留言板

尊敬的读者、作者、审稿人, 关于本刊的投稿、审稿、编辑和出版的任何问题, 您可以本页添加留言。我们将尽快给您答复。谢谢您的支持!

姓名
邮箱
手机号码
标题
留言内容
验证码

烧伤创面修复中的代谢问题及营养策略

彭曦 孙勇

彭曦, 孙勇. 烧伤创面修复中的代谢问题及营养策略[J]. 中华烧伤与创面修复杂志, 2022, 38(8): 707-713. DOI: 10.3760/cma.j.cn501225-20220708-00288.
引用本文: 彭曦, 孙勇. 烧伤创面修复中的代谢问题及营养策略[J]. 中华烧伤与创面修复杂志, 2022, 38(8): 707-713. DOI: 10.3760/cma.j.cn501225-20220708-00288.
Peng X,Sun Y.Metabolic issues and nutritional strategies in burn wound repair[J].Chin J Burns Wounds,2022,38(8):707-713.DOI: 10.3760/cma.j.cn501225-20220708-00288.
Citation: Peng X,Sun Y.Metabolic issues and nutritional strategies in burn wound repair[J].Chin J Burns Wounds,2022,38(8):707-713.DOI: 10.3760/cma.j.cn501225-20220708-00288.

烧伤创面修复中的代谢问题及营养策略

doi: 10.3760/cma.j.cn501225-20220708-00288
基金项目: 

国家自然科学基金面上项目 82172202

重庆英才创新领军人才项目 cstc2022ycjh-bgzxm0148

详细信息
    通讯作者:

    彭曦,Email:pxlrmm@163.com

Metabolic issues and nutritional strategies in burn wound repair

Funds: 

General Program of National Natural Science Foundation of China 82172202

Innovative Leading Talents Project of Chongqing cstc2022ycjh-bgzxm0148

More Information
  • 摘要: 创面是烧伤最根本的问题,其修复不仅依赖有效的创面处理,还依赖患者良好的营养状态。营养支持是改善患者营养状况、促进创面愈合的重要手段,如何使之与烧伤创面的代谢相匹配是营养治疗的难点。该文从分析烧伤创面愈合中不同阶段的代谢特征入手,着重论述了葡萄糖、蛋白质与谷氨酰胺在这些阶段的代谢特点,提出了与创面愈合相适应的营养策略,以期最大限度地发挥营养治疗在创面修复中的作用。

     

  • 参考文献(50)

    [1] 许伟石, 刘琰, 乐嘉芬. 烧伤创面修复[M].2版.武汉:湖北科学技术出版社, 2013: 36-66.
    [2] AbazariM, GhaffariA, RashidzadehH, et al. A systematic review on classification, identification, and healing process of burn wound healing[J]. Int J Low Extrem Wounds, 2022, 21(1): 18-30. DOI: 10.1177/1534734620924857.
    [3] 杨宗城. 烧伤治疗学[M].3版.北京: 人民卫生出版社, 2006: 180-211.
    [4] ClarkA, ImranJ, MadniT, et al. Nutrition and metabolism in burn patients[J/OL]. Burns Trauma, 2017,5:11[2022-07-20]. https://pubmed.ncbi.nlm.nih.gov/28428966/. DOI: 10.1186/s41038-017-0076-x.
    [5] YarmushML, GolbergA. Bioengineering in wound healing: a systems approach[M]. New Jersey: World Scientific, 2017: 135-168.
    [6] Arribas-LópezE, ZandN, OjoO, et al. The effect of amino acids on wound healing: a systematic review and meta-analysis on arginine and glutamine[J]. Nutrients, 2021, 13: 2498. DOI: 10.3390/nu13082498.
    [7] ČomaM, FröhlichováL, UrbanL, et al. Molecular changes underlying hypertrophic scarring following burns involve specific deregulations at all wound healing stages (inflammation, proliferation and maturation)[J]. Int J Mol Sci, 2021, 22(2):897.DOI: 10.3390/ijms22020897.
    [8] 彭曦. 重症烧伤患者的代谢分期及营养治疗策略[J].中华烧伤杂志,2021,37(9):805-810. DOI: 10.3760/cma.j.cn501120-20210802-00264.
    [9] VinaikR, BarayanD, AugerC, et al. Regulation of glycolysis and the Warburg effect in wound healing[J]. JCI Insight, 2020, 5(17):e138949. DOI: 10.1172/jci.insight.138949.
    [10] LiB, TangH, BianX, et al. Calcium silicate accelerates cutaneous wound healing with enhanced re-epithelialization through EGF/EGFR/ERK-mediated promotion of epidermal stem cell functions[J/OL]. Burns Trauma, 2021,9:tkab029[2022-07-20]. https://pubmed.ncbi.nlm.nih.gov/34604395/. DOI: 10.1093/burnst/tkab029.
    [11] WangCG, LouYT, TongMJ, et al. Asperosaponin Ⅵ promotes angiogenesis and accelerates wound healing in rats via up-regulating HIF-1α/VEGF signaling[J]. Acta Pharmacol Sin, 2018,39(3):393-404. DOI: 10.1038/aps.2017.161.
    [12] RussoTA, BanuthA, NaderHB, et al. Altered shear stress on endothelial cells leads to remodeling of extracellular matrix and induction of angiogenesis[J]. PLoS One, 2020,15(11):e0241040. DOI: 10.1371/journal.pone.0241040.
    [13] YingM, YouD, ZhuX, et al. Lactate and glutamine support NADPH generation in cancer cells under glucose deprived conditions[J]. Redox Biol, 2021,46:102065. DOI: 10.1016/j.redox.2021.102065.
    [14] ChenL, ZhangZ, HoshinoA, et al. NADPH production by the oxidative pentose-phosphate pathway supports folate metabolism[J]. Nat Metab, 2019,1:404-415.
    [15] SwamyM, PathakS, GrzesKM, et al. Glucose and glutamine fuel protein O-GlcNAcylation to control T cell self-renewal and malignancy[J]. Nat Immunol, 2016,17(6):712-720. DOI: 10.1038/ni.3439.
    [16] HewitsonTD, SmithER. A metabolic reprogramming of glycolysis and glutamine metabolism is a requisite for renal fibrogenesis-why and how?[J]. Front Physiol, 2021,12:645857. DOI: 10.3389/fphys.2021.645857.
    [17] PorterC, TompkinsRG, FinnertyCC, et al. The metabolic stress response to burn trauma: current understanding and therapies[J]. Lancet, 2016,388(10052):1417-1426. DOI: 10.1016/S0140-6736(16)31469-6.
    [18] 孙勇, 彭曦. 重视烧伤创面愈合中的蛋白质营养问题[J]. 肠外与肠内营养, 2022, 29(2): 65-68. DOI: 10.16151/j.1007-810x.2022.02.001.
    [19] AltmanBJ, StineZE, DangCV. From Krebs to clinic: glutamine metabolism to cancer therapy[J]. Nat Rev Cancer, 2016,16(10):619-634. DOI: 10.1038/nrc.2016.71.
    [20] ScaliseM, PochiniL, GalluccioM, et al. Glutamine transport. From energy supply to sensing and beyond[J]. Biochim Biophys Acta, 2016,1857(8):1147-1157. DOI: 10.1016/j.bbabio.2016.03.006.
    [21] ScaliseM, PochiniL, GalluccioM, et al. Glutamine transport and mitochondrial metabolism in cancer cell growth[J]. Front Oncol, 2017,7:306. DOI: 10.3389/fonc.2017.00306.
    [22] KimJS, MartinMJ. REDOX REDUX? glutamine, catabolism, and the urea-to-creatinine ratio as a novel nutritional metric[J]. Crit Care Med, 2022,50(7):1156-1159. DOI: 10.1097/CCM.0000000000005520.
    [23] GongJ, JingL. Glutamine induces heat shock protein 70 expression via O-GlcNAc modification and subsequent increased expression and transcriptional activity of heat shock factor-1[J]. Minerva Anestesiol, 2011,77(5):488-495.
    [24] ZhouT, YangY, ChenQ, et al. Glutamine metabolism is essential for stemness of bone marrow mesenchymal stem cells and bone homeostasis[J]. Stem Cells Int, 2019,2019:8928934. DOI: 10.1155/2019/8928934.
    [25] NelsonVL, NguyenH, Garcìa-CañaverasJC, et al. PPARγ is a nexus controlling alternative activation of macrophages via glutamine metabolism[J]. Genes Dev, 2018,32(15/16):1035-1044. DOI: 10.1101/gad.312355.118.
    [26] LiuPS, WangH, LiX, et al. α-ketoglutarate orchestrates macrophage activation through metabolic and epigenetic reprogramming[J]. Nat Immunol, 2017,18(9):985-994. DOI: 10.1038/ni.3796.
    [27] YangYJ, LiuMM, ZhangY, et al. Effectiveness and mechanism study of glutamine on alleviating hypermetabolism in burned rats[J]. Nutrition, 2020,79-80:110934. DOI: 10.1016/j.nut.2020.110934.
    [28] KimCS, DingX, AllmerothK, et al. Glutamine metabolism controls stem cell fate reversibility and long-term maintenance in the hair follicle[J]. Cell Metab, 2020,32(4):629-642.e8. DOI: 10.1016/j.cmet.2020.08.011.
    [29] YooHC, YuYC, SungY, et al. Glutamine reliance in cell metabolism[J]. Exp Mol Med, 2020,52(9):1496-1516. DOI: 10.1038/s12276-020-00504-8.
    [30] LiuJ, MarchaseRB, ChathamJC. Glutamine-induced protection of isolated rat heart from ischemia/reperfusion injury is mediated via the hexosamine biosynthesis pathway and increased protein O-GlcNAc levels[J]. J Mol Cell Cardiol, 2007,42(1):177-185. DOI: 10.1016/j.yjmcc.2006.09.015.
    [31] RaoX, DuanX, MaoW, et al. O-GlcNAcylation of G6PD promotes the pentose phosphate pathway and tumor growth[J]. Nat Commun, 2015,6:8468. DOI: 10.1038/ncomms9468.
    [32] KielerM, HofmannM, SchabbauerG. More than just protein building blocks: how amino acids and related metabolic pathways fuel macrophage polarization[J]. FEBS J, 2021, 288(12): 3694-3714. DOI: 10.1111/febs.15715
    [33] ShahAM, WangZ, MaJ. Glutamine metabolism and its role in immunity, a comprehensive review[J]. Animals (Basel), 2020, 10(2):326. DOI: 10.3390/ani10020326.
    [34] SunS, LiH, ChenJ, et al. Lactic acid: no longer an inert and end-product of glycolysis[J]. Physiology (Bethesda), 2017,32(6):453-463. DOI: 10.1152/physiol.00016.2017.
    [35] 彭曦. 烧伤临床营养新视角[J].中华烧伤杂志,2019,35(5):321-325. DOI: 10.3760/cma.j.issn.1009-2587.2019.05.001.
    [36] HewJJ, ParungaoRJ, MooneyCP, et al. Low-protein diet accelerates wound healing in mice post-acute injury[J/OL]. Burns Trauma, 2021,9:tkab010[2022-07-20]. https://pubmed.ncbi.nlm.nih.gov/34377708/. DOI: 10.1093/burnst/tkab010.
    [37] HoltB, GravesC, FaraklasI, et al. Compliance with nutrition support guidelines in acutely burned patients[J]. Burns, 2012,38(5):645-649. DOI: 10.1016/j.burns.2011.12.002.
    [38] RousseauAF, LosserMR, IchaiC, et al. ESPEN endorsed recommendations: nutritional therapy in major burns[J]. Clin Nutr, 2013,32(4):497-502. DOI: 10.1016/j.clnu.2013.02.012.
    [39] 彭曦. 重视谷氨酰胺在烧伤临床的规范应用[J].肠外与肠内营养,2021,28(1):1-4. DOI: 10.16151/j.1007-810x.2021.01.001.
    [40] KaufmanT, LevinM, HurwitzDJ. The effect of topical hyperalimentation on wound healing rate and granulation tissue formation of experimental deep second degree burns in guinea-pigs[J]. Burns Incl Therm Inj, 1984,10(4):252-256. DOI: 10.1016/0305-4179(84)90003-2.
    [41] ViljantoJ, RaekallioJ. Local hyperalimentation of open wounds[J]. Br J Surg, 1976,63(6):427-430. DOI: 10.1002/bjs.1800630603.
    [42] BergerMM, BinzPA, RouxC, et al. Exudative glutamine losses contribute to high needs after burn injury[J]. JPEN J Parenter Enteral Nutr, 2022,46(4):782-788. DOI: 10.1002/jpen.2227.
    [43] JafariP, ThomasA, HaselbachD, et al. Trace element intakes should be revisited in burn nutrition protocols: a cohort study[J]. Clin Nutr, 2018,37(3):958-964. DOI: 10.1016/j.clnu.2017.03.028.
    [44] WilgusTA, DiPietroLA. Complex roles for VEGF in dermal wound healing[J]. J Invest Dermatol, 2012,132(2):493-494. DOI: 10.1038/jid.2011.343.
    [45] 肖健, 张凡. 生长因子调控创面修复的进展与思考[J]. 中华烧伤与创面修复杂志, 2022, 38(7):610-615. DOI: 10.3760/cma.j.cn501225-20220416-00139.
    [46] 吴炜, 彭曦. 肠道谷氨酰胺转运载体研究进展[J].中华烧伤杂志,2014,30(2):171-174. DOI: 10.3760/cma.j.issn.1009-2587.2014.02.017.
    [47] 中华医学会烧伤外科学分会,《中华烧伤杂志》编辑委员会. 皮肤创面外用生长因子的临床指南[J].中华烧伤杂志,2017,33(12):721-727. DOI: 10.3760/cma.j.issn.1009-2587.2017.12.001.
    [48] HanCM, ChengB, WuP. Clinical guideline on topical growth factors for skin wounds[J]. Burns Trauma, 2020,8:tkaa035[2022-07-20]. https://pubmed.ncbi.nlm.nih.gov/33015207/. DOI: 10.1093/burnst/tkaa035.
    [49] LiQ, ZhongX, YaoW, et al. Inhibitor of glutamine metabolism V9302 promotes ROS-induced autophagic degradation of B7H3 to enhance antitumor immunity[J]. J Biol Chem, 2022,298(4):101753. DOI: 10.1016/j.jbc.2022.101753.
    [50] LiL, MengY, LiZ, et al. Discovery and development of small molecule modulators targeting glutamine metabolism[J]. Eur J Med Chem, 2019,163:215-242. DOI: 10.1016/j.ejmech.2018.11.066.
  • 加载中
图(1)
计量
  • 文章访问数:  3709
  • HTML全文浏览量:  99
  • PDF下载量:  77
  • 被引次数: 0
出版历程
  • 收稿日期:  2022-07-08

目录

    /

    返回文章
    返回