Burn injuries often lead to severe complications, including acute respiratory distress syndrome (ARDS), driven in part by systemic inflammation and glycocalyx disruption. In this study, we analyzed the sera of 28 patients after burn trauma and utilized transcriptomic analyses to decipher the impact of burn injury on glycocalyx derangement. We observed significant upregulation of immune cell-derived degrading enzymes, particularly matrix metalloproteinase-8 (MMP8), which correlated with increased immune cell infiltration and glycocalyx derangement. Serum analysis of burn patients revealed significantly elevated levels of shed glycocalyx components and MMP8, both correlating with the presence of inhalation injury. Consequently, treatment of human in vitro lung tissue models with MMP8 induced significant glycocalyx shedding in both, the endothelium and epithelium. Together our data suggest MMP8 as a contributor of glycocalyx disruption and lung injury post-burn.

The authors have declared no competing interest.

The authors would like to thank Hans Peter Haselsteiner and the CRISCAR Familienstiftung for their ongoing support of the Medical University/Aposcience AG public private partnership aiming to augment basic and translational clinical research in Austria/Europe. This work was supported by the Austrian Research Promotion Agency (#852748, #862068) and the Vienna Business Agency (#2343727) awarded to HJA. MM was funded by Aposcience AG.

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This study was approved by the institutional review board of the Medical University of Vienna (vote 1997/2023) and was conducted adhering to the principles outlined in the Declaration of Helsinki, as well as in compliance with the Good Scientific Practice guidelines by the Medical University of Vienna

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