Monitoring the lipid profile of acute burn wound healing in adults: Implications for improved scar management

Monique Ryan1, Dr Nicola Gray1,3, Dr Luke Whiley1,3, Dr Garth Maker2,3, Dr.  Nathan Lawler1,3, Dr. Aude-Claire Morillon1, Dr. Rongchang Yang1,3, Dr. Samantha Lodge1,3, Dr. Edward Raby4, Dr. Mark Fear5, Prof. Fiona Wood6, Prof. Elaine Holmes1,3

1Australian National Phenome Centre, Health Futures Institute, Harry Perkins Institute, Murdoch University, Murdoch, Australia, 2Separation Science and Metabolomics Laboratory and the Advanced Mass Spectrometry Facility, Murdoch University, Murdoch, Australia, 3Centre for Computational and Systems Medicine, Health Futures Institute, Murdoch University, Murdoch, Australia, 4Department of Microbiology, PathWest Laboratory Medicine, Department of Infectious Diseases, Fiona Stanley Hospital |, Perth, Australia, 5Burn Injury Research Unit, The University of Western Australia |, Crawley, Australia, 6Burn Injury Research Unit, University of Western Australia, Burns Service of Western Australia, Fiona Stanley Hospital and Pr inc ess Margaret Hospital, Perth, Australia

Abstract:

Introduction: Burns are traumatic injuries that are often associated with long-term physical and psychological problems. A burn can cause significant devitalisation, expose raw skin to the external environment, and can also spontaneously scar despite treatment. Monitoring a burn wound is challenging for clinicians, as there is a lack of quantitative techniques that define healthy healing parameters. It has recently been determined that lipid mediators are integral to healthy wound healing and could be potential biomarkers to predict healing outcomes for clinicians.

Objective: The main objective of this project is to identify lipids that are associated with abnormal wound healing outcomes in human plasma from acute burns patients.

Methods: Multiple plasma samples were collected from 61 acute burns patients with no known co-morbidities. Bloods were taken on admission, 72 hours after admission, and 24 hours, 2 weeks and 6 weeks post-operation. At 6 weeks, patients filled in a Patient and Observer Scar Assessment Score on how they perceived their healing process. All samples were analysed using a targeted LC-MS/MS of 900 lipids across 20 different classes.

Results: 859 lipids were measured in the plasma samples. Uni- and multivariate statistics revealed that high levels of phosphatidylinositol (PI) lipid species were associated with burn scars requiring laser treatment, which is supported its known role in fibrotic pathogenesis. OPLS-DA found that phosphatidylethanolamines, ceramides and phosphatidylcholine species were positively correlated with a patient’s perceived pain and itchiness scores. Spearman’s ranked correlation showed a moderate but significant correlation between hydroxyceramides and PI species with overall scarring pain, hypertrophy and stiffness severity.

Conclusion: Many dysregulated lipids were observed in burns patients following admission and are linked to poor re-epithelisation and scar formation. These findings provide insight into the lipid-based mechanisms behind acute burn wound healing and demonstrate that lipids play a role in the activation of nociceptor pain and stimulating an itchy sensation.


Biography:

In 2017, Monique completed her Honours in Bachelor of Biomedical Science at the University of Notre Dame, Fremantle in investigating the metabolomic profile of septic ICU patients. She is currently three years into her PhD Candidature with Murdoch University and the Australian National Phenome Centre researching biomarkers of acute burn wound healing to develop a predictive mass spectrometry-based method of healing outcomes in patients for improving burn scar management. She is an enthusiastic early career researcher whose passion lies in medical-based research, analytical chemistry and infectious diseases

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