β-Glucans obtained from fungus for wound healing: A review

The cell surface of fungus contains a large number of β-glucans, which exhibit various biological activities such as immunomodulatory, anti-inflammatory, and antioxidation. Fungal β-glucans with highly branched structure show great potential as wound healing reagents, because they can stimulate the expression of many immune- and inflammatory-related factors beneficial to wound healing. Recently, the wound healing ability of many fungal β-glucans have been investigated in animals and clinical trials. Studies have proved that fungal β-glucans can promote fibroblasts proliferation, collagen deposition, angiogenesis, and macrophage infiltration during the wound healing process. However, the development of fungal β-glucans as wound healing reagents is not systematically reviewed till now. This review discusses the wound healing studies of β-glucans obtained from different fungal species. The structure characteristics, extraction methods, and biological functions of fungal β-glucans with wound healing ability are summarized. Researches about fungal β-glucan-containing biomaterials and structurally modified β-glucans for wound healing are also involved.

Antimicrobial Nano-Zinc Oxide Biocomposites for Wound Healing Applications: A Review

Chronic wounds are a major concern for global health, affecting millions of individuals worldwide. As their occurrence is correlated with age and age-related comorbidities, their incidence in the population is set to increase in the forthcoming years. This burden is further worsened by the rise of antimicrobial resistance (AMR), which causes wound infections that are increasingly hard to treat with current antibiotics. Antimicrobial bionanocomposites are an emerging class of materials that combine the biocompatibility and tissue-mimicking properties of biomacromolecules with the antimicrobial activity of metal or metal oxide nanoparticles. Among these nanostructured agents, zinc oxide (ZnO) is one of the most promising for its microbicidal effects and its anti-inflammatory properties, and as a source of essential zinc ions. This review analyses the most recent developments in the field of nano-ZnO–bionanocomposite (nZnO-BNC) materials—mainly in the form of films, but also hydrogel or electrospun bandages—from the different preparation techniques to their properties and antibacterial and wound-healing performances. The effect of nanostructured ZnO on the mechanical, water and gas barrier, swelling, optical, thermal, water affinity, and drug-release properties are examined and linked to the preparation methods. Antimicrobial assays over a wide range of bacterial strains are extensively surveyed, and wound-healing studies are finally considered to provide a comprehensive assessment framework. While early results are promising, a systematic and standardised testing procedure for the comparison of antibacterial properties is still lacking, partly because of a not-yet fully understood antimicrobial mechanism. This work, therefore, allowed, on one hand, the determination of the best strategies for the design, engineering, and application of n-ZnO-BNC, and, on the other hand, the identification of the current challenges and opportunities for future research.

Enhancing of Wound Healing in Burn Patients through Candida albicans β-Glucan

The mortality and disability-adjusted life years (DALYs) of burn patients are decreasing over time. However, finding novel effective treatment approaches using natural agents is highly considered to reduce the burden of burn injuries. One of the recent agents used in wound healing is β-glucan, mainly extracted from fungi cell walls. This study aimed to evaluate the effect of 5% (m/m) of yeast β-glucan ointment on burn wound healing and to assess the impact of β-glucan on cytokines during the treatment. Thirty-three patients with second or third-degree burns were enrolled in this study. Two groups of twenty-three and ten patients used yeast 5% (m/m) β-glucan ointment (study group) and Stratamed ointment (control), respectively, on a daily basis, for a maximum of four weeks. The size of the burn wounds was measured before and at the end of the treatment. Blood samples of 14 and 10 patients in the β-glucan and control groups, respectively, were obtained before and after the treatment, and the enzyme-linked immunosorbent assay (ELISA) was performed to measure the serum concentration of the IL-4, IL-17, and IFN-γ cytokines. The log-binomial model was used to assess the efficacy of the β-glucan ointment on burn wound healing. ANOVA/ANCOVA was employed to assess the effects of β-glucan on the serum concentration of cytokines. After adjusting for potential confounders/covariates, patients receiving β-glucan had better wound healing (RR = 4.34; 95% CI: 0.73 to 25.67; p = 0.11). There was a significant difference in IL-4 secretion between the β-glucan and control groups after adjusting for potential confounders/covariates (MD = 77.27; 95% CI: 44.73 to 109.82; Cohen’s d = 2.21; 95% CI: 1.16 to 3.24; p = 0.0001). The results indicate that 5% (m/m) of β-glucan has efficacy in burn wound healing, and a significant difference was found in the level of IL-4 after receiving β-glucan. Further studies with a two-arm design and long-term use of ointment are needed to confirm the effect of β-glucan on wound healing and cytokine secretion.

Development of a novel beta-glucan supplemented hydrogel spray formulation and wound healing efficacy in a db/db diabetic mouse model

To relief the severe economic and social burdens and patient suffering caused by the increasing incidence of chronic wounds, more effective treatments are urgently needed. In this study, we focused on developing a novel sprayable wound dressing with the active ingredient β-1,3/1,6-glucan (βG). Since βG is already available as the active ingredient in a commercial wound healing product provided as a hydrogel in a tube (βG-Gel), the sprayable format should bring clinical benefit by being easily sprayed onto wounds; whilst retaining βG-Gel's physical stability, biological safety and wound healing efficacy. Potentially sprayable βG hydrogels were therefore formulated, based on an experimental design setup. One spray formulation, named βG-Spray, was selected for further investigation, as it showed favorable rheological and spraying properties. The βG-Spray was furthermore found to be stable at room temperature for more than a year, retaining its rheological properties and sprayability. The cytotoxicity of βG-Spray in keratinocytes in vitro, was shown to be promising even at the highest tested concentration of 100 μg/ml. The βG-Spray also displayed favorable fluid affinity characteristics, with a capacity to both donate and absorb close to 10% fluid relative to its own weight. Finally, the βG-Spray was proven comparably effective to the commercial product, βG-Gel, and superior to both the water and the carrier controls (NoβG-Spray), in terms of its ability to promote wound healing in healing-impaired animals. Contraction was found to be the main wound closure mechanism responsible for the improvement seen in the βG-treatment groups (βG-Spray and βG-Gel). In conclusion, the novel sprayable βG formulation, confirmed its potential to expand the clinical use of βG as wound dressing.

Trained Immunity as a Preventive Measure for Surgical Site Infections

Even with strict implementation of preventive measures, surgical site infections (SSIs) remain among the most prevalent health care-associated infections. New strategies to prevent SSIs would thus have a huge impact, also in light of increasing global rates of antimicrobial drug resistance. Considering the indispensable role of innate immune cells in host defense in surgical wounds, enhancing their function may represent a potential strategy for prevention of SSIs. Trained immunity is characterized by metabolic, epigenetic, and functional reprogramming of innate immune cells. These functional changes take place at multiple levels, namely, at the level of bone marrow precursors, circulating innate immune cells, and resident tissue macrophages. Experimental studies have shown that induction of trained immunity can protect against various infections. Increasing evidence suggests that it may also lower the risk and severity of SSIs. This may occur through several different mechanisms. First, trained immunity enhances local host defense against soft tissue infections, including those caused by Staphylococcus aureus, the most common cause of SSIs. Second, training effects on nonimmune cells such as fibroblasts have been shown to improve wound repair. Third, trained immunity may prevent or reverse the postoperative immunoparalysis that contributes to risk of infections following surgery. There are multiple approaches to inducing trained immunity, such as vaccination with the bacillus Calmette-Guérin (BCG) tuberculosis vaccine, topical administration of β-glucan, or treatment with the Toll-like receptor 7 agonist imiquimod. Clinical-experimental studies should establish if and how induction of trained immunity can best help prevent SSIs and what patient groups would most benefit.

Hydrogel containing (1 → 6)-β-D-glucan (lasiodiplodan) effectively promotes dermal wound healing

A hydrogel containing exocellular (1 → 6)-β-D-glucan (lasiodiplodan, LAS) was developed and its wound healing potential was evaluated. β-Glucans have attracted much interest by the cosmetic industry sector because of their bioactive and functional properties and in promoting skin health. In the present work an β-glucan was studied as a healing biomaterial that has not hitherto been reported in the scientific literature. LAS produced by the ascomycete Lasiodiplodia theobromae MMPI was used in the formulation of a healing hydrogel. Physicochemical and microbiological quality parameters, antioxidant potential and stability of the formulation was evaluated. FTIR, thermal analysis and SEM techniques were also employed in the characterization. Wistar rats were used as a biological model to investigate the wound healing potential. Histological analyses of cutaneous tissue from the dorsal region were conducted after 4, 7, 10 and 14 days of treatment, and evaluated re-epithelialization, cell proliferation and collagen production. Physicochemical stability, microbiological quality and antioxidant potential, especially in relation to its ability to scavenge hydroxyl radicals were found. The hydrogel stimulated cell re-epithelialization and proliferation during all days of the treatment, and stimulated an increase of collagen fibers. Lasiodiplodan showed immunomodulatory activity in wound healing and this biomacromolecule could be an alternative compound in wound care.

Cosmeceuticals: The Principles and Practice of Skin Rejuvenation by Nonprescription Topical Therapy

Background

Aesthetic practice relies on a harmonious relationship between medicine and commerce. Bridging the gap is a large number of skincare products that make therapeutic claims while avoiding the regulatory framework of pharmaceuticals. In this gray area, clinicians find themselves poorly disposed to counsel patients wisely as the industry is expanding faster than empirical evidence of efficacy and safety can be acquired. To serve our patients and engage with industry, we must understand the theoretical principles and evaluate the clinical evidence in practice.

Objectives

The purpose of this paper is to classify cosmeceuticals by method of action, explain how they work in principle with reference to skin aging, and evaluate the clinical evidence for them.

Methods

A literature and cosmetic clinic website search was conducted to establish a list of the most commonly advertised cosmeceuticals, and a peer-reviewed literature search was then conducted to establish the clinical evidence for them.

Results

A huge number of cosmeceuticals are marketed for skin rejuvenation but almost invariably they fall into 1 of 4 categories. These include the induction of tissue repair mechanisms, inflammatory modulation, scavenging of reactive oxygen species, or a combination of the 3. With the exception of retinol derivatives and hydroxy acids, the clinical evidence is limited, despite promising preclinical evidence for several cosmeceuticals.

Conclusions

Cosmeceuticals reside within a highly competitive ecosystem and are often brought to market based on preclinical, not clinical evidence. Success and failure will largely be governed by the establishment of clinical evidence in retrospect.

Combination of Beta Glucan, Honey and Chlorhexidine in the Wound Management in a Cat a Case Report

Wound management is one of the oldest and one of the most frequent therapeutic activities in medicine. Over the centuries there has been described and tested many therapeutic substances for the treatment of wounds with various effects. Due to the discovery of antibiotics, a wound management regime used to be limited only to a local application. Over years, it has been shown, that comprehensive therapy which uses only antibacterial preparations, also may contain some negative points (resistance of aggressive pathogens, toxicity, allergic reactions, etc.). According to studies, the best solution to this problem is a local application, using preparations that ensure the sterility of the affected parts of the skin, and the utilization of agents that are able to accelerate the granulation and lead to the healing process of the wound. Products that contain beta glucan combined with a gentle but effective antiseptics (chlorhexidine digluconate), or natural substance with antiseptic and also nourishment effect (honey), are very beneficial in wound management. A good penetration of active agents, the ability to moisturize defective tissues, and to make a protective film that hinder the intersection of impurities and decrease secondary contamination, are the benefits of a gel formulation, that is the most appropriate external form of application in veterinary practice that can improve and accelerate a successful healing process of wounds in animals.

β-Glucans: Multi-Functional Modulator of Wound Healing

β-glucans are derived from a variety of sources including yeast, grain and fungus and belong to the class of drugs known as biological response modifiers. They possess a broad spectrum of biological activities that enhance immunity in humans. One promising area for β-glucans’ application is dermatology, including wound care. Topical applications of β-glucans are increasing, especially due to their pluripotent properties. Macrophages, keratinocytes and fibroblasts are considered the main target cells of β-glucans during wound healing. β-glucans enhance wound repair by increasing the infiltration of macrophages, which stimulates tissue granulation, collagen deposition and reepithelialization. β-glucan wound dressings represent a suitable wound healing agent, with great stability and resistance to wound proteases. This review summarizes the current knowledge and progress made on characterizing β-glucans’ wound healing properties in vitro and in vivo and their safety and efficacy in managing non-healing wounds or other chronic dermatological conditions and diseases.