3-D model predicts severity of burns, impact of treatment: Natural vitamin E may mitigate burn injuries

The ongoing trials are the result of collaboration between mathematicians and regenerative medicine experts who developed the first ever three-dimensional mathematical model that predicts how deep and wide a burn will spread within the first twelve hours.

The model may help physicians select more effective treatments and give them a tool to predict the efficacy of intervention -- something that they are not currently able to do.

"Burn injury grows after the actual burn event. Understanding the dynamics of such growth is of substantial value" says Chandan Sen, PhD, executive director of the Comprehensive Wound Center at Ohio State's Wexner Medical Center. "The mathematical model that we developed gives an objective measure of how a burn wound will expand over time plus the ability to measure the impact of any given intervention, and that's enabled us to form a solid hypothesis for the current studies."

Supported by funding from the Ohio State Center for Clinical and Translational Science (CCTS) and published in Wound Repair and Regeneration, the 3D model also suggested that a form of natural vitamin E called tocotrienol could significantly reduce the amount of damage caused by lipid peroxidation, a process where a toxic cascade of chemicals released into the skin causes burns to grow and damage surrounding healthy tissue.

"The chemical stages of lipid peroxidation are a well-established, practical measure that indicates how much a wound is worsening. Our team developed a formula that correlates the rate of chemical changes to the growth of a burn," explained Avner Friedman, distinguished University professor at Ohio State. "Then we introduced vitamin E tocotrienol into the equation and found that we could interrupt the chemical reaction. Now we have the flexibility to change all sorts of parameters, and get a good idea of what the outcome will be."

Scientists have been exploring the use of topical antioxidants to break the lipid peroxidation chain for more than a decade, but there has been relatively little research to establish an optimal therapeutic window. Sen's team chose to test tocotrienol, a vitamin E derivative that has been shown in numerous publications to have beneficial impact against stroke.

"The model showed that if the level of tocotrienol in the skin is increased fivefold within the first six to twelve hours after a burn, subsequent burn damage will be reduced by at least 50 percent," said Sen. "It's a significant development because we now have a potential therapy and a timeframe to hone in on in a next phase of research."

Current pre-clinical testing of tocotrienol is using pig skin as a human bioequivalent to validate the mathematical model and gain a better understanding of the impact of preventing a post-burn chemical storm. The researchers acknowledge that more work is needed to account for other biological processes that occur after a burn, including the presence of neutrophils which can further exaggerate lipid peroxidation damage as well as other natural inflammatory and healing processes.

The research team hopes to conclude the study within the next year, and potentially move into human subjects within the next three to five years.

"Sometimes it's hard to imagine that math could push medicine forward or vice versa -- but then teams come up with something like this that has real world applicability to doctors, consumers, soldiers on the battlefront. I think it's incredibly inspirational to young researchers on both sides and brings new energy to the way they approach the science," said Friedman.

According to the American Burn Association, each year, more than 500,000 people in the US seek medical attention for burn injuries ranging from superficial or first degree burns where damage is limited to the top layers of skin, to fourth degree burns which penetrate deep into ligaments and muscles. Burn injuries tend to surge during summer and winter months, when people are more likely to come in contact with open flames.