Glucan Improves Impaired Wound Healing in Diabetic Rats
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Abstract: Purpose. Diabetes mellitus (DM) is a contributing factor to impaired wound healing in humans. A large body of evidence indicates that the diabetic state is associated with delayed or reduced wound repair capacity. The present study was designed to evaluate the efficacy of glucan on improving abdominal wall wound healing in rats with DM. Methods. Ninety-six female, Sprague-Dawley rats that weighed between 250 g and 300 g were used. A laparotomy was performed on all of the rats on the 14th day. Twenty-four healthy rats (group 1) served as the control. Streptozotocin was used to induce DM in groups 2 and 3 (n = 48). Rats in group 3 received glucan (n = 24). Rats in group 4 were not rendered with DM but received glucan (n = 24). The sutures were removed and abdominal bursting pressure was measured and recorded on the seventh postoperative day for all of the groups. Tissue samples were taken from the incision line for histopathological evaluation and hydroxyproline measurement. Results. In group 2, the bursting pressure was significantly lower than in groups 1, 3, and 4; the hydroxyproline content and histopathological evaluations also supported these findings. Conclusion. These results demonstrate that glucan improves impaired wound healing in rats with DM.
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Mehmet A. Gulcelik, MD
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Diabetes mellitus (DM) is a contributing factor to impaired wound healing in humans.1,2 A large body of evidence indicates that the diabetic state is associated with delayed or reduced wound repair capacity. Experimental studies of streptozotocin-induced or genetically diabetic rodents have demonstrated that cutaneous wound strength is decreased,3,4 and that the gastrointestinal tract appears to be similarly affected.5
Beta-D-glucan is a commonly used macrophage activator and has been shown to improve normal anastomotic wound healing.1 It is a glucose polymer that is derived from yeast, which is employed as an immune stimulant in clinical studies.1 Systemic administration of beta-D-glucan promotes wound healing by increasing macrophage infiltration into the wound environment, thereby stimulating collagen synthesis and re-epithelization. Topical and systemic administration of beta glucan enhances wound healing by increasing macrophage infiltration into the wound area, and by stimulating tissue granulation, collagen deposition, re-epithelization, and tensile strength.6 Beta-D-glucan causes no serious side effects; it is inexpensive and can be safely used in patients.7 Cerci et al6 have reported that both topical and systemic beta glucan administration significantly improved wound-healing activity; systemic administration was more effective than topical application.
Macrophages play an important role in the wound healing process by producing humoral factors and increasing fibroplasia, fibrogenesis, and angiogenesis in the wounded tissue. A decrease in the functionality of macrophages has been shown to impair wound healing and can be observed in DM.8–10 Similarly, enhanced macrophage function and an injection of macrophages into the wound have been demonstrated to accelerate wound healing.10
Methods
This study used 96 female Sprague-Dawley rats that each weighed between 250 g–300 g. The animals were brought to the facility 24 hours before the operation. Each animal was placed in its own cage to adapt to the laboratory conditions.
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