Kuznetsova Tatyana A, Andryukov Boris G, Besednova Natalia N
Somov Institute of Epidemiology and Microbiology, Russian Federal Service for Surveillance on Consumer Rights Protection and Human Wellbeing, 690087 Vladivostok, Russia.
School of Medicine, Far Eastern Federal University (FEFU), 690091 Vladivostok, Russia.
BioTech (Basel). 2022 May 27;11(2):18. doi: 10.3390/biotech11020018.
Burn injuries are among the most common peacetime injuries, with mortality ranging from 2.3% to 3.6%. At the same time, 85-90% of patients with burns are people of working age and children. Burn injury leads to metabolic disorders and systemic inflammatory response, inefficient energy consumption, and other physiological changes that can lead to dysfunction of organs and systems. The most formidable complication of burn injuries is sepsis mediated by multiple organ failure, the most common cause of poor prognosis in patients and has specific differences in these injuries. The purpose of this article was to dwell in detail on the most promising immunobiochemical markers of sepsis in the format of a mini-review, based on the main aspects of the immunopathogenesis of this complication. The pathogenesis of a burn injury and any general pathological process is based on an inflammatory reaction and large-scale changes in the skin and mucous membranes. This review is devoted to the progress in understanding the main aspects of the immunopathogenesis of burn lesions and the features of post-burn immune dysfunction, manifested by disorders in the innate and adaptive immunity systems. Attention is focused on the role in the immunopathogenesis of the development of systemic and local disorders in burn injury. Characterization of primary immunobiochemical markers of burn injury (cytokines, growth factors, C-reactive protein, procalcitonin, presepsin, matrix metalloproteinases, reactive oxygen species, nitric oxide, hemostasis parameters) is presented. The problem of treating burn lesions is associated with constant monitoring of the condition of patients and regular monitoring of specific immunobiochemical markers predicting sepsis for the timely initiation of a specific therapy.
烧伤是和平时期最常见的损伤之一，死亡率在2.3%至3.6%之间。与此同时，85%至90%的烧伤患者为工作年龄人群和儿童。烧伤会导致代谢紊乱和全身炎症反应、能量消耗效率低下以及其他生理变化，进而可能导致器官和系统功能障碍。烧伤最严重的并发症是由多器官功能衰竭介导的脓毒症，这是患者预后不良的最常见原因，且在这些损伤中存在特定差异。本文的目的是以小型综述的形式，基于该并发症免疫发病机制的主要方面，详细阐述脓毒症最有前景的免疫生化标志物。烧伤损伤和任何一般病理过程的发病机制都基于炎症反应以及皮肤和黏膜的大规模变化。本综述致力于在理解烧伤病变免疫发病机制的主要方面以及烧伤后免疫功能障碍的特征方面取得的进展，这些特征表现为先天性和适应性免疫系统的紊乱。重点关注烧伤损伤中全身和局部紊乱的发展在免疫发病机制中的作用。介绍了烧伤损伤的主要免疫生化标志物（细胞因子、生长因子、C反应蛋白、降钙素原、可溶性髓系细胞触发受体-1、基质金属蛋白酶、活性氧、一氧化氮、止血参数）的特征。烧伤病变的治疗问题与持续监测患者状况以及定期监测预测脓毒症的特定免疫生化标志物以及时启动特异性治疗有关。
