Department of Burn and Plastic Surgery, Rui Jin Hospital, Shanghai Jiao Tong University, School of Medicine, Shanghai, China.
Burns. 2009 Jun;35(4):547-52. doi: 10.1016/j.burns.2008.10.006. Epub 2009 Feb 8.
Organ protection is a routine therapy in severe burn/scald injuries, and damage following early scald injury was not been fully elucidated. Our aim was to verify the beneficial effects of ulinastatin on pancreatic and renal damage associated with scald injury. Lewis rats were subjected to 30% total body surface area (TBSA) scald injury, and were randomly divided into a burn control (S group) and an ulinastatin-treated group (U group). Pancreatic malondialdehyde (MDA) and superoxide dismutase (SOD) levels were determined. Serum amylase, serum creatinine (Scr) and blood urea nitrogen (BUN) were identified and the kidneys were examined histologically with immunohistochemistry (IHC) as well for the MHC class I chain-related antigen A (MICA) and Bcl-2 at 0, 1, 6, 12, 18, 24, 48 and 72 h after the injury. Ulinastatin decreased MDA levels and ameliorated the down-regulation of SOD activity. MICA was up-regulated after the scald, and this up-regulation was greatly diminished by ulinastatin. Bcl-2 was up-regulated after the scald, especially in the U group. From 24 to 72 h, in comparison with the U group, higher levels of BUN, Scr and serum amylase were observed in the S group which were all lower than the common upper limits. Our results demonstrated that pancreatic and renal damage associated with autoimmunity and oxidant attack occurred after severe scald. Ulinastatin exhibits significant protective effects on these effects.
器官保护是严重烧伤/烫伤患者的常规治疗方法，但早期烫伤损伤的机制尚未完全阐明。本研究旨在验证尿胰蛋白酶抑制剂（ulinastatin）对烫伤相关胰腺和肾脏损伤的有益作用。Lewis 大鼠接受 30%总体表面积（TBSA）烫伤，随机分为烧伤对照组（S 组）和尿胰蛋白酶抑制剂治疗组（U 组）。测定胰腺丙二醛（MDA）和超氧化物歧化酶（SOD）水平。检测血清淀粉酶、血清肌酐（Scr）和血尿素氮（BUN），并通过免疫组织化学（IHC）检测 MHC Ⅰ类链相关抗原 A（MICA）和 Bcl-2，以了解伤后 0、1、6、12、18、24、48 和 72 h 时肾脏的组织学变化。尿胰蛋白酶抑制剂降低 MDA 水平，改善 SOD 活性下调。烫伤后 MICA 上调，尿胰蛋白酶抑制剂可显著减弱其上调。烫伤后 Bcl-2 上调，尤其是 U 组。与 U 组相比，S 组伤后 24-72 h 时 BUN、Scr 和血清淀粉酶水平升高，均低于常见的上限值。这些结果表明，严重烫伤后会发生与自身免疫和氧化应激攻击相关的胰腺和肾脏损伤，尿胰蛋白酶抑制剂对这些损伤具有显著的保护作用。
