The relationship between local
inflammation and the subsequent systemic inflammatory response is poorly described. In a
burn injury model, the dermal inflammatory response may act as an ongoing trigger for the
systemic inflammatory response syndrome (SIRS) and subsequent systemic complications. We hypothesized that topical attenuation of
burn wound inflammatory signaling will control the dermal inflammatory source, attenuate SIRS, and reduce
acute lung injury. Mice received a 30% total body surface area
burn. Subgroups were treated with specific
p38 MAPK inhibitor or vehicle, which was topically applied to
wounds. Topical
p38 MAPK inhibition significantly reduced
burn wound inflammatory signaling and subsequent systemic expression of proinflammatory
cytokines and
chemokines. In vitro macrophage functional assays demonstrated a significant attenuation in serum inflammatory mediators from animals receiving the topical inhibitor. Topical
p38 MAPK inhibition resulted in significantly less pulmonary inflammatory response via reduction of pulmonary neutrophil
sequestration, pulmonary cytokine expression, and a significant reduction in pulmonary microvascular injury and
edema formation. Although dermal activating transcription factor-2, a downstream
p38 MAPK target, was significantly reduced, there was no reduction in pulmonary activating transcription factor-2 expression, arguing against significant systemic absorption of the topical inhibitor. These experiments demonstrate a strong interaction between dermal
inflammation and systemic inflammatory response. Attenuating local inflammatory signaling appears effective in reducing SIRS and subsequent systemic complications after
burn injury.