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Researcher
Ulrike Van Daele
- Research Expertise:Translational and clinical research in patients with burns and scars. Metabolic changes: Severe burned patients undergo rapid increases in metabolism (hypermetabolism) and increased energy expenditure caused by the initial inflammatory and humoral responses. These responses also elicit, on top of the bed rest period, a cascade of negative reactions leading to additional muscle wasting. Muscle wasting itself leads to insulin resistance and may have long-term health consequences. Some of these effects persist from the first few days following severe burn injury to as long as three years later after wound closing. Although insulin resistance is assumed to be triggered by several catabolic factors, an important contributor to insulin resistance is muscle wasting itself. Insulin-resistance, may eventually lead to diabetes mellitus and is a long-term complication of severe burn patients which has major implications for future morbidity and mortality. We do research on the short- and long-term effects of severe burns on energy metabolism, loss of muscle tissue, insulin-resistance and inflammation and the effect exercises on these parameters in adults and in a rat model. Skin/ Scar changes: Fibrosis and scar formation of the skin pose a substantial physiological and psychological burden on patients. Scars can be caused by physical trauma, surgical incisions, burn injuries and even acne. Most superficial injuries, that do not reach the dermis, do not leave significant scars. But deep cutaneous injuries induce pathological scars. Other factors, such as mechanical loading, prolonged inflammation, overactive proliferation, bacterial colonization, and foreign-body reaction are potential factors thought to underlie human hypertrophic and keloid scar formation or contractures. The effect may include pain, itching, functional impairment, aesthetic disadvantages, anxiety, depression and poor quality of life of the affected person. We do research on to regulate inflammation and fibrosis by adjusting mechaical forces on the skin. This activates a process of mechanotransduction, that can be defined as the intracellular conversion of mechanical stimuli into internal chemical signals which can influence gene transcription. Various non-invasive mechanical interventions of physical scar management (e.g. massage, tape and extracorporeal shock wave therapy or ESWT) apply mechanical load and thus initiate mechanotransduction.
- Keywords:BURNS, METABOLISM (ENERGY), MECHANOTHERAPY, SCAR, Medicine
- Disciplines:Medical intensive care, Pathophysiology
- Research techniques:I. Metabolic changes in burns: a) Laboratory measurements: Determination of metabolomic profile of skeletal muscle, liver and blood. Immune-histochemical, Western-blotting and biochemical analysis of the skeletal muscle activation and content of satellite cells, muscle capillarisation, autophagy and/or associated metabolic signaling pathways. Myostatin as muscle wasting regulator. Insulin resistance by the Homeostasis Model Assessment (HOMA) index. b) Clinical measurements: Bedside muscle force measurements, e.g. hand-held dynamometry and isometric muscle force measurements. Ultrageluid om de dwarsdoornsede van de spier te bepalen. II. Skin and scar measurements: a) Laboratory measurements: Mechanosensitive pathways reactivity. Integrin, TGF-β, Wnt/ β catenin, GPCRS and calcium-Ion pathways. Histological analysis type of collagen, number of myofibroblasts and fibroblasts b) Clinical measurements: redness, transepidermal water loss, thickness and elasticity of the scar/skin. III. Patient centered questionnaires: Generic and burn specific Quality of life questionnaires, POSAS, BSHSB. We are developing a clinical digital scar pathway for the scar patient.
- Users of research expertise:Researchers, clinicians and patient organisations in the domain of scars and burn rehabilitation.