Systemic long-term metabolic effects of acute non-severe paediatric burn injury

Abstract

A growing body of evidence supports the concept of a systemic response to non-severe thermal trauma. This provokes an immunosuppressed state that predisposes paediatric patients to poor recovery and increased risk of secondary morbidity. In this study, to understand the long-term systemic effects of non-severe burns in children, targeted mass spectrometry assays for biogenic amines and tryptophan metabolites were performed on plasma collected from child burn patients at least three years post injury and compared to age and sex matched non-burn (healthy) controls. A panel of 12 metabolites, including urea cycle intermediates, aromatic amino acids and quinolinic acid were present in significantly higher concentrations in children with previous burn injury. Correlation analysis of metabolite levels to previously measured cytokine levels indicated the presence of multiple cytokine-metabolite associations in the burn injury participants that were absent from the healthy controls. These data suggest that there is a sustained immunometabolic imprint of non-severe burn trauma, potentially linked to long-term immune changes that may contribute to the poor long-term health outcomes observed in children after burn injury.

Clinical prediction of wound re-epithelisation outcomes in non-severe burn injury using the plasma lipidome

“…However, these studies were conducted on the local wound rather than using biofluids, in which analysing biofluids, even though invasive, may be more reflective of wound healing outcomes as burn injuries cause a systemic response and numerous processes are involved in tissue repair [11,37].…”

“…New studies have demonstrated the predictive ability of metabolic phenotyping models, particularly with lipid [33] and lipoprotein [35,36] signatures that could stratify SARS-CoV-2 infections from other symptomatically similar infections [33,35] and their recovery trajectories post-infection with high accuracy and precision [36]. Lipid and lipoprotein metabolism has been associated with numerous inflammatory mechanisms and previous research into non-severe burns has identified dysregulation in these signatures three years post-burn injury [37]. No other studies have investigated lipid and lipoprotein metabolism longitudinally in non-severe burns to assess its ability to predict patient outcomes, even though it shows potential in severe burns [38,39] and other inflammatory conditions like ulcerative colitis [40].…”

Natural Polymer‐Based Materials for Wound Healing Applications

“…[ 39 ] Small burn injuries or nonsevere acute burn injuries have recently also been shown to affect the inflammatory response with a prolonged local and systemic reaction. [ 40 ] The effect of local and systemic response to a burn injury predominately affects the proliferation and remodeling phases of the wound healing cascade. The inflammatory signals activate fibroblasts to spread into the provisional wound matrix and become protomyofibroblasts, which further differentiate into α‐SMA‐expressing myofibroblasts.…”

Nonsevere Burn Induces a Prolonged Systemic Metabolic Phenotype Indicative of a Persistent Inflammatory Response Postinjury

“…21 However, most research into the metabolic consequences of a burn injury has been focused toward severe burns, 18,22−29 with a only small proportion examining changes in nonsevere burns. 17,30,31 In addition, as the incidence of a nonsevere injury is much greater than that of a severe, it is vital to understand how a less-severe injury impacts the systemic metabolic response, and the long-term health consequences of such injury events. Therefore, to explore the systemic metabolic consequence of a nonsevere burn injury, we applied a multimodal strategy to compare the lipidic content of blood plasma from participants with a nonsevere burn injury (classified as hospitalised with <15% total burn surface area) to nonburn controls.…”