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.
Highlights
According to the global burden of disease reports, the age-standardized incidence and mortality rate of burns in 2017 were 119 and 1.6 per 100,000, representing a decline of 5.4% and 46.6% from 1990 to 2017, respectively
This study aimed to assess the relationship between 5% (m/m) β-glucan ointment usage and remission of burn wounds compared with Stratamed ointment usage in the control group and evaluate the association between the two treatments and serum concentration of inflammatory/anti-inflammatory cytokines
The results demonstrated that participants who used the soluble β-glucan (SBG) for more than four weeks had more reduction in wound size, and more than 50% reduction in wound sizes occurred in 58%
Summary
According to the global burden of disease reports, the age-standardized incidence and mortality rate of burns in 2017 were 119 and 1.6 per 100,000, representing a decline of 5.4% and 46.6% from 1990 to 2017, respectively. The decrease in death rate and DALYs are attributed to therapeutic approaches, including antimicrobial agents, various ointments, skin grafts, and cell therapy for severe burn wounds [2]. Burn-induced tissue damage is mainly caused by the overproduction and diffusion of reactive oxygen species (ROS) and active inflammatory reactions induced by different cell types among molecular mediators activated in tissue damage caused by ischemia or protective signal pathways. The interaction between β-glucan and its receptors can activate nuclear factor-κB (NF-κB) and activator protein-1 (AP-1) transcription factors It can initiate several innate and adaptive responses, including activating via neutrophil and monocyte, complement activation, cytokine secretion, and T cell-mediated cytotoxicity [4,8]. It can activate cellular immunity via macrophage stimulation, protect against infections, and affect wound healing [8–10]
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