Department of Anatomy and Embryology, Faculty of Medicine, Carol Davila University of Medicine and Pharmacy, 8 Eroii Sanitari Blvd, 050474 Bucharest, Romania.
Department of Plastic and Reconstructive Surgery, Life Memorial Hospital, 365 Grivitei Street, 010719 Bucharest, Romania.
Int J Mol Sci. 2021 May 13;22(10):5159. doi: 10.3390/ijms22105159.
Severe burns represent an important challenge for patients and medical teams. They lead to profound metabolic alterations, trigger a systemic inflammatory response, crush the immune defense, impair the function of the heart, lungs, kidneys, liver, etc. The metabolism is shifted towards a hypermetabolic state, and this situation might persist for years after the burn, having deleterious consequences for the patient's health. Severely burned patients lack energy substrates and react in order to produce and maintain augmented levels of glucose, which is the fuel "ready to use" by cells. In this paper, we discuss biological substances that induce a hyperglycemic response, concur to insulin resistance, and determine cell disturbance after a severe burn. We also focus on the most effective agents that provide pharmacological modulations of the changes in glucose metabolism.
严重烧伤对患者和医疗团队来说是一个重大挑战。它们会导致深刻的代谢改变,引发全身性炎症反应,破坏免疫防御,损害心脏、肺、肾、肝等器官的功能。代谢会转向高代谢状态,这种情况可能会在烧伤后持续多年,对患者的健康造成有害影响。严重烧伤的患者缺乏能量底物,并会产生反应以产生和维持更高水平的葡萄糖,这是细胞“随时可用”的燃料。本文讨论了会引起高血糖反应、导致胰岛素抵抗以及确定严重烧伤后细胞紊乱的生物物质。我们还重点介绍了对葡萄糖代谢变化进行药理学调节最有效的药物。