Drugs Interfering with Insulin Resistance and Their Influence on the Associated Hypermetabolic State in Severe Burns: A Narrative Review

International Journal of Molecular Sciences

Silviu Constantin Badoiu¹  Maria Greabu²  Iulia-Ioana Stanescu-Spinu²  Daniela Miricescu²  Alexandra Ripszky Totan²  Michel Costagliola³  Viorel Jinga⁴  Silvia Elena Badoiu⁵ 

[1] Department of Anatomy and Embriology, Faculty of Medicine, Carol Davila University of Medicine and Pharmacy, 8 Eroii Sanitari Blvd, 050474 Bucharest, Romania;Department of Biochemistry, Faculty of Dental Medicine, Carol Davila University of Medicine and Pharmacy, 8 Eroii Sanitari Blvd, 050474 Bucharest, Romania;Department of Plastic and Reconstructive Surgery, Faculté de Médicine Toulouse-Rangueil 3, Université Toulouse III-Paul Sabatier, Rue de Languedoc, CEDEX 04, 31000 Toulouse, France;Department of Urology–Clinical Hospital Prof. Dr. Th. Burghele, Faculty of Medicine, Carol Davila University of Medicine and Pharmacy, 37 Dionisie Lupu Street, 030167 Bucharest, Romania;Faculty of Medicine, Carol Davila University of Medicine and Pharmacy, 8 Eroii Sanitari Blvd, 050474 Bucharest, Romania;

关键词: burns;    insulin resistance;    insulin signaling pathway;    β blockers;    statins;    thiazolidinediones;   

DOI  :  10.3390/ijms22189782

来源: DOAJ

【 摘 要 】

It has become widely accepted that insulin resistance and glucose hypermetabolism can be linked to acute pathologies, such as burn injury, severe trauma, or sepsis. Severe burns can determine a significant increase in catabolism, having an important effect on glucose metabolism and on muscle protein metabolism. It is imperative to acknowledge that these alterations can lead to increased mortality through organ failure, even when the patients survive the initial trauma caused by the burn. By limiting the peripheral use of glucose with consequent hyperglycemia, insulin resistance determines compensatory increased levels of insulin in plasma. However, the significant alterations in cellular metabolism lead to a lack of response to insulin’s anabolic functions, as well as to a decrease in its cytoprotective role. In the end, via pathological insulin signaling associated with increased liver gluconeogenesis, elevated levels of glucose are detected in the blood. Several cellular mechanisms have been incriminated in the development of insulin resistance in burns. In this context, the main aim of this review article is to summarize some of the drugs that might interfere with insulin resistance in burns, taking into consideration that such an approach can significantly improve the prognosis of the burned patient.

【 授权许可】

Unknown