Glucan Improves Impaired Wound Healing in Diabetic Rats
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Neoangiogenesis might maintain blood supply, thereby preventing wound ischemia. Thus, these factors alone or in combination can mediate the beneficial effects of beta-D-glucan on anastomotic wound healing.
In the present study, the mean values for bursting pressures and hydroxyproline levels of group 2, which is the group that was induced with DM but did not receive a glucan treatment, were lower than the other groups. These results correlate with previous studies.3,29 The monocytes and thrombocytes play an important role in wound healing—they secrete cytokines that are chemotactic for fibroblasts, which synthesize collagen. A decrease in these blood members causes a decrease in wound fibroblast stimulation and lower collagen synthesis. Earlier reports further support our results and indicate that the hydroxyproline levels decreased in the DM group that did not receive glucan (group 2). Hydroxyproline, a nonessential amino acid, is the major component of extracellular tissue. It provides strength and support, and acts as an indicator of the amount of collagen in a tissue sample. The measurement of the hydroxyproline is acceptable as an index for collagen turnover. In the present study, DM significantly decreased the hydroxyproline content of the wound when compared to that of the control group; the beta glucan treatment increased hydroxyproline levels. The reason for this is an increase of collagen synthesis, which is a secondary reaction to the stimulation of cell infiltration by glucan.
Bursting pressure and tension strength are acceptable methods to test the mechanical durability of wound healing.30–32 Bursting pressure was chosen because it is more closely related to physiological conditions. When bursting pressures were evaluated, the bursting pressure for the groups that received the glucan treatment was higher than that of the control group. The increased neovascularization, decreased necrosis, and increased inflammatory response in the histopathological examination of the groups that received the glucan treatment supports these findings. The results of the histopathology of the groups that received the glucan treatment correlate previous findings.29 Beta-D-glucan stimulates macrophage synthesis and promotes wound healing by increasing macrophage infiltration into the wound environment, and stimulate collagen synthesis and re-epithelization. These factors alone or in combination may play a role in the effects glucan has on improving incisional wound healing.
Experimental studies provide only a general basis for clinical approaches, and the results of experimental studies cannot be directly applied to clinical protocols. However, the present study is a foundation for future clinical and experimental studies. Impaired abdominal wall wound healing in patients with DM can be improved by glucan, but further studies are needed to establish its clinical application.
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