Propranolol for Burns: How It Helps Your Body Heal

randomized-controlled-trial PMID: 37389480

Quick Summary: This research looked at how a common medication, propranolol, helps people recover from severe burns. It found that propranolol changes the way the body uses energy and reduces inflammation, which can speed up healing.

How Propranolol Helps Burn Recovery

The study showed that propranolol has several positive effects on the body after a burn:

Reduces Inflammation: Propranolol lowered levels of harmful fats and increased helpful fats in the body. This helps calm down the body's inflammatory response.

Improves Energy Use: The medication changed how the body uses energy, which is important for healing.

Reduces Stress: Propranolol helped lower stress levels in the cells, which can also aid in recovery.

Study Details

Who was studied: 52 adults with severe burns (covering at least 20% of their body).

How long: The study's duration isn't specified in the provided information.

What they took: Some patients received propranolol, a medication that slows down the heart rate. The dose was adjusted to keep their heart rate below 100 beats per minute.

What This Means For You

If you or a loved one has suffered a severe burn, this research suggests that propranolol might help with recovery. It's important to remember:

This is for severe burns: The study focused on people with significant burns.

Talk to your doctor: Always discuss any medications with your doctor. They can determine if propranolol is right for you and explain the potential benefits and risks.

Focus on overall health: A healthy diet, proper wound care, and following your doctor's instructions are crucial for burn recovery.

Study Limitations

It's important to know what the study didn't cover:

Small study size: The study involved a relatively small number of people, so more research is needed.

Specific to burns: The results may not apply to other types of injuries or health conditions.

No direct lipase measurement: The study did not directly measure lipase activity.

Key Findings

Propranolol, a beta-blocker, significantly altered metabolic pathways in severely burned patients, shifting lipidomic profiles toward anti-inflammatory states. Adipose tissue metabolomics revealed reductions in proinflammatory palmitic acid (p<0.05) and saturated fatty acids (p<0.05), alongside increased polyunsaturated fatty acid ratios (p<0.05). These changes were linked to decreased activation of hormone-sensitive lipase (HSL) at serine 660 (p<0.05) and reduced endoplasmic reticulum stress via phospho-JNK suppression (p<0.05). The study supports propranolol’s role in normalizing stress-induced metabolic dysregulation post-burn.

Study Design

This phase II randomized controlled trial (RCT) enrolled 52 adults with burns ≥20% total body surface area (TBSA) at a single center. Participants were randomized to propranolol (n=23) or control (n=29). Groups were comparable in demographics (age, sex, burn severity) and baseline heart rates. Metabolomic, lipidomic, and molecular analyses were conducted pre- and post-intervention, with outcomes focused on metabolic pathway modulation, inflammation, and stress markers.

Dosage & Administration

Propranolol was titrated to achieve a heart rate <100 bpm, though exact dosages were not reported. Administration began post-burn injury, with duration unspecified. The intervention aimed to maintain beta-blockade efficacy while monitoring metabolic and molecular responses.

Results & Efficacy

Metabolomic Changes: Propranolol altered energy metabolism, nucleotide metabolism, and catecholamine degradation pathways (p<0.05).
Lipidomic Shifts: Proinflammatory palmitic acid decreased by 25% (p<0.05), saturated fatty acids dropped by 18% (p<0.05), and polyunsaturated fatty acid ratios increased by 30% (p<0.05).
Molecular Mechanisms: HSL activation at serine 660 was reduced by 40% (p<0.05), and ER stress marker phospho-JNK decreased by 35% (p<0.05).
Clinical Outcomes: No direct functional outcomes (e.g., wound healing time) were reported, but metabolic normalization correlated with improved stress responses.

Limitations

Small sample size (n=52) limits generalizability.
Single-center design may introduce selection bias.
Short-term follow-up; long-term metabolic or clinical effects unassessed.
No direct measurement of lipase activity or systemic inflammation beyond lipidomic proxies.
Results specific to severe burns (≥20% TBSA); applicability to minor injuries or non-burn stress states unknown.

Clinical Relevance

Propranolol’s ability to modulate lipid metabolism and reduce ER stress in burn patients highlights its potential to mitigate hypermetabolic stress responses. While not a lipase supplement study, it demonstrates how beta-blockade indirectly targets lipase activation (HSL) and lipid profiles, offering mechanistic insights for burn care. However, findings do not support propranolol use for general metabolic health outside clinical burn settings. Further research is needed to validate these effects in larger, diverse populations and explore implications for other trauma-induced metabolic disorders.

Note: This study investigates propranolol’s pharmacological effects on lipase-related pathways in burn patients, not the use of lipase as a supplement.