Blood vessel occlusion with erythrocyte aggregates causes burn injury progression-microvasculature dilation as a possible therapy

Experimental Dermatology
Richard A F ClarkMarcia G Tonnesen

Abstract

Burns are dynamic injuries characterized by progressive tissue death and continuous severe pain over the course of several days. The extent of burn injury progression determines the ultimate patient outcome. Initial burns result in a central zone of necrosis surrounded by a potentially viable zone of ischemia. Several mechanisms have been proposed to explain injury progression, including oxidant and cytokine stress resulting from either ischemia/reperfusion and/or inflammation, but no proven therapy has emerged. To address the unmet need to limit burn injury progression, the root cause of this process must be delineated. For this reason, we have recently focused on post-burn blood vessel occlusion, currently ascribed to microthrombi. We have found that blood vessel occlusion is initially, mainly and persistently caused by erythrocyte aggregation. Although thermal-induced cell necrosis is the immediate cause of cell death, apoptotic cells from persistent ischemia/anoxia, admixed with inflammatory cells, form a band between viable and nonviable tissue 24 hours later. The delayed cell death by apoptosis appears to be the main attractant for inflammatory cells. Finally, we posit that fibrinogen elevation arising from inflammation p...Continue Reading

References

May 1, 1992·The Journal of Trauma·F C Regas, H P Ehrlich
May 1, 1953·The British Journal of Surgery·D M JACKSON
Nov 19, 2011·Wound Repair and Regeneration : Official Publication of the Wound Healing Society [and] the European Tissue Repair Society·Steven T LanierRichard A F Clark
Oct 16, 2013·The Journal of Investigative Dermatology·Fubao LinRichard A F Clark
Jan 18, 2016·Burns : Journal of the International Society for Burn Injuries·Joseph MiccioRichard A F Clark
Mar 31, 2016·Wound Repair and Regeneration : Official Publication of the Wound Healing Society [and] the European Tissue Repair Society·Bilal AsifRichard A F Clark
Mar 16, 2017·Microcirculation : the Official Journal of the Microcirculatory Society, Inc·Mary D FrameRichard A F Clark

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Citations

Oct 14, 2019·Wound Repair and Regeneration : Official Publication of the Wound Healing Society [and] the European Tissue Repair Society·Katherine GoldsmithAdam J Singer
Mar 27, 2021·Journal of Burn Care & Research : Official Publication of the American Burn Association·Nathan HaywoodMark E Roeser
Jun 20, 2021·Journal of Burn Care & Research : Official Publication of the American Burn Association·Vladislav A DolgachevMark R Hemmila
Dec 21, 2021·Annals of Plastic Surgery·Alper UralMehmet Bekerecioğlu

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