title: The biochemical alterations underlying post-burn hypermetabolism.
abstract: A severe burn can trigger a hypermetabolic state which lasts for years following the injury, to the detriment of the patient. The drastic increase in metabolic demands during this phase renders it difficult to meet the body's nutritional requirements, thus increasing muscle, bone and adipose catabolism and predisposing the patient to a host of disorders such as multi-organ dysfunction and sepsis, or even death. Despite advances in burn care over the last 50 years, due to the multifactorial nature of the hypermetabolic phenomenon it is difficult if not impossible to precisely identify and pharmacologically modulate the biological mediators contributing to this substantial metabolic derangement. Here, we discuss biomarkers and molecules which play a role in the induction and mediation of the hypercatabolic condition post-thermal injury. Furthermore, this thorough review covers the development of the factors released after burns, how they induce cellular and metabolic dysfunction, and how these factors can be targeted for therapeutic interventions to restore a more physiological metabolic phenotype after severe thermal injuries. This article is part of a Special Issue entitled: Immune and Metabolic Alterations in Trauma and Sepsis edited by Dr. Raghavan Raju.
authors.affiliation: Ross Tilley Burn Centre, Sunnybrook Health Sciences Centre, Toronto, Ontario, M4N 3M5, Canada.
authors.forename: Christopher
authors.initials: C
authors.lastname: Auger
authors.affiliation: Ross Tilley Burn Centre, Sunnybrook Health Sciences Centre, Toronto, Ontario, M4N 3M5, Canada.
authors.forename: Osai
authors.initials: O
authors.lastname: Samadi
authors.affiliation: Ross Tilley Burn Centre, Sunnybrook Health Sciences Centre, Toronto, Ontario, M4N 3M5, Canada. Electronic address: marc.jeschke@sunnybrook.ca.
authors.forename: Marc G
authors.initials: MG
authors.lastname: Jeschke
mesh_terms: D000818:Animals; D002056:Burns / Q000276:immunology / Q000378:metabolism* / Q000473:pathology / Q000628:therapy; D006801:Humans; D009102:Multiple Organ Failure / Q000276:immunology / Q000378:metabolism* / Q000628:therapy; D018805:Sepsis / Q000276:immunology / Q000378:metabolism* / Q000473:pathology / Q000628:therapy
keywords: Burns; Catabolism; Hypermetabolism; Insulin resistance; Mitochondria; Trauma