Review Oxidative stress and anti-oxidative mobilization in burn injury Arti Parihar a , Mordhwaj S. Parihar b , Stephen Milner c , Satyanarayan Bhat c, * a Department of Pharmacology, Southern Illinois School of Medicine, Springfield, IL, USA b Medical Microbiology & Immunology, Southern Illinois School of Medicine, Springfield, IL, USA c Johns Hopkins Burn Center/Michael D. Hendrix Burn Research Center, Department of Surgery, Johns Hopkins University, 5210 Eastern Avenue, Baltimore 21224, MD, USA Contents 1. Introduction .................................................................................... 7 2. ROS production ................................................................................. 7 2.1. Contribution of mitochondrial electron transport ................................................. 8 2.2. Contribution of peroxisomal b-oxidation and cytochrome P-450 isozymes .............................. 8 2.3. Contribution of phagocytic NADPH: the oxidative burst............................................. 8 burns 34 (2008) 6–17 article info Article history: Accepted 10 April 2007 Keywords: Burn injury Reactive oxygen species Reactive nitrogen species Antioxidants NAD(P)H oxidase abstract A severe burn is associated with release of inflammatory mediators which ultimately cause local and distant pathophysiological effects. Mediators including Reactive Oxygen Species (ROS) and Reactive Nitrogen Species (RNS) are increased in affected tissue, which are implicated in pathophysiological events observed in burn patients. The purpose of this article is to understand the role of oxidative stress in burns, in order to develop therapeutic strategies. All peer-reviewed, original and review articles published in the English language literature relevant to the topic of oxidative stress in burns in animals and human subjects were selected for this review and the possible roles of ROS and RNS in the pathophysiology of burns are discussed. Both increased xanthine oxidase and neutrophil activation appear to be the oxidant sources in burns. Free radicals have been found to have beneficial effects on antimicrobial action and wound healing. However following a burn, there is an enormous production of ROS which is harmful and implicated in inflammation, systemic inflamma- tory response syndrome, immunosuppression, infection and sepsis, tissue damage and multiple organ failure. Thus clinical response to burn is dependent on the balance between production of free radicals and its detoxification. Supplementation of antioxidants in human and animal models has proven benefit in decreasing distant organ failure suggesting a cause and effect relationship. We conclude that oxidative damage is one of the mechan- isms responsible for the local and distant pathophysiological events observed after burn, and therefore anti-oxidant therapy might be beneficial in minimizing injury in burned patients. # 2007 Elsevier Ltd and ISBI. All rights reserved. * Corresponding author. Tel.: +1 410 550 2643; fax: +1 410 550 4601. E-mail address: sbhat3@jhmi.edu (S. Bhat). available at www.sciencedirect.com journal homepage: www.elsevier.com/locate/burns 0305-4179/$34.00 # 2007 Elsevier Ltd and ISBI. All rights reserved. doi:10.1016/j.burns.2007.04.009