title: Lipidomic analysis enables prediction of clinical outcomes in burn patients.
abstract: Recent discoveries have highlighted the novel metabolic functions of adipose tissue in enhancing hypermetabolism after trauma. As the exact function and expression profiles of serum lipids and free fatty acids (FFA) are essentially unknown, we determined the lipidomic expression profile after burn in correlation to clinical outcomes to identify important lipid mediators affecting post-burn outcomes. We conducted a prospective cohort study with 46 adult burn patients and 5 healthy controls at the Ross Tilley Burn Center in Toronto, Canada. Patients were stratified based on major demographic and clinical variables, including age, burn severity, mortality, and sepsis. Serum FFAs and inflammatory markers were measured during acute hospital stay. We found that FFAs were acutely elevated post-burn and returned to baseline over time. Greater burn severity and age were associated with an impaired acute response in unsaturated FFAs and pro-inflammatory cytokines. Elevations in saturated and mono-unsaturated FFAs correlated significantly to increased mortality. In summary, persistent elevation of unsaturated lipids was associated with a functionally altered inflammatory-immunological milieu and worse clinical outcomes. The present lipidomic analysis indicates profound alterations in the lipid profile after burn by characterizing key lipids as potential diagnostic and outcome indicators in critically injured patients.
authors.affiliation: Faculty of Medicine, University of Toronto, Toronto, Canada.|Biological Sciences, Sunnybrook Research Institute, Toronto, Canada.
authors.forename: Peter
authors.initials: P
authors.lastname: Qi
authors.affiliation: Biological Sciences, Sunnybrook Research Institute, Toronto, Canada.
authors.forename: Abdikarim
authors.initials: A
authors.lastname: Abdullahi
authors.affiliation: Ross Tilley Burn Centre, Sunnybrook Health Sciences Centre, Toronto, Canada.
authors.forename: Mile
authors.initials: M
authors.lastname: Stanojcic
authors.affiliation: Ross Tilley Burn Centre, Sunnybrook Health Sciences Centre, Toronto, Canada.
authors.forename: David
authors.initials: D
authors.lastname: Patsouris
authors.affiliation: Biological Sciences, Sunnybrook Research Institute, Toronto, Canada.|Ross Tilley Burn Centre, Sunnybrook Health Sciences Centre, Toronto, Canada.|Department of Surgery, Division of Plastic Surgery, Department of Immunology, University of Toronto, Toronto, ON, Canada.
authors.forename: Marc G
authors.initials: MG
authors.lastname: Jeschke
mesh_terms: D000328:Adult; D000367:Age Factors; D015415:Biomarkers; D002056:Burns / Q000097:blood* / Q000150:complications / Q000175:diagnosis* / Q000401:mortality; D016022:Case-Control Studies; D016207:Cytokines / Q000097:blood; D005230:Fatty Acids, Nonesterified / Q000097:blood; D005260:Female; D006801:Humans; D008055:Lipids / Q000097:blood*; D008297:Male; D008875:Middle Aged; D016017:Odds Ratio; D011379:Prognosis; D018805:Sepsis / Q000209:etiology; D012720:Severity of Illness Index; D013997:Time Factors
chemical_list: D015415:Biomarkers; D016207:Cytokines; D005230:Fatty Acids, Nonesterified; D008055:Lipids