62 Chapter 3 ABSTRACT Burns are often accompanied by a dysfunctional immune response, which can lead to systemic inflammation, shock and excessive scarring. Because detailed information on the underlying immune reactions is scattered, we systematically reviewed animal experimental data for all reported inflammatory mediators. Meta-analyses of 352 studies revealed a strong increase in cytokines, chemokines and growth factors, particularly 19 mediators in blood and 12 in burn tissue. Temporal kinetics showed long-lasting surges of pro-inflammatory cytokines in blood and burn tissue. Significant time-dependent effects were seen for IL-1β, IL-6, TGF-β1 and CCL2. The response of anti-inflammatory mediators was limited. Burn technique had a profound impact on systemic response levels. Large burn size and scalds further increased systemic, but not local inflammation. Animal characteristics greatly impacted inflammation, e.g., IL-1β, IL-6 and TNF-α levels were highest in young, male rats. Collectively, this review provides guidance for experimental set-ups to advance burn research and exposes inflammatory pathways that could be targeted through immunotherapy for burn patients.
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