Results of protease inhibitor instructions in patients in acute burning disease

Keywords: burn disease, proteinase inhibitors, inflammation, cytokines


The purpose of the study was to determine the clinical efficiency of proteinase inhibitor usage in patients with burns. Materials and Methods. The results of studies performed in 32 patients with superficial and deep burns were analyzed: 12 patients of the main group, whom were used the proteinase inhibitor drug in the complex treatment, and 20 comparison groups, who were treated according to the standard scheme.  The content of calpains, α-1 proteinase inhibitor (α-1-IP), α-2 macroglobulin (α-2-MG) and tumor necrosis factor α (TNF-α) in patients’ peripheral blood were determined. Results. The decrease in proteolytic activity of blood in patients of the main group was determined as a decrease in calpain levels by 1.16 times (50.51 ± 10.32 μEq/min on the 10th-16th day compared to baseline 58.83 ± 3.62 μEq/min on the 1-4th day after injury), while in the comparison group indicators of calpain content did not tend to decrease. Comparing the TNF-α values ​​of the main group and the comparison group, it was found that the values ​​of the main group were significantly lower 1.15 times on the 5th-9th day (245.33 ± 10.36 pg/ml and 281.2 ± 13, 67 pg/ml) and 1.08 times lower on the 10th-16th day (236.60 ± 8.78 pg/ml and 256.35 ± 15.70 pg/ml). The usage of ulinastatin led to a less pronounced decreasing in proteinase inhibitors levels: α-1-IP (79.31 ± 1.54 μmol/l of the main group compared with 72.1 ± 7.8 μmol/l of the control group on the 5th-9th day after injury and 75.34 ± 5.13 μmol/l of the main group compared with 68.0 ± 4.9 μmol/l of the control group on the 10-16th day after injury), α-2-MG (2.63 ± 0.24 g/l of the main group compared with 2.2 ± 0.4 g/l of the control group on the 10-16th day after injury). Conclusion. The results of the study indicate that the proteinase inhibitor drug included in the standard treatment regimen for acute burns optimizes the proteolytic activity of peripheral blood, promotes the inflammatory response optimal development, inhibits the endothelial dysfunction development.


World Health Organization. Global Health Estimates. 2018. global_burden_disease/en/.

Cannon, AR, Akhtar S, Hammer A M [et al.]. Effects of Mesalamine Treatment on Gut Barrier Integrity After Burn Injury. Journal of burn care & research: official publication of the American Burn Association. 2016;37(5):283–292. https://doi. org/10.1097/BCR.0000000000000396.

Greenhalgh DG. Management of Burns. N Engl J Med. 2019 Jun 13; 380 (24): 2349–2359. doi: 10.1056/NEJMra1807442. PMID: 31189038.

Jeschke MG, van Baar ME, Choudhry MA, Chung KK, Gibran NS, & Logsetty S. Burn injury. Nature reviews. Disease primers. 2020;6 (1):11.

Kozinets GP, Osadchaya OI, Kovalenko OM, Lynnyk OM. Wound Process Influence on Formation Systemic Inflammatory Response and Early Sepsis in Patients with Burns in Acute Period of Burn Disease. Modern medical technologies. 2019; 41 (2/3): 13–20.

Shupp JW, Nasabzadeh TJ, Rosenthal DS, Jordan MH, Fidler P, Jeng JC. A review of the local pathophysiologic bases of burn wound progression. J Burn Care Res. 2010 Nov-Dec; 31 (6): 849–73. doi: 10.1097/BCR.0b013e3181f93571. PMID: 21105319.

Baud L, Fouqueray B, Bellocq A, Peltier J. Les calpaïnes participent au développement de la réaction inflammatoire [Calpains participate in inflammatory reaction development]. Med Sci (Paris). 2003 Jan; 19 (1): 71–6. French. doi: 10.1051/medsci/200319171. PMID: 12836194.

Veremeyenko KN Goloborodko OP, Kizim AI. Proteolysis: norm and pathology. Kyiv: Zdorov'ya; 1988. 198 p.

Janciauskiene S, Wrenger S, Immenschuh S [et al.]. The Multifaceted Effects of Alpha1- Antitrypsin on Neutrophil Functions. Front Pharmacol. 2018 Apr 17; 9: 341. doi: 10.3389/ fphar.2018.00341. PMID: 29719508; PMCID: PMC5914301.

Shimomura R, Nezu T, Hosomi N, [et al.].Alpha-2-macroglobulin as a Promising Biological Marker of Endothelial Function. J Atheroscler Thromb. 2018 Apr 1; 25 (4): 350–358. doi: 10.5551/ jat.41335. Epub 2017 Nov 1. PMID: 29093276; PMCID: PMC5906188.

Suhas VA, Arvind MV. Impact of Ulinastatin on Outcomes in Acute Burns Patients. J Burn Care & Research. 2018 January-February; 39 (1). 109–116.

Liu D, Yu Z, Yin J [et al.].Effect of ulinastatin combined with thymosin alpha1 on sepsis: A systematic review and meta-analysis of Chinese and Indian patients. J Crit Care. 2017 Jun;39:259-266. doi: 10.1016/j. jcrc.2016.12.013. Epub 2016 Dec 27. PMID: 28069319.

Vinogradova RP. Measuring units of enzyme activity. Ukr. Biokhim. Zhurnal. 1999; 71 (2): 96–99.

Samokhina LM, Topchiy II, Nesen AA. Calpains in the proteinase-proteinase inhibitor system in hypertension and chronic kidney disease. World of Medicine and Biology, 2011; 7 (3), 116–121.

Dubinina EE, Pustygina AV. Oxidative modification of proteins, its role in pathologic states. Ukr Biokhim Zh. 2008 Nov-Dec; 80 (6): 5–18.

Starodub NF, Samokhina LM, Koval SN, Snegurskaya IA. Calpains: general characteristics and role in various states of the organism. Ukr. Biochim.Zh. 2014 Jan-Feb; 86 (1): 5–20.

How to Cite
Lynnyk, O., Kozynets, H., & Osadcha, O. (2022). Results of protease inhibitor instructions in patients in acute burning disease. Modern Medical Technology, (1(52), 56-61.
Original research