Intestinal barrier dysfunction in severe burn injury

Abstract

Severe burn injury is often accompanied by intestinal barrier dysfunction, which is closely associated with post-burn shock, bacterial translocation, systemic inflammatory response syndrome, hypercatabolism, sepsis, multiple organ dysfunction syndrome, and other complications. The intestinal epithelium forms a physical barrier that separates the intestinal lumen from the internal milieu, in which the tight junction plays a principal role. It has been well documented that after severe burn injury, many factors such as stress, ischemia/hypoxia, proinflammatory cytokines, and endotoxins can induce intestinal barrier dysfunction via multiple signaling pathways. Recent advances have provided new insights into the mechanisms and the therapeutic strategies of intestinal epithelial barrier dysfunction associated with severe burn injury. In this review, we will describe the current knowledge of the mechanisms involved in intestinal barrier dysfunction in response to severe burn injury and the emerging therapies for treating intestinal barrier dysfunction following severe burn injury.

Keywords: Burn; Intestinal barrier dysfunction; Myosin light chain; Myosin light chain kinase; Rho-associated protein kinase; Tight junction.

Fig. 1

The schematic diagram illustrating the mechanisms of intestinal barrier dysfunction in severe burn injury. IFN-γ interferon-γ, TNF-α tumor necrosis factor, ILs interleukins, MLCK myosin light chain kinase, ROCK rho-associated protein kinase, MLC myosin light chain, TJPs tight junction proteins, ZO-1 zonula occludens