Nitric oxide, antioxidant capacity, nitric oxide synthase and xanthine oxidase plasma levels in a cohort of burn patients

Cerium Nitrate Treatment Provides Eschar Stabilization through Reduction in Bioburden, DAMPs, and Inflammatory Cytokines in a Rat Scald Burn Model

In this study, we used a clinically relevant rat scald burn model to determine the treatment effects of cerium nitrate (CN) for stabilizing burn eschars through reduction of damage-associated molecular patterns (DAMPs), inflammatory cytokines, and bioburden. Forty-two male Sprague-Dawley rats were anesthetized before undergoing a scald burn at 99°C for 6 seconds to create a 10% full-thickness burn. The test groups included sham burn, burn with water bathing, and burn with CN bathing. End point parameters included circulating DAMPs, proinflammatory cytokines, tissue myeloperoxidase activity, and quantification of resident flora in burn skin. The high mobility group protein box 1 was found to be elevated in burn animals at postoperative days (POD) 1 and 7. CN significantly alleviated the increase (P < .05 at POD 1 and P < .01 at POD 7). CN also lessened the heightened levels of hyaluronan in burn animals (P < .05 at POD 7). Additionally, CN significantly reduced the burn-induced increases in interleukin-1β, growth-regulated oncogene/keratinocyte chemoattractant, and macrophage inflammatory protein-1α in burn wounds. The anti-inflammatory effect of CN was also demonstrated in its ability to mitigate the upregulated circulatory xanthine oxidase/dehydrogenase and increased tissue neutrophil infiltration in burn animals. Last, CN suppressed postburn proliferation of resident skin microbes, resulting in a significant 2-log reduction by POD 7. In conclusion, these results suggest that CN attenuates the burn-induced DAMPs, tissue inflammatory responses, and regrowth of resident skin flora, all of which collectively could improve the quality of burn eschar when applied at the point of injury in prolonged field care situations.

Role of inducible nitric oxide synthase and interleukin-6 expression in estimation of skin burn age and vitality

Estimation of age and vitality of burn injury both in the living and dead is essential in forensic practice. Nitric oxide and interleukin-6 (IL-6) play an important role in skin burn healing. In this study, the expression of inducible nitric oxide synthase (iNOS) and IL-6 proteins during skin burn healing in rats was studied for purposes of burn dating and to differentiate between ante-mortem and post-mortem burn. Ante-mortem skin burns were created on forty five rats. Normal and burnt skin samples were taken at 1, 3, 5, 7, 9, 11, 13, 15 and 21 days following burn induction (5 rats for each stage). Post-mortem burn was inflicted 6 h after scarification in another five rats. There was a statistically significant difference in both iNOS and IL-6 expression between the different time intervals of the ante-mortem burn. Expression of both iNOS and IL-6 decreased remarkably in the post-mortem burn with a statistically significant difference from ante-mortem intervals. A statistically significant positive association between the two markers was found. These results indicate that both iNOS and IL-6 expression in ante-mortem burnt skin was time dependent and significantly differed from post-mortem burn. Further research on humans is recommended.

Biphasic changes (overreduction and overoxidation) of plasma redox status and clinical implications in early stage of severe burns

PURPOSE

Although the changes of redox status in the early stage of severe burns are considered to be associated with the disease progression, whereas antioxidant therapy cannot improve the prognosis, the characteristics and mechanisms of dynamic change of redox status related with the disease progression deserve further study.

METHODS

Blood redox potential (ORP) values (ΔORP value was adopted), plasma uric acid (UA) levels, and the inflammation-related indicators of 67 burn patients were dynamically monitored in the early stage.

RESULTS

Compared with healthy persons, the results revealed the biphasic changes of redox status in the early stage after burns, and both of them were closely related to the prognosis of severe burns. Overreduction status and overoxidation status were related to the dynamic changes of plasma UA level and the inflammation-related indicators of severe burns. In addition, the change of ΔORP value was found to associate with the traditional prognostic markers.

CONCLUSIONS

This study firstly revealed the excessive, biphasic changes of redox status and clinical implications in the early stage of severe burns, providing a new viewpoint for early pathological changes of severe burns and will be helpful for corresponding early treatment. ΔORP value also appears to be a potential early prognostic marker.

The year in burns 2007

In the year 2007, approximately 1000 original burn research articles were published in scientific journals using the English language. This article reviews approximately 90 of these which were deemed by the author to be the most important in terms of clinical burn care. Relevant topics include epidemiology, wound characterisation, critical care physiology, inhalation injury, infection, metabolism and nutrition, psychological considerations, pain management, rehabilitation, and burn reconstruction. Each selected article is mentioned briefly with editorial comment.