{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,10]],"date-time":"2026-10-10T02:34:53Z","timestamp":1791599693512,"version":"4.3.4"},"reference-count":47,"publisher":"MDPI AG","issue":"20","license":[{"start":{"date-parts":[[2025,10,17]],"date-time":"2025-10-17T00:00:00Z","timestamp":1760659200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["IJMS"],"abstract":"<jats:p>Burn injury triggers a complex inflammatory cascade in which the interplay between pro- and anti-inflammatory mediators determines recovery or progression to sepsis, ventilator-associated pneumonia (VAP) or multi-organ dysfunction, and mortality. We systematically searched PubMed, Embase, Cochrane Library, Web of Science, and Scopus for studies published between 2006 and 2024, identifying 1883 records. We conducted a comprehensive systematic review in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. After screening and eligibility assessment, 24 studies covering both pediatric and adult populations met the inclusion criteria. Data on cytokines, acute-phase proteins, complement fragments, and systemic inflammatory indices were synthesized narratively. The evidence indicates that the inflammatory response to burn injury is not a linear sequence of events but a dynamic and unstable equilibrium, where outcomes are determined less by the initial magnitude of cytokine release and more by the persistence of dysregulated inflammation or failure of compensatory mechanisms.<\/jats:p>","DOI":"10.3390\/ijms262010131","type":"journal-article","created":{"date-parts":[[2025,10,17]],"date-time":"2025-10-17T16:13:03Z","timestamp":1760717583000},"page":"10131","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Variation of Pro- and Anti-Inflammatory Factors in Severe Burns: A Systematic Review"],"prefix":"10.3390","volume":"26","author":[{"ORCID":"https:\/\/orcid.org\/0009-0000-8538-7811","authenticated-orcid":false,"given":"Mihai-Codrin","family":"Constantinescu","sequence":"first","affiliation":[{"name":"Faculty of Medicine, Grigore T. Popa University of Medicine and Pharmacy Iasi, 700115 Ia\u0219i, Romania"},{"name":"Department of Plastic Surgery and Reconstructive Microsurgery, \u201cSf. Spiridon\u201d Emergency County Hospital, 700111 Ia\u0219i, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5308-7192","authenticated-orcid":false,"given":"Mihaela","family":"Pertea","sequence":"additional","affiliation":[{"name":"Faculty of Medicine, Grigore T. Popa University of Medicine and Pharmacy Iasi, 700115 Ia\u0219i, Romania"},{"name":"Department of Plastic Surgery and Reconstructive Microsurgery, \u201cSf. Spiridon\u201d Emergency County Hospital, 700111 Ia\u0219i, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9192-7607","authenticated-orcid":false,"given":"Stefana","family":"Avadanei-Luca","sequence":"additional","affiliation":[{"name":"Faculty of Medicine, Grigore T. Popa University of Medicine and Pharmacy Iasi, 700115 Ia\u0219i, Romania"},{"name":"Department of Plastic Surgery and Reconstructive Microsurgery, \u201cSf. Spiridon\u201d Emergency County Hospital, 700111 Ia\u0219i, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0000-2154-9236","authenticated-orcid":false,"given":"Alexandru-Hristo","family":"Amarandei","sequence":"additional","affiliation":[{"name":"Department of Plastic Surgery and Reconstructive Microsurgery, \u201cSf. Spiridon\u201d Emergency County Hospital, 700111 Ia\u0219i, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0005-0145-7269","authenticated-orcid":false,"given":"Andra-Irina","family":"Bulgaru-Iliescu","sequence":"additional","affiliation":[{"name":"Faculty of Medicine, Grigore T. Popa University of Medicine and Pharmacy Iasi, 700115 Ia\u0219i, Romania"},{"name":"Department of Plastic Surgery and Reconstructive Microsurgery, \u201cSf. Spiridon\u201d Emergency County Hospital, 700111 Ia\u0219i, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0008-5525-2420","authenticated-orcid":false,"given":"Malek","family":"Benamor","sequence":"additional","affiliation":[{"name":"Department of Plastic Surgery and Reconstructive Microsurgery, \u201cSf. Spiridon\u201d Emergency County Hospital, 700111 Ia\u0219i, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2571-1496","authenticated-orcid":false,"given":"Dan Cristian","family":"Moraru","sequence":"additional","affiliation":[{"name":"Faculty of Medicine, Grigore T. Popa University of Medicine and Pharmacy Iasi, 700115 Ia\u0219i, Romania"},{"name":"Department of Plastic Surgery and Reconstructive Microsurgery, \u201cSf. Spiridon\u201d Emergency County Hospital, 700111 Ia\u0219i, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3552-6267","authenticated-orcid":false,"given":"Viorel","family":"Scripcariu","sequence":"additional","affiliation":[{"name":"Faculty of Medicine, Grigore T. Popa University of Medicine and Pharmacy Iasi, 700115 Ia\u0219i, Romania"},{"name":"First Surgical Oncological Unit, Regional Institute of Oncology, 700483 Ia\u0219i, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2025,10,17]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","unstructured":"Burgess, M., Valdera, F., Varon, D., Kankuri, E., and Nuutila, K. (2022). The immune and regenerative response to burn injury. Cells, 11.","DOI":"10.3390\/cells11193073"},{"key":"ref_2","doi-asserted-by":"crossref","unstructured":"Cowin, A.J., Bayat, A., Murray, R.Z., and Kopecki, Z. (2021). 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