The burn repair molecule?: evaluating FGF-21 in thermal injury : a systematic review
Severe burns induce a hypermetabolic and inflammatory state, impairing wound healing and contributing to long-term morbidity. Fibroblast growth factor 21 (FGF-21), a metabolic hormone regulating lipid oxidation, glucose uptake, and mitochondrial homeostasis, has emerged as a potential biomarker and...
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| Main Authors: | , , , , , , , , , , , |
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| Format: | Article (Journal) |
| Language: | English |
| Published: |
17 November 2025
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| In: |
Burns
Year: 2026, Volume: 52, Issue: 1, Pages: 1-13 |
| ISSN: | 1879-1409 |
| DOI: | 10.1016/j.burns.2025.107785 |
| Online Access: | Verlag, lizenzpflichtig, Volltext: https://doi.org/10.1016/j.burns.2025.107785 Verlag, lizenzpflichtig, Volltext: https://www.sciencedirect.com/science/article/pii/S0305417925004140 
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| Author Notes: | Tobias Niederegger, Thomas Schaschinger, Jule Brandt, Leonard Knoedler, Samuel Knoedler, Alen Palackic, Felix J. Klimitz, Dorothea Noll, Patrick Most, Julia Ritterhoff, Adriana C. Panayi, Gabriel Hundeshagen |
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| 520 | |a Severe burns induce a hypermetabolic and inflammatory state, impairing wound healing and contributing to long-term morbidity. Fibroblast growth factor 21 (FGF-21), a metabolic hormone regulating lipid oxidation, glucose uptake, and mitochondrial homeostasis, has emerged as a potential biomarker and therapeutic modulator in critical illness. This systematic review followed PRISMA 2020 guidelines and assessed seven studies (2015-2024) published until April 2025. Clinical, in vivo, and in vitro investigations were included. Methodological quality was evaluated using the Level of Evidence, Newcastle-Ottawa Scale, and the SYRCLE Risk of Bias tool. In our study, FGF-21 was commonly upregulated following burn injury and was associated with hypermetabolism, adipose tissue browning, mitochondrial stress, and systemic inflammation. Nutritional interventions, including hydrolyzed collagen and omega-3 fatty acids, reduced FGF-21 levels, improved wound healing, and attenuated inflammatory responses. Preclinical models demonstrated that administration of exogenous FGF-21 enhanced re-epithelialization, angiogenesis, mitochondrial function, and anti-inflammatory signaling pathways. Conversely, chronically elevated endogenous FGF-21 levels were consistently linked to metabolic exhaustion, liver dysfunction, and impaired recovery. Overall, FGF-21 may be a promising diagnostic and therapeutic target in burn care. Its clinical relevance and long-term effects require further investigation for successful integration into clinical practice. | ||
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