Department of Surgery, University of North Carolina at Chapel Hill, 4041 Burnett Womack, 101 Manning Drive, CB# 7050, Chapel Hill, NC, 27599-7050, USA.
Department of Microbiology and Immunology, University of North Carolina at Chapel Hill, Chapel Hill, USA.
J Transl Med. 2020 Mar 30;18(1):141. doi: 10.1186/s12967-020-02300-4.
Smoke inhalation injury increases overall burn mortality by up to 20 times. Current therapy remains supportive with a failure to identify an optimal or targeted treatment protocol for smoke inhalation injury. The goal of this review is to describe emerging therapies that are being developed to treat the pulmonary pathology induced by smoke inhalation injury with or without concurrent burn injury.
A comprehensive literature search was performed using PubMed (1995-present) for therapies not approved by the U.S. Food and Drug Administration (FDA) for smoke inhalation injury with or without concurrent burn injury. Therapies were divided based on therapeutic strategy. Models included inhalation alone with or without concurrent burn injury. Specific animal model, mechanism of action of medication, route of administration, therapeutic benefit, safety, mortality benefit, and efficacy were reviewed. Multiple potential therapies for smoke inhalation injury with or without burn injury are currently under investigation. These include stem cell therapy, anticoagulation therapy, selectin inhibition, inflammatory pathway modulation, superoxide and peroxynitrite decomposition, selective nitric oxide synthase inhibition, hydrogen sulfide, HMG-CoA reductase inhibition, proton pump inhibition, and targeted nanotherapies. While each of these approaches shows a potential therapeutic benefit to treating inhalation injury in animal models, further research including mortality benefit is needed to ensure safety and efficacy in humans.
Multiple novel therapies currently under active investigation to treat smoke inhalation injury show promising results. Much research remains to be conducted before these emerging therapies can be translated to the clinical arena.
吸入烟雾造成的伤害会使整体烧伤死亡率增加高达 20 倍。目前的治疗方法仍然是支持性的，未能确定吸入性烟雾伤害的最佳或针对性治疗方案。本综述的目的是描述正在开发的新兴疗法，以治疗吸入性烟雾伤害引起的肺部病理变化，无论是否同时伴有烧伤。
使用 PubMed（1995 年至今）对未经美国食品和药物管理局（FDA）批准用于治疗吸入性烟雾伤害（无论是否同时伴有烧伤）的疗法进行了全面的文献检索。根据治疗策略对疗法进行了分类。模型包括单独吸入和同时吸入，伴有或不伴有烧伤。综述了特定动物模型、药物作用机制、给药途径、治疗效果、安全性、死亡率益处和疗效。目前正在研究多种用于治疗吸入性烟雾伤害（无论是否伴有烧伤）的潜在疗法。这些包括干细胞疗法、抗凝治疗、选择素抑制、炎症途径调节、超氧化物和过氧亚硝酸盐分解、选择性一氧化氮合酶抑制、硫化氢、HMG-CoA 还原酶抑制、质子泵抑制和靶向纳米疗法。虽然这些方法中的每一种在动物模型中都显示出对治疗吸入性损伤的潜在治疗益处，但为了确保在人类中的安全性和疗效，还需要进行更多包括死亡率益处的研究。
目前正在积极研究多种用于治疗吸入性烟雾伤害的新型疗法，显示出有前景的结果。在这些新兴疗法能够转化为临床应用之前，还有很多研究工作要做。
