The effects and mechanisms of insulin on systemic inflammatory response and immune cells in severe trauma, burn injury, and sepsis.
Insulin resistance, hyperglycemia, inflammatory disorders and immune dysfunction cause high morbidity and mortality in patients with severe trauma, burn injuries, or sepsis. Many studies have shown that intensive insulin therapy can combat insulin resistance, decrease blood glucose levels, and induce anabolic processes, thus, decreasing morbidity and mortality. Moreover, in recent years, it has been proven that insulin can attenuate systemic inflammatory responses and modulate the proliferation, apoptosis, differentiation and immune functions of certain immune cells, especially monocytes/macrophages, neutrophils, and T cells associated with severe trauma, burn injury, or sepsis. This effect of insulin may expand our understanding of intensive insulin therapy in critically ill patients. This review attempts to summarize studies on the modulatory effects and mechanisms of insulin therapy on systemic inflammation and immune cells in severe trauma, burn injury and sepsis, and further propose some questions for future studies.
Deng
Hu-Ping
HP
Department of Burn and Plastic Surgery, Burns Institute, First Affiliated Hospital of General Hospital of PLA (Formerly 304th Hospital), Beijing 100048, PR China.
Chai
Jia-Ke
JK
D002056:Burns / Q000188:drug therapy / Q000276:immunology* / Q000378:metabolism; D006801:Humans; D006943:Hyperglycemia / Q000188:drug therapy; D007249:Inflammation / Q000188:drug therapy*; D018836:Inflammation Mediators / Q000378:metabolism; D007328:Insulin / Q000627:therapeutic use*; D008214:Lymphocytes / Q000187:drug effects*; D018448:Models, Immunological; D010586:Phagocytes / Q000187:drug effects*; D018805:Sepsis / Q000188:drug therapy / Q000276:immunology*; D015398:Signal Transduction / Q000187:drug effects; D018746:Systemic Inflammatory Response Syndrome / Q000188:drug therapy* / Q000276:immunology / Q000378:metabolism; D014947:Wounds and Injuries / Q000188:drug therapy / Q000276:immunology* / Q000378:metabolism
D018836:Inflammation Mediators; D007328:Insulin