1
|
Allahham A, Rowe G, Stevenson A, Fear MW, Vallence AM, Wood FM. The impact of burn injury on the central nervous system. BURNS & TRAUMA 2024; 12:tkad037. [PMID: 38312739 PMCID: PMC10835674 DOI: 10.1093/burnst/tkad037] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 04/13/2023] [Revised: 05/31/2023] [Accepted: 06/21/2023] [Indexed: 02/06/2024]
Abstract
Burn injuries can be devastating, with life-long impacts including an increased risk of hospitalization for a wide range of secondary morbidities. One area that remains not fully understood is the impact of burn trauma on the central nervous system (CNS). This review will outline the current findings on the physiological impact that burns have on the CNS and how this may contribute to the development of neural comorbidities including mental health conditions. This review highlights the damaging effects caused by burn injuries on the CNS, characterized by changes to metabolism, molecular damage to cells and their organelles, and disturbance to sensory, motor and cognitive functions in the CNS. This damage is likely initiated by the inflammatory response that accompanies burn injury, and it is often long-lasting. Treatments used to relieve the symptoms of damage to the CNS due to burn injury often target inflammatory pathways. However, there are non-invasive treatments for burn patients that target the functional and cognitive damage caused by the burn, including transcranial magnetic stimulation and virtual reality. Future research should focus on understanding the mechanisms that underpin the impact of a burn injury on the CNS, burn severity thresholds required to inflict damage to the CNS, and acute and long-term therapies to ameliorate deleterious CNS changes after a burn.
Collapse
Affiliation(s)
- Amira Allahham
- Burn injury research unit, School of Biomedical Sciences, University of Western Australia, 35 Stirling Highway, Crawley, Perth, WA 6009, Australia
- Fiona Wood Foundation, 11 Robin Warren Dr, Murdoch WA 6150, Australia
| | - Grant Rowe
- Centre for Molecular Medicine and Innovative Therapeutics, Murdoch University, 90 South Street, Murdoch, Perth 6150, Australia
| | - Andrew Stevenson
- Burn injury research unit, School of Biomedical Sciences, University of Western Australia, 35 Stirling Highway, Crawley, Perth, WA 6009, Australia
- Fiona Wood Foundation, 11 Robin Warren Dr, Murdoch WA 6150, Australia
| | - Mark W Fear
- Burn injury research unit, School of Biomedical Sciences, University of Western Australia, 35 Stirling Highway, Crawley, Perth, WA 6009, Australia
- Fiona Wood Foundation, 11 Robin Warren Dr, Murdoch WA 6150, Australia
| | - Ann-Maree Vallence
- Centre for Molecular Medicine and Innovative Therapeutics, Murdoch University, 90 South Street, Murdoch, Perth 6150, Australia
- Centre for Healthy Ageing, Health Futures Institute, Murdoch University, 90 South Street, Murdoch Perth 6150, Australia
- Burn Service of Western Australia, Fiona Stanley Hospital, MNH (B), Level 4, 102-118 Murdoch Drive, Murdoch, Perth, WA 6150, Australia
| | - Fiona M Wood
- Burn injury research unit, School of Biomedical Sciences, University of Western Australia, 35 Stirling Highway, Crawley, Perth, WA 6009, Australia
- Fiona Wood Foundation, 11 Robin Warren Dr, Murdoch WA 6150, Australia
- School of Psychology, College of Health and Education, Murdoch University, 90 South Street, Murdoch, Perth 6150, Australia
| |
Collapse
|
2
|
Chen J, Zhang D, Zhang J, Wang Y. Pathological changes in the brain after peripheral burns. BURNS & TRAUMA 2023; 11:tkac061. [PMID: 36865685 PMCID: PMC9972189 DOI: 10.1093/burnst/tkac061] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 09/11/2022] [Revised: 12/22/2022] [Indexed: 02/09/2023]
Abstract
Brain injuries are common complications in patients with thermal burns and are associated with unpleasant outcomes. In clinical settings, it was once believed that brain injuries were not major pathological processes after burn, at least in part due to the unavailability of specific clinical manifestations. Burn-related brain injuries have been studied for more than a century, but the underlying pathophysiology has not been completely clarified. This article reviews the pathological changes in the brain following peripheral burns at the anatomical, histological, cytological, molecular and cognitive levels. Therapeutic indications based on brain injury as well as future directions for research have been summarized and proposed.
Collapse
Affiliation(s)
- Jigang Chen
- Department of Burn and Plastic Surgery, Beijing Children’s Hospital, Capital Medical University, National Center for Children's Health, Beijing 100045, China
| | - Danfeng Zhang
- Department of Neurosurgery, Shanghai Changzheng Hospital, Second Military Medical University, Shanghai 200003, China
| | | | | |
Collapse
|
3
|
Xie C, Hu J, Cheng Y, Yao Z. Researches on cognitive sequelae of burn injury: Current status and advances. Front Neurosci 2022; 16:1026152. [PMID: 36408414 PMCID: PMC9672468 DOI: 10.3389/fnins.2022.1026152] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2022] [Accepted: 10/20/2022] [Indexed: 09/29/2023] Open
Abstract
Burn injury is a devastating disease with high incidence of disability and mortality. The cognitive dysfunctions, such as memory defect, are the main neurological sequelae influencing the life quality of burn-injured patients. The post-burn cognitive dysfunctions are related to the primary peripheral factors and the secondary cerebral inflammation, resulting in the destruction of blood-brain barrier (BBB), as is shown on Computed Tomography (CT) and magnetic resonance imaging examinations. As part of the neurovascular unit, BBB is vital to the nutrition and homeostasis of the central nervous system (CNS) and undergoes myriad alterations after burn injury, causing post-burn cognitive defects. The diagnosis and treatment of cognitive dysfunctions as burn injury sequelae are of great importance. In this review, we address the major manifestations and interventions of post-burn cognitive defects, as well as the mechanisms involved in memory defect, including neuroinflammation, destruction of BBB, and hormone imbalance.
Collapse
Affiliation(s)
- Chenchen Xie
- Department of Neurology, Affiliated Hospital and Clinical Medical College of Chengdu University, Chengdu, China
- Department of Neurology, The Second Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Jun Hu
- Department of Neurology, First Affiliated Hospital of Army Medical University, Chongqing, China
| | - Yong Cheng
- Department of Neurology, General Hospital of Central Theater Command of PLA, Wuhan, China
| | - Zhongxiang Yao
- Department of Physiology, Army Medical University, Chongqing, China
| |
Collapse
|
4
|
Montero-Taboada R, Sotil G, Dionicio-Acedo J, Rosado-Salazar M, Aguirre-Velarde A. Tolerance of juvenile Peruvian rock seabass (Paralabrax humeralis Valenciennes, 1828) and Peruvian grunt (Anisotremus scapularis Tschudi, 1846) to low-oxygen conditions. JOURNAL OF FISH BIOLOGY 2022; 100:1497-1509. [PMID: 35398900 DOI: 10.1111/jfb.15060] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/17/2021] [Revised: 03/28/2022] [Accepted: 04/06/2022] [Indexed: 06/14/2023]
Abstract
Hypoxia is currently one of the greatest threats to coastal ecosystems worldwide, generating massive mortality of marine organisms, loss of benthic ecosystems and a decrease in fishery production. We evaluated and compared the tolerance to hypoxia of two species from different habitats of the Peruvian coast, the Peruvian rock seabass Paralabrax humeralis and the Peruvian grunt Anisotremus scapularis. The effect of hypoxia was measured as a function of the exposure time (progressive and chronic) on the behavioural and physiological responses of the two species, as well as on the enzymatic activity associated with the oxidative stress response of lactate dehydrogenase (LDH), superoxide dismutase (SOD) and alkaline phosphatase (AKP). The ventilatory frequency was measured at two different temperatures (16 and 22°C) under progressive hypoxia conditions to determine the ventilatory critical point (Vcp). A. scapularis showed a higher Vcp than P. humeralis, which was positively affected by temperature. The median lethal time of A. scapularis was 36 min at 60% of oxygen saturation, while P. humeralis showed no mortality after 31 days of exposure at 5% oxygen saturation. Different enzymatic activity (P < 0.05) between species under hypoxia was recorded, in SOD (gill and muscle) and AKP (blood). A general tendency, under hypoxia, to slightly increase LDH activity (except for blood in A. scapularis, P < 0.05) and SOD activity (mainly in muscle of A. scapularis, P < 0.05), and decrease AKP activity (mainly in liver of P. humeralis, P < 0.05) was observed. The response of P. humeralis to hypoxia goes through a reduction in activity and metabolism, so this species can be considered hypoxia-tolerant, allowing it to face hypoxia events during prolonged periods. On the other hand, A. scapularis response to hypoxia prioritizes avoidance mechanisms and, together with other adaptations, makes it especially vulnerable to hypoxia and able to be considered hypoxia-intolerant.
Collapse
Affiliation(s)
- Rebeca Montero-Taboada
- Universidad Científica del Sur, Carretera Panamerica Sur Km 19, Lima, Peru
- Instituto del Mar del Perú, Esquina General Valle y Gamarra S/N, Callao, Peru
- College of Marine Life Sciences, Ocean University of China, Qingdao, China
| | - Giovanna Sotil
- Instituto del Mar del Perú, Esquina General Valle y Gamarra S/N, Callao, Peru
- Facultad de Ciencias Biológicas, Universidad Nacional Mayor de San Marcos, Av. Venezuela s/n, Ciudad Universitaria, Lima, Peru
| | - Jhon Dionicio-Acedo
- Instituto del Mar del Perú, Esquina General Valle y Gamarra S/N, Callao, Peru
| | | | | |
Collapse
|
5
|
Zhang J, Jiang M, Zhao H, Han L, Jin Y, Chen W, Wang J, Zhang Z, Peng C. Synthesis of Paeonol-Ozagrel Conjugate: Structure Characterization and In Vivo Anti-Ischemic Stroke potential. Front Pharmacol 2021; 11:608221. [PMID: 33597878 PMCID: PMC7883289 DOI: 10.3389/fphar.2020.608221] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2020] [Accepted: 12/11/2020] [Indexed: 12/16/2022] Open
Abstract
Ischemic stroke is a common neurological disease that can lead to mortality and disability. The current curative effect remains unsatisfactory because drug accumulation in the diseased areas is insufficient as a result of the unique blood–brain barrier. Therefore, much attention has been paid to develop a novel therapeutic compound, paeonol-ozagrel conjugate (POC), for ischemic stroke. Then, POC was successfully synthesized by conjugating of paeonol and ozagrel as mutual prodrug. A series of in vitro characterizations and evaluations, including high - resolution mass spectroscopy, nuclear magnetic resonance spectroscopy, partition coefficient, and assessment of cytotoxicity against PC12 cells, were performed. Pharmacokinetic study demonstrated POC is eliminated quickly (t1/2 = 53.46 ± 19.64 min), which supported a short dosing interval. The neurological score, infarct volume, histopathological changes, oxidative stress, inflammatory cytokines levels, and TXA2 levels also were evaluated in vivo in middle cerebral artery occlusion (MCAO) rats. All results showed that POC had a significant curative and therapeutic effect on ischemic stroke, as evaluated by the middle cerebral artery occlusion. Overall, POC can be expected to become a new drug candidate for the treatment of ischemic stroke.
Collapse
Affiliation(s)
- Jing Zhang
- College of Pharmacy, Anhui University of Chinese Medicine, Hefei, China.,Institute of Pharmaceutics, Anhui Academy of Chinese Medicine, Hefei, China.,Anhui Province Key Laboratory of Pharmaceutical Preparation Technology and Application, Hefei, China
| | - Miaomiao Jiang
- College of Pharmacy, Anhui University of Chinese Medicine, Hefei, China.,Institute of Pharmaceutics, Anhui Academy of Chinese Medicine, Hefei, China.,Department of Pharmacy, the Fourth Affiliated Hospital of Anhui Medical University, Hefei, China
| | - Hui Zhao
- Department of Pharmacy, the Fourth Affiliated Hospital of Anhui Medical University, Hefei, China
| | - Lan Han
- College of Pharmacy, Anhui University of Chinese Medicine, Hefei, China.,Institute of Pharmaceutics, Anhui Academy of Chinese Medicine, Hefei, China.,Anhui Province Key Laboratory of Pharmaceutical Preparation Technology and Application, Hefei, China
| | - Yu Jin
- Chaohu Jinchen Pharmacy Co., Ltd., Shanghai Haihong Industrial Group, Chaohu, China
| | - Weidong Chen
- College of Pharmacy, Anhui University of Chinese Medicine, Hefei, China.,Institute of Pharmaceutics, Anhui Academy of Chinese Medicine, Hefei, China.,Anhui Province Key Laboratory of Pharmaceutical Preparation Technology and Application, Hefei, China
| | - Jianqing Wang
- Department of Pharmacy, the Fourth Affiliated Hospital of Anhui Medical University, Hefei, China
| | - Ziyu Zhang
- College of Pharmacy, Anhui University of Chinese Medicine, Hefei, China.,Institute of Pharmaceutics, Anhui Academy of Chinese Medicine, Hefei, China
| | - Can Peng
- College of Pharmacy, Anhui University of Chinese Medicine, Hefei, China.,Institute of Pharmaceutics, Anhui Academy of Chinese Medicine, Hefei, China.,Anhui Province Key Laboratory of Pharmaceutical Preparation Technology and Application, Hefei, China
| |
Collapse
|
6
|
|
7
|
Wang QF, Shen WL, Hou CC, Liu C, Wu XF, Zhu JQ. Physiological responses and changes in gene expression in the large yellow croaker Larimichthys crocea following exposure to hypoxia. CHEMOSPHERE 2017; 169:418-427. [PMID: 27889508 DOI: 10.1016/j.chemosphere.2016.11.099] [Citation(s) in RCA: 35] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/28/2016] [Revised: 11/17/2016] [Accepted: 11/18/2016] [Indexed: 06/06/2023]
Abstract
Organisms at all levels of evolutionary complexity react to hypoxic stress. To clarify the effects of acute hypoxia on physiological and biochemical responses of Larimichthys crocea, we measured the activity levels of the antioxidant enzymes superoxide dismutase and catalase, hemoglobin concentration, functional indices of the liver (aspartate transaminase, alanine transaminase), heart (phosphocreatine kinase), and immune system (alkaline phosphatase), as well as mRNA expression levels of the immunity-related genes Hsp70 and HIF-1α at different time points of hypoxic. In addition, liver, gill, and kidney samples were histologically analyzed. We found that hemoglobin concentration and all enzyme activities increased during hypoxia, although these effects were transient and most indices returned to basal levels thereafter. The extent of the increase in the parameter values was inversely proportional to the dissolved oxygen content. Hsp70 and HIF-1α mRNA expression levels increased significantly in the blood, liver, gills, and kidneys following exposure to hypoxia, which may play an important role in protecting fish against oxidative damage. However, we found histological evidence of hypoxia-induced injuries to the gills, liver, and kidneys, which are involved in breathing, detoxification, and osmotic balance maintenance, respectively. Thus, despite the upregulation of defensive mechanisms, acute hypoxia still caused irreversible damage of organs. In conclusion, we observed that, in response to acute hypoxic stress, L. crocea enhances immune defensive function and antioxidant capacity. A better understanding of the regulation of the molecular anti-hypoxia mechanisms can help speeding up the selective breeding of hypoxia-tolerant L. crocea.
Collapse
Affiliation(s)
- Qian-Feng Wang
- Key Laboratory of Applied Marine Biotechnology of Ministry of Education, College of Marine Sciences, Ningbo University, Ningbo, Zhejiang 315211, China; Ningbo Academy of Oceanology and Fishery, Zhejiang 315012, China
| | - Wei-Liang Shen
- Ningbo Academy of Oceanology and Fishery, Zhejiang 315012, China
| | - Cong-Cong Hou
- Key Laboratory of Applied Marine Biotechnology of Ministry of Education, College of Marine Sciences, Ningbo University, Ningbo, Zhejiang 315211, China
| | - Cheng Liu
- Key Laboratory of Applied Marine Biotechnology of Ministry of Education, College of Marine Sciences, Ningbo University, Ningbo, Zhejiang 315211, China; Ningbo Academy of Oceanology and Fishery, Zhejiang 315012, China
| | - Xiong-Fei Wu
- Ningbo Academy of Oceanology and Fishery, Zhejiang 315012, China
| | - Jun-Quan Zhu
- Key Laboratory of Applied Marine Biotechnology of Ministry of Education, College of Marine Sciences, Ningbo University, Ningbo, Zhejiang 315211, China.
| |
Collapse
|
8
|
Jiang T, Xie L, Lou X, Li D, Chen Z, Xiao H, Ma L. T2 relaxation time measurements in the brains of scalded rats. SCIENCE CHINA-LIFE SCIENCES 2017; 60:5-10. [PMID: 28078505 DOI: 10.1007/s11427-016-0382-7] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/07/2016] [Accepted: 11/07/2016] [Indexed: 12/23/2022]
Abstract
This study aimed to evaluate the T2 relaxation time of the brain in severely scalded rats using a magnetic resonance (MR) T2 mapping sequence, and to investigate the correlation between T2 relaxation time and plasma glucose level. Twenty-eight Wistar rats were randomly divided into the scalded group (n=21) and control group (n=7). Magnetic resonance scans were performed with T1WI, T2WI, and T2-mapping sequences in the scalded group; the scans were performed 1 day prior to scalding and 1, 3, 5, and 7 days post-scalding; in addition, identical MR scans were performed in the control group at the same time points. T2-maps were generated and T2 relaxation times were acquired from the following brain regions: the hippocampus, thalamus, caudate-putamen, and cerebrum. Pathological changes of the hippocampus were observed. The plasma glucose level of each rat was measured before each MR scan, and a correlation analysis was performed between T2 relaxation time and plasma glucose level. We found that conventional T1WI and T2WI did not reveal any abnormal signals or morphological changes in the hippocampus, thalamus, caudate-putamen, or cerebrum post-scalding. Both the T2 relaxation times of the selected brain regions and plasma glucose levels increased 1, 3, and 5 days post-scalding, and returned to normal levels 7 days post-scalding. The most marked increase of T2 relaxation time was found in the hippocampus; similar changes were also revealed in the thalamus, caudate-putamen, and cerebrum. No correlation was found between T2 relaxation time and plasma glucose level in scalded rats. Pathological observation of the hippocampus showed edema 1, 3, and 5 days post-scalding, with recovery to normal findings at 7 days post-scalding. Thus, we concluded that T2 mapping is a sensitive method for detecting and monitoring scald injury in the rat brain. As the hippocampus is the main region for modulating a stress reaction, it showed significantly increased water content along with an increased plasma glucose level post-scalding.
Collapse
Affiliation(s)
- Tao Jiang
- Department of Radiology, PLA General Hospital, Beijing, 100853, China
- Department of Radiology, PLA 401 Hospital, Qingdao, 266071, China
| | - Liqi Xie
- Department of Radiology, PLA 401 Hospital, Qingdao, 266071, China
| | - Xin Lou
- Department of Radiology, PLA General Hospital, Beijing, 100853, China
| | - Dawei Li
- Department of Burn and Plastic Surgery, PLA 304 Hospital, Beijing, 100048, China
| | - Zhiye Chen
- Department of Radiology, PLA General Hospital, Beijing, 100853, China
| | - Huafeng Xiao
- Department of Radiology, PLA 302 Hospital, Beijing, 100039, China
| | - Lin Ma
- Department of Radiology, PLA General Hospital, Beijing, 100853, China.
| |
Collapse
|
9
|
Dynamic Observation on Opening of the Blood–Brain Barrier in the Primary Stage of Severely Scalded Rabbits, a Multimodal Study. J Burn Care Res 2016; 37:e279-86. [DOI: 10.1097/bcr.0000000000000172] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
|
10
|
Zhang QH, Chen Q, Kang JR, Liu C, Dong N, Zhu XM, Sheng ZY, Yao YM. Treatment with gelsolin reduces brain inflammation and apoptotic signaling in mice following thermal injury. J Neuroinflammation 2011; 8:118. [PMID: 21936896 PMCID: PMC3191361 DOI: 10.1186/1742-2094-8-118] [Citation(s) in RCA: 35] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2011] [Accepted: 09/21/2011] [Indexed: 12/25/2022] Open
Abstract
Background Burn survivors develop long-term cognitive impairment with increased inflammation and apoptosis in the brain. Gelsolin, an actin-binding protein with capping and severing activities, plays a crucial role in the septic response. We investigated if gelsolin infusion could attenuate neural damage in burned mice. Methods Mice with 15% total body surface area burns were injected intravenously with bovine serum albumin as placebo (2 mg/kg), or with low (2 mg/kg) or high doses (20 mg/kg) of gelsolin. Samples were harvested at 8, 24, 48 and 72 hours postburn. The immune function of splenic T cells was analyzed. Cerebral pathology was examined by hematoxylin/eosin staining, while activated glial cells and infiltrating leukocytes were detected by immunohistochemistry. Cerebral cytokine mRNAs were further assessed by quantitative real-time PCR, while apoptosis was evaluated by caspase-3. Neural damage was determined using enzyme-linked immunosorbent assay of neuron-specific enolase (NSE) and soluble protein-100 (S-100). Finally, cerebral phospho-ERK expression was measured by western blot. Results Gelsolin significantly improved the outcomes of mice following major burns in a dose-dependent manner. The survival rate was improved by high dose gelsolin treatment compared with the placebo group (56.67% vs. 30%). Although there was no significant improvement in outcome in mice receiving low dose gelsolin (30%), survival time was prolonged against the placebo control (43.1 ± 4.5 h vs. 35.5 ± 5.0 h; P < 0.05). Burn-induced T cell suppression was greatly alleviated by high dose gelsolin treatment. Concurrently, cerebral abnormalities were greatly ameliorated as shown by reduced NSE and S-100 content of brain, decreased cytokine mRNA expressions, suppressed microglial activation, and enhanced infiltration of CD11b+ and CD45+ cells into the brain. Furthermore, the elevated caspase-3 activity seen following burn injury was remarkably reduced by high dose gelsolin treatment along with down-regulation of phospho-ERK expression. Conclusion Exogenous gelsolin infusion improves survival of mice following major burn injury by partially attenuating inflammation and apoptosis in brain, and by enhancing peripheral T lymphocyte function as well. These data suggest a novel and effective strategy to combat excessive neuroinflammation and to preserve cognition in the setting of major burns.
Collapse
Affiliation(s)
- Qing-Hong Zhang
- Department of Microbiology and Immunology, Burns Institute, First Hospital Affiliated to the Chinese PLA General Hospital, Beijing 100048, PR China
| | | | | | | | | | | | | | | |
Collapse
|