COVID-19 shared stress responding gene network deciphers CD1C-CD141- DCs as the key cellular components in septic prognosis

“…It is known that the incidence of sepsis in burn patients, typically resulting from infection, is higher (8–42.5%) than trauma (2.4–16.9%) or even critical care patients (19–38%) [ 40 ]. Burn injuries can also increase patients’ susceptibility to infection by compromising their metabolic and immunological defenses [ 7 , 41 ].…”