The Effects of Topical and Systemic Beta Glucan Administration on Wound Healing Impaired by Corticosteroids
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Abstract: Background. Corticosteroid hormones are widely used to treat a variety of diseases. Corticosteriods have been shown to impair wound healing, which has become a serious clinical problem in wound care. The present study was designed to evaluate the efficacy of topical and systemic beta glucan administration on wound healing impaired by corticosteroids. Methods. Wistar albino rats were used for the incision and excision wound models. Percentage of wound contraction, epithelialization period, hydroxyproline level, histopathological examination, and tensile strength were evaluated. Results. Although both systemic and local administration of beta glucan enhanced percentage wound contraction, improved epithelialization time, tensile strength, and elevated hydroxyproline level, systemic administration was found to be more effective. Conclusion. These results indicate that systemic and topical beta glucan improve wound healing that has been impaired by corticosteroids, and that systemic administration is more effective than topical application.
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Celal Cerci, MD
Modernevler 3103
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Phone: 90 505 2933423
E-mail: celalcerci@yahoo.com
Corticosteroids affect almost every phase of wound healing and delay the appearance of inflammatory cells, fibroblasts, and the deposition of ground substance, collagen, regenerating capillaries, contraction, and epithelial migration.1
Beta glucan, a complex carbohydrate, is found in the cell walls of yeast, fungi, and cereal plants, and is known as a potent macrophage stimulator. 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. 2–7 Beta glucan directly affects the chemotactic capacity of circulating neutrophils through a p38 mitogen-activated protein kinase-dependent mechanism and potentiates antimicrobial host defense. 8 Macrophage cells have an important role in wound repair; 9 they are pattern recognition receptors for glucans on mammalian macrophages, 10 and the ligation of glucan by its cognate receptors on macrophages modulates functional activity of the cells. 11 The effect of glucan on wound repair also involves macrophage release of wound growth factors with subsequent modulation of fibroblast activity, which includes collagen biosynthesis. 2–4 Kougias et al12 have reported on the glucan binding sites for normal human dermal fibroblasts. According to the Kougias findings, it can be suggested that glucans can directly modulate the functional activity of human fibroblasts. Glucan also stimulates collagen biosynthesis in cultured normal human dermal fibroblasts by activating the modulation of the reparative process. 13 During wound healing, glucan also stimulates both type I and III collagen production by activating fibroblasts, which increases wound tensile strength. 14,15
This experimental study was designed to evaluate the efficacy of topical and systemic beta glucan administration on wound healing impaired by corticosteroids using both excisional and incisional wound models.
Materials and Methods
Animals. Eighty adult Wistar-albino rats weighing between 200 g–250 g were used. Guidelines for the humane use of laboratory animals were strictly adhered to throughout the study. The animals were acclimatized for 1 week to the laboratory conditions prior to experimental manipulation. They had free access to standard laboratory chow and water ad libitum.
The animals (N = 80) were divided into 4 equal groups (n = 20).
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