Burn injuries are a significant global health concern, with more than 11 million people requiring medical intervention each year and approximately 180,000 deaths annually. Despite progress in health and social care, burn injuries continue to result in socioeconomic burdens for victims and their families. The management of severe burn injuries involves preventing and treating burn shock and promoting skin repair through a two-step procedure of covering and closing the wound. Currently, split-thickness/full-thickness skin autografts are the gold standard for permanent skin substitution. However, deep burns treated with split-thickness skin autografts may contract, leading to functional and appearance issues. Conversely, defects treated with full-thickness skin autografts often result in more satisfactory function and appearance. The development of tissue-engineered dermal templates has further expanded the scope of wound repair, providing scar reductive and regenerative properties that have extended their use to reconstructive surgical interventions. Although their interactions with the wound microenvironment are not fully understood, these templates have shown potential in local infection control. This narrative review discusses the current state of wound repair in burn injuries, focusing on the progress made from wound cover to wound closure and local infection control. Advancements in technology and therapies hold promise for improving the outcomes for burn injury patients. Understanding the underlying mechanisms of wound repair and tissue regeneration may provide new insights for developing more effective treatments in the future.
- MeSH
- hojení ran MeSH
- jizva etiologie prevence a kontrola chirurgie MeSH
- kůže patologie MeSH
- lidé MeSH
- popálení * chirurgie patologie MeSH
- transplantace kůže metody MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- časopisecké články MeSH
- přehledy MeSH
Identification of therapeutic targets for treating fibrotic diseases and cancer remains challenging. Our study aimed to investigate the effects of TGF-β1 and TGF-β3 on myofibroblast differentiation and extracellular matrix deposition in different types of fibroblasts, including normal/dermal, cancer-associated, and scar-derived fibroblasts. When comparing the phenotype and signaling pathways activation we observed extreme heterogeneity of studied markers across different fibroblast populations, even within those isolated from the same tissue. Specifically, the presence of myofibroblast and deposition of extracellular matrix were dependent on the origin of the fibroblasts and the type of treatment they received (TGF-β1 vs. TGF-β3). In parallel, we detected activation of canonical signaling (pSMAD2/3) across all studied fibroblasts, albeit to various extents. Treatment with TGF-β1 and TGF-β3 resulted in the activation of canonical and several non-canonical pathways, including AKT, ERK, and ROCK. Among studied cells, cancer-associated fibroblasts displayed the most heterogenic response to TGF-β1/3 treatments. In general, TGF-β1 demonstrated a more potent activation of signaling pathways compared to TGF-β3, whereas TGF-β3 exhibited rather an inhibitory effect in keloid- and hypertrophic scar-derived fibroblasts suggesting its clinical potential for scar treatment. In summary, our study has implications for comprehending the role of TGF-β signaling in fibroblast biology, fibrotic diseases, and cancer. Future research should focus on unraveling the mechanisms beyond differential fibroblast responses to TGF-β isomers considering inherent fibroblast heterogeneity.
- MeSH
- fibroblasty metabolismus MeSH
- hojení ran MeSH
- jizva hypertrofická * metabolismus patologie MeSH
- karcinogeneze metabolismus patologie MeSH
- kultivované buňky MeSH
- lidé MeSH
- nádorová transformace buněk metabolismus MeSH
- protein - isoformy metabolismus MeSH
- transformující růstový faktor beta metabolismus MeSH
- transformující růstový faktor beta1 * farmakologie metabolismus MeSH
- transformující růstový faktor beta3 metabolismus farmakologie MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- časopisecké články MeSH
- MeSH
- lidé MeSH
- popálení ošetřování MeSH
- popáleninové jednotky klasifikace statistika a číselné údaje MeSH
- válečná poranění * ošetřování MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- rozhovory MeSH
- Geografické názvy
- Česká republika MeSH
- Ukrajina MeSH
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- bakteriální infekce terapie MeSH
- emigranti a imigranti MeSH
- hromadné neštěstí MeSH
- lidé MeSH
- ozbrojené konflikty * MeSH
- popálení * terapie MeSH
- popáleninové jednotky MeSH
- stresové poruchy z válečných bojů MeSH
- uprchlíci MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- rozhovory MeSH
- Geografické názvy
- Česká republika MeSH
- Ukrajina MeSH
BACKGROUND/AIM: We have previously shown that the water extract of Agrimonia eupatoria L. (AE) is a valuable source of polyphenols with excellent antioxidant properties and has clinical potential for the prevention and/or adjuvant therapy of cardiovascular complications associated with diabetes. Inspired by our previously published data, in the present study we examined whether AE improves skin wound healing in a series of in vitro and in vivo experiments. MATERIALS AND METHODS: In detail, we investigated the ability of the AE extract to induce fibroblast to myofibroblast conversion, extracellular matrix (ECM) deposition, and keratinocyte proliferation/differentiation, in vitro. In parallel, in an animal model, we measured wound tensile strength (TS) and assessed the progression of open wounds using basic histology and immunofluorescence. RESULTS: The AE extract induced the myofibroblast-like phenotype and enhanced ECM deposition, both in vitro and in vivo. Furthermore, the wound TS of skin incisions and the contraction rates of open excisions were significantly increased in the AE-treated group. CONCLUSION: The present data show that AE water extract significantly improves the healing of open and sutured skin wounds. Therefore, our data warrant further testing in animal models that are physiologically and evolutionarily closer to humans.
Burn injury is one of the most serious traumatic events with possible psychological and psychosocial consequences. Health status perception is one of the main health outcomes. The severity of psychological symptoms does not always correlate with that of the burn injury, suggesting that early screening for psychological vulnerabilities may be beneficial. The aim of our study was to identify the personality, clinical, and sociodemographic characteristics related to patient's subjective perception of health, depression, and anxiety in a sample of 52 adult patients with severe burn injury shortly before discharge from specialty burn clinic. Subjective health perception was predicted by depression (β = -.143, t(47) = -3.94, P < .001) and neuroticism (β = -.106, t(43) = -4.83, P < .001), and it correlated positively with extraversion (r = .2858, P = .0465) and conscientiousness (r = .3663, P = .0096). Depression was predicted by neuroticism (F(1,49) = 18.4; P < .001) and correlated with attachment avoidance (r = .29, P = .0383) and negatively with extraversion (r = -.32, P = .0220). Anxiety was related to attachment anxiety (F(1,49) = 4.25; P = .045), neuroticism (F(1,49) = 15.75; P < .001), and agreeableness (r = -.36, P = .0101). Unemployed patients experienced higher levels of depression and anxiety. This research suggests that personality traits and adult attachment may play an important role in the acute phase of the recovery from a severe burn injury. These findings can be relevant for early intervention and holistic rehabilitation.
- MeSH
- adaptace psychologická * MeSH
- duševní poruchy psychologie MeSH
- lidé středního věku MeSH
- lidé MeSH
- nezaměstnanost psychologie MeSH
- popálení psychologie MeSH
- rizikové faktory MeSH
- stupeň závažnosti nemoci MeSH
- Check Tag
- lidé středního věku MeSH
- lidé MeSH
- mužské pohlaví MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- MeSH
- Acinetobacter baumannii patogenita MeSH
- acitretin aplikace a dávkování MeSH
- acyklovir terapeutické užití MeSH
- biopsie MeSH
- Corynebacterium patogenita MeSH
- Darierova nemoc * diagnóza komplikace patologie MeSH
- erytém etiologie MeSH
- foskarnet aplikace a dávkování MeSH
- horečka etiologie MeSH
- hydrokortison aplikace a dávkování MeSH
- Kaposiho erupce variceliformní etiologie farmakoterapie patologie virologie MeSH
- Klebsiella pneumoniae patogenita MeSH
- kombinace léků piperacilin a tazobactam terapeutické užití MeSH
- léková rezistence MeSH
- lidé středního věku MeSH
- lidé MeSH
- lidský herpesvirus 1 patogenita MeSH
- meropenem aplikace a dávkování MeSH
- oxacilin terapeutické užití MeSH
- pneumonie etiologie komplikace virologie MeSH
- progrese nemoci MeSH
- terapie neúspěšná MeSH
- umělé dýchání MeSH
- výsledek terapie MeSH
- Check Tag
- lidé středního věku MeSH
- lidé MeSH
- mužské pohlaví MeSH
- Publikační typ
- kazuistiky MeSH
BACKGROUND: Severe burn injury is a specific type of trauma, which induces a unique complex of responses in the body and leads to an extreme increase in stress hormones and proinflammatory cytokines. These hypermetabolic and stress responses are desirable in the acute phase but can persist for several years and lead - due to several mechanisms - to many late complications, including myocardial dysfunction. METHODS: The databases of PubMed, ScienceDirect, National Institutes of Health (NIH) of the United States, and Google Scholar were searched. Studies relevant to the topic of late cardiovascular dysfunction after burn injury were compiled using key words. RESULTS: Burn-induced heart disease significantly increases morbidity and mortality and contributes to the reduction in the quality of life of patients after severe burn trauma. A variety of mechanisms causing myocardial dysfunction after burn trauma have been detailed but understanding all of the exact consequences is limited, especially regarding chronic cardiovascular changes. CONCLUSION: A detailed understanding of the pathophysiology of chronic cardiac changes can contribute to a comprehensive and preventive treatment plan and improve long-term outcomes of burn patients.
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- cytokiny MeSH
- kardiologové * MeSH
- kvalita života MeSH
- lidé MeSH
- nemoci srdce * etiologie MeSH
- popálení * komplikace MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- časopisecké články MeSH
- přehledy MeSH
Toxic epidermal necrolysis (TEN) is a rare disease, which predominantly manifests as damage to the skin and mucosa. Antibiotics count among the most common triggers of this hypersensitive reaction. Patients with TEN are highly susceptible to infectious complications due to the loss of protective barriers and immunosuppressant therapy. The aim of this study was to investigate the potential relationship between antibiotics used before the development of TEN and early and late-onset infectious complications in TEN patients. In this European multicentric retrospective study (Central European Lyell syndrome: therapeutic evaluation (CELESTE)), records showed that 18 patients with TEN used antibiotics (mostly aminopenicillins) before the disease development (group 1), while in 21 patients, TEN was triggered by another factor (group 2). The incidence of late-onset infectious complications (5 or more days after the transfer to the hospital) caused by Gram-positive bacteria (especially by Enterococcus faecalis/faecium) was significantly higher in group 1 than in group 2 (82.4% vs. 35.0%, p = 0.007/pcorr = 0.014) while no statistically significant difference was observed between groups of patients with infection caused by Gram-negative bacteria, yeasts, and filamentous fungi (p > 0.05). Patients with post-antibiotic development of TEN are critically predisposed to late-onset infectious complications caused by Gram-positive bacteria, which may result from the dissemination of these bacteria from the primary focus.
- Publikační typ
- časopisecké články MeSH
