Upper Airway Mucus Deposition in Lung Tissue of Burn Trauma Victims

Abstract

Previous study in an ovine model of smoke inhalation and burn (S + B) injury has shown distal migration of upper airway mucus. This study examines the localization of an upper airway gland specific mucus, mucin 5B (MUC5B) in lung autopsy tissues of burn-only injury and in victims of S + B injury. We hypothesize that victims with S + B injury would exhibit increased distal migration of MUC5B than that seen in victims of burn-only injury. Autopsy lung tissue from victims of burn injury alone (n = 38) and combined S + B injury (n = 22) were immunostained for MUC5B. No normal lung tissues were included in the study. Semiquantitative analysis of the extent of MUC5B in bronchioles and parenchyma was performed on masked slides. Irrespective of injury conditions, all victims showed MUC5B in bronchioles. Mucin 5B was seen in the parenchyma except in two burn victims. No statistically significant difference was seen in the mean bronchiolar and parenchyma MUC5B scores between S + B and burn-only victims (P > 0.05). No strong statistical correlation of MUC5B scores with days postinjury or to the number of ventilatory days was evident. The percentage of pneumonia, identified histologically, was also similar between study groups. This study did not confirm our results in an ovine model of S + B injury. In contrast, virtually all pediatric burn victims, regardless of concomitant inhalation injury, showed MUC5B in their bronchioles and parenchyma. Increased mucus synthesis and/or impaired mucociliary function may contribute to the pulmonary pathophysiology associated with burn injury.

Thrombocytopenia induces multiple intracranial hemorrhages in patients with severe burns: A review of 16 cases

“…In general, strategies to prevent infection, such as early excision and grafting, aggressive anti-microbial therapy, including the use of colistin, and early enteral feedings improve the survival rate (17–18). In the current study, two the of 16 cases underwent early escharectomies, leading to a significant improvement in body and wound infections.…”

Morphological Changes in Subcutaneous White Adipose Tissue After Severe Burn Injury

“…Morphometric analysis of adipose tissue was performed in at least three images obtained at the same magnification from three different location of same tissue section. Immunostaining was performed in 6µm thick sections of sWAT according to a standard protocol for immunohistochemistry (13) and immunofluorescence. Anti-rabbit CD68 antibody (Abcam, MA, USA), ABC kit, DAB kit and Texas Red labelled - anti-rabbit IgG (Vector laboratories, Inc, Burlingame, USA) were used.…”

Delayed asphyxia due to inhalation injury

“…In an ovine model, Cox et al [13] could demonstrate that relevant bronchial obstruction occurs after inhalation trauma, reaches a maximum after 24 h and is followed by bronchiolar obstruction whose peak is reached after 72 h. The increase in bronchiolar obstruction is partially due to distal migration of bronchial obstructive casts mainly constituted of mucous and cell debris [14]. The bronchial obstruction and the distal migration of potentially contaminated bronchial obstructive material increase the risk of pneumonia [14].…”