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metabolic response to trauma

Matthew P Rowan, Darrick J Beckman, Julie A Rizzo, Claire L Isbell, Christopher E White, Stephen M Cohn, Kevin K Chung
BACKGROUND: Burn and trauma patients present a clinical challenge due to metabolic derangements and hypermetabolism that result in a prolonged catabolic state with impaired healing and secondary complications, including ventilator dependence. Previous work has shown that circulating levels of growth hormone (GH) are predictive of mortality in critically ill adults, but few studies have examined the prognostic potential of GH levels in adult trauma patients. METHODS: To investigate the utility of GH and other endocrine responses in the prediction of outcomes, we conducted a prospective, observational study of adult burn and trauma patients...
October 4, 2016: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine
Craig Porter, Ronald G Tompkins, Celeste C Finnerty, Labros S Sidossis, Oscar E Suman, David N Herndon
Major burns provoke a profound stress response, which is unrivalled in terms of its magnitude and duration. Evidence suggests that the pathophysiological stress response to severe burn trauma persists for several years after injury. Thus, there is a pressing need for novel strategies that mitigate this response and restore normal metabolic function in patients with burns. This is the first in a Series of three papers about the care of people with burns. In this paper, we review the current knowledge of the stress response to burn trauma, with a focus on hypermetabolism, muscle wasting, and stress-induced diabetes...
October 1, 2016: Lancet
Clair Hartmann, Sebastian Hafner, Angelika Scheuerle, Peter Möller, Markus Huber-Lang, Birgit Jung, Benedikt Nubaum, Oscar McCook, Michael Gröger, Florian Wagner, Sandra Weber, Bettina Stahl, Enrico Calzia, Michael Georgieff, Csaba Szabó, Rui Wang, Peter Radermacher, Katja Wagner
Pre-traumatic cigarette smoke (CS) exposure aggravates post-traumatic acute lung injury (ALI). Cystathionine-γ-lyase (CSE) protects against ALI and CS exposure-induced chronic obstructive lung disease (COPD). Therefore, we tested the hypothesis whether genetic CSE knockout (CSE) would aggravate post-traumatic ALI after CS exposure. After 3-4 weeks of CS exposure, anesthetized wild type (WT) and CSE mice underwent blunt chest trauma, surgical instrumentation and 4 hours of lung-protective mechanical ventilation...
September 28, 2016: Shock
Matej Orešič, Jussi P Posti, Maja H Kamstrup-Nielsen, Riikka S K Takala, Hester F Lingsma, Ismo Mattila, Sirkku Jäntti, Ari J Katila, Keri L H Carpenter, Henna Ala-Seppälä, Anna Kyllönen, Henna-Riikka Maanpää, Jussi Tallus, Jonathan P Coles, Iiro Heino, Janek Frantzén, Peter J Hutchinson, David K Menon, Olli Tenovuo, Tuulia Hyötyläinen
Traumatic brain injury (TBI) is a major cause of death and disability worldwide, especially in children and young adults. TBI is an example of a medical condition where there are still major lacks in diagnostics and outcome prediction. Here we apply comprehensive metabolic profiling of serum samples from TBI patients and controls in two independent cohorts. The discovery study included 144 TBI patients, with the samples taken at the time of hospitalization. The patients were diagnosed as severe (sTBI; n=22), moderate (moTBI; n=14) or mild TBI (mTBI; n=108) according to Glasgow Coma Scale...
July 15, 2016: EBioMedicine
Katharina Gapp, Alberto Corcoba, Gretchen van Steenwyk, Isabelle M Mansuy, João Mn Duarte
Adverse environmental and social conditions early in life have a strong impact on health. They are major risk factors for mental diseases in adulthood and, in some cases, their effects can be transmitted across generations. The consequences of detrimental stress conditions on brain metabolism across generations are not well known. Using high-field (14.1 T) magnetic resonance spectroscopy, we investigated the neurochemical profile of adult male mice exposed to traumatic stress in early postnatal life and of their offspring, and of undisturbed control mice...
September 7, 2016: Journal of Cerebral Blood Flow and Metabolism
Hari Shanker Sharma, Dafin F Muresanu, José V Lafuente, Ala Nozari, Ranjana Patnaik, Stephen D Skaper, Aruna Sharma
The blood-brain barrier (BBB) plays a pivotal role in the maintenance of the central nervous system (CNS) function in health and disease. Thus, in almost all neurodegenerative, traumatic or metabolic insults the BBB breakdown occurs to large molecules e.g., serum proteins. Entry of serum proteins into the brain fluid microenvironment leads to edema formation and subsequently cellular injuries. Accordingly, restoration of the BBB function using drugs will lead to neurorepair. However, injury to the brain occurring following blast, bullet wounds, or knife injury appears to initiate different set of pathophysiological responses...
September 2, 2016: CNS & Neurological Disorders Drug Targets
E Scott Helton, Steven Palladino, Eroboghene E Ubogu
Microvascular barrier permeability to water is an essential biophysical property required for the homeostatic maintenance of unique tissue microenvironments. This is of particular importance in peripheral nerves where strict control of ionic concentrations is needed for axonal signal transduction. Previous studies have associated inflammation, trauma, toxin exposure and metabolic disease with increases in water influx and hydrostatic pressure in peripheral nerves with resultant endoneurial edema that may impair axonal function...
August 31, 2016: Microvascular Research
Beatriz P Costa, Paulo Martins, Carla Veríssimo, Marta Simões, Marisa Tomé, Manuela Grazina, Jorge Pimentel, Francisco Castro-Sousa
BACKGROUND: Arginine is an amino acid determinant in the metabolic, immune and reparative responses to severe trauma. The present study aims to determine argininemia and plasma arginine bioavailability (PAB) in critical trauma patients and to analyze its correlation with prognosis. METHODS: A prospective study of 23 critical trauma patients was undertaken. Aminoacidemias were determined, by ion exchange chromatography, at admission and in the first and third days and compared with those of 11 healthy individuals...
2016: Nutrition & Metabolism
Sebastian Hafner, Katja Wagner, Sandra Weber, Michael Gröger, Martin Wepler, Oscar McCook, Angelika Scheuerle, Bettina Stahl, Markus Huber-Lang, Birgit Jung, Enrico Calzia, Michael Georgieff, Peter Möller, Manfred Frick, Peter Radermacher, Florian Wagner
Both acute and chronic lung injury are associated with up-regulation of the pulmonary expression of the purinergic receptors P2XR4 and P2XR7. Genetic deletion or blockade of P2XR7 attenuated pulmonary hyper-inflammation, but simultaneous P2XR4 up-regulation compensated for P2XR7 deletion. Therefore, we tested the hypothesis whether genetic P2XR4 deletion would attenuate the pulmonary inflammatory response and thereby improve organ function after blunt chest trauma in mice with and without pre-traumatic cigarette smoke (CS) exposure...
August 24, 2016: Shock
Aruna Sharma, Preeti Menon, Dafin F Muresanu, Asya Ozkizilcik, Z Ryan Tian, José V Lafuente, Hari Sharma
The BBB is a physiological regulator of transport of essential items from blood to brain for the maintenance of homeostasis of the central nervous system (CNS) within the narrow limit. The BBB is also responsible for export of harmful or metabolic products from brain to blood to keep the fluid microenvironment of the CNS healthy. However, following any noxious insult to the brain caused by trauma, ischemia or environmental/chemical toxins the function of the BBB is altered to small as well as to large molecules e...
August 19, 2016: CNS & Neurological Disorders Drug Targets
Fabia Gamboni, Cameron Anderson, Sanchayita Mitra, Julie A Reisz, Travis Nemkov, Monika Dzieciatkowska, Kenneth L Jones, Kirk C Hansen, Angelo D'Alessandro, Anirban Banerjee
Uncontrolled inflammatory responses underlie the etiology of acute lung injury and acute distress respiratory syndrome, the most common late complications in trauma, the leading cause of death under the age of 59. Treatment with HTS decreases lung injury in clinical trials, rat models of trauma and hemorrhagic shock and inflammation in lung cell lines, although the mechanisms underlying these responses are still incompletely understood. Transcriptomics (RNaseq), proteomics, and U-(13)C-glucose tracing metabolomics experiments were performed to investigate the mechanisms of cellular responses to HTS treatment in primary small airway epithelial cells in the presence or absence of inflammatory injury mediated by a cocktail of cytokines (10 ng/mL of IFNγ, IL-1β, and TNFα)...
October 7, 2016: Journal of Proteome Research
Francesca Miranda Di Mauro, Gretchen Lee Schoeffler
Lactate is generated as a consequence of anaerobic glycolysis by all tissues of the body. Increased l-lactate, the isoform produced by most mammals, reflects increased anaerobic metabolism secondary to tissue hypoperfusion or tissue hypoxia in most clinical situations, and is called type A lactic acidosis. The utility of lactate measurement and serial lactate monitoring in veterinary patients has been demonstrated in multiple studies. Blood lactate concentration is significantly elevated in many disease processes including septic peritonitis, immune-mediated hemolytic anemia, Babesiosis, trauma, gastric dilation and volvulus, and intracranial disease...
March 2016: Topics in Companion Animal Medicine
David H Jang, John C Greenwood, Meghan B Spyres, David M Eckmann
Metabolic biomarkers have potentially wider use in disease diagnosis and prognosis as well as in monitoring disease response to treatment. While biomarkers such as interleukins, microRNA, and lactate have been proposed for disease surveillance, there are still conflicting results regarding their clinical utility. Treatment of commonly encountered disease of acute care such as sepsis, trauma, and poisoning often relies on clinical diagnosis and therapy guided by use of surrogate markers of illness severity. The measurement of mitochondrial function, including respiration and motility, may offer superior alternatives to such markers...
July 21, 2016: Journal of Intensive Care Medicine
Alban Longchamp, Ming Tao, Alexander Bartelt, Kui Ding, Lydia Lynch, Christopher Hine, Jean-Marc Corpataux, Bruce S Kristal, James R Mitchell, C Keith Ozaki
The adipose organ, which comprises brown, white and beige adipocytes, possesses remarkable plasticity in response to feeding and cold exposure. The development of beige adipocytes in white adipose tissue (WAT), a process called browning, represents a promising route to treat metabolic disorders. While surgical procedures constantly traumatize adipose tissue, its impact on adipocyte phenotype remains to be established. Herein, we studied the effect of trauma on adipocyte phenotype one day after sham, incision control, or surgical injury to the left inguinal adipose compartment...
April 2016: Adipocyte
Sarah N Schmeltzer, James P Herman, Renu Sah
Posttraumatic stress disorder (PTSD) is a trauma-evoked syndrome, with variable prevalence within the human population due to individual differences in coping and resiliency. In this review, we discuss evidence supporting the relevance of neuropeptide Y (NPY), a stress regulatory transmitter in PTSD. We consolidate findings from preclinical, clinical, and translational studies of NPY that are of relevance to PTSD with an attempt to provide a current update of this area of research. NPY is abundantly expressed in forebrain limbic and brainstem areas that regulate stress and emotional behaviors...
July 1, 2016: Experimental Neurology
Rohit Rao, Qian Yang, Mehmet A Orman, Francois Berthiaume, Marianthi G Ierapetritou, Ioannis P Androulakis
Circadian rhythms play an important role in maintaining homeostasis and solid organ function. The purpose of this study is to assess the implications of burn injury in rats on the underlying circadian patterns of gene expression in liver. Circadian-regulated genes and burn-induced genes were identified by applying consensus clustering methodology to temporally differentially expressed probe sets obtained from burn and sham-burn data sets. Of the liver specific genes which we hypothesize that exhibit circadian rhythmicity, 88% are not differentially expressed following the burn injury...
2016: International Journal of Burns and Trauma
Ina Israel, Andrea Ohsiek, Ehab Al-Momani, Christiane Albert-Weissenberger, Christian Stetter, Stine Mencl, Andreas K Buck, Christoph Kleinschnitz, Samuel Samnick, Anna-Leena Sirén
BACKGROUND: Traumatic brain injury (TBI) is a major cause of death and disability. Neuroinflammation contributes to acute damage after TBI and modulates long-term evolution of degenerative and regenerative responses to injury. The aim of the present study was to evaluate the relationship of microglia activation to trauma severity, brain energy metabolism, and cellular reactions to injury in a mouse closed head injury model using combined in vivo PET imaging, ex vivo autoradiography, and immunohistochemistry...
2016: Journal of Neuroinflammation
Kevin R Carr, Michelle Rodriguez, Alex Ottesen, Joel Michalek, Colin Son, Vaibhav Patel, David Jimenez, Ali Seifi
BACKGROUND: Severe traumatic brain injury is associated with a multi-systemic response and changes in metabolic demand. Patients requiring intracranial pressure monitoring or cerebrospinal fluid diversion, often signifies a greater severity of injury. For this group, the association between RBC transfusion, transfusion thresholds, and clinical recovery is unknown. In this study, we studied the association between transfusion and clinical recovery for severe traumatic brain injury patients requiring external ventricular drain or intracranial pressure monitor placement...
October 2016: Neurocritical Care
Sophie Leclercq, Paul Forsythe, John Bienenstock
Gut bacteria strongly influence our metabolic, endocrine, immune, and both peripheral and central nervous systems. Microbiota do this directly and indirectly through their components, shed and secreted, ranging from fermented and digested dietary and host products to functionally active neurotransmitters including serotonin, dopamine, and γ-aminobutyric acid. Depression has been associated with enhanced levels of proinflammatory biomarkers and abnormal responses to stress. Posttraumatic stress disorder (PTSD) appears to be marked in addition by low cortisol responses, and these factors seem to predict and predispose individuals to develop PTSD after a traumatic event...
April 2016: Canadian Journal of Psychiatry. Revue Canadienne de Psychiatrie
Vasiliki Michopoulos, Aimee Vester, Gretchen Neigh
Posttraumatic stress disorder (PTSD) is a heterogeneous psychiatric disorder that affects individuals exposed to trauma and is highly co-morbid with other adverse health outcomes, including cardiovascular disease and obesity. The unique pathophysiological feature of PTSD is the inability to inhibit fear responses, such that individuals suffering from PTSD re-experience traumatic memories and are unable to control psychophysiological responses to trauma-associated stimuli. However, underlying alterations in sympathetic nervous system activity, neuroendocrine systems, and metabolism associated with PTSD are similar to those present in traditional metabolic disorders, such as obesity and diabetes...
May 28, 2016: Experimental Neurology
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