Low molecular weight heparin mediated regulation of nitric oxide synthase during burn wound healing.

Nitric oxide (NO) is an important signal molecule in many types of cells and tissues. Efficiently balanced NO production was noted to play an important role in the healing of burns. Inducible nitric oxygen synthase (iNOS) is responsible for the discontinuous synthesis of high amounts of NO. Dysregulation of nitric oxygen synthase (NOS) activity has been associated with multiple organ failure in burn patients and may therefore represent a novel therapeutic target in such circumstances. Heparin and low molecular weight heparin (LMWH) derivatives may offer therapeutic benefit for inflammatory diseases, whereas NO plays a protagonist role. Burn injury in humans has been associated with a significant increase in NO(2)/NO(3) (nitrite/nitrate) plasma levels. In this prospective study burn patients were treated with and without LMWH to provide evidence that LMWH has NOS-reducing activity. This was proved by colorimetric and immunohistological studies. There was a significantly different NOS activity between the treated and the control group and our results suggest that LMWH was more effective in the treatment of burn patients through iNOS inhibition. Treatment with LMWH was initiated within 6 h post-burn.