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Bharath S, Agarwal P, Prabhakar T, Ravi S, Sharma D, Dhakar JS. Correlation of thermal burn hepatic dysfunction with outcomes. Burns 2024; 50:611-615. [PMID: 38097440 DOI: 10.1016/j.burns.2023.10.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2023] [Revised: 10/01/2023] [Accepted: 10/04/2023] [Indexed: 04/08/2024]
Abstract
INTRODUCTION Organ dysfunction and failure increase the morbidity and mortality following major burn. Alteration of liver morphology and function is common following major burns; however, it has not received much attention. In this study we have assessed the impact of thermal burn on liver in relation with mortality. MATERIAL AND METHODS 55 patients (33 female and 22 males) with TBSA 10-90% and age ranged from 18 to 75 years were included. A bed side serial ultrasonography to assess the volume of liver and liver function tests was done on the 2nd, 9th and 16th day following burn. Baseline demographic and clinical information such as age, gender, burn size and outcome of patient were also collected. RESULTS - 8 patients died during 2nd week following burn and 47 survived. The mean TBSA for survivors was 37% and for non survivors 80%. Mean liver volume in survivors steadily decreased from 1693.70 cm3 to 1631.31 cm3 over 3 weeks. Mean liver volume in non- survivors steadily increased from 1855.88 cm3 to 2028.50 cm3 over 2 weeks. Liver function test in survivors steadily improved while in non survivors it deteriorated over 2 weeks. CONCLUSION There is a correlation between altered liver morphology and function with mortality among severely burnt patients however liver volume did not show statistical significance. A decreasing trend of liver dysfunction parameters and hepatomegaly following burn is associated with good prognosis.
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Affiliation(s)
- S Bharath
- Senior Resident Department of Surgery, NSCB Government Medical College, Jabalpur 482003, Madhya Pradesh, India
| | - Pawan Agarwal
- Professor and in charge Plastic Surgery Unit, Department of Surgery NSCB Government Medical College, Jabalpur 482003, Madhya Pradesh, India.
| | - Thangavel Prabhakar
- Resident Department of Surgery, NSCB Government Medical College, Jabalpur 482003, Madhya Pradesh, India
| | - Saranya Ravi
- Resident Department of Radiology, NSCB Government Medical College, Jabalpur 482003, Madhya Pradesh, India
| | - Dhananjaya Sharma
- Professor and head, Department of Surgery, NSCB Government Medical College, Jabalpur 482003, Madhya Pradesh, India
| | - Jagmohan Singh Dhakar
- Statistician and tutor, Department of Community Medicine, NSCB Government Medical College, Jabalpur 482003, Madhya Pradesh, India
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Soedjana H, Putri A, Arsyad M, Andalu N. Description of Aspartate Aminotransferase and Alanine Aminotransferase in Burn Patients at the Burn Unit of Dr. Hasan Sadikin General Hospital (Rshs) Bandung. ANNALS OF BURNS AND FIRE DISASTERS 2023; 36:217-221. [PMID: 38680431 PMCID: PMC11041932] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Received: 05/17/2022] [Accepted: 07/03/2022] [Indexed: 05/01/2024]
Abstract
Burn injury is trauma with several metabolic reactions including hepatocytes that can cause apoptosis and necrosis. Proliferation occurs to compensate for this reaction but complicates with the loss of protein of the injury. The aim of this study is to describe the level of aspartate aminotransferase (AST) and alanine aminotransferase (ALT) in burn injury. This study was a descriptive retrospective design using secondary data from medical records of patients at the Burns Unit of Dr. Hasan Sadikin Hospital Bandung (RSHS) in the period August 2017 to July 2019. Total samples in this study were 116 people. Normal level of AST and ALT was found in 23 people (19.8%), elevation of AST in 31 people (26.7%), elevation of ALT in 5 people (4.3%) and elevation of both AST and ALT in 57 people (41.3%). Increased levels of AST and ALT mostly occurred in men (51%), aged 45 years (56%), with injury due to electricity (26%), 20-29% burn area (32%), and occurred in the first week of wound onset. Most cases of burn injury showed increasing levels of AST and ALT. This might be due to the metabolism of hepatocytes in burn cases. Elevation of AST and ALT was mainly found in burn injury cases at RSHS notably in the first week of onset. Further research is needed to verify the relation of this condition. Elevated levels of AST and ALT should be the consideration of clinicians in giving therapy.
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Affiliation(s)
- H. Soedjana
- Division of Plastic and Reconstructive Surgery, Department of Surgery, Dr. Hasan Sadikin General Hospital, Bandung, Indonesia
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3
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Yoksa DT, Abba Y, Shamaki BU, Satumari NA. Effects of resveratrol topical ointment on wound healing of full-thickness cutaneous burns in albino rats. J Wound Care 2022; 31:780-791. [PMID: 36113542 DOI: 10.12968/jowc.2022.31.9.780] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
OBJECTIVE In this study, the effects of resveratrol topical ointment on wound contraction and histopathology of full-thickness cutaneous burn wounds were evaluated. METHOD Adult albino rats were grouped into four equal-sized groups of 15 rats each, as follows: Group A-no wound, no treatment (control); Group B-1% silver sulphadiazine; Group C-5% resveratrol, and Group D-wound without treatment (control). A burn wound measuring 23.5mm was created on the skin at the dorsum of all rats in groups B-D after shaving. The percentage of wound contraction was measured using a digital Vernier Caliper on days 1, 3, 5, 7, 10, 14, 16, 18 and 21, post-wounding. From each group, five rats were then euthanised and tissue samples of the skin, liver and kidney were collected in 10% buffered formalin for histopathology. RESULTS The percentage of wound contraction was significant (p<0.05) on 7, 14 and 18 days post treatment. Histopathologically, 5% resveratrol topical ointment application resulted in a thicker epidermis with neovascularisation and an increased collagen distribution. Resveratrol topical ointment ameliorated the extent of hepatocellular and nephrotubular injuries following burn-induced hepatocellular and acute kidney injuries. CONCLUSION In this study, topical application of 5% resveratrol ointment appeared to enhance burn wound healing by increasing the rate of wound contraction through collagen fibre synthesis, granulation tissue formation and epithelial regeneration.
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Affiliation(s)
- Daniel T Yoksa
- Department of Veterinary Pathology, Faculty of Veterinary Medicine, University of Maiduguri, PMB 1069 Maiduguri, Borno State
| | - Yusuf Abba
- Department of Veterinary Pathology, Faculty of Veterinary Medicine, University of Maiduguri, PMB 1069 Maiduguri, Borno State
| | - Bala U Shamaki
- Department of Veterinary Pharmacology and Toxicology, Faculty of Veterinary Medicine, University of Maiduguri, PMB 1069 Maiduguri, Borno State
| | - Ngamarju A Satumari
- Department of Medical Laboratory Science, Faculty of Allied Health Sciences, University of Maiduguri, PMB 1069 Maiduguri, Borno State
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Lam N, Khanh P, An N. Characteristics And Outcome Influence Of Increased Plasma Triglyceride Level In Severely Burned Adult Patients. ANNALS OF BURNS AND FIRE DISASTERS 2021; 34:145-149. [PMID: 34584502 PMCID: PMC8396158] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Received: 10/05/2020] [Accepted: 12/20/2020] [Indexed: 06/13/2023]
Abstract
The aims of this study were to investigate the profile of serum triglyceride level and its influence on outcomes in adult patients with severe burns. An observational study was conducted on 62 patients with burn extent from and over 20% TBSA. Results indicated that serum triglyceride level steadily increased from 1.9mmo/l on the 3rd day to 2.5 mmol/l on the 14th day before reducing on the 21st day after burn. Remarkably higher triglyceride level was seen in patients with full thickness burn area >20% TBSA and in inhalation injury (p < .05). Liver size significantly increased over time and was greater in increased triglyceride patients, but the difference was not significant (p > .05). In addition, patients with elevated serum triglyceride level had significantly higher rates of multiple organ failure and death compared with the remaining group. Further studies need to be conducted to understand and determine intervention for increased plasma triglyceride levels in severely burned patients.
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Affiliation(s)
- N.N. Lam
- Medical Military University, Vietnam
- National Burn Hospital, Hanoi, Vietnam
| | - P.Q. Khanh
- MedicalMilitary Region 4 Hospital, Vietnam
| | - N.H. An
- Medical Military University, Vietnam
- National Burn Hospital, Hanoi, Vietnam
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5
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Heard TC, Gómez BI, Saathoff ME, Duarte J, Dubick MA, Bynum JA, Christy RJ, Burmeister DM. Minimal Effects of Intravenous Administration of Xenogeneic Adipose Derived Stem Cells on Organ Function in a Porcine 40%TBSA Burn Model. J Burn Care Res 2021; 42:870-879. [PMID: 34057993 DOI: 10.1093/jbcr/irab094] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
Adipose stem cells (ASCs) have shown therapeutic promise for various conditions, including burn injury. While ASCs have immunomodulatory properties, concerns exist over pro-coagulant activity after intravenous (IV) administration. In the present study, we examined IV human ASC delivery in terms of coagulation, organ function, and inflammation in a 40% total body surface area (TBSA) swine burn model. Anesthetized female Yorkshire swine were burned and randomized to receive 15ml/kg Lactated Ringer's containing: no ASCs; a low dose (5x10 5 ASCs/kg), or a high dose (5x10 6 ASCs/kg). For biochemical analysis, blood was collected at baseline (BL), 3, 6, 12, and 24 hours post-burn, while kidney and liver tissue was collected post-euthanasia. A significant, but transient, effect of ASCs was seen on prothrombin times and INR, wherein low doses revealed slight hypercoagulation. Burns increased partial thromboplastin time, fibrinogen, and d-dimer levels, which was unchanged with ASC administration. ASCs tended to exacerbate increases in bilirubin at 3 hours, but this didn't reach statistical significance. A significant effect of ASCs on creatinine and BUN was seen, wherein low doses elevated levels at 24 hours (creatinine, p=0.0012; BUN, p=0.0195). Hepatic and renal TUNEL staining were similar for all groups. A dose-dependent decrease in IL-8 was observed, while low doses significantly increased IL-1RA at 3 (p=0.050), IL-12 at 12 (p=0.021) and IL-6 at 24 hours post-burn (p=0.035). IV administration of xenogeneic ASCs slightly increased coagulation, but effects on burn-induced renal and hepatic dysfunction effects were minimal. Despite some significant immunomodulation, organ dysfunction effects were modest. Collectively, this study provides evidence to be skeptical about xenogeneic ASC administration in regards to burn.
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Affiliation(s)
- Tiffany C Heard
- United States Army Institute of Surgical Research, JBSA Fort Sam Houston, TX, United States of America
| | - Belinda I Gómez
- United States Army Institute of Surgical Research, JBSA Fort Sam Houston, TX, United States of America
| | - Micaela E Saathoff
- United States Army Institute of Surgical Research, JBSA Fort Sam Houston, TX, United States of America
| | - Jamila Duarte
- United States Army Institute of Surgical Research, JBSA Fort Sam Houston, TX, United States of America
| | - Michael A Dubick
- United States Army Institute of Surgical Research, JBSA Fort Sam Houston, TX, United States of America
| | - James A Bynum
- United States Army Institute of Surgical Research, JBSA Fort Sam Houston, TX, United States of America
| | - Robert J Christy
- United States Army Institute of Surgical Research, JBSA Fort Sam Houston, TX, United States of America
| | - David M Burmeister
- Uniformed Services University of the Health Sciences, Bethesda, MD, United States of America
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6
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Wu Y, Hao C, Han G, Liu X, Xu C, Zou Z, Zhou J, Yin J. SS-31 ameliorates hepatic injury in rats subjected to severe burns plus delayed resuscitation via inhibiting the mtDNA/STING pathway in Kupffer cells. Biochem Biophys Res Commun 2021; 546:138-144. [PMID: 33582556 DOI: 10.1016/j.bbrc.2021.01.110] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2020] [Accepted: 01/31/2021] [Indexed: 10/22/2022]
Abstract
Hepatic injury is common in patients who suffer from severe burns plus delayed resuscitation (B + DR). Stimulator of interferon genes (STING) is primarily expressed in Kupffer cells (KCs). We demonstrated that B + DR caused hepatic injury and oxidative stress. Reactive oxygen species (ROS) damage mitochondrial membranes in hepatocytes, leading to the release of mitochondrial DNA (mtDNA) into the hepatocyte cytosol and the circulation. The damaged hepatocytes then activate the mtDNA/STING pathway in KCs and trigger KCs polarization towards pro-inflammatory phenotype. SS-31 is a strong antioxidant that specifically concentrates in the inner mitochondrial membrane. SS-31 prevented hepatic injury by neutralizing ROS, inhibiting the release of mtDNA, protecting hepatocyte mitochondria, suppressing the activation of the mtDNA/STING pathway and inhibiting KCs polarization into pro-inflammatory phenotype.
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Affiliation(s)
- Yin Wu
- Department of Burn and Plastic Surgery, Nanjing First Hospital, Nanjing Medical University, Nanjing, PR China.
| | - Chao Hao
- Department of Burn and Plastic Surgery, Nanjing First Hospital, Nanjing Medical University, Nanjing, PR China
| | - Guangye Han
- Department of Burn and Plastic Surgery, Nanjing First Hospital, Nanjing Medical University, Nanjing, PR China
| | - Xiongfei Liu
- Department of Burn and Plastic Surgery, Nanjing First Hospital, Nanjing Medical University, Nanjing, PR China
| | - Changzheng Xu
- Department of Burn and Plastic Surgery, Nanjing First Hospital, Nanjing Medical University, Nanjing, PR China
| | - Zhongtao Zou
- Department of Burn and Plastic Surgery, Nanjing First Hospital, Nanjing Medical University, Nanjing, PR China
| | - Jinfeng Zhou
- Department of Burn and Plastic Surgery, Nanjing First Hospital, Nanjing Medical University, Nanjing, PR China
| | - Jun Yin
- Department of Burn and Plastic Surgery, Nanjing First Hospital, Nanjing Medical University, Nanjing, PR China
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Tapking C, Houschyar KS, Rontoyanni VG, Hundeshagen G, Kowalewski KF, Hirche C, Popp D, Wolf SE, Herndon DN, Branski LK. The Influence of Obesity on Treatment and Outcome of Severely Burned Patients. J Burn Care Res 2020; 40:996-1008. [PMID: 31294797 DOI: 10.1093/jbcr/irz115] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
Obesity and the related medical, social, and economic impacts are relevant multifactorial and chronic conditions that also have a meaningful impact on outcomes following a severe injury, including burns. In addition to burn-specific difficulties, such as adequate hypermetabolic response, fluid resuscitation, and early wound coverage, obese patients also present with common comorbidities, such as arterial hypertension, diabetes mellitus, or nonalcoholic fatty liver disease. In addition, the pathophysiologic response to severe burns can be enhanced. Besides the increased morbidity and mortality compared to burn patients with normal weight, obese patients present a challenge in fluid resuscitation, perioperative management, and difficulties in wound healing. The present work is an in-depth review of the current understanding of the influence of obesity on the management and outcome of severe burns.
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Affiliation(s)
- Christian Tapking
- Department of Surgery, University of Texas Medical Branch, Galveston.,Shriners Hospitals for Children, Galveston, Texas.,Department of Hand, Plastic and Reconstructive Surgery, Burn Center, BG Trauma Center Ludwigshafen, University of Heidelberg, Germany
| | - Khosrow S Houschyar
- Department of Plastic Surgery, Hand Surgery, Sarcoma Center, BG University Hospital, Ruhr University, Bochum, Germany
| | - Victoria G Rontoyanni
- Department of Surgery, University of Texas Medical Branch, Galveston.,Metabolism Unit, Shriners Hospitals for Children, Galveston, Texas
| | - Gabriel Hundeshagen
- Department of Hand, Plastic and Reconstructive Surgery, Burn Center, BG Trauma Center Ludwigshafen, University of Heidelberg, Germany
| | | | - Christoph Hirche
- Department of Hand, Plastic and Reconstructive Surgery, Burn Center, BG Trauma Center Ludwigshafen, University of Heidelberg, Germany
| | - Daniel Popp
- Department of Surgery, University of Texas Medical Branch, Galveston.,Shriners Hospitals for Children, Galveston, Texas.,Department of Urology, University Medical Center Mannheim, University of Heidelberg, Germany
| | - Steven E Wolf
- Department of Surgery, University of Texas Medical Branch, Galveston.,Shriners Hospitals for Children, Galveston, Texas
| | - David N Herndon
- Department of Surgery, University of Texas Medical Branch, Galveston
| | - Ludwik K Branski
- Department of Surgery, University of Texas Medical Branch, Galveston.,Shriners Hospitals for Children, Galveston, Texas.,Division of Plastic, Aesthetic and Reconstructive Surgery, Department of Surgery, Medical University of Graz, Austria
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8
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Sumsuzzman DM, Choi J, Khan ZA, Hong Y. Protective Effects of Melatonin against Severe Burn-Induced Distant Organ Injury: A Systematic Review and Meta-Analysis of Experimental Studies. Antioxidants (Basel) 2020; 9:antiox9121196. [PMID: 33261180 PMCID: PMC7760393 DOI: 10.3390/antiox9121196] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2020] [Revised: 11/22/2020] [Accepted: 11/24/2020] [Indexed: 12/21/2022] Open
Abstract
Extensive burns result in a local wound response and distant-organ injury (DOI) caused by oxidative-stress and inflammation. Melatonin (MT) shows promise in alleviating oxidative-stress and inflammation, but its role in thermal injury is largely unexplored. The present systematic review and meta-analysis were designed to assess the effects of MT on oxidative-stress and inflammatory markers against severe burn-induced DOI. Mean difference (MD)/standard mean difference (SMD) with 95% confidence interval (CI) were estimated using fixed-effect/random-effects models. Eighteen experimental studies met the inclusion criteria. Compared with the control group, MT significantly decreased the levels of malondialdehyde (SMD, −1.03; 95% CI, −1.30, −0.76, p < 0.00001) and 4-hydroxynonenal (MD, −1.06; 95% CI, −1.57, −0.56, p < 0.0001). Additionally, MT increased the levels of glutathione (SMD, 1.94; 95% CI, 1.27, 2.61, p < 0.00001) and superoxide-dismutase (SMD, 0.76; 95% CI, 0.08, 1.45, p = 0.03). Finally, MT significantly decreased the levels of tumor necrosis factor-α (SMD, −1.34; 95% CI, −1.92 to −0.77; p < 0.00001) and C-reactive protein (MD, −12.67; 95% CI, −16.72 to −8.62; p < 0.00001). Meta-analysis indicates that severe burn followed by immediate MT (10 mg/kg) intervention shows significant beneficial effects after 24-h against DOI by regulating oxidative-stress and the inflammatory response.
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Affiliation(s)
- Dewan Md. Sumsuzzman
- Department of Rehabilitation Science, Graduate School of Inje University, Gimhae 50834, Korea; (D.M.S.); (J.C.)
- Biohealth Products Research Center (BPRC), Inje University, Gimhae 50834, Korea;
- Ubiquitous Healthcare & Anti-Aging Research Center (u-HARC), Inje University, Gimhae 50834, Korea
- Department of Physical Therapy, College of Healthcare Medical Science & Engineering, Gimhae 50834, Korea
| | - Jeonghyun Choi
- Department of Rehabilitation Science, Graduate School of Inje University, Gimhae 50834, Korea; (D.M.S.); (J.C.)
- Biohealth Products Research Center (BPRC), Inje University, Gimhae 50834, Korea;
- Ubiquitous Healthcare & Anti-Aging Research Center (u-HARC), Inje University, Gimhae 50834, Korea
- Department of Physical Therapy, College of Healthcare Medical Science & Engineering, Gimhae 50834, Korea
| | - Zeeshan Ahmad Khan
- Biohealth Products Research Center (BPRC), Inje University, Gimhae 50834, Korea;
- Ubiquitous Healthcare & Anti-Aging Research Center (u-HARC), Inje University, Gimhae 50834, Korea
- Department of Physical Therapy, College of Healthcare Medical Science & Engineering, Gimhae 50834, Korea
| | - Yonggeun Hong
- Department of Rehabilitation Science, Graduate School of Inje University, Gimhae 50834, Korea; (D.M.S.); (J.C.)
- Biohealth Products Research Center (BPRC), Inje University, Gimhae 50834, Korea;
- Ubiquitous Healthcare & Anti-Aging Research Center (u-HARC), Inje University, Gimhae 50834, Korea
- Department of Physical Therapy, College of Healthcare Medical Science & Engineering, Gimhae 50834, Korea
- Department of Medicine, Division of Hematology/Oncology, Harvard Medical School-Beth Israel Deaconess Medical Center, Boston, MA 02215, USA
- Correspondence: ; Tel.: +82-55-320-3681; Fax: +82-55-329-1678
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Idrovo JP, Boe DM, Kaahui S, Yang WL, Kovacs EJ. Hepatic inflammation after burn injury is associated with necroptotic cell death signaling. J Trauma Acute Care Surg 2020; 89:768-774. [PMID: 33017135 PMCID: PMC8386183 DOI: 10.1097/ta.0000000000002865] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
BACKGROUND Burn injury still has a high attributable mortality. The elevated mortality rate of severe burns is still concerning. Hepatic inflammation and injury are common after burns and are associated with poor outcomes. Necroptosis is a programmed cell death linked with inflammation. Thus, assessing necroptotic pathways in the liver can lead to new therapeutic modalities to improve mortality after severe burns. METHODS Mice underwent 15% total body surface area burn or sham injury. Three hours after burn, the mice were euthanized to collect blood and livers. Histology, injury markers, genes expression, and tissue protein levels were compared between groups. RESULTS Compared with sham, burned mice had heightened liver inflammatory cell infiltration and edema. Serum aspartate aminotransferase and alanine aminotransferase were increased by 4.9- and 3.4-fold, respectively, in burned mice relative to sham (p < 0.05). Expression of tumor necrosis factor α, interleukin-6, interleukin-1β, and CXCL1 (KC) genes were elevated in livers of burned mice by 10-, 86-, 10-, and 828-fold, respectively, compared with sham (p < 0.05). Expression of necroptotic genes, namely, receptor-interacting protein kinases 1 and 3, and mixed lineage kinase domain-like in livers of burned mice were increased by 10-, 13-, and 4.5-fold, respectively, relative to sham (p < 0.05). Receptor-interacting protein kinase 1 and phosphorylated mixed lineage kinase domain-like protein levels measured by Western-blot in livers after burn injury were elevated by 22- and 17-fold, respectively, compared with sham (p < 0.05). CONCLUSION Liver damage occurs early after burns in mice and is associated with elevation of proinflammatory cytokines, chemokine, and proteins involved in the necroptotic pathway. This study suggests that necroptosis plays a role in the pathogenesis of liver failure secondary to burn injury.
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Affiliation(s)
- Juan-Pablo Idrovo
- From the Division of GI, Trauma, and Endocrine Surgery, Department of Surgery (J.-P.I., S.K.), Division of GI, Trauma, and Endocrine Surgery, Department of Surgery, Burn Research Program (D.M.B., E.J.K.), and Department of Immunology and Microbiology (D.M.B., E.J.K.), University of Colorado Denver, Anschutz Medical Campus, Aurora, Colorado; Department of Radiation Oncology (W.-L.Y.), Albert Einstein College of Medicine, Bronx, New York; Division of GI, Trauma, and Endocrine Surgery, Department of Surgery, Alcohol Research Program (E.J.K.), University of Colorado Denver, Anschutz Medical Campus, Aurora, Colorado
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Wu Y, Hao C, Liu X, Han G, Yin J, Zou Z, Zhou J, Xu C. MitoQ protects against liver injury induced by severe burn plus delayed resuscitation by suppressing the mtDNA-NLRP3 axis. Int Immunopharmacol 2020; 80:106189. [PMID: 31931374 DOI: 10.1016/j.intimp.2020.106189] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2019] [Revised: 12/17/2019] [Accepted: 01/03/2020] [Indexed: 12/23/2022]
Abstract
INTRODUCTION Liver injury induced by burn plus delayed resuscitation (B + DR) is life threatening in clinical settings. Mitochondrial damage and oxidative stress may account for the liver injury. MitoQ is a mitochondria-targeted antioxidant. We aimed to evaluate whether MitoQ protects against B + DR-induced liver injury. METHODS Rats were randomly divided into three groups: (1) the sham group; (2) the B + DR group, which was characterized by third-degree burn of 30% of the total body surface area plus delayed resuscitation, and (3) the treatment group, in which rats from the B + DR model received the target treatment. MitoQ was injected intraperitoneally (i.p) at 15 min before resuscitation and shortly after resuscitation. In the vitro experiments, Kupffer cells (KCs) were subjected to hypoxia/reoxygenation (H/R) injury to simulate the B + DR model. Mitochondrial characteristics, oxidative stress, liver function, KCs apoptosis and activation of the NLRP3 inflammasome in KCs were measured. RESULTS B + DR caused liver injury and oxidative stress. Excessive ROS lead to liver injury by damaging mitochondrial integrity and activating the mitochondrial DNA (mtDNA)-NLRP3 axis in KCs. The oxidized mtDNA, which was released into the cytosol during KCs apoptosis, directly bound and activated the NLRP3 inflammasome. MitoQ protected against liver injury by scavenging intracellular and mitochondrial ROS, preserving mitochondrial integrity and function, reducing KCs apoptosis, inhibiting the release of mtDNA, and suppressing the mtDNA-NLRP3 axis in KCs. CONCLUSION MitoQ protected against B + DR-induced liver injury by suppressing the mtDNA-NLRP3 axis.
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Affiliation(s)
- Yin Wu
- Department of Burn and Plastic Surgery, Nanjing First Hospital, Nanjing Medical University, Nanjing, PR China
| | - Chao Hao
- Department of Burn and Plastic Surgery, Nanjing First Hospital, Nanjing Medical University, Nanjing, PR China.
| | - Xiongfei Liu
- Department of Burn and Plastic Surgery, Nanjing First Hospital, Nanjing Medical University, Nanjing, PR China
| | - Guangye Han
- Department of Burn and Plastic Surgery, Nanjing First Hospital, Nanjing Medical University, Nanjing, PR China
| | - Jun Yin
- Department of Burn and Plastic Surgery, Nanjing First Hospital, Nanjing Medical University, Nanjing, PR China
| | - Zhongtao Zou
- Department of Burn and Plastic Surgery, Nanjing First Hospital, Nanjing Medical University, Nanjing, PR China
| | - Jinfeng Zhou
- Department of Burn and Plastic Surgery, Nanjing First Hospital, Nanjing Medical University, Nanjing, PR China
| | - Changzheng Xu
- Department of Burn and Plastic Surgery, Nanjing First Hospital, Nanjing Medical University, Nanjing, PR China
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11
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Menegat TA, Oliveira AFD, Majewski MGC, Blanes L, Juliano Y, Novo NF, Ferreira LM. Experimental models of scald burns. A scope review. Acta Cir Bras 2019; 34:e201901007. [PMID: 31826150 PMCID: PMC6907881 DOI: 10.1590/s0102-865020190100000007] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2019] [Accepted: 09/07/2019] [Indexed: 11/22/2022] Open
Abstract
Purpose: To conduct a scope review of the experimental model described by Walker and
Mason, by identifying and analyzing the details of the method. Methods: The authors searched Pubmed-Medline, Cochrane-Bireme and PEDro databases for
articles published between January 2016 and December 2018, using the
following search queries: burns, burn injuries, models animal, and animal
experimentation. All articles whose authors used Walker and Mason's model -
with or without changes to the method in Wistar rats - were included in this
study. Results: The search identified 45 mentions of Walker and Mason's model; however, after
reading each summary, 20 were excluded (of which 5 due to duplicity). The
inconsistencies observed after the scope review were: water temperature,
length of time of exposure of the experimental model's skin to water, extent
of the burnt area, and the description of the thickness/depth of the
injury. Conclusions: Reproducibility of a scientific method is the basis to prove the veracity of
the observed results. Thus, it is necessary to have a greater number of
publications that adopt a reproducible scientific method, for this review
found inconsistencies in the description of Walker and Mason's model.
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Affiliation(s)
- Taís Amadio Menegat
- Fellow Master degree, Postgraduate Program in Translational Surgery, Division of Plastic Surgery, Department of Surgery, Universidade Federal de São Paulo (UNIFESP), Brazil. Conception and design of the study; acquisition, analysis and interpretation of data; technical procedures; manuscript preparation and writing
| | - Andrea Fernandes de Oliveira
- PhD, Health Sciences, Postgraduate Program in Translational Surgery, UNIFESP, Sao Paulo-SP, Brazil. Conception and design of the study; acquisition, analysis and interpretation of data; manuscript writing; critical revision; final approval
| | | | - Leila Blanes
- PhD, Health Sciences, Postgraduate Program in Translational Surgery, UNIFESP, Sao Paulo-SP, Brazil. Conception and design of the study; acquisition, analysis and interpretation of data; manuscript writing; critical revision; final approval
| | - Yara Juliano
- Full Professor, Biostatistics Department, Universidade Santo Amaro (UNISA), Sao Paulo-SP, Brazil. Technical procedures, interpretation of data, statistical analysis
| | - Neil Ferreira Novo
- Full Professor, Biostatistics Department, Universidade Santo Amaro (UNISA), Sao Paulo-SP, Brazil. Technical procedures, interpretation of data, statistical analysis
| | - Lydia Masako Ferreira
- Head, Full Professor, Division of Plastic Surgery, UNIFESP. Researcher 1A-CNPq, Director Medicine III-CAPES, Sao Paulo-SP, Brazil. Intellectual, scientific, conception and design of the study; critical revision
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MONMEESIL P, FUNGFUANG W, TULAYAKUL P, PONGCHAIRERK U. The effects of astaxanthin on liver histopathology and expression of superoxide dismutase in rat aflatoxicosis. J Vet Med Sci 2019; 81:1162-1172. [PMID: 31270307 PMCID: PMC6715921 DOI: 10.1292/jvms.18-0690] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2018] [Accepted: 06/19/2019] [Indexed: 12/27/2022] Open
Abstract
The metabolism of aflatoxin B1 (AFB1) generates reactive oxygen species (ROS) that destroys hepatocytes. Meanwhile, astaxanthin (AX) is known to have stronger antioxidative activity than other carotenoids. This study aimed to investigate hepatoprotective role of AX from AFB1-induced toxicity in rat by histopathological study and immunohistochemistry of Cu/Zn-SOD (SOD1) which acts as the first enzyme in antioxidative reaction against cell injury from ROS. Twenty Wistar rats were randomly divided into 4 groups. The control and AFB1 groups were gavaged by water for 7 days followed by a single DMSO and 1 mg/kg AFB1, respectively. The AXL+ AFB1 and AXH+ AFB1 groups were given of 5 mg/kg and 100 mg/kg AX for 7 days before 1 mg/kg AFB1 administration. The result showed significantly elevated liver weight per 100 g body weight in AFB1 group. The histopathological finding revealed vacuolar degeneration, necrosis, megalocytosis and binucleation of hepatocytes with bile duct hyperplasia in AFB1 group. The severities of pathological changes were sequentially reduced in AXL+AFB1 and AXH+AFB1 groups. Most rats in AXH+AFB1 group owned hypertrophic hepatocytes and atypical proliferation of cholangiocytes which are adaptive responses to severe hepatocyte damage. The SOD1 expression was also significantly higher in AXH+AFB1 group than solely treated AFB1 and AXL+AFB1 groups. In conclusion, AX alleviated AFB1-induced liver damage in rat by stimulating SOD1 expression and transdifferentiation of cholangiocytes in dose dependent manner.
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Affiliation(s)
- Poempool MONMEESIL
- Department of Anatomy, Faculty of Veterinary Medicine,
Kasetsart University, 50 Ngamwongwan Road, Ladyao, Jatuchak, Bangkok 10900, Thailand
| | - Wirasak FUNGFUANG
- Department of Zoology, Faculty of Science, Kasetsart
University, 50 Ngamwongwan Road, Ladyao, Jatuchak, Bangkok 10900, Thailand
| | - Phitsanu TULAYAKUL
- Department of Veterinary Public Health, Faculty of
Veterinary Medicine, Kasetsart University, Malaiman Road, Kamphaeng Saen, Nakhon Pathom
73140, Thailand
| | - Urai PONGCHAIRERK
- Department of Anatomy, Faculty of Veterinary Medicine,
Kasetsart University, 50 Ngamwongwan Road, Ladyao, Jatuchak, Bangkok 10900, Thailand
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Baptista VIDA, Quintana HT, Lazzarin MC, Benfato ID, De Carvalho FP, Le Sueur-Maluf L, De Oliveira CAM, Baptista JDS, De Oliveira F. Short time insulin treatment post burn improves elastic-collagen rearrangement and reepithelization. Connect Tissue Res 2019; 60:230-239. [PMID: 29929404 DOI: 10.1080/03008207.2018.1484916] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
Extensive burn may cause acute resistance to insulin, which accentuates hypermetabolism, impairs glucose metabolism, immune dysfunction and risks of sepsis. To minimize these effects, insulin is used as a treatment. The purpose was to analyze the collagen-elastic arrangement effects of insulin on the burned skin. Wistar rats were assigned in groups: control (C); control with insulin (C + I); scald burn injury (SBI); and SBI with insulin (SBI+ I). SBI were submitted to 45% total body surface area burn and the insulin-treated groups received insulin (5 UI/Kg/day) for 4 or 14 days (d). Insulin levels, glucose tolerance test and HOMA index were determined. The skin sections were analyzed for histophatological and morphoquantitative data. Histopathological findings showed increased reepithelization of SBI+ I and formation of a new muscle layer after 14 days. In the collagen-elastic arrangement, insulin for 4 days increased the volume fraction (Vv) of thin collagen and elastic fibers. After 14 days, independently of injury, insulin decreased the elastic fibers. Insulin was able to reverse damages in the collagen-elastic rearrangement and stimulate reepithelization after 4 days. Untreated scald-burned animals showed higher Vv of thick collagen after 4 days, while those treated had a higher Vv of thin collagen. The Vv of elastic fibers was increased in SBI+ I for 4 days. In conclusion, insulin treatment was able to stimulate reepithelization. It also reversed the damages to the collagen-elastic arrangement in the scald-burned group, improving the organization of thin collagen and increasing the Vv of elastic fibers in the injured group treated with insulin for a short time, that is, for 4 days.
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Affiliation(s)
| | | | - Mariana Cruz Lazzarin
- a Department of Biosciences , Federal University of São Paulo, UNIFESP , SP , Brazil
| | - Izabelle Dias Benfato
- a Department of Biosciences , Federal University of São Paulo, UNIFESP , SP , Brazil
| | | | | | | | | | - Flavia De Oliveira
- a Department of Biosciences , Federal University of São Paulo, UNIFESP , SP , Brazil
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Abstract
Thermal injury may lead to multiple organ dysfunction through release of proinflammatory mediators and reactive oxygen radicals. This study investigated the effects of thermal injury on remote organs of rats and the possible protective effect of lutein. Thermal trauma was induced in the back of rats by exposing them to 90 °C bath for 10 s. Rats were sacrificed 48 h after burn, and blood samples were collected to monitor liver and kidney functions. Tissue samples from liver, kidneys, and lungs were taken for studying oxidative stress parameters, gene expressions of TNF-α and Casp-3, besides histopathological examination. Skin scald injury caused significant elevations of liver and kidney function biomarkers in the serum. In tissue samples, increments of MDA, GPx, and 8-OHdG were recorded while GSH level and the activities of CAT and SOD were suppressed. The expressions of TNF-α and caspase-3 mRNA were increased, and histopathological results revealed remote organ injury. Oral administration of lutein (250 mg/kg) resulted in amelioration of the biochemical and molecular changes induced by burn as well as the histopathological alterations. According to the findings of the present study, lutein possesses anti-oxidant, anti-inflammatory, and anti-apoptotic effects that protect against burn-induced damage in remote organs.
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