Systemically administration of androgens in burn injury wound healing

Mr Huaikai Shi1, Mrs Ulla Simanainen2, Miss Roxanne Parungao3, Mr  Brian Lesmana4, Mr  Brenton  Condor5, Mr David Handelsman6, Mr Mark  Cooper7, Mr Peter  Maitz8, Mrs Yiwei Wang9

1ANZAC Research Institute, Concord, Australia, 2ANZAC Research Institute, Concord, Australia, 3ANZAC Research Institute, Concord, Australia, 4ANZAC Research Institute, Concord, Australia, 5ANZAC Research Institute, Concord, Australia, 6ANZAC Research Institute, Concord, Australia, 7ANZAC Research Institute, Concord, Australia , 8Burns Unit, Concord Repatriation General Hospital , Concord, Australia, 9ANZAC Research Institute, Concord, Australia

Rational: Androgens have been known to inhibit cutaneous (non-burn) wound repair in men and male mice by exacerbating wound inflammation and modifying re-epithelialization. However, recent studies have reported that in severe burn injury (over 20% TBSA), androgen treated patients better maintain lean body mass, have improved hypermetabolic response and shorter healing time. This highlights a contradictory and context-dependent role of androgens in the wound healing of burn injury and simple incisional skin wound healing.

Objective:The aim of this study was to identify the role of androgens in severe burn injury wound healing, in particular whether androgens target local healing processes or systemic burn induced hypermetabolic state.

Methods: Mice were subjected to a thermal injury from a hot brass rod (4cm²) constituting a severe large burn. After 48 hrs following thermal injury, the wound site was debrided to remove damaged skin and to avoid infection prior to wound dressing. Mice were weighed and harvested at different time points post injury. Energy expenditure and metabolic changes were measured using metabolic cages. Wound healing rate, epidermal migration, matrix deposition were also analysed.

Results: In the present study, all mice induced hypermetabolism response with continued weight lost and muscle wasting over 7 days post burn injury. Androgen (DHT) treated mice had significantly improved burn injury wound healing with respect to body weight, muscle wasting and better maintained adipose tissue. However, no differences were shown on local wound healing parameters, suggesting systemic administration of DHT has no negative effects on local healing process.

Mr Shi, a first year PHD student works at Burns Unit, Anzac Research Institute, The university of Sydney. His PHD focus on identifing the role of androgens in severe burn injury wound healing, in particularly whether androgen targets local healing process or systemic burn induced hypermetabolic state.


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