Effects of insulin combined with ethyl pyruvate on inflammatory response and oxidative stress in multiple-organ dysfunction syndrome rats with severe burns

Am J Emerg Med. 2016 Nov;34(11):2154-2158. doi: 10.1016/j.ajem.2016.08.014. Epub 2016 Aug 9.


Background: Inflammation response and oxidative stress promote the occurrence and development of multiple-organ dysfunction syndrome (MODS).

Methods: Eighty MODS rats with third-degree burns were divided randomly into 4 groups: insulin, ethyl pyruvate (EP), insulin combined with EP, and control. Blood levels of glucose, alanine aminotransferase (ALT), creatine (CRE), creatine kinase (CK), tumor necrosis factor α (TNF-α), high-mobility group box 1 (HMGB-1), malondialdehyde (MDA), and total antioxidant capacity (TAC) before as well as 1, 3, 5, and 7 days after burns were measured.

Results: Blood levels of ALT, CRE, CK, TNF-α, HMGB-1, and MDA in INS, EP, and INS+EP groups at different time points were significantly lower, and TAC was significantly higher than that in the control group (C) (P<.01). These parameters in the INS+EP group were significantly lower, and TAC was significantly higher than that in INS and EP groups (P<.01). Blood levels of TNF-α, HMGB-1, and TAC in the INS group at different time points after burns were significantly lower, and MDA was significantly higher than that in the EP group (P<.01).

Conclusions: Insulin combined with EP can effectively reduce the inflammatory response, oxidative stress, and main organ dysfunctions in MODS rats after severe burns. The therapeutic effect of insulin combined with EP is superior to single-agent treatment. The insulin anti-inflammatory effect is better than that of pyruvic acid ethyl ester, and the ethyl pyruvate antioxidation effect is better than that of insulin. The insulin can treat inflammation, whereas EP can reduce oxidative stress in MODS rats.

MeSH terms

  • Alanine Transaminase / blood
  • Animals
  • Antioxidants / metabolism
  • Blood Glucose
  • Burns / blood*
  • Burns / complications
  • Creatine / blood
  • Creatine Kinase / blood
  • Drug Therapy, Combination
  • HMGB1 Protein / blood
  • Hypoglycemic Agents / therapeutic use*
  • Inflammation / blood
  • Inflammation / drug therapy*
  • Inflammation / etiology
  • Insulin / therapeutic use*
  • Malondialdehyde / blood
  • Multiple Organ Failure / blood*
  • Multiple Organ Failure / etiology
  • Oxidative Stress / drug effects*
  • Pyruvates / therapeutic use*
  • Rats
  • Rats, Sprague-Dawley
  • Time Factors
  • Tumor Necrosis Factor-alpha / blood


  • Antioxidants
  • Blood Glucose
  • HMGB1 Protein
  • Hbp1 protein, rat
  • Hypoglycemic Agents
  • Insulin
  • Pyruvates
  • Tumor Necrosis Factor-alpha
  • ethyl pyruvate
  • Malondialdehyde
  • Alanine Transaminase
  • Creatine Kinase
  • Creatine