Effectiveness of Inflammatory Cytokines Induced by Sericin Compared to Sericin in Combination with Silver Sulfadiazine Cream
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Abstract: Silk sericin (SS) has been shown to promote collagen synthesis during wound healing, but it lacks antimicrobial activity. We investigated the effectiveness and the induction of the inflammatory mediators IL-1bβ and TNF-aα by SS, silver sulfadiazine (SSD) cream, and SS in combination with SSD cream on wound healing in rats. The results show that SS at 8% w/w partially inhibits SSD antibacterial activity. Treating wounds with a combination of SS and SSD did not induce significant wound size reduction when compared to other treatments. However, SS can promote collagen production in wounds even in the presence of SSD. Wounds treated with the combination of SS and SSD cream showed higher levels of IL-1β and TNF-α when compared to wounds treated by SS alone, but the differences were not significant. Although SS may decrease the antimicrobial effect of SSD, SS in combination with SSD cream has the benefit of promoting collagen production without generating significant levels of inflammatory cytokines.
Address correspondence to:
Pornanong Aramwit, PharmD, PhD
Faculty of Pharmaceutical Sciences
Chulalongkorn University
254 Phyathai Rd.
Patumwan, Bangkok
Thailand 10330
Phone: 66 899 217 255
E-mail: aramwit@gmail.com
Silk sericin (SS), a group of glue proteins produced in the middle silk gland of the silkworm, is an essential component of the cocoon filament. It is comprised of granular and high molecular weight proteins with adhesive and gelatin-like characteristics.1 Our previous study demonstrated that SS can promote reduction in wound size and increase collagen production in rats without causing any allergic reactions.2 Several studies also demonstrated the advantages of using SS in wound healing by enhancing the attachment and growth of mouse fibroblasts, human skin fibroblasts, and human and mouse hybridoma in culture media.3–5 However, there are several reports on immune response that argue against silk sutures containing SS proteins6–8 and assert that the SS proteins are responsible for skin irritation and allergies.9 The fact that SS shows no antibacterial activity may also make it less attractive for wound regeneration.
Wound healing is a dynamic process that involves the integrated action of many cell types, the extracellular matrix, and chemical mediators. Wound repair can be divided into three overlapping stages: inflammation, formation of new tissue, and tissue remodeling.10 The initial inflammatory phase is characterized by localized activation of innate immune mechanisms. This results in an initial influx of neutrophilic granulocytes into damaged tissue followed by an accumulation of macrophages.11 An infection that occurs during this stage will impede the regeneration process. The impact of local inflammatory responses on the wound healing process has been debated for decades. Recently, Eming et al12 demonstrated that the number of macrophages infiltrating the wound tissue mediates accelerated tissue repair and thus is significant. The healing process is characterized by macrophages and fibroblasts initiating repair and deposition of new fibrous tissue above and below the dermal substitutes, which envelopes them under an epidermal layer.13 Collagen production, an important factor for wound healing, is subsequently stimulated.14 New blood vessels and capillaries are normally observed within the dermal substitutes and new fibrous tissue is generated beneath the dermal substitutes.
Severe injury of the skin can lead to sepsis, a major cause of high mortality in patients with burns.
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