Chronic Stress Response to a Burn Injury: Current Understanding and Therapies

Mr Tyler Osborne1,2, Associate Professor Dale Edgar3,4,5,6, Winthrop Professor Fiona Wood3,4,6, Associate Professor Timothy Fairchild1, Dr Bradley Wall1,2

1Disciple of Exercise Science, Murdoch University, , Australia, 2Centre for Health Ageing, Health Futures Institute, Murdoch University, , Australia, 3State Adult Burns Unit, Government of Western Australia South Metropolitan Health Service, Murdoch, Australia, 4Fiona Wood Foundation, Fiona Stanley Hospital, Murdoch, Australia, 5Burn Injury Research Node, Institute for Health Research, The University of Notre Dame, , Australia, 6Burn Injury Research Unit, University of Western Australia, , Australia


Previous research in burns has identified burned patients exhibit increased inflammatory and metabolic markers for at least 3 years post-injury, potentially leading to increased systemic morbidity for diseases of ageing including cancer, diabetes, and cardiovascular disease. Immediately following a burn injury, an inflammatory response ensues which is more pronounced than other similar forms of trauma. A state of immunosuppression follows, highlighting the need for effective long-term strategies to ameliorate the chronic stress response post-burn.

Current therapeutic strategies for post-burn recovery are aimed at minimising the hyper-metabolic and inflammatory responses, as well as reducing loss of lean body mass. These interventions include surgery via an excision and graft, nutritional supplementation for both caloric intake and macronutrient support, and rehabilitative exercise.

A novel assessment technique for the burned population is metabolic flexibility assessment. This concept has been investigated in obese and diabetic populations and has been linked with reduced mitochondrial function and futile substrate cycling which are also key physiological characteristics following a burn injury. The identification of metabolic inflexibility in burned patients will allow for early lifestyle intervention in prevention of metabolic conditions such as Type 2 Diabetes.

The utilisation of assessment techniques such as metabolic flexibility will aid clinicians and researchers in further understanding the specific mechanisms behind a burn injury and therefore the long-term stress response that follows. This will be achieved via individualised treatment options tailored to patient’s unique systemic responses following a burn, facilitating a precision medicine approach to improve clinical and physiological outcomes in burned patients.


Tyler Osborne is a PhD student with Murdoch University and the Fiona Wood Foundation within the discipline of Exercise Science. His research focuses on lifestyle based strategies to mitigate the long-term systemic stress following a burn injury.

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