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

Monique J Ryan; Edward Raby; Luke Whiley; Reika Masuda; Samantha Lodge; Philipp Nitschke; Garth L Maker; Julien Wist; Elaine Holmes; Fiona M Wood; Jeremy K Nicholson; Mark W Fear; Nicola Gray

doi:10.1021/acs.jproteome.3c00516

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

J Proteome Res. 2023 Nov 21. doi: 10.1021/acs.jproteome.3c00516. Online ahead of print.

Authors

Monique J Ryan^{1

2}, Edward Raby^{3

4

5}, Luke Whiley^{1

2}, Reika Masuda¹, Samantha Lodge^{1

2}, Philipp Nitschke¹, Garth L Maker¹, Julien Wist^{1

2

6}, Elaine Holmes^{2

7}, Fiona M Wood^{3

8

9}, Jeremy K Nicholson^{1

10}, Mark W Fear^{8

9}, Nicola Gray^{1

2}

Affiliations

¹ Australian National Phenome Centre, Health Futures Institute, Harry Perkins Institute, Murdoch University, 5 Robin Warren Drive, Perth, Western Australia 6150, Australia.
² Centre for Computational and Systems Medicine, Health Futures Institute, Harry Perkins Institute, Murdoch University, 5 Robin Warren Drive, Perth, Western Australia 6150, Australia.
³ Burns Service of Western Australia, WA Department of Health, Murdoch, Western Australia 6150, Australia.
⁴ Department of Microbiology, PathWest Laboratory Medicine, Perth, Western Australia 6009, Australia.
⁵ Department of Infectious Diseases, Fiona Stanley Hospital, Perth, Western Australia 6150, Australia.
⁶ Chemistry Department, Universidad del Valle, Cali 76001, Colombia.
⁷ Department of Metabolism Digestion and Reproduction, Faculty of Medicine, Imperial College London, London SW7 2AZ, United Kingdom.
⁸ Burn Injury Research Unit, School of Biomedical Sciences, University of Western Australia, Perth, Western Australia 6009, Australia.
⁹ Fiona Wood Foundation, Perth, Western Australia 6150, Australia.
¹⁰ Institute of Global Health Innovation, Imperial College London, London SW7 2AZ, United Kingdom.

PMID: 38104259
DOI: 10.1021/acs.jproteome.3c00516

Abstract

Globally, burns are a significant cause of injury that can cause substantial acute trauma as well as lead to increased incidence of chronic comorbidity and disease. To date, research has primarily focused on the systemic response to severe injury, with little in the literature reported on the impact of nonsevere injuries (<15% total burn surface area; TBSA). To elucidate the metabolic consequences of a nonsevere burn injury, longitudinal plasma was collected from adults (n = 35) who presented at hospital with a nonsevere burn injury at admission, and at 6 week follow up. A cross-sectional baseline sample was also collected from nonburn 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 glycoprotein signatures and 852 lipid species from across 20 subclasses. Multivariate data modeling (orthogonal projections to latent structures-discriminate analysis; OPLS-DA) revealed alterations in lipoprotein and lipid metabolism when comparing the 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 a nonsevere burn injury. The phenotype is indicative of an acute inflammatory profile that continues to be sustained postinjury, suggesting an impact on systems health beyond the site of injury. The phenotypes contained metabolic signatures consistent with chronic inflammatory states reported to have an elevated incidence postburn injury. Such phenotypic signatures may provide patient stratification opportunities, to identify individual responses to injury, personalize intervention strategies, and improve acute care, reducing the risk of chronic comorbidity.

Keywords: acute burn injury; inflammation; lipids; lipoproteins; liquid chromatography-tandem mass spectrometry; metabolic phenotyping; nonsevere burn; nuclear magnetic resonance; supramolecular phospholipid composite; thermal injury.