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Carlton M, Voisey J, Parker TJ, Punyadeera C, Cuttle L. A review of potential biomarkers for assessing physical and psychological trauma in paediatric burns. BURNS & TRAUMA 2021; 9:tkaa049. [PMID: 33654699 PMCID: PMC7901707 DOI: 10.1093/burnst/tkaa049] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/07/2020] [Revised: 09/09/2020] [Accepted: 01/03/2021] [Indexed: 01/08/2023]
Abstract
Biological markers that evaluate physical healing as well as psychological impact of a burn are essential for effective treatment of paediatric burns. The objective of this review is to summarize the evidence supporting the use of biomarkers in children with burns. An extensive review of the literature was performed using PubMed. A total of 59 biomarkers were identified relating to burn presence, specifically relating to processes involved in inflammation, wound healing, growth and metabolism. In addition, biomarkers involved in the stress response cascade following a burn trauma were also identified. Although many biomarkers have been identified that are potentially associated with burn-related physical and psychological trauma, an understanding of burn biology is still lacking in children. We propose that future research in the field of children’s burns should be conducted using broad screening methods for identifying potential biomarkers, examine the biological interactions of different biomarkers, utilize child-appropriate biological fluids such as urine or saliva, and include a range of different severity burns. Through further research, the biological response to burn injury may be fully realized and clinically relevant diagnostic tests and treatment therapies utilizing these biomarkers could be developed, for the improvement of healing outcomes in paediatric burn patients.
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Affiliation(s)
- Morgan Carlton
- Queensland University of Technology (QUT), Centre for Children's Burn and Trauma Research, Centre for Children's Health Research, South Brisbane, Queensland, Australia
| | - Joanne Voisey
- Queensland University of Technology (QUT), Faculty of Health, School of Biomedical Sciences, Brisbane, Queensland, Australia
| | - Tony J Parker
- Queensland University of Technology (QUT), Faculty of Health, School of Biomedical Sciences, Brisbane, Queensland, Australia
| | - Chamindie Punyadeera
- Queensland University of Technology (QUT), Faculty of Health, School of Biomedical Sciences, Saliva and Liquid Biopsy Translational Laboratory, Brisbane, Queensland, Australia
| | - Leila Cuttle
- Queensland University of Technology (QUT), Centre for Children's Burn and Trauma Research, Centre for Children's Health Research, South Brisbane, Queensland, Australia
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Proteasome Activity and C-Reactive Protein Concentration in the Course of Inflammatory Reaction in Relation to the Type of Abdominal Operation and the Surgical Technique Used. Mediators Inflamm 2018; 2018:2469098. [PMID: 30405319 PMCID: PMC6204193 DOI: 10.1155/2018/2469098] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2018] [Revised: 09/04/2018] [Accepted: 09/10/2018] [Indexed: 11/30/2022] Open
Abstract
Surgical tissue damage and the accompanying inflammatory response lead to proteasome activation, initiation of damaged protein degradation, and induction of acute-phase inflammatory response. The aim of this study was to investigate the rate of change in proteasome chymotrypsin-like (ChT-L) activity and C-reactive protein concentration depending on the degree of tissue damage and their correlation with prealbumin concentrations in children before and after abdominal surgery. This experimental study included children who underwent abdominal surgery between 2015 and 2017. Plasma prealbumin concentrations and C-reactive protein levels (CRP) were determined by standard biochemical laboratory procedures. Proteasome activity was assessed using a Suc-Leu-Leu-Val-Tyr-AMC peptide substrate. Elevation of plasma proteasome activity was noted in children after laparoscopic and open abdominal surgeries. However, 20S proteasome activity in children undergoing conventional open surgery was significantly higher (P < 0.05) than in patients subjected to laparoscopy. At the same time, an increase in the CRP level was observed. However, there was no correlation between C-reactive protein concentrations and the type of abdominal surgery while there was a correlation observed in the case of proteasomes. Proteasome activity correlates with the degree of surgical tissue damage and prealbumin concentrations. More invasive surgery leads to a stronger activation of the proteasome involved in removing proteins that were damaged due to the surgical procedure. Proteasomes are more specific markers because there is a correlation between proteasome activity and the type of abdominal surgery in contrast to C-reactive protein concentrations which are not different in response to surgery performed in regard to ovarian cysts or cholelithiasis.
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Matuszczak E, Tylicka M, Dębek W, Sankiewicz A, Gorodkiewicz E, Hermanowicz A. Concentration of Proteasome in the Blood Plasma of Children with Acute Appendicitis, Before and After Surgery, and Its Correlation with CRP. World J Surg 2018; 42:2259-2264. [PMID: 29264727 DOI: 10.1007/s00268-017-4407-7] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
OBJECTIVE The determination of 20S proteasome concentration in the blood plasma of children with appendicitis and its correlation with CRP. DESIGN AND SETTING Thirty-one children with acute appendicitis, were randomly included into the study (age 5 years up to 17 years, mean age 11.5 + 1 years). PARTICIPANTS There were 17 girls and 14 boys. Eighteen healthy, age-matched subjects, admitted for planned surgeries served as controls. Exclusion criteria were: severe preexisting infections, immunological or cardiovascular diseases that required long-term medication, and complicated cases of appendicitis with perforation of appendix and/or peritonitis. MAIN OUTCOME MEASURES The 20S proteasome concentrations in the blood plasma of patients with acute appendicitis were highest before the surgery and were above the range of concentrations measured in controls, and the difference was statistically significant. RESULTS The 20S proteasome concentration measured 24 and 72 h after the operation, slowly decreased over time, and still did not reach the normal range, when compared with the concentration measured in controls (p < 0.05). CONCLUSIONS 20S proteasome concentration may reflect the metabolic response to acute state inflammation, and the process of gradual ebbing of the inflammation. The method of operation-classic open appendectomy, or laparoscopic appendectomy, does not influence the general trend in 20S proteasome concentration.
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Affiliation(s)
- Ewa Matuszczak
- Pediatric Surgery Department, Medical University of Bialystok, Waszyngtona 17, 15-274, Bialystok, Poland.
| | - Marzena Tylicka
- Biophysics Department, Medical University of Bialystok, Bialystok, Poland
| | - Wojciech Dębek
- Pediatric Surgery Department, Medical University of Bialystok, Waszyngtona 17, 15-274, Bialystok, Poland
| | - Anna Sankiewicz
- Electrochemistry Department, University of Bialystok, Bialystok, Poland
| | - Ewa Gorodkiewicz
- Electrochemistry Department, University of Bialystok, Bialystok, Poland
| | - Adam Hermanowicz
- Pediatric Surgery Department, Medical University of Bialystok, Waszyngtona 17, 15-274, Bialystok, Poland
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Matuszczak E, Weremijewicz A, Komarowska M, Sankiewicz A, Markowska D, Debek W, Gorodkiewicz E, Milewski R, Hermanowicz A. Immunoproteasome in the Plasma of Pediatric Patients With Moderate and Major Burns, and Its Correlation With Proteasome and UCHL1 Measured by SPR Imaging Biosensors. J Burn Care Res 2018. [DOI: 10.1093/jbcr/iry011] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Affiliation(s)
- Ewa Matuszczak
- Department of Pediatric Surgery, Medical University of Bialystok, Poland
| | - Artur Weremijewicz
- Department of Pediatric Surgery, Medical University of Bialystok, Poland
| | - Marta Komarowska
- Department of Pediatric Surgery, Medical University of Bialystok, Poland
| | - Anna Sankiewicz
- Department of Electrochemistry, University of Bialystok, Poland
| | - Diana Markowska
- Department of Electrochemistry, University of Bialystok, Poland
| | - Wojciech Debek
- Department of Pediatric Surgery, Medical University of Bialystok, Poland
| | | | - Robert Milewski
- Department of Statistics, Medical University of Bialystok, Poland
| | - Adam Hermanowicz
- Department of Pediatric Surgery, Medical University of Bialystok, Poland
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Matuszczak E, Sankiewicz A, Debek W, Gorodkiewicz E, Milewski R, Hermanowicz A. Immunoproteasome in the blood plasma of children with acute appendicitis, and its correlation with proteasome and UCHL1 measured by SPR imaging biosensors. Clin Exp Immunol 2017; 191:125-132. [PMID: 28940383 DOI: 10.1111/cei.13056] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/19/2017] [Indexed: 12/19/2022] Open
Abstract
The aim of this study was to determinate the immunoproteasome concentration in the blood plasma of children with appendicitis, and its correlation with circulating proteasome and ubiquitin carboxyl-terminal hydrolase L1 (UCHL1). Twenty-seven children with acute appendicitis, managed at the Paediatric Surgery Department, were included randomly into the study (age 2 years 9 months up to 14 years, mean age 9·5 ± 1 years). There were 10 girls and 17 boys; 18 healthy, age-matched subjects, admitted for planned surgeries served as controls. Mean concentrations of immunoproteasome, 20S proteasome and UCHL1 in the blood plasma of children with appendicitis before surgery 24 h and 72 h after the appendectomy were higher than in the control group. The immunoproteasome, 20S proteasome and UCHL1 concentrations in the blood plasma of patients with acute appendicitis were highest before surgery. The immunoproteasome, 20S proteasome and UCHL1 concentration measured 24 and 72 h after the operation decreased slowly over time and still did not reach the normal range (P < 0·05). There was no statistical difference between immunoproteasome, 20S proteasome and UCHL1 concentrations in children operated on laparoscopically and children after classic appendectomy. The immunoproteasome concentration may reflect the metabolic response to acute state inflammation, and the process of gradual ebbing of the inflammation may thus be helpful in the assessment of the efficacy of treatment. The method of operation - classic open appendectomy or laparoscopic appendectomy - does not influence the general trend in immunoproteasome concentration in children with appendicitis.
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Affiliation(s)
- E Matuszczak
- Paediatric Surgery Department, Medical University of Bialystok, Bialystok, Poland
| | - A Sankiewicz
- Electrochemistry Department, University of Bialystok, Bialystok, Poland
| | - W Debek
- Paediatric Surgery Department, Medical University of Bialystok, Bialystok, Poland
| | - E Gorodkiewicz
- Electrochemistry Department, University of Bialystok, Bialystok, Poland
| | - R Milewski
- Statistics Department, Medical University of Bialystok, Bialystok, Poland
| | - A Hermanowicz
- Paediatric Surgery Department, Medical University of Bialystok, Bialystok, Poland
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Tylicka M, Matuszczak E, Karpińska M, Hermanowicz A, Dębek W, Ostrowska H. Proteasome and C-reactive protein inflammatory response in children undergoing shorter and longer lasting laparoscopic cholecystectomy. Scandinavian Journal of Clinical and Laboratory Investigation 2017; 77:610-616. [PMID: 29022764 DOI: 10.1080/00365513.2017.1385839] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
Operations of varying duration cause the release of a number of inflammatory mediators, in particular cytokines which lead to proteasome and acute-phase reactions. The purpose of this novel human study, was to characterize inflammatory response in children undergoing laparoscopic cholecystectomy, by analyzing changes in selected inflammatory mediators: C-reactive protein concentration and circulating 20S proteasome activity following surgical injury and to correlate them with the duration of the surgical procedure. Plasma C-reactive protein concentration (CRP) was determined by standard biochemical laboratory procedures. Proteasome activity in the plasma of children was assessed using Suc-Leu-Leu-Val-Tyr-AMC peptide substrate. Statistically significant increase in the plasma proteasome activity and C-reactive protein concentration, was noted (p < .05) in children after laparoscopic cholecystectomy. We found the correlation between the 20S proteasome activity and the length of the procedure. In children undergoing longer lasting laparoscopic cholecystectomy the proteasome activity was much higher than in patients having shorter surgical procedure. The CRP concentration and 20S proteasome activity significantly increase after surgery, but only 20S proteasome activity correlate with the length of the surgery. This may confirm that CRP is only an indicator of pathological state, while the function of the proteasomes is more complex because of their participation in the processes of repair and wound healing, and in the removal of damaged proteins.
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Affiliation(s)
- Marzena Tylicka
- a Department of Biophysics , Medical University of Białystok , Białystok , Poland
| | - Ewa Matuszczak
- b Department of Pediatric Surgery , Medical University of Białystok , Białystok , Poland
| | - Maria Karpińska
- a Department of Biophysics , Medical University of Białystok , Białystok , Poland
| | - Adam Hermanowicz
- b Department of Pediatric Surgery , Medical University of Białystok , Białystok , Poland
| | - Wojciech Dębek
- b Department of Pediatric Surgery , Medical University of Białystok , Białystok , Poland
| | - Halina Ostrowska
- c Department of Biology , Medical University of Białystok , Białystok , Poland
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Zang T, Broszczak DA, Broadbent JA, Cuttle L, Lu H, Parker TJ. The biochemistry of blister fluid from pediatric burn injuries: proteomics and metabolomics aspects. Expert Rev Proteomics 2015; 13:35-53. [PMID: 26581649 DOI: 10.1586/14789450.2016.1122528] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
Burn injury is a prevalent and traumatic event for pediatric patients. At present, the diagnosis of burn injury severity is subjective and lacks a clinically relevant quantitative measure. This is due in part to a lack of knowledge surrounding the biochemistry of burn injuries and that of blister fluid. A more complete understanding of the blister fluid biochemistry may open new avenues for diagnostic and prognostic development. Burn insult induces a highly complex network of signaling processes and numerous changes within various biochemical systems, which can ultimately be examined using proteome and metabolome measurements. This review reports on the current understanding of burn wound biochemistry and outlines a technical approach for 'omics' profiling of blister fluid from burn wounds of differing severity.
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Affiliation(s)
- Tuo Zang
- a Tissue Repair and Regeneration Program , Institute of Health and Biomedical Innovation , Kelvin Grove , Australia.,b School of Biomedical Sciences , Queensland University of Technology , Brisbane , Australia.,c Wound Management Innovation Co-operative Research Centre , West End , Australia
| | - Daniel A Broszczak
- a Tissue Repair and Regeneration Program , Institute of Health and Biomedical Innovation , Kelvin Grove , Australia.,b School of Biomedical Sciences , Queensland University of Technology , Brisbane , Australia.,c Wound Management Innovation Co-operative Research Centre , West End , Australia
| | - James A Broadbent
- a Tissue Repair and Regeneration Program , Institute of Health and Biomedical Innovation , Kelvin Grove , Australia.,b School of Biomedical Sciences , Queensland University of Technology , Brisbane , Australia.,c Wound Management Innovation Co-operative Research Centre , West End , Australia
| | - Leila Cuttle
- a Tissue Repair and Regeneration Program , Institute of Health and Biomedical Innovation , Kelvin Grove , Australia.,b School of Biomedical Sciences , Queensland University of Technology , Brisbane , Australia.,d Centre for Children's Burns and Trauma Research , Queensland University of Technology, Institute of Health and Biomedical Innovation at the Centre for Children's Health Research , South Brisbane , Australia
| | - Haitao Lu
- a Tissue Repair and Regeneration Program , Institute of Health and Biomedical Innovation , Kelvin Grove , Australia.,b School of Biomedical Sciences , Queensland University of Technology , Brisbane , Australia
| | - Tony J Parker
- a Tissue Repair and Regeneration Program , Institute of Health and Biomedical Innovation , Kelvin Grove , Australia.,b School of Biomedical Sciences , Queensland University of Technology , Brisbane , Australia
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Tanzer C, Sampson DL, Broadbent JA, Cuttle L, Kempf M, Kimble RM, Upton Z, Parker TJ. Evaluation of haemoglobin in blister fluid as an indicator of paediatric burn wound depth. Burns 2015; 41:1114-21. [PMID: 25637955 DOI: 10.1016/j.burns.2014.12.017] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2014] [Revised: 12/21/2014] [Accepted: 12/25/2014] [Indexed: 01/13/2023]
Abstract
The early and accurate assessment of burns is essential to inform patient treatment regimens; however, this first critical step in clinical practice remains a challenge for specialist burns clinicians worldwide. In this regard, protein biomarkers are a potential adjunct diagnostic tool to assist experienced clinical judgement. Free circulating haemoglobin has previously shown some promise as an indicator of burn depth in a murine animal model. Using blister fluid collected from paediatric burn patients, haemoglobin abundance was measured using semi-quantitative Western blot and immunoassays. Although a trend was observed in which haemoglobin abundance increased with burn wound severity, several patient samples deviated significantly from this trend. Further, it was found that haemoglobin concentration decreased significantly when whole cells, cell debris and fibrinous matrix was removed from the blister fluid by centrifugation; although the relationship to depth was still present. Statistical analyses showed that haemoglobin abundance in the fluid was more strongly related to the time between injury and sample collection and the time taken for spontaneous re-epithelialisation. We hypothesise that prolonged exposure to the blister fluid microenvironment may result in an increased haemoglobin abundance due to erythrocyte lysis, and delayed wound healing.
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Affiliation(s)
- Catherine Tanzer
- Tissue Repair and Regeneration Program, Institute of Health and Biomedical Innovation, Queensland University of Technology, Kelvin Grove, Brisbane, QLD, Australia; School of Biomedical Science, Faculty of Health, Queensland University of Technology, Kelvin Grove, Brisbane, QLD, Australia; Centre for Children's Burns and Trauma Research, Queensland Children's Medical Research Institute, Royal Children's Hospital, Herston, Brisbane, QLD, Australia; Wound Management Innovation Co-operative Research Centre, Kelvin Grove, Brisbane, QLD, Australia.
| | - Dayle L Sampson
- Tissue Repair and Regeneration Program, Institute of Health and Biomedical Innovation, Queensland University of Technology, Kelvin Grove, Brisbane, QLD, Australia; School of Biomedical Science, Faculty of Health, Queensland University of Technology, Kelvin Grove, Brisbane, QLD, Australia; Wound Management Innovation Co-operative Research Centre, Kelvin Grove, Brisbane, QLD, Australia.
| | - James A Broadbent
- Tissue Repair and Regeneration Program, Institute of Health and Biomedical Innovation, Queensland University of Technology, Kelvin Grove, Brisbane, QLD, Australia; School of Biomedical Science, Faculty of Health, Queensland University of Technology, Kelvin Grove, Brisbane, QLD, Australia; Wound Management Innovation Co-operative Research Centre, Kelvin Grove, Brisbane, QLD, Australia.
| | - Leila Cuttle
- Tissue Repair and Regeneration Program, Institute of Health and Biomedical Innovation, Queensland University of Technology, Kelvin Grove, Brisbane, QLD, Australia; School of Biomedical Science, Faculty of Health, Queensland University of Technology, Kelvin Grove, Brisbane, QLD, Australia; Centre for Children's Burns and Trauma Research, Queensland Children's Medical Research Institute, Royal Children's Hospital, Herston, Brisbane, QLD, Australia.
| | - Margit Kempf
- Centre for Children's Burns and Trauma Research, Queensland Children's Medical Research Institute, Royal Children's Hospital, Herston, Brisbane, QLD, Australia.
| | - Roy M Kimble
- Centre for Children's Burns and Trauma Research, Queensland Children's Medical Research Institute, Royal Children's Hospital, Herston, Brisbane, QLD, Australia.
| | - Zee Upton
- Tissue Repair and Regeneration Program, Institute of Health and Biomedical Innovation, Queensland University of Technology, Kelvin Grove, Brisbane, QLD, Australia; School of Biomedical Science, Faculty of Health, Queensland University of Technology, Kelvin Grove, Brisbane, QLD, Australia.
| | - Tony J Parker
- Tissue Repair and Regeneration Program, Institute of Health and Biomedical Innovation, Queensland University of Technology, Kelvin Grove, Brisbane, QLD, Australia; School of Biomedical Science, Faculty of Health, Queensland University of Technology, Kelvin Grove, Brisbane, QLD, Australia.
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