Endothelial Permeability and 3-Nitrotyrosine in Major Burns

In patients with extensive burns microvascular hyperpermeability occurs not only at the injured sites but also in regions distant from the injury. The mechanism of this burn oedema is still not completely understood, nor why it stops after 18-36 hours. However, there is increasing evidence that an overwhelming production of reactive oxygen and nitrogen species (ROS/RNS) plays an important role in this context. Our data document the generation of peroxynitrite (ONOO - ) by detection of its footprint 3-nitrotyrosine in thermally injured human skin. The immunohistological detection reveals the location of 3-nitrotyrosine at the endothelium and further adds to the hypothesis of oxidative/nitrosative stress. A promising therapeutic approach might be high-dose antioxidant treatment as the enhanced free radical production in burn trauma is paralleled by impaired antioxidant mechanisms. The most promising results for the reduction of oedema formation and decreased early resuscitation fluid volume are known for intravenous vitamin C treatment. This paper gives a short review of the literature on this topic.