Abstract
The increase in the vascular permeability is the most important pathological event in the pathogenesis of a burn injury. A massive leakage of fluid from the vascular space leads to a loss of blood plasma and a decrease in the effective circulatory blood volume, resulting in the formation of severe tissue edema, hypotension or even shock in a severe burn injury [1]. Fluid resuscitation has been the only valid method of sustaining a burn patient’s blood pressure for a long time owing to the lack of an overall and profound understanding of the mechanisms of a burn-induced vascular hyperpermeability response.
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Demling RH. The burn edema process: current concepts. J Burn Care Rehabil. 2005;26(3):207–27.
Mehta D, Malik AB. Signaling mechanisms regulating endothelial permeability. Physiol Rev. 2006;86:279–367.
Dejana E, Tournier-Lasserve E, Weinstein BM. The control of vascular integrity by endothelial cell junctions: molecular basis and pathological implications. Dev Cell. 2009;16(2):209–21.
Komarova YA, Mehta D, Malik AB. Dual regulation of endothelial junctional permeability. Sci STKE. 2007;(412):re8.
Van Nieuw Amerongen GP, van Hinsbergh VW. Targets for pharmacological intervention of endothelial hyperpermeability and barrier function. Vasc Pharmacol. 2002;39:257–72.
Zhao KS, Guo YW, Zhou LD. Effects of cortisone on vascular permeability in early stage of severe burn. Acta Physiologica Sinica. 1966;29:70–3.
Zheng HZ, Zhao KS, Huang QB, et al. Role of Rho kinase and actin filament in the increased vascular permeability of skin venule in rat after scalding. Burns. 2003;29(8):820–7.
Huang Q, Xu W, Ustinova E, et al. Myosin light chain kinase-dependent microvascular hyperpermeability in thermal injury. Shock. 2003;20(4):363–8.
Wautier JL, Zoukourian C, Chappey O, et al. Receptor-mediated endothelial cell dysfunction in diabetic vasculopathy: soluble receptor for advanced glycation end products blocks hyperpermeability in diabetic rats. J Clin Invest. 1996;97:238–43.
Guo XH, Huang QB, Chen B, et al. Mechanism of advanced glycation end products-induced hyperpermeability in endothelial cells. Acta Physiol Sino. 2005;57:205–10 (Chinese, English abstract).
Li Q, Guo XH, Zhu YJ, et al. The mechanism of advanced glycation end products-induced morphological changes of tight junction in endothelial cells. Chin J Arterioscler. 2006;14:499–502.
Breviario F, Caveda L, Corada M, et al. Functional properties of human vascular endothelial cadherin (7B4/cadherin-5), an endothelium-specific cadherin. Arterioscler Thromb Vasc Biol. 1995;15:1229–39.
Liu XL, Wu W, Li Q, et al. Effect of sphingosine 1-phosphate on morphological and functional responses in endothelia and venules after scalding injury. Burns. 2009;35:1171–9.
Levy MM, Fink MP, Marshall JC, et al. 2001 SCCM/ESICM/ACCP/ATS/SIS international sepsis definitions conference. Crit Care Med. 2003;31:1250–6.
Song L, Huang QB, Zhao KS, et al. Effects of LPS on the organization and localization of VE-cadherin and F-actin in cultured endothelial cells. Chin J Pathophysiol. 2003;19:150–2.
Wang ZH, Guo XH, Liu XL, et al. The morphological changes of vascular endothelial cadherin in human umbilical vein endothelial cells induced by advanced glycation end products. Chin J Arterioscler. 2008;16:505–9.
Geeves MA, Holmes KC. Structural mechanism of muscle contraction. Annu Rev Biochem. 1999;68:687–728.
Lai CH, Kuo KH, Leo JM. Critical role of actin in modulating BBB permeability. Brain Res Rev. 2005;50:7–13.
Yuan Y, Huang Q, Wu HM. Myosin light chain phosphorylation: modulation of basal and agonist-stimulated venular permeability. Am J Physiol. 1997;272(3 Pt 2):H1437–43.
Chen B, Guo XH, Wang Y, et al. Myosin light chain kinase contributes to cytoskeletal alteration of endothelial cells by rat burn serum. J 1st Mil Med Univ. 2004;24:481–4.
Huang QB, Song L, Zhao KS, et al. Effects of lipopolysaccharide on actin reorganization and actin pools in endothelial cells. Chin J Traumatol. 2004;7:195–200.
Hall A. Rho GTPase and the actin cytoskeleton. Science. 1998;279:509–14.
Waschke J, Baumgartner W, Adamson RH, et al. Requirement of Rac activity for maintenance of capillary endothelial barrier properties. Am J Physiol Heart Circ Physiol. 2004;286:H394–401.
Kuroda S, Fukata M, Nakagawa M, et al. Role of IQGAP1, a target of the small GTPase Cdc42 and Rac1, in regulation of E-cadherin-mediated cell-cell adhesion. Science. 1998;281:832–5.
Widmann C, Gilson S, Jarpe MB, et al. Mitogen-activated protein kinase: conservation of a three-kinase module from yeast to human. Physiol Rev. 1999;79:143–80.
Zarubin T, Han JH. Activation and signaling of the p38 MAP kinase pathway. Cell Res. 2005;15:11–8.
Murphya LO, Blenisb J. MAPK signal specificity: the right place at the right time. Trends Biochem Sci. 2006;31:268–75.
Huang Q, Zhao M, Wang Sh Y, et al. The role of p38 alpha and p38 delta MAP kinases in the genesis of increased vascular permeability in burns. Microcirculation. 2007;14:506.
Borbiev T, Birukova A, Liu F, et al. p38 MAP kinase-dependent regulation of endothelial cell permeability. Am J Physiol Lung Cell Mol Physiol. 2004;287:L911–8.
Johnson A, Hocking DC, Ferro TJ. Mechanisms of pulmonary edema induced by a diacylglycerol second messenger. Am J Physiol (HeartCirc Physiol 27). 1990;258:H85–91.
Murray MA, Heistad DD, Mayhan WG. Role of protein kinase C in bradykinin-induced increases in microvascular permeability. Circ Res. 1991;68:1340–8.
Huang Q, Yuan Y. Interaction of PKC and NOS in signal transduction of microvascular hyperpermeability. Am J Physiol. 1997;273(5 Pt 2):H2442–51.
Yang T, Huang QB. The activation and translocation of protein kinase C induced by burn serum. Chin Crit Care Med. 2001;13:427–9.
Dempsey EC, Newton AC, Mochly-Rosen D, et al. Protein kinase C isozymes and the regulation of diverse cell responses. Am J Physiol Lung Cell Mol Physiol. 2000;279:L429–38.
Bell RM. Protein kinase C activation by second messengers. Cell. 1986;45:631–2.
Garcia JGN, Davis HW, Patterson CE. Regulation of endothelial-cell gap formation and barrier dysfunction-role of myosin light-chain phosphorylation. J Cell Physiol. 1995;163:510–22.
Larsson C. Protein kinase C and the regulation of the actin cytoskeleton. Cell Signal. 2006;18:276–84.
Knezevic N, Roy A, Timblin B, et al. GDI-1 phosphorylation switch at serine 96 induces RhoA activation and increased endothelial permeability. Mol Cell Biol. 2007;27:6323–33.
Mehta D, Rahman A, Malik AB. Protein kinase C-alpha signals rho-guanine nucleotide dissociation inhibitor phosphorylation and rho activation and regulates the endothelial cell barrier function. J Biol Chem. 2001;276:22614–20.
Bogatcheva NV, Adyshev D, Mambetsariev B, et al. Involvement of microtubules, p38, and Rho kinases pathway in 2-methoxyestradiol-induced lung vascular barrier dysfunction. Am J Physiol Lung Cell Mol Physiol. 2007;292:L487–99.
Marinissen MJ, Chiariello M, Gutkind JS. Regulation of gene expression by the small GTPase Rho through the ERK6 (p38 gamma) MAP kinase pathway. Genes Dev. 2001;15(5):535–53.
McVerry BJ, Garcia JG. In vitro and in vivo modulation of vascular barrier integrity by sphingosine 1-phosphate: mechanistic insights. Cell Signal. 2005;17:131–9.
Fujimi S, MacConmara MP, Maung AA, et al. Platelet depletion in mice increases mortality after thermal injury. Blood. 2006;107(11):4399–406.
Garcia JG, Liu F, Verin AD, et al. Sphingosine 1-phosphate promotes endothelial cell barrier integrity by Edg-dependent cytoskeletal rearrangement. J Clin Invest. 2001;108(5):689–701.
Lee MJ, Thangada S, Claffey KP, et al. Vascular endothelial cell adherens junction assembly and morphogenesis induced by sphingosine-1-phosphate. Cell. 1999;99:301–12.
Liu XL, Wang H, Li Q, et al. Effects of sphingosine-1-phosphate on vascular permeability in scalding injury. J Chin Microcirc. 2008;12(5):267–70.
Alewijnse AE, Peters SL. Sphingolipid signalling in the cardiovascular system: good, bad or both? Eur J Pharmacol. 2008;585(2–3):292–302.
Moore TM, Chetham PM, Kelly JJ, et al. Signal transduction and regulation of lung endothelial cell permeability. Interaction between calcium and cAMP. Am J Physiol. 1998;275:L203–22.
Wu H, Huang Q, Yuan Y, et al. VEGF induces NO-dependent hyperpermeability in coronary venules. Am J Physiol. 1996;271:H2735–9.
Wu MH. Endothelial focal adhesions and barrier function. J Physiol. 2005;569(Pt 2):359–66.
Tuma PL, Hubbard AL. Transcytosis: crossing cellular barriers. Physiol Rev. 2003;83:871–932.
Zhao KS. Microcirculation in burns: microcirculatory changes in burned skin. Chin J Burn Reconst. 1987;3:15–57.
Zhao KS. The microcirculatory alterations in burns. Peoples Mil Surg. 1979;1:35–9.
Zhao KS, Zhu ZG, Wu GY, et al. The role of microcirculatory disorder in the genesis of burn shock. Med J Chin Lib Army. 1984;9:18–20.
Wu GY. The application of rabbit ear chamber technique in microcirculatory research of burned skin. The selection of Scientific Research (First Military Medical University). 1979;5:31.
Zhao KS, Wu GY, Tian Y, et al. The effect of polydatin on the change of microcirculation of burned skin. Med J Chin Lib Army. 1980;5:75–8.
Zhao KS, Woo GY, Tian Y, et al. The effect of polygonum cuspidatun on the microcirculation of burned skin. In: Chang HM et al., editors. Advances in Chinese medicinal materials research. World Scientific Pub: Singapore; 1985. p. 591–5.
Wu GY, Zhao KS, Zhu ZJ, et al. The electron microscopic observation of microvessels in burned skin. J First Mil Med Univ. 1984;4:49–51.
Zhao KS. The advances of microcirculatory research in burns. J First Mil Med Univ. 1984;4:131–8.
Zhao KS, Wu GY, Zhu ZG, et al. The role of leukocyte in microcirculatory disorder of shock. Chin J Med. 1986;10:722–5.
Wu XB, Zhao KS, Huang XL. The change of leukocyte adhesive feature in rat with severe burns. Chin J Med. 1994;74:312–4.
Zhao KS, Wu XB, Wang YC. Effect of polygonum cuspidatum on the leukocyte activation and adhesion of rat during burn shock. In: Niimi H et al., editors. Progress in microcirculation research. Oxford: Elsevier Science Ltd; 1994. p. 55–68.
Wang YC, Zhao KS, Wu XB. The prognostic implication of determination of activation of leukocyte in severe burns. Chin J Burn Reconst. 1994;10:286–5.
Wang YC, Zhao KS. The surface expression of LFA-1 on leukocyte in shock. Microcirc Tech. 1997;1:9–11.
Zhao ZH, Zhao KS, Zhu ZJ. Study on the expression of L-selectin at transcription level in severe burn shock rat. Chin J Pathophysiol. 1998;14:43–5.
Zhao KS. The research on leukocyte behavior of microcirculation in shock. J Microcir. 1992;2:40.
Zhao KS. Advances in the study on rheological behavior of leukocyte during severe shock. Chin Med J. 1996;109:110–1.
Wu XB, Huang QB, Zhao KS. The effect of LFA-1 monoclonal antibody on the microcirculatory disturbance of endotoxin shock in rabbit. Chin J Trauma. 1986;12:25–7.
Zhao KS. Integrin family and leukocyte adhesion. In: Zhao KS, Jin L, editors. Cellular and molecular basis of shock. Beijing: Scient Pub; 2002. p. 11–4.
Wu KY, Huang QB, Zhao KS. The effect of TNF monoclonal antibody on leukocyte adhesion and hemodynamic of microcirculation in rat with burn shock. Chin J Pathophysiol. 1996;12:425–7.
Wu KY, Zhao KS, Zhu ZJ, et al. Burn shock can be treated with peritoneal dialysis. Chin J Pathophysiol. 1987;3:88–91.
Ballard-Croft C, Carlson D, Maass DL, et al. Burn trauma alters calcium transporter protein expression in the heart. J Appl Physiol. 2004;97:1470–6.
Horton JW. Left ventricular contractile dysfunction as a complication of thermal injury. Shock. 2004;22:495–507.
Horton JW, White DJ, Maass D, et al. Calcium antagonists improve cardiac mechanical performance after thermal trauma. J Surg Res. 1999;87:39–50.
Murphy JT, Giroir B, Horton JW. Thermal injury alters myocardial sarcoplasmic reticulum calcium channel function. J Surg Res. 1999;82:244–52.
White DJ, Maass DL, Sanders B, et al. Cardiomyocyte intracellular calcium and cardiac dysfunction after burn trauma. Crit Care Med. 2002;30:14–22.
Kawai K, Kawai T, Sambol JT, et al. Cellular mechanisms of burn-related changes in contractility and its prevention by mesenteric lymph ligation. Am J Physiol Heart Circ Physiol. 2007;292:H2475–84.
Berridge MJ, Bootman MD, Roderick HL. Calcium signalling: dynamics, homeostasis and remodelling. Nat Rev Mol Cell Biol. 2003;4:517–29.
Berridge MJ, Lipp P, Bootman MD. The versatility and universality of calcium signalling. Nat Rev Mol Cell Biol. 2000;1:11–21.
Bers DM, Perez-Reyes E. Ca channels in cardiac myocytes: structure and function in Ca influx and intracellular Ca release. Cardiovasc Res. 1999;42(2):339–60.
Zhao KS, Zhu ZJ, Wu KY, et al. Importance of enhancing cardiac function in the treatment of burn shock-effect of crystal NO4 of polygonum cuspidatum. In: Sheng CY, editor. Advances in burns. Beijing: International Academic Publishers; 1992. p. 31–8.
Moore RL, Yelamarty RV, Misawa H, et al. Altered Ca2+ dynamics in single cardiac myocytes from renovascular hypertensive rats. Am J Physiol. 1991;260:C327–37.
Hasenfuss G, Pieske B. Calcium cycling in congestive heart failure. J Mol Cell Cardiol. 2002;34:951–69.
O’Rourke B, Kass DA, Tomaselli GF, et al. Mechanisms of altered excitation-contraction coupling in canine tachycardia-induced heart failure, I: experimental studies. Circ Res. 1999;84:562–70.
Fill M, Copello JA. Ryanodine receptor calcium release channels. Physiol Rev. 2002;82(4):893–922.
Meissner G. Ryanodine receptor/Ca2+ release channels and their regulation by endogenous effectors. Annu Rev Physiol. 1994;56:485–508.
Deng J, Wang G, Huang Q, et al. Oxidative stress induced leaky sarcoplasmic reticulum underlying acute heart failure in severe burn trauma. Free Radical Biol Med. 2008;44:375–85.
Acknowledgment
This work was supported by several sources: Chinese National Natural Scientific Foundation grant 30028008, 30771028 and 30971201; National Key Foundation for Basic Science Research of China (grant G2005CB522601); Natural Science Foundation of Guangdong, China (grant 4020373).
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Zhao, K., Huang, Q. (2015). The Alterations of Microcirculation in Burns. In: Yang, Z. (eds) Chinese Burn Surgery. Springer, Dordrecht. https://doi.org/10.1007/978-94-017-8575-4_2
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