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Guo R, Li S, Xia H, Feng Z, Tang Q, Peng C. Effects of Myeloperoxidase on Methicillin-Resistant Staphylococcus aureus-Colonized Burn Wounds in Rats. Adv Wound Care (New Rochelle) 2019; 8:271-280. [PMID: 31737417 DOI: 10.1089/wound.2018.0865] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2018] [Accepted: 01/14/2019] [Indexed: 01/10/2023] Open
Abstract
Objective: To achieve better therapeutic results in burn wound infections and to examine alternatives to antibiotics, we designed this study to elaborate the role of myeloperoxidase (MPO) on infected burn wounds in rats. Approach: We compared chemical properties as well as bacteriostatic ability of MPO in different concentrations with NeutroPhase. Subsequently, we applied MPO (MPO group), NeutroPhase (NeutroPhase group), NaCl+H2O2 (NaCl+H2O2 group), or NaCl (control group) on rat dorsal burn wounds inoculated with methicillin-resistant Staphylococcus aureus (MRSA). Their effects on MRSA-colonized wounds were evaluated by microscopy, histologic section, and Western blot. Results: MPO produced more H+ and HClO-, leading to a more acidic environment. Moreover, MPO inhibited the growth of MRSA more intensely after 6 h of inoculation ex vivo. In vivo the open wound rate in the MPO group was significantly lower, while the contraction rate and epithelialization rate of MPO group were higher than that of the control group, NaCl+H2O2 group, and NeutroPhase group on day 20. The hematoxylin and eosin staining of MPO group showed better wound healing than other groups. More vascular endothelial growth factor (VEGF) was expressed in wound tissue of MPO group by Western blot. Innovation: This is the first study to use MPO for MRSA-colonized burn wound therapy. Conclusion: MPO displayed more effective bacteriostatic ability, possibly beneficial for MRSA-colonized wound healing.
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Affiliation(s)
- Ren Guo
- Department of Plastic Surgery, the Third Xiangya Hospital, Central South University, Changsha, China
- Department of Pharmacy, the Third Xiangya Hospital, Central South University, Changsha, China
| | - Shuaihua Li
- Department of Cosmetic and Plastic Surgery, the First People's Hospital of Chenzhou, Chenzhou, China
| | - Hansong Xia
- Department of Orthopedics, the Third Xiangya Hospital, Central South University, Changsha, China
| | - Zhicai Feng
- Department of Plastic Surgery, the Third Xiangya Hospital, Central South University, Changsha, China
| | - Qiyu Tang
- Department of Plastic Surgery, the Third Xiangya Hospital, Central South University, Changsha, China
| | - Cheng Peng
- Department of Plastic Surgery, the Third Xiangya Hospital, Central South University, Changsha, China
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Schwacha MG, Scroggins SR, Montgomery RK, Nicholson SE, Cap AP. Burn injury is associated with an infiltration of the wound site with myeloid-derived suppressor cells. Cell Immunol 2019; 338:21-26. [PMID: 30902343 DOI: 10.1016/j.cellimm.2019.03.001] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2018] [Revised: 03/12/2019] [Accepted: 03/13/2019] [Indexed: 12/19/2022]
Abstract
Myeloid-derived suppressor cells (MDSCs) have been identified in the burn wound, however their characterization is incomplete. To study this, mice were subjected to a major burn and skin cells were isolated 3 days thereafter for analysis. Significant infiltration of the burn wound with MDSCs was observed as compared with uninjured skin. The skin of naïve mice did not contain MDSCs. Characterization of the cells showed that 33% of MDSCs in the wound were monocytic (M)-MDSCs, which was significantly less than that found in uninjured skin (52%). In contrast, polymorphonuclear (PMN)-MDSCs were greater in the burn wound as compared with uninjured skin. Burn wound TLR expression by both MDSCs subsets was decreased as compared with uninjured skin. Wound MDSCs produced pro- and anti-inflammatory cytokines and iNOS was present in both MDSC subsets, whereas ARG1 was only present in M-MDSCs. In conclusion, both M- and PMN-MDSCs infiltrate burn wound with after injury, however, they displayed decreased TLR expression, suggesting receptor down-regulation.
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Affiliation(s)
- Martin G Schwacha
- Department of Surgery, The University of Texas Health Science Center at San Antonio, San Antonio, TX, United States.
| | - Shannon R Scroggins
- Department of Surgery, The University of Texas Health Science Center at San Antonio, San Antonio, TX, United States
| | - Robbie K Montgomery
- Coagulation and Blood Research Program, US Army Institute of Surgical Research, JBSA Fort Sam Houston, TX, United States
| | - Susannah E Nicholson
- Department of Surgery, The University of Texas Health Science Center at San Antonio, San Antonio, TX, United States
| | - Andrew P Cap
- Department of Surgery, The University of Texas Health Science Center at San Antonio, San Antonio, TX, United States; Coagulation and Blood Research Program, US Army Institute of Surgical Research, JBSA Fort Sam Houston, TX, United States
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Marreiro de Sales-Neto J, Lima ÉA, Cavalcante-Silva LHA, Vasconcelos U, Rodrigues-Mascarenhas S. Anti-inflammatory potential of pyocyanin in LPS-stimulated murine macrophages. Immunopharmacol Immunotoxicol 2019; 41:102-108. [PMID: 30623710 DOI: 10.1080/08923973.2018.1555845] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
Context: Pyocyanin is a typical Pseudomonas aeruginosa virulence factor, a common Gram-negative rod responsible for a wide range of severe nosocomial infections. There is evidence indicating that pyocyanin has multiple biological activities, but little is known about anti-inflammatory properties. Objective: This study investigated pyocyanin effect on nitric oxide and cytokine production in lipopolysaccharide (LPS)-activated murine peritoneal macrophages. Materials and methods: Macrophages were incubated in the presence and absence of pyocyanin (1, 5, 10, 50, and 100 µM) with and without LPS (1 µg/mL). Nitric oxide production was determined by Griess reagent and tumor necrosis factor (TNF)-α and interleukin (IL)-1β production was assessed by enzyme-linked immunosorbent assay. In addition, pyocyanin effects on zymosan A-induced peritonitis in mice were evaluated. Results: Pyocyanin (5 and 10 µM) decreased nitric oxide, TNF-α, and IL-1β production independent of macrophage death. On the other hand, in vivo, pyocyanin (5 mg/kg) was not able to affect leukocyte migration into the site of inflammation. Discussion and conclusion: Thus, our findings suggest that pyocyanin exerts anti-inflammatory effects on murine peritoneal macrophages, downregulating nitric oxide, TNF-α, and IL-1β levels, which seems to be independent of cell migration. These effects may represent a mechanism of immune evasion; nevertheless more detailed studies should be performed to confirm this hypothesis.
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Affiliation(s)
| | - É A Lima
- a Departamento de Biologia Celular e Molecular , Universidade Federal da Paraíba , João Pessoa , Brazil
| | - L H A Cavalcante-Silva
- a Departamento de Biologia Celular e Molecular , Universidade Federal da Paraíba , João Pessoa , Brazil
| | - U Vasconcelos
- b Departamento de Biotecnologia , Universidade Federal da Paraíba , João Pessoa , Brazil
| | - S Rodrigues-Mascarenhas
- a Departamento de Biologia Celular e Molecular , Universidade Federal da Paraíba , João Pessoa , Brazil
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Time series analysis of gene changes and processes after burn with human gene expression profiles. Burns 2018; 45:387-397. [PMID: 30527648 DOI: 10.1016/j.burns.2018.08.022] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2018] [Revised: 07/25/2018] [Accepted: 08/02/2018] [Indexed: 12/28/2022]
Abstract
Severe burns might be followed by severe infection associated with high mortality. In this study, we aimed to identify changes in genes and processes across time points after burn via analyzing time series gene expression profiles in burn patients and control from the Gene Expression Omnibus (GEO). Patients were classified into four groups according to time after burn and weighted gene co-expression network analysis (WGCNA) obtained three gene modules including magenta, yellow and greenyellow modules that significantly correlated positively with time after burn. We also identified four groups of differentially expressed genes (DEGs) in samples at 0-1d, 1-2d, 2-4d, and 4-7d after burn compared with controls. Functional enrichment analysis of those DEGs indicated significant enrichment of inflammatory/immune related processes throughout time points after burn, while, samples at later time points were also closely associated with cell activation regulation related processes. Short time series expression analysis of overlapping genes among the four lists of DEGs screened out two temporal gene expression profiles that exhibited decreasing and increasing expression trend across times after burn, and genes contained in those two profiles might be related to pathologic changes after severe burn.
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Abstract
Thermal injury may lead to multiple organ dysfunction through release of proinflammatory mediators and reactive oxygen radicals. This study investigated the effects of thermal injury on remote organs of rats and the possible protective effect of lutein. Thermal trauma was induced in the back of rats by exposing them to 90 °C bath for 10 s. Rats were sacrificed 48 h after burn, and blood samples were collected to monitor liver and kidney functions. Tissue samples from liver, kidneys, and lungs were taken for studying oxidative stress parameters, gene expressions of TNF-α and Casp-3, besides histopathological examination. Skin scald injury caused significant elevations of liver and kidney function biomarkers in the serum. In tissue samples, increments of MDA, GPx, and 8-OHdG were recorded while GSH level and the activities of CAT and SOD were suppressed. The expressions of TNF-α and caspase-3 mRNA were increased, and histopathological results revealed remote organ injury. Oral administration of lutein (250 mg/kg) resulted in amelioration of the biochemical and molecular changes induced by burn as well as the histopathological alterations. According to the findings of the present study, lutein possesses anti-oxidant, anti-inflammatory, and anti-apoptotic effects that protect against burn-induced damage in remote organs.
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Wu ZS, Lo JJ, Wu SH, Wang CZ, Chen RF, Lee SS, Chai CY, Huang SH. Early Hyperbaric Oxygen Treatment Attenuates Burn-Induced Neuroinflammation by Inhibiting the Galectin-3-Dependent Toll-Like Receptor-4 Pathway in a Rat Model. Int J Mol Sci 2018; 19:ijms19082195. [PMID: 30060489 PMCID: PMC6121430 DOI: 10.3390/ijms19082195] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2018] [Revised: 07/22/2018] [Accepted: 07/25/2018] [Indexed: 02/07/2023] Open
Abstract
Hyperbaric oxygen (HBO) treatment has been proven to decrease neuroinflammation in rats. This study aimed to determine the potential mechanism underlying the anti-inflammatory effects of HBO treatment on burn-induced neuroinflammation in rats. Thirty-six adult male Sprague-Dawley (SD) rats were randomly assigned to the following six groups (n = 6 per group): (1) sham burn with sham HBO treatment; (2) sham burn with HBO treatment; (3) burn with one-week sham HBO treatment; (4) burn with two-week sham HBO treatment; (5) burn with one-week HBO treatment; and (6) burn with two-week HBO treatment. SD rats that received third-degree burn injury were used as a full-thickness burn injury model. Subsequently, we analyzed the expression of proteins involved in the galectin-3 (Gal-3)-dependent Toll-like receptor-4 (TLR-4) pathway through enzyme-linked immunosorbent assay (ELISA), immunohistochemistry (IHC) analysis, and Western blotting. A behavior test was also conducted, which revealed that HBO treatment significantly suppressed mechanical hypersensitivity in the burn with HBO treatment group compared to the burn with sham HBO treatment group (p < 0.05). ELISA results showed that tumor necrosis factor α (TNF-α) and interleukin 1 beta (IL-1β) levels in the dorsal horn of the spinal cord and the skin significantly decreased in the burn with HBO treatment group compared with the burn with sham HBO treatment group (p < 0.05). Western blotting results demonstrated that HBO treatment significantly reduced the expression of Gal-3 and TLR-4 in the dorsal horn of the spinal cord in the burn with HBO treatment group compared with the burn with sham HBO treatment group (p < 0.05). IHC analysis showed that the expression of Gal-3, TLR-4, CD68 and CD45 in the dorsal horn of the spinal cord was significantly lower in the burn with HBO treatment group than in the burn with sham HBO treatment group (p < 0.05), and the expression of CD68 and macrophage migration inhibitory factor (MIF) in the right hind paw skin was significantly lower. The expression of vimentin and fibroblast growth factor in the right hind paw skin was significantly higher after HBO treatment (p < 0.05). This study proved that early HBO treatment relieves neuropathic pain, inhibits the Gal-3-dependent TLR-4 pathway, and suppresses microglia and macrophage activation in a rat model.
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Affiliation(s)
- Zong-Sheng Wu
- Department of Medical Laboratory Science and Biotechnology, College of Health Sciences, Kaohsiung Medical University, 807 Kaohsiung, Taiwan.
| | - Jing-Jou Lo
- School of Post-Baccalaureate Medicine, College of Medicine, Kaohsiung Medical University, 807 Kaohsiung, Taiwan.
| | - Sheng-Hua Wu
- Department of Anesthesiology, Kaohsiung Medical University Hospital, 807 Kaohsiung, Taiwan.
- Department of Anesthesiology, Kaohsiung Municipal Hsiao-Kang Hospital, Kaohsiung Medical University, 807 Kaohsiung, Taiwan.
| | - Chau-Zen Wang
- Graduate Institute of Medicine, College of Medicine, Kaohsiung Medical University, 807 Kaohsiung, Taiwan.
- Department of Physiology, College of Medicine, Kaohsiung Medical University, 807 Kaohsiung, Taiwan.
- Department of Medical Research, Kaohsiung Medical University Hospital, 807 Kaohsiung, Taiwan.
- Orthopaedic Research Center, College of Medicine, Kaohsiung Medical University, 807 Kaohsiung, Taiwan.
| | - Rong-Fu Chen
- Division of Plastic Surgery, Department of Surgery, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan, 807 Kaohsiung, Taiwan.
| | - Su-Shin Lee
- Division of Plastic Surgery, Department of Surgery, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan, 807 Kaohsiung, Taiwan.
- Department of Surgery, School of Medicine, College of Medicine, Kaohsiung Medical University, 807 Kaohsiung, Taiwan.
| | - Chee-Yin Chai
- Department of Pathology, Kaohsiung Medical University Hospital, Kaohsiung Medical University, 807 Kaohsiung, Taiwan.
| | - Shu-Hung Huang
- Division of Plastic Surgery, Department of Surgery, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan, 807 Kaohsiung, Taiwan.
- Department of Surgery, School of Medicine, College of Medicine, Kaohsiung Medical University, 807 Kaohsiung, Taiwan.
- Hyperbaric Oxygen Therapy Room, Kaohsiung Medical University Hospital, Kaohsiung Medical University, 807 Kaohsiung, Taiwan.
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Balasubramaniam A, Sheriff S, Friend LA, James JH. Phosphodiesterase 4B knockout prevents skeletal muscle atrophy in rats with burn injury. Am J Physiol Regul Integr Comp Physiol 2018; 315:R429-R433. [PMID: 29693432 DOI: 10.1152/ajpregu.00042.2018] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
The phosphodiesterase 4 (PDE4)-cAMP pathway plays a predominant role in mediating skeletal muscle proteolysis in burn injury. The present investigations to determine the PDE4 isoform(s) involved in this action revealed that burn injury increased the expression of rat skeletal muscle PDE4B mRNA by sixfold but had little or no effect on expression of other PDE4 isoforms. These observations led us to study the effects of burn in PDE4B knockout (KO) rats. As reported by us previously, burn injury significantly increased extensor digitorum longus (EDL) muscle total and myofibrillar proteolysis in wild-type (WT) rats, but there were no significant effects on either total or myofibrillar protein breakdown in EDL muscle of PDE4B KO rats with burn injury. Moreover, burn injury increased PDE4 activity in the skeletal muscle of WT rats, but this was reduced by >80% in PDE4B KO rats. Also, burn injury decreased skeletal muscle cAMP concentration in WT rats but had no significant effects in the muscles of PDE4B KO rats. Incubation of the EDL muscle of burn-PDE4B KO rats with an inhibitor of the exchange factor directly activated by cAMP, but not with a protein kinase A inhibitor, eliminated the protective effects of PDE4B KO on EDL muscle proteolysis and increased muscle proteolysis to the same extent as in the EDL of burn-WT rats. These novel findings confirm a major role for PDE4B in skeletal muscle proteolysis in burn injury and suggest that an innovative therapy based on PDE4B-selective inhibitors could be developed to treat skeletal muscle cachexia in burn injury without the fear of causing emesis, which is associated with PDE4D inhibition.
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Affiliation(s)
- Ambikaipakan Balasubramaniam
- Department of Surgery, University of Cincinnati Medical Center , Cincinnati, Ohio.,Shriner's Hospital for Children , Cincinnati, Ohio
| | - Sulaiman Sheriff
- Department of Surgery, University of Cincinnati Medical Center , Cincinnati, Ohio
| | - Lou Ann Friend
- Department of Surgery, University of Cincinnati Medical Center , Cincinnati, Ohio
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Abstract
As a result of many years of research, the intricate cellular mechanisms of burn injury are slowly becoming clear. Yet, knowledge of these cellular mechanisms and a multitude of resulting studies have often failed to translate into improved clinical treatment for burn injuries. Perhaps the most valuable information to date is the years of clinical experience and observations in the management and treatment of patients, which has contributed to a gradual improvement in reported outcomes of mortality. This review provides a discussion of the cellular mechanisms and pathways involved in burn injury, resultant systemic effects on organ systems, current management and treatment, and potential therapies that we may see implemented in the future.
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60
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Nunez Lopez O, Cambiaso-Daniel J, Branski LK, Norbury WB, Herndon DN. Predicting and managing sepsis in burn patients: current perspectives. Ther Clin Risk Manag 2017; 13:1107-1117. [PMID: 28894374 PMCID: PMC5584891 DOI: 10.2147/tcrm.s119938] [Citation(s) in RCA: 50] [Impact Index Per Article: 7.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022] Open
Abstract
Modern burn care has led to unprecedented survival rates in burn patients whose injuries were fatal a few decades ago. Along with improved survival, new challenges have emerged in the management of burn patients. Infections top the list of the most common complication after burns, and sepsis is the leading cause of death in both adult and pediatric burn patients. The diagnosis and management of sepsis in burns is complex as a tremendous hypermetabolic response secondary to burn injury can be superimposed on systemic infection, leading to organ dysfunction. The management of a septic burn patient represents a challenging scenario that is commonly encountered by providers caring for burn patients despite preventive efforts. Here, we discuss the current perspectives in the diagnosis and treatment of sepsis and septic shock in burn patients.
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Affiliation(s)
- Omar Nunez Lopez
- Department of Surgery, University of Texas Medical Branch.,Shriners Hospitals for Children, Galveston, TX, USA
| | - Janos Cambiaso-Daniel
- Department of Surgery, University of Texas Medical Branch.,Shriners Hospitals for Children, Galveston, TX, USA.,Division of Plastic, Aesthetic and Reconstructive Surgery, Department of Surgery, Medical University of Graz, Graz, Austria
| | - Ludwik K Branski
- Department of Surgery, University of Texas Medical Branch.,Shriners Hospitals for Children, Galveston, TX, USA
| | - William B Norbury
- Department of Surgery, University of Texas Medical Branch.,Shriners Hospitals for Children, Galveston, TX, USA
| | - David N Herndon
- Department of Surgery, University of Texas Medical Branch.,Shriners Hospitals for Children, Galveston, TX, USA.,Department of Pediatrics, University of Texas Medical Branch, Galveston, TX, USA
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Kim A, Lang T, Xue M, Wijewardana A, Jackson C, Vandervord J. The Role of Th-17 Cells and γδ T-Cells in Modulating the Systemic Inflammatory Response to Severe Burn Injury. Int J Mol Sci 2017; 18:ijms18040758. [PMID: 28368347 PMCID: PMC5412343 DOI: 10.3390/ijms18040758] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2017] [Revised: 02/26/2017] [Accepted: 03/27/2017] [Indexed: 12/19/2022] Open
Abstract
Burns are a global public health problem, accounting for an estimated 265,000 deaths annually. Inflammation is essential in supplying the growth factors, cytokines and chemokines needed to recruit T-cells and myeloid cells to the site of a burn injury for wound healing. However, major burns generate a marked pathophysiological inflammatory response through a widespread release of abundant pro-inflammatory mediators that predispose patients to a systemic inflammatory response syndrome, sepsis and multi-organ failure. Recently, there has been promising investigation into the role of γδ T-cells and Th-17 cells in the regulation and propagation of this inflammatory response. This study reviews the current literature on the post-burn immune response.
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Affiliation(s)
- Albert Kim
- Severe Burns Unit, Royal North Shore Hospital, St Leonards NSW 2065, Australia.
| | - Thomas Lang
- Severe Burns Unit, Royal North Shore Hospital, St Leonards NSW 2065, Australia.
| | - Meilang Xue
- Sutton Arthritis Research Laboratory, Institute of Bone and Joint Research, University of Sydney, Sydney NSW 2006, Australia.
| | - Aruna Wijewardana
- Severe Burns Unit, Royal North Shore Hospital, St Leonards NSW 2065, Australia.
| | - Chris Jackson
- Sutton Arthritis Research Laboratory, Institute of Bone and Joint Research, University of Sydney, Sydney NSW 2006, Australia.
| | - John Vandervord
- Severe Burns Unit, Royal North Shore Hospital, St Leonards NSW 2065, Australia.
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Mitochondrial DNA-Induced Inflammatory Responses and Lung Injury in Thermal Injury Rat Model. J Burn Care Res 2017; 38:304-311. [DOI: 10.1097/bcr.0000000000000501] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
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Damage-associated molecular patterns (DAMPs) released after burn are associated with inflammation and monocyte activation. Burns 2016; 43:297-303. [PMID: 28341255 DOI: 10.1016/j.burns.2016.10.001] [Citation(s) in RCA: 76] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2015] [Revised: 10/04/2016] [Accepted: 10/04/2016] [Indexed: 11/24/2022]
Abstract
Burns are associated with activation of the innate immunity that can contribute to complications. Damage-associated molecular patterns (DAMPs) released after tissue injury play a critical role in the activation of the innate immunity, which appears to be mediated via toll-like receptors (TLRs). Previous findings have shown that TLRs and TLR-mediated responses are up-regulated after burn. Nonetheless, it is unclear what impact burn has on circulating levels of DAMPs. To study this, male C57BL/6 mice were subjected to a major burn or sham procedure. Three hours to 7days thereafter, plasma was collected and assayed for the representative DAMPs (i.e., HMGB1, cytochrome C, DNA and S100A) and extracellular cleavage products (fibronectin and hyaluronan). HMGB1, cytochrome C, fibronectin and hyaluronan levels were elevated in a time-dependent manner after burn as compared to sham levels. A significant elevation in TNF-α, IL-6 and IL-10 cytokine plasma levels was also found after burn. All cytokine levels were increased as early as 3h and remained elevated up to 24h. Circulating CD11b+ monocytes were increased at 24h after burn and showed increased expression of TLR-2. In conclusion, these findings support the concept that burn-induced elevations in circulating DAMPs are in part responsible for monocyte activation and the development of inflammatory complications under such conditions and warrants further investigation.
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64
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Dropulic LK, Lederman HM. Overview of Infections in the Immunocompromised Host. Microbiol Spectr 2016; 4:10.1128/microbiolspec.DMIH2-0026-2016. [PMID: 27726779 PMCID: PMC8428766 DOI: 10.1128/microbiolspec.dmih2-0026-2016] [Citation(s) in RCA: 66] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2016] [Indexed: 12/12/2022] Open
Abstract
Understanding the components of the immune system that contribute to host defense against infection is key to recognizing infections that are more likely to occur in an immunocompromised patient. In this review, we discuss the integrated system of physical barriers and of innate and adaptive immunity that contributes to host defense. Specific defects in the components of this system that predispose to particular infections are presented. This is followed by a review of primary immunodeficiency diseases and secondary immunodeficiencies, the latter of which develop because of a specific illness or condition or are treatment-related. The effects of treatment for neoplasia, autoimmune diseases, solid organ and stem cell transplants on host defenses are reviewed and associated with susceptibility to particular infections. In conclusion, an approach to laboratory screening for a suspected immunodeficiency is presented. Knowledge of which host defects predispose to specific infections allows clinicians to prevent, diagnose, and manage infections in their immunocompromised patients most effectively.
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Affiliation(s)
- Lesia K Dropulic
- The National Institutes of Health, National Institute of Allergy and Infectious Diseases, Division of Intramural Research, Bethesda, MD 20892
| | - Howard M Lederman
- Departments of Pediatrics, Medicine, and Pathology, The Johns Hopkins University School of Medicine, Baltimore, MD 21287
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Gao Y, Nai W, Yang L, Lu Z, Shi P, Jin H, Wen H, Wang G. Construction of an immunorelated protein-protein interaction network for clarifying the mechanism of burn. Burns 2015; 42:405-13. [PMID: 26739088 DOI: 10.1016/j.burns.2015.06.015] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2015] [Revised: 06/20/2015] [Accepted: 06/24/2015] [Indexed: 12/20/2022]
Abstract
BACKGROUND AND AIM Severe burn is known to induce a series of pathological responses resulting in increased susceptibility to systemic inflammatory response and multiple organ failure, but the underlying molecular mechanism remains unclear at present. The main aim of this study was to expand our understanding of the events leading to circulating leukocyte response after burn by subjecting the gene expression profiles to a bioinformatic analysis. MATERIALS AND METHODS Comprehensive gene expression analysis was performed to identify differentially expressed genes (DEGs) using the expression profile GSE7404 (Mus musculus, circulating leukocyte, 25% of total body surface area (TBSA), full thickness) downloaded from the Gene Expression Omnibus, followed by the Gene Ontology and Kyoto Encyclopedia of Genes and Genomes (KEGG) enrichment analyses. In addition, a postburn protein-protein interaction (PPI) network was constructed to identify potential biomarkers. RESULTS Maximum changes in the gene expression profile were detected 1 day post burn. Separate Gene Ontology (GO) functional enrichment analysis for upregulated and downregulated DEGs revealed significant alterations of genes related to biological process such as "response to stimuli," "metabolic," "cellular and immune system processes," "biological regulation," and "death" in the leukocyte transcriptome after the burn. The KEGG pathway enrichment analysis showed that the upregulated DEGs were significantly enriched in the nodes of immunorelated and signal transduction-related pathways, and the downregulated genes were significantly enriched for the immunorelated pathways. The PPI network and module analysis revealed that, 1 day after the burn, lymphocyte-specific protein tyrosine kinase (Lck) (downregulated), Jun (upregulated), Cd19 (downregulated), Stat1 (downregulated), and Cdk1 (upregulated) were located centrally in both the PPI network and modules. CONCLUSIONS Based on an integrated bioinformatic analysis, we concluded that Lck, Jun, Cd19, Stat1, and Cdk1 may be critical 1 day after the burn. These findings expand our understanding of the molecular mechanisms of this important pathological process. Further studies are needed to support our work, focused on identifying candidate biomarkers with sufficient predictive power to act as prognostic and therapeutic biomarkers for burn injury.
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Affiliation(s)
- Yanbin Gao
- Department of Burns, Nanfang Hospital, Southern Medical University, Guangzhou 510515, China
| | - Wenqing Nai
- Department of Health Management, Nanfang Hospital, Southern Medical University, Guangzhou 510515, China
| | - Lei Yang
- Department of Burns, Nanfang Hospital, Southern Medical University, Guangzhou 510515, China.
| | - Zhiyang Lu
- Department of Burns, Nanfang Hospital, Southern Medical University, Guangzhou 510515, China
| | - Pengwei Shi
- Department of Burns, Nanfang Hospital, Southern Medical University, Guangzhou 510515, China
| | - Hui Jin
- Department of Burns, Nanfang Hospital, Southern Medical University, Guangzhou 510515, China
| | - Huangding Wen
- Department of Burns, Nanfang Hospital, Southern Medical University, Guangzhou 510515, China
| | - Guifang Wang
- Department of Burns, Nanfang Hospital, Southern Medical University, Guangzhou 510515, China
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66
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Xiu F, Diao L, Qi P, Catapano M, Jeschke MG. Palmitate differentially regulates the polarization of differentiating and differentiated macrophages. Immunology 2015; 147:82-96. [PMID: 26453839 DOI: 10.1111/imm.12543] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2015] [Revised: 08/31/2015] [Accepted: 09/17/2015] [Indexed: 12/27/2022] Open
Abstract
The tissue accumulation of M1 macrophages in patients with metabolic diseases such as obesity and type 2 diabetes mellitus has been well-documented. Interestingly, it is an accumulation of M2 macrophages that is observed in the adipose, liver and lung tissues, as well as in the circulation, of patients who have had major traumas such as a burn injury or sepsis; however, the trigger for the M2 polarization observed in these patients has not yet been identified. In the current study, we explored the effects of chronic palmitate and high glucose treatment on macrophage differentiation and function in murine bone-marrow-derived macrophages. We found that chronic treatment with palmitate decreased phagocytosis and HLA-DR expression in addition to inhibiting the production of pro-inflammatory cytokines. Chronic palmitate treatment of bone marrows also led to M2 polarization, which correlated with the activation of the peroxisome proliferator-activated receptor-γ signalling pathway. Furthermore, we found that chronic palmitate treatment increased the expression of multiple endoplasmic reticulum (ER) stress markers, including binding immunoglobulin protein. Preconditioning with the universal ER stress inhibitor 4-phenylbutyrate attenuated ER stress signalling and neutralized the effect of palmitate, inducing a pro-inflammatory phenotype. We confirmed these results in differentiating human macrophages, showing an anti-inflammatory response to chronic palmitate exposure. Though alone it did not promote M2 polarization, hyperglycaemia exacerbated the effects of palmitate. These findings suggest that the dominant accumulation of M2 in adipose tissue and liver in patients with critical illness may be a result of hyperlipidaemia and hyperglycaemia, both components of the hypermetabolism observed in critically ill patients.
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Affiliation(s)
- Fangming Xiu
- Sunnybrook Research Institute, University of Toronto, Toronto, ON, Canada
| | - Li Diao
- Sunnybrook Research Institute, University of Toronto, Toronto, ON, Canada
| | - Peter Qi
- Sunnybrook Research Institute, University of Toronto, Toronto, ON, Canada
| | - Michael Catapano
- Sunnybrook Research Institute, University of Toronto, Toronto, ON, Canada
| | - Marc G Jeschke
- Sunnybrook Research Institute, University of Toronto, Toronto, ON, Canada.,Ross Tilley Burn Centre, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, ON, Canada.,Division of Plastic Surgery, Department of Surgery, Department of Immunology, University of Toronto, Toronto, ON, Canada
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Abdullahi A, Jeschke MG. Nutrition and anabolic pharmacotherapies in the care of burn patients. Nutr Clin Pract 2015; 29:621-30. [PMID: 25606644 DOI: 10.1177/0884533614533129] [Citation(s) in RCA: 40] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022] Open
Abstract
Thermal injury is a devastating injury that results in a number of pathological alterations in almost every system in the body. Hypermetabolism, muscle wasting, depressed immunity, and impaired wound healing are all clinical features of burns. Failure to address each of these specific pathological alterations can lead to increased mortality. Nutrition supplementation has been recommended as a therapeutic tool to help attenuate the hypermetabolism and devastating catabolism evident following burn. Despite the wide consensus on the need of nutrition supplementation in burn patients, controversy exists with regard to the type and amount of nutrition recommended. Nutrition alone is also not enough in these patients to halt and reverse some of the damage done by the catabolic pathways activated following severe burn injury. This has led to the use of anabolic pharmacologic agents in conjunction with nutrition to help improve patient outcome following burn injury. In this review, we examine the relevant literature on nutrition after burn injury and its contribution to the attenuation of the postburn hypermetabolic response, impaired wound healing, and suppressed immunological responses. We also review the commonly used anabolic agents clinically in the care of burn patients. Finally, we provide nutrition and pharmacological recommendations gained from prospective trials, retrospective analyses, and expert opinions based on our practice at the Ross Tilley Burn Center in Toronto, Canada.
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Affiliation(s)
- Abdikarim Abdullahi
- Sunnybrook Health Sciences Centre, Ross Tilley Burn Centre, Rm D7-04B, 2075 Bayview Avenue, Toronto, ON, M4N 3M5, Canada.
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Selective decontamination of the digestive tract ameliorates severe burn-induced insulin resistance in rats. Burns 2015; 41:1076-85. [DOI: 10.1016/j.burns.2014.12.018] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2014] [Revised: 12/22/2014] [Accepted: 12/25/2014] [Indexed: 02/07/2023]
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Flurbiprofen Axetil Enhances Analgesic Effects of Sufentanil and Attenuates Postoperative Emergence Agitation and Systemic Proinflammation in Patients Undergoing Tangential Excision Surgery. Mediators Inflamm 2015; 2015:601083. [PMID: 26273138 PMCID: PMC4530280 DOI: 10.1155/2015/601083] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2015] [Accepted: 02/16/2015] [Indexed: 12/12/2022] Open
Abstract
Objective. Our present study tested whether flurbiprofen axetil could reduce perioperative sufentanil consumption and provide postoperative analgesia with decrease in emergency agitation and systemic proinflammatory cytokines release. Methods. Ninety patients undergoing tangential excision surgery were randomly assigned to three groups: (1) preoperative dose of 100 mg flurbiprofen axetil and a postoperative dose of 2 μg/kg sufentanil and 10 mL placebo by patient-controlled analgesia (PCA) pump, (2) preoperative dose of 100 mg flurbiprofen axetil and a postoperative dose of 2 μg/kg sufentanil and 100 mg flurbiprofen axetil by PCA pump, and (3) 10 mL placebo and a postoperative dose of 2 μg/kg sufentanil and 10 mL placebo by PCA pump. Results. Preoperative administration of flurbiprofen axetil decreased postoperative tramadol consumption and the visual analog scale at 4, 6, 12, and 24 h after surgery, which were further decreased by postoperative administration of flurbiprofen axetil. Furthermore, flurbiprofen axetil attenuated emergency agitation score and Ramsay score at 0, 5, and 10 min after extubation and reduced the TNF-α and interleukin- (IL-) 6 levels at 24 and 48 h after the operation. Conclusion. Flurbiprofen axetil enhances analgesic effects of sufentanil and attenuates emergence agitation and systemic proinflammation in patients undergoing tangential excision surgery.
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Blet A, Benyamina M, Legrand M. Manifestations respiratoires précoces d’un patient brûlé grave. MEDECINE INTENSIVE REANIMATION 2015; 24:433-443. [PMID: 32288740 PMCID: PMC7117817 DOI: 10.1007/s13546-015-1084-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2015] [Accepted: 05/08/2015] [Indexed: 11/29/2022]
Affiliation(s)
- A. Blet
- Département d’anesthésie-réanimation et centre de traitement des brûlés, AP–HP, groupe hospitalier Saint-Louis-Lariboisière, F-75010 Paris, France
- Université Paris-Diderot, F-75475 Paris, France
- UMR Inserm 942, Institut national de la santé et de la recherche médicale (Inserm), hôpital Lariboisière, F-75010 Paris, France
| | - M. Benyamina
- Département d’anesthésie-réanimation et centre de traitement des brûlés, AP–HP, groupe hospitalier Saint-Louis-Lariboisière, F-75010 Paris, France
- Université Paris-Diderot, F-75475 Paris, France
| | - M. Legrand
- Département d’anesthésie-réanimation et centre de traitement des brûlés, AP–HP, groupe hospitalier Saint-Louis-Lariboisière, F-75010 Paris, France
- Université Paris-Diderot, F-75475 Paris, France
- UMR Inserm 942, Institut national de la santé et de la recherche médicale (Inserm), hôpital Lariboisière, F-75010 Paris, France
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Azevedo F, Pessoa A, Moreira G, Dos Santos M, Liberti E, Araujo E, Carvalho C, Saad M, Lima MH. Effect of Topical Insulin on Second-Degree Burns in Diabetic Rats. Biol Res Nurs 2015; 18:181-92. [PMID: 26111834 DOI: 10.1177/1099800415592175] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
The healing process is complex in diabetic wounds, and the healing mechanism of burn wounds is different from that of incisional or excisional wounds. Data from our previous study indicated that topical insulin cream reduced wound closure time in diabetic rats. Our aim was to investigate the effect of topical insulin cream on wound healing following second-degree burns in control and diabetic rats. Rats were divided into four groups: control (nondiabetic) rats treated with placebo (CP), control (nondiabetic) rats treated with topical insulin cream (CI), diabetic rats treated with placebo (DP), and diabetic rats treated with topical insulin cream (DI). The wounds were assessed at 4 time points (1, 7, 14, and 26 days) post-wounding for morphometric analysis of wound sections stained with hematoxylin/eosin, α-smooth muscle actin, and Picrosirius red to evaluate general aspects of the wound, inflammatory infiltrate, blood vessels, and Types I and III collagen fibers. Histological analysis showed that topical insulin cream increased the inflammatory cell infiltrate in the DI group (at 7 and 14 days postburn, p < .05) and blood vessels (at 14 days postburn, p < .05) to levels similar to those of groups CP and CI. Wounds treated with topical insulin cream (CI and DI groups) showed significantly stronger staining for fibrillar collagen than wounds of the DP group. The use of topical insulin may reduce the duration of the inflammatory phase; improve wound reepithelialization, tissue granulation, and wound contraction; and increase collagen deposition in second-degree burns in healthy and diabetic animals.
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Affiliation(s)
- F Azevedo
- Faculty of Nursing, FCM, State University of Campinas, Campinas, São Paulo, Brazil
| | - A Pessoa
- Department of Cell and Developmental Biology, Institute of Biomedical Sciences, University of Sao Paulo, Sao Paulo, Brazil
| | - G Moreira
- Department of Physiology and Biophysiology, Institute of Biomedical Sciences, University of Sao Paulo, Sao Paulo, Brazil
| | - M Dos Santos
- Department of Cell and Developmental Biology, Institute of Biomedical Sciences, University of Sao Paulo, Sao Paulo, Brazil
| | - E Liberti
- Department of Anatomy, Institute of Biomedical Sciences, University of Sao Paulo, Sao Paulo, Brazil
| | - E Araujo
- Faculty of Nursing, FCM, State University of Campinas, Campinas, São Paulo, Brazil
| | - C Carvalho
- Department of Physiology and Biophysiology, Institute of Biomedical Sciences, University of Sao Paulo, Sao Paulo, Brazil
| | - M Saad
- Department of Internal Medicine, FCM, State University of Campinas, Campinas, São Paulo, Brazil
| | - M H Lima
- Faculty of Nursing, FCM, State University of Campinas, Campinas, São Paulo, Brazil
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Zhou C, Bai W, Chen Q, Xu Z, Zhu X, Wen A, Yang X. Protective effect of crocetin against burn-induced intestinal injury. J Surg Res 2015; 198:99-107. [PMID: 26119275 DOI: 10.1016/j.jss.2015.05.052] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2015] [Revised: 04/22/2015] [Accepted: 05/27/2015] [Indexed: 11/18/2022]
Abstract
BACKGROUND Oxidative stress and inflammation exert central roles in burn-induced intestinal injury. Crocetin, a natural carotenoid compound from gardenia fruits and saffron, has been shown to inhibit oxidative stress and inflammatory response. However, the possibility of crocetin to be used in the treatment of intestinal injury after burn injury has not been investigated. The purpose of the present study was to investigate the effects and potential mechanisms of crocetin in burn-induced intestinal injury. MATERIALS AND METHODS Several free radical-generating and lipid peroxidation models were used to systematically assess the antioxidant activities of crocetin in vitro. A common burn model was used to induce the intestinal injury in rats. Changes in the levels of malondialdehyde, superoxidase dismutase, catalase, glutathione peroxidase, tumor necrosis factor α, interleukin 6, polymorphonuclear neutrophil accumulation, intestinal permeability, and intestinal histology were examined. RESULTS In several models of antioxidant activity, crocetin exhibited marked inhibitory action against free radicals and lipid peroxidation. Crocetin increased levels of antioxidant enzymes and reduced intestinal oxidative injury in burn models. In addition, crocetin inhibited polymorphonuclear neutrophil accumulation, ameliorated tumor necrosis factor α and interleukin 6 levels, intestinal permeability, and histological changes. CONCLUSIONS Crocetin treatment may protect against burn-induced small intestinal injury, possibly by inhibiting burn-induced oxidative stress and inflammatory response.
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Affiliation(s)
- Chunxiang Zhou
- Department of Pharmacy, Xijing Hospital, The Fourth Military Medical University, Xi'an, Shaanxi, PR China; State Key Laboratory of Cancer Biology, The Fourth Military Medical University, Xi'an, Shaanxi, PR China; Department of Biochemistry and Molecular Biology, The Fourth Military Medical University, Xi'an, Shaanxi, PR China
| | - Wei Bai
- Department of Burns and Cutaneous Surgery, Xijing Hospital, The Fourth Military Medical University, Xi'an, Shaanxi, PR China; Brigade of student, The Fourth Military Medical University, Xi'an, Shaanxi, PR China
| | - Qiaohua Chen
- Department of Burns and Cutaneous Surgery, Xijing Hospital, The Fourth Military Medical University, Xi'an, Shaanxi, PR China
| | - Zhigang Xu
- Department of Burns and Cutaneous Surgery, Xijing Hospital, The Fourth Military Medical University, Xi'an, Shaanxi, PR China
| | - Xiongxiang Zhu
- Department of Burns and Cutaneous Surgery, Xijing Hospital, The Fourth Military Medical University, Xi'an, Shaanxi, PR China
| | - Aidong Wen
- Department of Pharmacy, Xijing Hospital, The Fourth Military Medical University, Xi'an, Shaanxi, PR China; State Key Laboratory of Cancer Biology, The Fourth Military Medical University, Xi'an, Shaanxi, PR China; Department of Biochemistry and Molecular Biology, The Fourth Military Medical University, Xi'an, Shaanxi, PR China.
| | - Xuekang Yang
- Department of Burns and Cutaneous Surgery, Xijing Hospital, The Fourth Military Medical University, Xi'an, Shaanxi, PR China.
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Shabbir A, Badiavas EV. Toward an ‘off the shelf’ technology for burn victims: healing wounds with mesenchymal stem cells. Regen Med 2015; 10:381-4. [DOI: 10.2217/rme.15.20] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023] Open
Affiliation(s)
- Arsalan Shabbir
- Department of Dermatology & Cutaneous Surgery, University of Miami Miller School of Medicine, Miami, FL 33136, USA
| | - Evangelos V Badiavas
- Department of Dermatology & Cutaneous Surgery, Interdisciplinary Stem Cell Instititue, University of Miami Miller School of Medicine, Miami, FL 33136, USA
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Abstract
Major burns induce immune complications, which are associated with myeloid cell activation by ill-defined mechanisms. Although γδ T cells have been shown to be important in postinjury inflammation and wound healing, their role in the regulation of myeloid cells remains unknown. To study this, wild-type (WT) and γδ T cell-deficient (δTCR) mice were subjected to major burn (25% total body surface area, third degree) or sham treatment. At 3 days thereafter, skin samples were assayed for cytokine content or used to isolate single cells that were used for myeloid cell characterization by flow cytometry. The number of CD11b myeloid cells increased by approximately 75% in the wound skin of WT mice. This influx was caused by increased myeloid-derived suppressor cells (CD11b GR1) whose numbers increased 19-fold compared with those of sham skin. In contrast, macrophage (MØ; CD11b F4/80) numbers decreased by approximately 50% after burn. In δTCR mice, burn increased the myeloid cell numbers approximately 5-fold. The increase in myeloid cells at the injury site of δTCR mice was caused by both a myeloid-derived suppressor cell (50-fold) and a MØ (2-fold) influx. Burn increased skin cytokine levels for a number of prototypic inflammatory cytokines (interleukin 1β, interleukin 6, tumor necrosis factor-α, macrophage inflammatory protein [MIP] 1β, etc). Tumor necrosis factor-α, MIP-1α, and MIP-1β levels were further elevated (2- to 3-fold) in the injured skin of δTCR mice compared with those of WT mice. In conclusion, these data show that γδ T cells regulate myeloid cell infiltration of the wound site and act to quell inflammation, thereby promoting the transition to the proliferative phase of wound healing.
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Liu H, Ding J, Ma Z, Zhu Z, Shankowsky HA, Tredget EE. A novel subpopulation of peripheral blood mononuclear cells presents in major burn patients. Burns 2015; 41:998-1007. [PMID: 25683215 DOI: 10.1016/j.burns.2014.12.005] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2014] [Revised: 11/28/2014] [Accepted: 12/08/2014] [Indexed: 10/24/2022]
Abstract
Hypertrophic scars (HTS) are generally believed to result from proliferation and activation of resident connective tissue fibroblasts after burns. To demonstrate a potential role of blood-borne cells, the peripheral blood mononuclear cells (PBMCs) and the effect of PBMCs on dermal fibroblast behavior was investigated. Flow cytometry was used to analyze the surface and intracellular protein expression of PBMCs and fibroblasts. Transwell migration assay, enzyme-linked immunosorbent assay and real-time reverse transcription polymerase chain reaction was performed to assess fibroblast functions. We identified a novel subpopulation of PBMCs in burn patients in vivo that appears at an early stage following major thermal injuries, which primarily express procollagen 1, leukocyte specific protein 1, CD204, toll-like receptor 4 and stromal cell-derived factor 1 (SDF-1) receptor CXCR4. In vitro, the conditioned media from burn patient PBMCs up-regulated the expression of fibrotic growth factors and extracellular matrix molecules, down-regulated antifibrotic factor decorin, enhanced cell chemotaxis and promoted cell differentiation into contractile myofibroblasts in dermal fibroblasts. After thermal injury, this novel subpopulation of PBMCs is systemically triggered and attracted to the wounds under SDF-1/CXCR4 signaling where they appear to modulate the functions of resident connective tissue cells and thus contribute to the development of HTS.
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Affiliation(s)
- Hongbin Liu
- Wound Healing Research Group, Division of Plastic and Reconstructive Surgery, University of Alberta, 2D2.28 WMC, 8440-112 Street, Edmonton, AB, Canada T6G 2B7
| | - Jie Ding
- Wound Healing Research Group, Division of Plastic and Reconstructive Surgery, University of Alberta, 2D2.28 WMC, 8440-112 Street, Edmonton, AB, Canada T6G 2B7
| | - Zengshuan Ma
- Wound Healing Research Group, Division of Plastic and Reconstructive Surgery, University of Alberta, 2D2.28 WMC, 8440-112 Street, Edmonton, AB, Canada T6G 2B7; Division of Critical Care Medicine, Department of Surgery, University of Alberta, 2D2.28 WMC, 8440-112 Street, Edmonton, AB, Canada T6G 2B7
| | - Zhenshen Zhu
- Wound Healing Research Group, Division of Plastic and Reconstructive Surgery, University of Alberta, 2D2.28 WMC, 8440-112 Street, Edmonton, AB, Canada T6G 2B7; Division of Critical Care Medicine, Department of Surgery, University of Alberta, 2D2.28 WMC, 8440-112 Street, Edmonton, AB, Canada T6G 2B7
| | - Heather A Shankowsky
- Wound Healing Research Group, Division of Plastic and Reconstructive Surgery, University of Alberta, 2D2.28 WMC, 8440-112 Street, Edmonton, AB, Canada T6G 2B7
| | - Edward E Tredget
- Wound Healing Research Group, Division of Plastic and Reconstructive Surgery, University of Alberta, 2D2.28 WMC, 8440-112 Street, Edmonton, AB, Canada T6G 2B7; Division of Critical Care Medicine, Department of Surgery, University of Alberta, 2D2.28 WMC, 8440-112 Street, Edmonton, AB, Canada T6G 2B7.
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Neely AN, Gallardo V, Barth E, Haugland RA, Warden GD, Vesper SJ. Rapid Monitoring by Quantitative Polymerase Chain Reaction for Pathogenic Aspergillus During Carpet Removal From a Hospital. Infect Control Hosp Epidemiol 2015; 25:350-2. [PMID: 15108736 DOI: 10.1086/502405] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
AbstractMonitoring for pathogenic Aspergillus species using a rapid, highly sensitive, quantitative polymerase chain reaction technique during carpet removal in a burn unit provided data that allowed patients to be safely returned to the refloored area sooner than if only conventional culture monitoring had been used.
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Affiliation(s)
- Alice N Neely
- Shriners Burns Hospital, Cincinnati, OH 45229-3095, USA
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Shen L, Cui Z, Lin Y, Wang S, Zheng D, Tan Q. Anti-inflammative effect of glycyrrhizin on rat thermal injury via inhibition of high-mobility group box 1 protein. Burns 2014; 41:372-8. [PMID: 25440843 DOI: 10.1016/j.burns.2014.05.008] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2013] [Revised: 04/21/2014] [Accepted: 05/12/2014] [Indexed: 11/15/2022]
Abstract
AIM Glycyrrhizin (Gly) has been reported as an inhibitor of extracellular HMGB1 (high-mobility group box 1 protein) cytokine's activity, and protects spinal cord, liver, heart and brain against ischemia-reperfusion-induced injury in rats. The purpose of this study was to investigate the protective effect of Gly in rat skin thermal injury model and to elucidate the underlying mechanisms. METHODS Twenty-four male Sprague-Dawley rats (200-250g) were randomly divided into control group, vehicle-treated and Gly-treated burn groups, each group contained eight animals. In the latter two groups, rats were subjected to 30% TBSA (Total Body Surface Area) full-thickness scald injury. In Gly-treated burn group, glycyrrhizin (60mg/kg) was administered intraperitoneally immediately after and at 24th hour burn; in vehicle-treated burn group, Ringer's solution (4ml/kg, as a vehicle) was administered intraperitoneally immediately after and at 24th hour burn. The animals were sacrificed at 48h after injury. Aortic blood samples were obtained to detect tumor necrosis factor-α (TNF-α) and interleukin-1β (IL-1β) with ELISA (Enzyme-Linked Immuno Sorbent Assay) kits. Lung, liver and kidney tissue samples were collected to determine the expression of HMGB1 mRNA and protein. HMGB1 mRNA level was semiquantitatively measured by Real-Time PCR using β-actin as an internal standard, and protein expression of HMGBI was determined by Western blot. RESULTS Severe skin scald injury caused a significant increase in plasma TNF-α and IL-1β versus the control group (P<0.001) in 48h after burns. Intraperitoneal administration of Gly (60mg/kg) significantly reduced the levels of serum TNF-α and IL-1β (P<0.01). Gly treatment reduced these biochemical indices accompanied by lower level of HMGB1 protein (P<0.05) and mRNA expression (P<0.01). CONCLUSION These results demonstrate that Gly possesses an anti-inflammation effect to protect the remote organs from burn-induced injury.
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Affiliation(s)
- Liangyun Shen
- Department of Burns and Plastic Surgery, The Drum Tower Clinical Medical College, Nanjing Medical University, Nanjing 210008, China
| | - Ziwei Cui
- Department of Burns and Plastic Surgery, The Drum Tower Clinical Medical College, Nanjing Medical University, Nanjing 210008, China
| | - Yue Lin
- Department of Burns and Plastic Surgery, Affiliated Drum Tower Hospital, Nanjing University Medical School, Nanjing 210008, China
| | - Shuqin Wang
- Department of Burns and Plastic Surgery, Affiliated Drum Tower Hospital, Nanjing University Medical School, Nanjing 210008, China
| | - Dongfeng Zheng
- Department of Burns and Plastic Surgery, Affiliated Drum Tower Hospital, Nanjing University Medical School, Nanjing 210008, China
| | - Qian Tan
- Department of Burns and Plastic Surgery, The Drum Tower Clinical Medical College, Nanjing Medical University, Nanjing 210008, China; Department of Burns and Plastic Surgery, Affiliated Drum Tower Hospital, Nanjing University Medical School, Nanjing 210008, China.
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Abstract
Decompensation of epilepsy in burned patients may be caused by several factors. Burn is a classic etiology of systemic inflammatory response syndrome, and evolves into two physiological phases. The first 48h after injury corresponds to the first phase involving severe hypovolemic shock. The second phase corresponds to the hypermetabolic response to burns. Altered pharmacokinetics of anticonvulsant drugs is observed. Albumin and other plasma proteins are reduced, leading to increased free fraction of phenytoin, resulting in greater clearance and a lower total drug concentration. Associated with metabolic changes of burned patient, this fact predisposes to seizures in epileptic burned patients. The authors present the case of an epileptic 36-year-old-woman who developed recurrent seizures after a thermal injury, despite using the same medications and doses of anticonvulsant drugs of last 12 years, with controlled epilepsy.
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Abstract
Major burn triggers immune dysfunction, which is associated with wound healing complications. Gamma-δ T-cells have been shown to be important in postburn inflammation and wound healing; however, their cytokine phenotype at the burn wound site is unknown. C57BL/6 male mice were subjected to a major burn (25% TBSA, third degree) or sham treatment. At 3 hours, 3 days, and 7 days thereafter, skin samples were collected and subjected to dispase and trypsin digestion to isolate single cells. The cells were phenotyped and evaluated for cytokine profiles by flow cytometry. Th1 cells were defined as interferon (IFN)γ positive, Th2 cells were defined as interleukin (IL)-10 positive, and Th17 cells were defined as IL-17 positive. At 7 days after burn a shift toward Th2 and Th17 positive T-cells at the wound site was observed. Further analysis revealed that at 3-hour postinjury the percentage of γδ T-cells positive for IFNγ, IL-10, and IL-17 were comparable between sham and burn skin samples. At 3 days and 7 days postinjury the percentage of cells positive for each cytokine increased; however, the increase was significantly greater for IL-10 and IL-17, as compared with IFNγ (ie, 9-20-fold vs 3-fold). Skin αβ T-cells preferentially produced IFNγ (~20%), which was unaffected by burn injury. These data demonstrate that burn wound γδ T-cells are activated for enhanced cytokine production and display a shift toward a Th2 and/or Th17 phenotype. In contrast, burn wound αβ T-cells were not activated for enhanced cytokine production.
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Özyurt H, Çevik Ö, Özgen Z, Özden AS, Çadırcı S, Elmas MA, Ercan F, Gören MZ, Şener G. Quercetin protects radiation-induced DNA damage and apoptosis in kidney and bladder tissues of rats. Free Radic Res 2014; 48:1247-55. [DOI: 10.3109/10715762.2014.945925] [Citation(s) in RCA: 42] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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Gupta P, Chhibber S, Harjai K. Efficacy of purified lactonase and ciprofloxacin in preventing systemic spread of Pseudomonas aeruginosa in murine burn wound model. Burns 2014; 41:153-62. [PMID: 25015706 DOI: 10.1016/j.burns.2014.06.009] [Citation(s) in RCA: 40] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2014] [Revised: 05/21/2014] [Accepted: 06/05/2014] [Indexed: 12/01/2022]
Abstract
Pseudomonas aeruginosa is an important etiological agent associated with systemic infection in burn patients. Quorum sensing (QS) mechanism of P. aeruginosa contributes to its virulence. Inhibition of QS signals can serve as an effective anti-virulence strategy. Aim of the present study was to evaluate the efficacy of lactonase alone and in combination with ciprofloxacin in treating P. aeruginosa murine burn wound infection. Topical application of lactonase alone and ciprofloxacin alone prevented systemic spread of P. aeruginosa through burned skin and also reduced the mortality. When lactonase (topical) and ciprofloxacin (I/P) were used in combination, zero mortality was observed. It not only significantly reduced systemic dissemination and severity of histopathologic lesions but also resulted in skin regeneration. Decreased production of pathologic index factors (malondialdehyde and reactive nitrogen intermediates) and interleukins (IL-10, IL-6 and MIP-2) was also observed in comparison to control. The results of present study suggest that combination of lactonase and ciprofloxacin can potentially attenuate the virulence of P. aeruginosa. This is the first report of topical administration of lactonase along with antibiotic for the efficient control of burn wound infection.
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Affiliation(s)
- Parul Gupta
- Department of Microbiology, BMS Block, Panjab University, Chandigarh 160014, India
| | - Sanjay Chhibber
- Department of Microbiology, BMS Block, Panjab University, Chandigarh 160014, India
| | - Kusum Harjai
- Department of Microbiology, BMS Block, Panjab University, Chandigarh 160014, India.
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Joyce C, Kelly J, Sugrue C. A bibliometric analysis of the 100 most influential papers in burns. Burns 2014; 40:30-7. [DOI: 10.1016/j.burns.2013.10.025] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2013] [Revised: 10/19/2013] [Accepted: 10/21/2013] [Indexed: 10/25/2022]
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84
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Flagellin treatment prevents increased susceptibility to systemic bacterial infection after injury by inhibiting anti-inflammatory IL-10+ IL-12- neutrophil polarization. PLoS One 2014; 9:e85623. [PMID: 24454904 PMCID: PMC3893295 DOI: 10.1371/journal.pone.0085623] [Citation(s) in RCA: 49] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2013] [Accepted: 12/05/2013] [Indexed: 12/28/2022] Open
Abstract
Severe trauma renders patients susceptible to infection. In sepsis, defective bacterial clearance has been linked to specific deviations in the innate immune response. We hypothesized that innate immune modulations observed during sepsis also contribute to increased bacterial susceptibility after severe trauma. A well-established murine model of burn injury, used to replicate infection following trauma, showed that wound inoculation with P. aeruginosa quickly spreads systemically. The systemic IL-10/IL-12 axis was skewed after burn injury with infection as indicated by a significant elevation in serum IL-10 and polarization of neutrophils into an anti-inflammatory ("N2"; IL-10(+) IL-12(-)) phenotype. Infection with an attenuated P. aeruginosa strain (ΔCyaB) was cleared better than the wildtype strain and was associated with an increased pro-inflammatory neutrophil ("N1"; IL-10(-)IL-12(+)) response in burn mice. This suggests that neutrophil polarization influences bacterial clearance after burn injury. Administration of a TLR5 agonist, flagellin, after burn injury restored the neutrophil response towards a N1 phenotype resulting in an increased clearance of wildtype P. aeruginosa after wound inoculation. This study details specific alterations in innate cell populations after burn injury that contribute to increased susceptibility to bacterial infection. In addition, for the first time, it identifies neutrophil polarization as a therapeutic target for the reversal of bacterial susceptibility after injury.
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85
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Rani M, Zhang Q, Scherer MR, Cap AP, Schwacha MG. Activated skin γδ T-cells regulate T-cell infiltration of the wound site after burn. Innate Immun 2014; 21:140-50. [PMID: 24412847 DOI: 10.1177/1753425913519350] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Burn induces an immunopathological response involving multiple immune cell types that includes γδ T-cells. Nonetheless, the role of γδ T-cells at the wound site after burn is not clearly defined. Wild type and γδ T-cell receptor deficient (δ TCR(-/-)) mice were subjected to a major burn or sham procedure. At 1-7 d thereafter, skin samples were collected and T-cell populations analyzed. The majority of T-cells in the skin of sham mice were γδ T-cells. After burn, however, an increase in the total T-cells was observed at the wound site and these cells were predominantly αβ T-cells. Their influx was γδ T-cell dependent, as it was markedly reduced in injured δ TCR(-/-) mice. Burn wound γδ T-cells were activated with increased expression of TLRs and CD69. In contrast, the infiltrating αβ T-cells TLR and CD69 expressions were attenuated after burn. Thus, burn is associated with of γδ T-cell activation at the injury site, which initiates a massive infiltration of the wound with αβ T-cells that likely facilitate the transition from the inflammatory to the proliferative phase of healing.
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Affiliation(s)
- Meenakshi Rani
- Department of Surgery, The University of Texas Health Science Center, San Antonio, TX, USA
| | - Qiong Zhang
- Department of Surgery, The University of Texas Health Science Center, San Antonio, TX, USA
| | | | - Andrew P Cap
- Department of Surgery, The University of Texas Health Science Center, San Antonio, TX, USA US Army Institute of Surgical Research, Fort Sam Houston, TX, USA
| | - Martin G Schwacha
- Department of Surgery, The University of Texas Health Science Center, San Antonio, TX, USA US Army Institute of Surgical Research, Fort Sam Houston, TX, USA
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Yang X, Bai H, Cai W, Liu J, Wang Y, Xu Y, Li J, Zhou Q, Han J, Zhu X, Dong M, Hu D. Inhibition of Na+/H+ exchanger 1 by cariporide alleviates burn-induced multiple organ injury. J Surg Res 2013; 185:797-804. [DOI: 10.1016/j.jss.2013.06.049] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2013] [Revised: 06/16/2013] [Accepted: 06/20/2013] [Indexed: 12/11/2022]
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88
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Yang X, Chen J, Bai H, Tao K, Zhou Q, Hou H, Hu D. Inhibition of Na+/H+ exchanger 1 by cariporide reduces burn-induced intestinal barrier breakdown. Burns 2013; 39:1557-64. [DOI: 10.1016/j.burns.2013.04.007] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2012] [Revised: 04/07/2013] [Accepted: 04/10/2013] [Indexed: 12/29/2022]
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89
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Cherry JD, Williams JP, O'Banion MK, Olschowka JA. Thermal injury lowers the threshold for radiation-induced neuroinflammation and cognitive dysfunction. Radiat Res 2013; 180:398-406. [PMID: 24059681 DOI: 10.1667/rr3363.1] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
The consequences of radiation exposure alone are relatively well understood, but in the wake of events such as the World War II nuclear detonations and accidents such as Chernobyl, other critical factors have emerged that can substantially affect patient outcome. For example, ~70% of radiation victims from Hiroshima and Nagasaki received some sort of additional traumatic injury, the most common being thermal burn. Animal data has shown that the addition of thermal insult to radiation results in increased morbidity and mortality. To explore possible synergism between thermal injury and radiation on brain, C57BL/6J female mice were exposed to either 0 or 5 Gy whole-body gamma irradiation. Irradiation was immediately followed by a 10% total-body surface area full thickness thermal burn. Mice were sacrificed 6 h, 1 week or 6 month post-injury and brains and plasma were harvested for histology, mRNA analysis and cytokine ELISA. Plasma analysis revealed that combined injury synergistically upregulates IL-6 at acute time points. Additionally, at 6 h, combined injury resulted in a greater upregulation of the vascular marker, ICAM-1 and TNF-α mRNA. Enhanced activation of glial cells was also observed by CD68 and Iba1 immunohistochemistry at all time points. Additionally, doublecortin staining at 6 months showed reduced neurogenesis in all injury conditions. Finally, using a novel object recognition test, we observed that only mice with combined injury had significant learning and memory deficits. These results demonstrate that thermal injury lowers the threshold for radiation-induced neuroinflammation and long-term cognitive dysfunction.
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Affiliation(s)
- Jonathan D Cherry
- a Department of Pathology and Laboratory Medicine, University of Rochester School of Medicine and Dentistry, Rochester, New York 14642
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90
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Saracoglu KT, Saracoglu A, Umuroglu T, Ugurlu MU, Deniz M, Gogus FY. The preventive effect of dopamine infusion in rats with abdominal compartment syndrome. J INVEST SURG 2013; 26:334-9. [PMID: 23957751 DOI: 10.3109/08941939.2013.808289] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Abstract
BACKGROUND The most significant perfusion disorder of the intra-abdominal viscera occurs in the abdominal compartment syndrome (ACS). Free oxygen radicals diffuse into the body during the reperfusion phase of ACS. Our aim was to determine the effects of dopamine infusion (3 μg/kg/min) on renal perfusion, cytokine levels, free oxygen radicals, and renal histopathological changes in the presence of ACS in a prospective randomized manner. METHODS Twenty-four male Sprague-Dawley rats were randomly divided into four groups (n = 6). Group 1 was used as control. In group 2, air was inflated until the intra-abdominal pressure (IAP) reached 20 mmHg. In group 3, dopamine was infused for 60 min meanwhile IAP was kept at 20 mmHg. In group 4, dopamine was infused for 60 min before IAP rise. After this phase, renal artery (RA) perfusion was measured continuously. Myeloperoxidase activity (MPO), glutathione (GSH), and lipid peroxidation (MDA) levels were measured in tissue samples and histopathological scoring was performed. RESULTS Dopamine treatment before and during ACS significantly decreased MPO and MDA levels and also increased renal blood flow and GSH levels. However, histopathological damage was improved simultaneously. CONCLUSION Dopamine infusion before and during ACS, increases renal perfusion and decreases free oxygen radicals. According to our findings, dopamine infusion may be proposed for the treatment of ACS and perfusion disorders in critically ill patients.
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91
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Xiu F, Stanojcic M, Jeschke MG. Norepinephrine inhibits macrophage migration by decreasing CCR2 expression. PLoS One 2013; 8:e69167. [PMID: 23844252 PMCID: PMC3699643 DOI: 10.1371/journal.pone.0069167] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2013] [Accepted: 06/11/2013] [Indexed: 11/18/2022] Open
Abstract
Increased incidences of infectious and septic complications during post-burn courses represent the main contributor to burn injury mortality. Sustained increases in catecholamine levels, especially norepinephrine (NE), contribute to immune disturbances in severely burned patients. The precise mechanisms underlying NE-mediated immunoregulation are not fully understood. Here we hypothesize that persistently elevated NE levels are associated with immunodysfunctions. We examined the effects of NE on the phenotype and functions of bone marrow-derived macrophages (BMMs). Whole mouse bone marrow cells were treated in vitro with 40 ng/mL of M-CSF and with 1 x 10-6 M or 1 x 10-8 M of NE or without NE for 7 days; cells were collected and stained with antibodies for CD11b, F4/80, MHC II and the inflammatory CC chemokine receptor 2 (CCR2). We found 1 x 10-6 M of NE inhibited MHC II and CCR2 expression on CD11b+/F4/80+ BMM cells. It also inhibited BMM proliferation by inhibiting CSF-1R expression. On the contrary, 1 x 10-8 M of NE slightly increased both MHC II and CCR2 expression on CD11b+/F4/80+ BMM cells but inhibited CD11b+/F4/80+ BMM proliferation. MCP-1 based migration assay showed that the migration of 1 x 10-6 M of NE-treated BMM toward MCP-1 was significantly decreased compared to BMM without NE treatment. Both 1 x 10-8 M and 1 x 10-6 M of NE enhanced TNF-α production and phagocytosis of FITC-Dextran. Intracellular staining of transcriptional factor MafB showed that 1 x 10-6 M of NE treatment enhanced its expression, whereas 1 x 10-8 M of NE decreased expression. Stimulation with LPS in the last 24-hours of BMM culture further decreased CCR2 and MHC II expression of these BMM, suggesting the synergistic effect of LPS and NE on macrophage. Our results demonstrate that NE regulates macrophage differentiation, proliferation and function, and may play a critical role in the dysfunctional immune response post-burn.
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Affiliation(s)
- Fangming Xiu
- Ross Tilley Burn Centre, Sunnybrook Health Science Centre, Sunnybrook Research Institute, Division of Plastic Surgery, Department of Surgery, Department of Immunology, University of Toronto, Toronto, Ontario, Canada
| | - Mile Stanojcic
- Ross Tilley Burn Centre, Sunnybrook Health Science Centre, Sunnybrook Research Institute, Division of Plastic Surgery, Department of Surgery, Department of Immunology, University of Toronto, Toronto, Ontario, Canada
| | - Marc G. Jeschke
- Ross Tilley Burn Centre, Sunnybrook Health Science Centre, Sunnybrook Research Institute, Division of Plastic Surgery, Department of Surgery, Department of Immunology, University of Toronto, Toronto, Ontario, Canada
- * E-mail:
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92
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Fazal N. OX62+OX6+OX35+ rat dendritic cells are unable to prime CD4+ T cells for an effective immune response following acute burn injury. RESULTS IN IMMUNOLOGY 2013; 3:64-72. [PMID: 24600560 DOI: 10.1016/j.rinim.2013.06.001] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/23/2013] [Revised: 06/22/2013] [Accepted: 06/24/2013] [Indexed: 02/02/2023]
Abstract
Co-stimulatory molecules expressed on Dendritic Cells (DCs) function to coordinate an efficient immune response by T cells in the peripheral lymph nodes. We hypothesized that CD4+ T cell-mediated immune suppression following burn injury may be related to dysfunctional DCs residing in gut associated lymphoid tissues (GALT), such as Mesenteric Lymph Nodes (MLN). Therefore, we studied co-stimulatory molecules expressed on burn rat MLN DCs as an index of functional DCs that would mount an effective normal CD4+ T cell immune response. In a rat model of 30% Total Body Surface Area (TBSA) scald burn, OX62+OX6+OX35+ DCs and CD4+ T cells were isolated from MLN of day 3 post-burn and sham control rats. DCs were tested for their expression of co-stimulatory molecules, and prime CD4+ T cell (DC:CD4+T cell co-culture assays) to determine an effector immune response such as CD4+ T cell proliferation. The surface receptor expressions of MLN DCs co-stimulatory molecules, i.e., MHC-II, CD40, CD80 (B7-1), and CD86 (B7-2) were determined by Flow cytometry (quantitatively) and confocal microscopy (qualitatively). Tritiated thymidine and CFDA-SE determined CD4+ T cell proliferation following co-incubation with DCs. Cytokine milieu of MLN (IL-12 and IL-10) was assessed by mRNA determination by RT-PCR. The results showed down-regulated expressions of co-stimulatory markers (CD80, CD86, CD40 and MHC-II) of MLN DCs obtained from burn-injured rats, as well as lack of ability of these burn-induced DCs to stimulate CD4+ T cell proliferation in co-culture assays, as compared to the sham rats. Moreover, anti-CD40 stimulation of affected burn MLN DCs did not reverse this alteration. Furthermore, a marked up-regulation of mRNA IL-10 and down-regulation of mRNA IL-12 in burn MLN as compared to sham animals was also observed. To surmise, the data indicated that dysfunctional OX62+OX6+OX35+ rat MLN DCs may contribute to CD4+ T-cell-mediated immune suppression observed following acute burn injury.
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Affiliation(s)
- Nadeem Fazal
- Department of Pharmaceutical Sciences, College of Pharmacy, 206 Douglas Hall, Chicago State University, 9501 South King Drive, Chicago, IL 60628, USA
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93
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Kinoshita M, Miyazaki H, Ono S, Seki S. Immunoenhancing therapy with interleukin-18 against bacterial infection in immunocompromised hosts after severe surgical stress. J Leukoc Biol 2013; 93:689-98. [DOI: 10.1189/jlb.1012502] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023] Open
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95
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Destructive Pulmonary Effects of Smoke Inhalation and Simultaneous Alterations in Circulating IL-6, TNF-α, and IFN-γ Levels at Different Burn Depths. J Burn Care Res 2013; 34:334-41. [DOI: 10.1097/bcr.0b013e3182644e9b] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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96
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Fazal N, Shelip A, Alzahrani AJ. Burn-injury affects gut-associated lymphoid tissues derived CD4+ T cells. RESULTS IN IMMUNOLOGY 2013; 3:85-94. [PMID: 24600563 DOI: 10.1016/j.rinim.2013.09.001] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/02/2013] [Revised: 09/06/2013] [Accepted: 09/11/2013] [Indexed: 01/18/2023]
Abstract
After scald burn-injury, the intestinal immune system responds to maintain immune balance. In this regard CD4+T cells in Gut-Associated Lymphoid Tissues (GALT), like mesenteric lymph nodes (MLN) and Peyer's patches (PP) respond to avoid immune suppression following major injury such as burn. Therefore, we hypothesized that the gut CD4+T cells become dysfunctional and turn the immune homeostasis towards depression of CD4+ T cell-mediated adaptive immune responses. In the current study we show down regulation of mucosal CD4+ T cell proliferation, IL-2 production and cell surface marker expression of mucosal CD4+ T cells moving towards suppressive-type. Acute burn-injury lead to up-regulation of regulatory marker (CD25+), down regulation of adhesion (CD62L, CD11a) and homing receptor (CD49d) expression, and up-regulation of negative co-stimulatory (CTLA-4) molecule. Moreover, CD4+CD25+ T cells of intestinal origin showed resistance to spontaneous as well as induced apoptosis that may contribute to suppression of effector CD4+ T cells. Furthermore, gut CD4+CD25+ T cells obtained from burn-injured animals were able to down-regulate naïve CD4+ T cell proliferation following adoptive transfer of burn-injured CD4+CD25+ T cells into sham control animals, without any significant effect on cell surface activation markers. Together, these data demonstrate that the intestinal CD4+ T cells evolve a strategy to promote suppressive CD4+ T cell effector responses, as evidenced by enhanced CD4+CD25+ T cells, up-regulated CTLA-4 expression, reduced IL-2 production, tendency towards diminished apoptosis of suppressive CD4+ T cells, and thus lose their natural ability to regulate immune homeostasis following acute burn-injury and prevent immune paralysis.
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Affiliation(s)
- Nadeem Fazal
- Department of Pharmaceutical Sciences, College of Pharmacy, Chicago State University, Chicago, IL 60628, USA
| | - Alla Shelip
- Department of Pharmaceutical Sciences, College of Pharmacy, Chicago State University, Chicago, IL 60628, USA
| | - Alhusain J Alzahrani
- Department of Clinical laboratory Sciences, College of Applied Medical Sciences, King Saud University, Riyadh, Saudi Arabia
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97
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Vagal nerve stimulation blocks peritoneal macrophage inflammatory responsiveness after severe burn injury. Shock 2012; 38:294-300. [PMID: 22683732 DOI: 10.1097/shk.0b013e31825f5fb2] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
Large surface area burn injuries lead to activation of the innate immune system, which can be blocked by parasympathetic inputs mediated by the vagus nerve. We hypothesized that vagal nerve stimulation (VNS) would alter the inflammatory response of peritoneal macrophages after severe burn injury. Male BALB/c mice underwent right cervical VNS before 30% total body surface area steam burn and were compared with animals subjected to burn alone. Peritoneal macrophages were harvested at several time points following injury and exposed to lipopolysaccharide (LPS) in culture conditions. The inflammatory response of peritoneal macrophages was measured by analyzing changes in nuclear factor κB p65 phosphorylation using flow cytometry. We found that peritoneal macrophages isolated from mice subjected to burn injury were hyperresponsive to LPS challenge, suggesting burn-induced macrophage activation. We identified a protective role for VNS in blocking peritoneal macrophage activation. Analysis of the phosphorylation state of nuclear factor κB pathway mediator, p65 Rel A, revealed a VNS-mediated reduction in p65 phosphorylation levels after exposure to LPS compared with burn alone. In combination, these studies suggest VNS mediates the inflammatory response in peritoneal macrophages by affecting the set point of LPS responsiveness.
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98
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Chen C, Zhang F, Zhang Z, Peng M, Wang Y, Chen Y. TLR4 signaling-induced heme oxygenase upregulation in the acute lung injury: role in hemorrhagic shock and two-hit induced lung inflammation. Mol Biol Rep 2012; 40:1167-72. [PMID: 23065289 DOI: 10.1007/s11033-012-2158-y] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2012] [Accepted: 10/06/2012] [Indexed: 12/19/2022]
Abstract
Resuscitated hemorrhagic shock is believed to promote the development of acute lung injury (ALI) by priming the immune system for an exaggerated inflammatory response to a second trivial stimulus. This work explored effects of TLR4 on hemorrhage-induced ALI and "second-hit" responses, and further explore the mechanisms involved in "second-hit" responses. Expression of HO-1, IL-10, lung W/D and MPO markedly increased at nearly all time-points examined in HSR/LPS group as compared with sham/LPS group in WT mice. In HSR/LPS mice, the induced amount of IL-10 and the expressions of HO-1 of WT mice were significantly higher compared with TLR-4d/d. This study provides in vivo evidence that pulmonary infections after LPS instillation contribute to local tissue release of pro-inflammatory mediators after HSR systemic. Activation of TLR4 might induce HO-1 expression and HO-1 modulates proinflammatory responses that are triggered via TLR4 signaling.
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Affiliation(s)
- Chang Chen
- Department of Anesthesiology, Zhongnan Hospital, Medical College of Wuhan University, Donghu Road, Wuhan, 430071, Hubei, People's Republic of China
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Jafarzadeh A, Nemati M, Rezayati MT, Ebrahimi M, Hassan ZM. Cimetidine enhances delayed-type hypersensitivity responses and serum interleukin (IL)-2, -10, -12, and IL-17 levels after burn injury in an animal model. J Immunotoxicol 2012; 10:201-9. [DOI: 10.3109/1547691x.2012.708365] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/30/2023] Open
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100
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Abstract
Obesity and related type 2 diabetes are increasing at epidemic proportions globally. It is now recognized that inflammatory responses mediated within the adipose tissue in obesity are central to the development of disease. Once initiated, chronic inflammation associated with obesity leads to the modulation of immune cell function. This review will focus specifically on the impact of obesity on γδ T cells, a T-cell subset that is found in high concentrations in epithelial tissues such as the skin, intestine, and lung. Epithelial γδ T cell function is of particular concern in obesity as they are the guardians of the epithelial barrier and mediate repair. A breakdown in their function, and subsequently the deterioration of the epithelium can result in dire consequences for the host. Obese patients are more prone to non-healing injuries, infection, and disease. The resulting inflammation from these pathologies further perpetuates the disease condition already present in obese hosts. Here we will provide insight into the immunomodulation of γδ T cells that occurs in the epithelial barrier during obesity and discuss current therapeutic options.
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