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Non-severe burns induce a prolonged systemic metabolic phenotype indicative of a persistent inflammatory response post-injury
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Non-severe burns induce a prolonged systemic metabolic phenotype indicative of a persistent inflammatory response post-injury

Monique J Ryan, Edward Raby, Luke Whiley, Reika Masuda, Sam L Lodge, Philipp Nitschke, Garth Maker, Julien Wist, Elaine Holmes, Fiona M Wood, …
2023
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Non-severe burns induce a prolonged systemic metabolic phenotype indicative of a persistent inflammatory response post-injury797.56 kBDownloadView
Preprint (Author's original)CC BY-NC-ND V4.0 Open Access

Abstract

Acute burn injury Non-severe burn Thermal injury Inflammation Metabolic phenotyping Lipids Lipoproteins Supramolecular phospholipid composite Nuclear magnetic resonance Liquid chromatography-tandem mass spectrometry
Globally, burns are a significant cause of injury that can cause substantial acute trauma as well as lead to increased incidence of chronic co-morbidity and disease. To date, research has primarily focused on the systemic response to severe injury, with little in the literature reported on impact of non-severe injuries (<15% total burn surface area; TBSA). To elucidate the metabolic consequences of non-severe burn injury, longitudinal plasma was collected from adults (n=35) who presented at hospital with a non-severe burn injury at admission, and at 6 week follow up. A cross-sectional baseline sample was also collected from non-burn control participants (n=14). Samples underwent multiplatform metabolic phenotyping using 1H nuclear magnetic resonance spectroscopy and liquid chromatography-mass spectrometry to quantify 112 lipoprotein and glycoproteins signatures and 852 lipid species from across 20 subclasses. Multivariate data modelling (Orthogonal projection to latent structures-discriminate analysis) revealed alterations in lipoprotein and lipid metabolism when comparing baseline control to hospital admission samples, with the phenotypic signature found to be sustained at follow up. Univariate (Mann-Whitney U) testing and OPLS-DA indicated specific increases in GlycB (p-value <1.0e-4), low density lipoprotein-2 subfractions (Variable importance in projection score; VIP >6.83e-1) and monoacyglyceride (20:4)(p-value <1.0e-4) and decreases in circulating anti-inflammatory high-density lipoprotein-4 subfractions (VIP >7.75e-1), phosphatidylcholines, phosphatidylglycerols, phosphatidylinositols and phosphatidylserines. The results indicate a persistent systemic metabolic phenotype that occurs even in cases of non-severe burn injury. The phenotype is indicative of an acute inflammatory profile which continues to be sustained post-injury, suggesting an impact on systems health beyond the site of injury. The phenotypes contained metabolic signatures consistent with chronic inflammatory states reported to have elevated incidence post-burn injury. Such phenotypic signatures may provide patient stratification opportunities, to identify individual responses to injury, personalise intervention strategies and improve acute care, reducing risk of chronic co-morbidity.

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