Department of Biochemistry, Faculty of Dental Medicine, Carol Davila University of Medicine and Pharmacy, 8 Eroii Sanitari Blvd, 050474 Bucharest, Romania.
Department of Anatomy and Embriology, Faculty of Medicine, Carol Davila University of Medicine and Pharmacy, 8 Eroii Sanitari Blvd, 050474 Bucharest, Romania.
Int J Mol Sci. 2021 Sep 10;22(18):9782. doi: 10.3390/ijms22189782.
It has become widely accepted that insulin resistance and glucose hypermetabolism can be linked to acute pathologies, such as burn injury, severe trauma, or sepsis. Severe burns can determine a significant increase in catabolism, having an important effect on glucose metabolism and on muscle protein metabolism. It is imperative to acknowledge that these alterations can lead to increased mortality through organ failure, even when the patients survive the initial trauma caused by the burn. By limiting the peripheral use of glucose with consequent hyperglycemia, insulin resistance determines compensatory increased levels of insulin in plasma. However, the significant alterations in cellular metabolism lead to a lack of response to insulin's anabolic functions, as well as to a decrease in its cytoprotective role. In the end, via pathological insulin signaling associated with increased liver gluconeogenesis, elevated levels of glucose are detected in the blood. Several cellular mechanisms have been incriminated in the development of insulin resistance in burns. In this context, the main aim of this review article is to summarize some of the drugs that might interfere with insulin resistance in burns, taking into consideration that such an approach can significantly improve the prognosis of the burned patient.
人们普遍认为，胰岛素抵抗和葡萄糖代谢亢进与急性疾病有关，如烧伤、严重创伤或败血症。严重烧伤可导致分解代谢显著增加，对葡萄糖代谢和肌肉蛋白质代谢产生重要影响。必须认识到，这些改变可能导致器官衰竭的死亡率增加，即使患者在烧伤引起的初始创伤中幸存下来。通过限制外周葡萄糖的使用，从而导致高血糖，胰岛素抵抗导致血浆中胰岛素代偿性增加。然而，细胞代谢的显著改变导致对胰岛素合成作用的反应不足，以及其细胞保护作用的降低。最终，与肝糖异生增加相关的病理性胰岛素信号导致血液中葡萄糖水平升高。在烧伤中，已经有几种细胞机制被牵连到胰岛素抵抗的发展中。在这方面，本文综述的主要目的是总结一些可能干预烧伤中胰岛素抵抗的药物，考虑到这种方法可以显著改善烧伤患者的预后。
