Maine Health Institute for Research, 81 Research Drive, Scarborough, ME 04074, USA.
Maine Health Institute for Research, 81 Research Drive, Scarborough, ME 04074, USA; Maine Medical Center, 22 Bramhall Street, Portland, ME 04105, USA.
Burns. 2024 May;50(4):947-956. doi: 10.1016/j.burns.2024.01.024. Epub 2024 Feb 1.
Burn wound conversion is the observed process where superficial partial thickness burns convert into deep partial or full thickness burn injuries. This conversion process often involves surgical excision to achieve timely wound healing. Unfortunately, the pathophysiology of this phenomenon is multifactorial and poorly understood. Thus, a therapeutic intervention that may prevent secondary progression and cell death in burn-injured tissue is desirable. Recent work by our group and others has established that tranexamic acid (TXA) has significant anti-inflammatory properties in addition to its well-known anti-fibrinolytic effects. This study investigates TXA as a novel therapeutic treatment to mitigate burn wound conversion and reduce systemic inflammation. Sprague-Dawley rats were subjected to a hot comb burn contact injury. A subset of animals underwent a similar comb burn with an adjacent 30%TBSA contact injury. The interspaces represent the ischemic zones simulating the zone of stasis. The treatment group received injections of TXA (100 mg/kg) immediately after injury and once daily until euthanasia. Animals were harvested for analyses at 6 h and 7 days after injury. Full-thickness biopsies from the ischemic zones and lung tissue were assessed with established histological techniques. Plasma was collected for measurement of damage associated molecular patterns (DAMPs), and liver samples were used to study inflammatory cytokines expression. Treatment with TXA was associated with reduced burn wound conversion and decreased burn-induced systemic inflammatory response syndrome (SIRS). Lung inflammation and capillary leak were also significantly reduced in TXA treated animals. Future research will elucidate the underlying anti-inflammatory properties of TXA responsible for these findings.
烧伤创面转化是指观察到的一种过程，即浅二度部分厚度烧伤转化为深二度部分或全层厚度烧伤损伤。这个转化过程通常需要手术切除来实现及时的伤口愈合。不幸的是，这种现象的病理生理学是多因素的，目前还不太了解。因此，需要一种治疗干预措施，以防止烧伤组织中的继发性进展和细胞死亡。我们小组和其他小组的最近研究表明，氨甲环酸（TXA）除了具有众所周知的抗纤维蛋白溶解作用外，还具有显著的抗炎特性。本研究探讨了 TXA 作为一种新型治疗方法，以减轻烧伤创面转化和减少全身炎症。Sprague-Dawley 大鼠接受热梳子接触烧伤损伤。一部分动物接受了类似的梳子烧伤，并伴有相邻 30%的 TBSA 接触损伤。这些间隔代表模拟停滞区的缺血区。治疗组在损伤后立即和每天一次接受 TXA（100mg/kg）注射，直到安乐死。在损伤后 6 小时和 7 天收集动物进行分析。用既定的组织学技术评估缺血区和肺组织的全层活检。收集血浆以测量损伤相关分子模式（DAMPs），并使用肝样本来研究炎症细胞因子的表达。TXA 治疗与减少烧伤创面转化和降低烧伤诱导的全身炎症反应综合征（SIRS）有关。TXA 治疗的动物肺部炎症和毛细血管渗漏也明显减少。未来的研究将阐明 TXA 的潜在抗炎特性，这些特性是导致这些发现的原因。
