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

Abstract

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.

A review of the current state of natural biomaterials in wound healing applications

“…The evaluation results showed that patients who received β-glucan ointment showed better wound healing (RR = 4.34; 95% Cl; 0.73 to 25.67; p = 0.11). In addition, patients receiving β-glucan ointment showed a significant difference in the level of IL-4 cytokine secretion compared to the control group ( Abedini et al, 2022 ). According to these results, β-glucan can be mentioned as an ideal natural biopolymer in wound healing applications.…”

Current research on fungi in chronic wounds

“…Due to an imbalance between inflammatory cells and inhibitors, chronic wounds usually stagnate in the inflammatory phase ( Schultz, et al, 2003 ; Satish, 2015 ). Overexpression of interferon-gamma (IFN-γ), a proinflammatory cytokine that is essential for the regulation of collagen synthesis, delays wound healing, and dysfunction of interleukin-17 (IL-17) inhibits progression to the proliferation phase in nonhealing wounds ( Abedini, et al, 2022 ). Compared with acute wounds, nonhealing wounds display clinical, morphological, microbiological and biochemical differences ( Kirker, et al, 2017 ).…”

β-glucans: a potential source for maintaining gut microbiota and the immune system

“…Multiple features of β-glucan, including anticancer (14), anti-diabetic (15), anti-inflammatory, and a decrease in the glycemic index as well as serum cholesterol and triglycerides, have been demonstrated. β-glucans maintain the balance of blood glucose and cardiovascular diseases (16), enhance the immune system (17) and wound healing activities (18), and show antimicrobial (antibacterial and antiviral) properties (Figure 1). Proved antioxidant, wound healing, and moisturizing properties of β-glucan derived from microorganisms and cereal (19).…”