The Immune and Regenerative Response to Burn Injury

Abstract

Burn are diverse and complex injuries that not only have local effects but also serious systemic consequences through severe and prolonged inflammatory response. They are caused by heat, electricity, friction, chemicals, or radiation and are commonly divided into superficial, superficial partial-, deep partial- and full-thickness injuries. The severity of the burn depends mainly on the size and depth of the injury but also on location, age, and underlying systemic diseases. A prolonged and strong immune response makes major burns even worse by causing multiple systemic effects including damage to the heart, lungs, blood vessels, kidneys, and other organs. Burns that do not require surgical excision, superficial and superficial partial-thickness, follow the known progression of wound healing (inflammation, proliferation, remodeling), whilst deep partial- and full thickness injuries requiring excision and grafting do not. For these burns, intervention is required for optimal coverage, function, and cosmesis. Annually millions of people worldwide suffer from burns associated with high morbidity and mortality. Fortunately, over the past decades, burn care has significantly improved. The improvement in understanding the pathophysiology of burn injury and burn wound progression has led to developments in skin grafting, fluid resuscitation, infection control and nutrition This review article focuses on the immune and regenerative responses following burn injury. In the Introduction, we describe the epidemiology of burns and burn pathophysiology. The focus of the following chapter is on systemic responses to burn injury. Next, we define the immune response to burns introducing all the different cell types involved. Subsequently, we discuss the regenerative cell response to burns as well as some of the emerging novel treatments in the battle against burns.

Identification of ferroptosis-related genes and predicted overall survival in patients with burns

“…The control (healthy) group showed significantly higher levels of T, NK, and B primitive cells compared with the burn group. The burned individuals showed significantly higher levels of monocytes, macrophages, mast cells, neutrophils, plasma cells, and T cells gamma delta, which was consistent with our cognition (Figure 8A) (22).…”

“…Notably, mast cells are not only present in the early stages of the immune system response to burns. Meanwhile, the role of B cells may be downregulated after thermal injury ( 22 ). In our study, these phenomena were well confirmed.…”

Histological assessment of nanostructured fibrin‐agarose skin substitutes grafted in burnt patients. A time‐course study

“…Large burns are very relevant public health problems causing massive tissue destruction and dramatic pathophysiologic effects on the burnt patient 1 . As an intact healthy skin is necessary to protect the internal tissues, a proper skin barrier is essential for patient survival 2 .…”

Mast Cells in Regeneration of the Skin in Burn Wound with Special Emphasis on Molecular Hydrogen Effect

“…The morphological aspects of the wound process are the focus of attention for various researchers. Burn wounds are of special significance compared to other skin injuries due to both the specificity of the wound process and the long-term restoration of skin integrity [ 1 , 2 ]. The restoration of the skin as an organ after thermal alteration is directly related to the state of the extracellular matrix of the dermis, including the amphora and fibrous components.…”