Microbiome Alterations and Intestinal Barrier Dysfunction in Thermal Injury

Severe thermal injury provokes profound changes in the gut microbial ecosystem and undermines the integrity of the intestinal epithelium. Post-burn alterations include reduced microbial richness, shifts in major phyla—typically a decline in Firmicutes and Bacteroidetes ratios and an overgrowth of Proteobacteria—and loss of beneficial commensals. Concurrently, epithelial tight junctions become disrupted, with decreased expression and mislocalisation of proteins such as zonula occludens-1 and occludin. These changes heighten mucosal permeability, permitting bacterial translocation and systemic dissemination of endotoxin, thereby fuelling systemic inflammation and sepsis risk. Metabolic outputs of the microbiota, notably short-chain fatty acids, are diminished, further compromising barrier function. Interventions ranging from fluid resuscitation strategies to prebiotic supplementation have shown promise in modulating microbiome composition, restoring barrier integrity and improving clinical outcomes in experimental models. Understanding the mechanistic interplay between microbial communities and the epithelial barrier is essential for developing targeted therapies to reduce post-burn complications and enhance patient recovery.

Research from Nature Portfolio

In a rodent model, dietary supplementation with inulin has been shown to counteract burn-induced skeletal muscle atrophy by reshaping the gut microbiota. Inulin intake enriched beneficial Firmicutes and Actinobacteria, suppressed Proteobacteria and activated the PI3K/AKT signalling pathway to promote muscle protein synthesis. A swine study of burn resuscitation revealed that limited-volume colloid infusion exacerbated loss of bacterial diversity and dysbiosis, correlating with hepatic stress and altered ATP pathways, thereby highlighting a gut–liver axis in thermal injury. A longitudinal pilot in burn patients mapped reductions in cutaneous and gastrointestinal alpha diversity over the first month post-injury, demonstrating that antibiotic use, grafting and nutritional support significantly influence microbial trajectories and may predict infection risk.

Microbiome Alterations and Intestinal Barrier Dysfunction in Thermal Injury publication trend

The graph below shows the total number of articles in microbiome alterations and intestinal barrier dysfunction in thermal injury across all publications each year (not limited to Nature Index journals).

Technical terms

Dysbiosis: A perturbation of the normal microbial community balance, often resulting in overrepresentation of pathogenic species and loss of beneficial commensals.

Intestinal barrier function: The selective permeability of the gut lining maintained by epithelial cells and junctional complexes to allow nutrient absorption while preventing entry of harmful agents.

Tight junction proteins: Transmembrane and scaffolding proteins (e.g., occludin, claudins, zonula occludens-1) that seal gaps between adjacent epithelial cells.

Short-chain fatty acids (SCFAs): Metabolic by-products of microbial fermentation of dietary fibres, including acetate, propionate and butyrate, that support epithelial health and immune regulation.

Prebiotic: A non-digestible dietary compound that selectively promotes growth or activity of beneficial gut microbiota.

Bacterial translocation: The passage of bacteria or bacterial products from the intestinal lumen across the mucosal barrier to mesenteric lymph nodes or systemic circulation.

References

1. Microbial community succession in the intestine of mice with deep partial-thickness burns. Frontiers in Microbiology (2023).
2. In silico analysis of intestinal microbial instability and symptomatic markers in mice during the acute phase of severe burns. BMC Microbiology (2024).
3. Dietary supplementation with inulin improves burn-induced skeletal muscle atrophy by regulating gut microbiota disorders. Scientific Reports (2024).
4. Burn resuscitation strategy influences the gut microbiota-liver axis in swine. Scientific Reports (2020).
5. Longitudinal profiling of the burn patient cutaneous and gastrointestinal microbiota: a pilot study. Scientific Reports (2021).
6. Burn Injury Alters the Intestinal Microbiome and Increases Gut Permeability and Bacterial Translocation. PLOS ONE (2015).
7. Severe burn injury alters intestinal microbiota composition and impairs intestinal barrier in mice. Burns & Trauma (2019).