Institute of Medical Science, University of Toronto, Toronto, Canada.
Sunnybrook Research Institute, Toronto, Canada.
Ann Surg. 2023 Dec 1;278(6):e1267-e1276. doi: 10.1097/SLA.0000000000005880. Epub 2023 Apr 14.
We conducted a large-scale investigation of the systemic and adipose tissue-specific alterations in a clinical population of burn patients to identify factors that may influence hypermetabolism.
Previous research has identified chronic disturbances in adipose tissue inflammation, lipolysis, and browning, which may drive the perpetuation of hypermetabolism following the severe adrenergic stress of a burn injury. Given that adipose tissue is thought to be a central node in the regulation of systemic metabolism, we believe that systematically delineating the pathologic role of adipose tissue postburn, will lead to the identification of novel interventions to mitigate morbidity and mortality from severe burns.
This was a single-institution cohort study, which obtained plasma and subcutaneous adipose tissue samples from severely burn adult patients over various time points during acute hospitalization. Whole-body clinical, metabolic, and inflammatory mediators were assessed in plasma, while genetic analyses through RT-qPCR and single-nuclei RNA sequencing were conducted in adipose tissue.
Systemic inflammation and adrenergic stress increase IL-6 signaling, lipolysis, browning, and adipokine dysfunction in the adipose tissue of adult burn patients, which may further propagate the long-term hypermetabolic response. Moreover, using single-nuclei RNA sequencing, we provide the first comprehensive characterization of alterations in the adipose tissue microenvironment occurring at acute and chronic stages postburn.
We provide novel insight toward the effect of burns on adipokine release, inflammatory signaling pathways, and adipose heterogeneity over the trajectory of acute and chronic stages.
我们对烧伤患者的临床人群进行了大规模的系统性和脂肪组织特异性改变调查,以确定可能影响代谢亢进的因素。
先前的研究已经确定了脂肪组织炎症、脂肪分解和棕色化的慢性紊乱,这些可能导致烧伤后严重肾上腺素能应激下代谢亢进的持续存在。鉴于脂肪组织被认为是调节全身代谢的中心节点,我们认为系统地描绘烧伤后脂肪组织的病理作用,将导致确定减轻严重烧伤发病率和死亡率的新干预措施。
这是一项单机构队列研究,在急性住院期间的不同时间点从严重烧伤的成年患者中获得血浆和皮下脂肪组织样本。在血浆中评估全身临床、代谢和炎症介质,而通过 RT-qPCR 和单核 RNA 测序在脂肪组织中进行基因分析。
全身炎症和肾上腺素能应激增加了成年烧伤患者脂肪组织中的 IL-6 信号、脂肪分解、棕色化和脂肪因子功能障碍,这可能进一步促进长期代谢亢进反应。此外,我们通过单核 RNA 测序首次全面描述了烧伤后急性和慢性阶段脂肪组织微环境的改变。
我们提供了关于烧伤对急性和慢性阶段脂肪因子释放、炎症信号通路和脂肪异质性影响的新见解。