The beneficial role of probiotics and gut microbiota in signaling pathways, immunity, apoptosis, autophagy, and intestinal barrier for effective wound healing post-burn injury.

Abstract

Severe burn injuries are associated with complex systemic disturbances, including profound immune dysregulation, compromised intestinal barrier function, and alterations in gut microbiota composition-factors that collectively contribute to impair wound healing and increased mortality. While broad-spectrum antibiotics are routinely employed to combat infection, their use may inadvertently aggravate mucosal barrier dysfunction and facilitate bacterial translocation. Emerging evidence underscores the potential of probiotics in restoring intestinal homeostasis and enhancing immune responses in critically ill populations; however, their application within the context of burn care remains insufficiently studied. This review seeks to address this knowledge gap by evaluating the therapeutic utility of probiotic supplementation in supporting gastrointestinal barrier integrity, attenuating inflammatory responses, and facilitating post-burn recovery. A comprehensive narrative review of relevant literature was performed via PubMed and Google Scholar, targeting studies involving microbiota, probiotics, and burn trauma. Probiotic strains, particularly Lactobacillus and Bifidobacterium, have been shown to modulate cytokine profiles, boost secretory IgA production, enhance epithelial regeneration, and influence key signaling pathways such as PI3K/Akt/mTOR, which are integral to regulating apoptosis and autophagy. Experimental models indicate that probiotics can decrease bacterial translocation and systemic inflammation, reinforce tight junction architecture, and elevate short-chain fatty acid concentrations. Notably, probiotic administration in burn models has resulted in up to a 75 % reduction in infection-related mortality and enhanced anti-inflammatory responses via IL-10 and Th1 pathway activation. Moreover, adjunctive use of probiotics in topical formulations has shown efficacy in promoting wound healing in both diabetic and surgical settings. Collectively, these findings highlight the promise of probiotics as a complementary therapeutic approach in burn management, offering multifaceted benefits in reducing infection, supporting tissue regeneration, and improving clinical outcomes.