Abstract
Wound healing is a highly dynamic phenomenon comprising numerous coordinated steps including homeostasis/coagulation, inflammation, migration, proliferation, and remodeling. Diabetes mellitus (DM) is a multisystem chronic epidemic that prolongs inflammation in wounds and is associated with impaired healing. This study aimed to investigate the effect of an ethanol extract from Lactobacillus plantarum TWK10 (TWK10)-fermented soymilk on wound healing. The anti-inflammatory effects of the ethanol extract of TWK10-fermented soymilk on lipopolysaccharide-stimulated RAW264.7 macrophage cells were examined. The ethanol extract of TWK10-fermented soymilk (100 µg/mL) significantly decreased nitric oxide production from 11.34 ± 0.74 μM to 8.24 ± 2.02 µM (p < 0.05) and enhanced proliferation in Detroit 551 cells cultured in high-glucose medium; the cell number peaked at 128.44 ± 7.67% (compared to the untreated control) at 600 µg/mL. An ethanol extract of TWK10-fermented soymilk + vaseline-treated rat model of streptozotocin-induced diabetic wounds was generated herein, and the following groups were formed herein: normal control (NC), blank control (BC), low dose group (LD, 0.24 mg/wound), intermediate dose (MD, 0.48 mg/wound), and high dose (HD, 2.40 mg/wound). On day 14 after wound infliction, the wound area in the LD, MD, and HD groups was significantly decreased to 10.2, 8.4, and 8.5% respectively (p < 0.05). Moreover, in the LD, MD, and, HD groups, tumor necrosis factor-α, interleukin 6, and matrix metalloproteinase-9 were downregulated in the wounded skin. These results show that the topical application of the ethanol extract of TWK10-fermented soymilk is beneficial for enhancing wound healing and for the closure of diabetic wounds.
Highlights
Wound healing is a complex phenomenon involving the repair of damaged skin and other tissues after injury
This study aimed to investigate the effects of the ethanol extract of Lactobacillus plantarum TWK10 (TWK10)-fermented soymilk on wound healing
The ethanol extracts of TWK10-fermented soymilk at 100 μg/mL were used as the maximum concentration to treat RAW264.7 cells
Summary
Wound healing is a complex phenomenon involving the repair of damaged skin and other tissues after injury. It involves four complex phases: coagulation, inflammation, proliferation, and remodeling. Oxidative stress can be increased in hyperglycemia, leading to abnormal fibroblast metabolism, thereby reducing cell migration and proliferation and being detrimental to wound healing and inflammation (Shaw et al 2010). Excessive oxidative stress in diabetic wounds results in cellular damage and decrease cell differentiation and migration. If keratinocytes and fibroblasts do not migrate successfully to the wound, the healing time and the risk of infection, and limb amputation, are increased (Saltiel and Kahn 2001). A high glucose concentration provides a rich source of nutrients for bacteria growth, increasing the risk of traumatic wound infection in patients with diabetes mellitus (American Diabetes 1999)
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