Effect of insulin on the inflammatory and acute phase response after burn injury

Marc G. Jeschke, Darren F. Boehning, Celeste Finnerty, David Herndon

Research output: Contribution to journalArticle

38 Citations (Scopus)

Abstract

After a severe burn, the liver plays a pivotal role by modulating inflammatory processes, metabolic pathways, immune functions, and the acute phase response. Therefore, liver integrity and function are important for recovery. A thermal injury, however, causes hepatic damage by inducing hepatic edema, fatty infiltration, hepatocyte apoptosis, and metabolic derangements associated with insulin resistance and impaired insulin signaling. In preliminary studies, we found that these pathophysiological processes are related to hepatic inflammation, altered intracellular signaling, and mitochondrial dysfunction. We hypothesize that modulation of these processes with insulin could improve hepatic structure and function and, therefore, outcome of burned and critically ill patients. Insulin administration improves survival and decreases the rate of infections in severely burned and critically ill patients. Here, we show that insulin administration decreases the synthesis of proinflammatory cytokines and signal transcription factors and improves hepatic structure and function after a severe burn injury; insulin also restores hepatic homeostasis and improves hepatic dysfunction postburn via alterations in the signaling cascade.

Original languageEnglish (US)
JournalCritical Care Medicine
Volume35
Issue number9 SUPPL.
DOIs
StatePublished - Sep 2007

Fingerprint

Acute-Phase Reaction
Insulin
Liver
Wounds and Injuries
Critical Illness
Recovery of Function
Metabolic Networks and Pathways
Insulin Resistance
Hepatocytes
Edema
Homeostasis
Transcription Factors
Survival Rate
Hot Temperature
Apoptosis
Cytokines
Inflammation

Keywords

  • Acute phase response
  • Burn injury
  • Inflammatory response
  • Insulin
  • Liver

ASJC Scopus subject areas

  • Critical Care and Intensive Care Medicine

Cite this

Effect of insulin on the inflammatory and acute phase response after burn injury. / Jeschke, Marc G.; Boehning, Darren F.; Finnerty, Celeste; Herndon, David.

In: Critical Care Medicine, Vol. 35, No. 9 SUPPL., 09.2007.

Research output: Contribution to journalArticle

Jeschke, Marc G. ; Boehning, Darren F. ; Finnerty, Celeste ; Herndon, David. / Effect of insulin on the inflammatory and acute phase response after burn injury. In: Critical Care Medicine. 2007 ; Vol. 35, No. 9 SUPPL.
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