epiglucan and Wounds-and-Injuries

To relieve 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.

Topics: Adjuvants, Immunologic; Animals; beta-Glucans; Diabetes Complications; Drug Compounding; Drug Stability; Humans; Hydrogels; Mice; Mice, Inbred Strains; Occlusive Dressings; Treatment Outcome; Wound Healing; Wounds and Injuries

To evaluate the cost-effectiveness of a soluble beta-glucan-containing gel as short-term adjunct therapy in the treatment of hard-to-heal wounds in a UK community health-care setting.. A comparative clinical evaluation involving consecutive patients treated for up to eight weeks with a beta-glucan-containing gel as adjunct to standard care. This was compared with consecutive patients as retrospective controls, and using the same standard care protocol from a year previously. The inclusion criteria was wounds that were slow-healing or stalled (<40% healing in four weeks).. A total of 300 patients took part. Complete follow-up at 24 weeks was available for 144 patients in the beta-glucan group, and 136 patients in the standard care group. At 24 weeks, the beta-glucan group had a 96% healing rate compared with 75% in the standard care group (p<0.001). The improvement in healing was associated with a reduction in the mean number of weeks of treatment per patient (7.2 and 10.7 for beta-glucan and standard care, respectively), and a reduction in the mean cost of treatment (£576 versus £685 for beta-glucan and standard care, respectively). Treatment costs included nursing time, prescription medications and dressings. In a subset of ulcer wounds (50% of the full sample), at 24 weeks the beta-glucan group had a 92% healing rate compared with 46% in the standard care group (p<0.001). Mean weeks of treatment were 10.4 versus 17.6, leading to a reduction in treatment cost of £388 per patient (£1227 versus £839) over 24 weeks.. The results of this evaluation suggest that short-term use of the beta-glucan gel as an adjunct to standard care on slow-healing wounds can shorten healing times and reduce NHS costs.

Topics: beta-Glucans; Cost-Benefit Analysis; Female; Health Care Costs; Humans; Male; Middle Aged; Retrospective Studies; United Kingdom; Wound Healing; Wounds and Injuries

Clinicians across all health-care settings are challenged daily by wounds that are slow or static in healing due to time constraints, reduced resources and the negative impact upon the patient's quality of life (QoL). Community settings are particularly challenging due to the varied environments, patient social, psychological and financial constraints, and multi-clinician wound care monitoring. The aim of this clinical evaluation is to clinically evaluate bioactive soluble beta-glucan gel (BSBG) on those wounds that have stalled at four weeks as an adjunct to normal standards of care.. A clinical observational evaluation was undertaken within a large community setting, reviewing patients who self-presented with stalled healing/chronic wounds, and the effects upon adding a BSBG gel twice a week for eight weeks as part of their set standard care. Formulary cleansing and dressing products were continued and results monitored by a designated clinician. All data was collected as part of the patient's normal wound review routine in relation to primary outcome of wound reduction with secondary outcomes relating to pain reduction, slough and necrosis reduction, exudate reduction and adverse events.. At six months, analysis of data demonstrated >2-times a higher rate of healing in chronic wounds with eight weeks' initial treatment and >4-times a higher rate of healing over six months in those patients with ulceration (PU, VLU, DFU). A reduction of per patient care cost saving was achieved across the treatment group compared with the standard care retrospective group.. The administration of a wound healing gel within a moderate size cohort of patients presenting with chronic wounds resulted in improved wound reduction and significant cost savings.

Topics: Bandages, Hydrocolloid; beta-Glucans; Chronic Disease; Cohort Studies; Female; Gels; Humans; Male; Retrospective Studies; Treatment Outcome; Wound Healing; Wounds and Injuries

Wounds that have stalled healing are costly in terms of patient morbidity and increase in use of material and financial resources. A natural polymer beta-glucans has been incorporated into a methylcellulose gel to provide a topical gel designed to accelerate healing in wounds where it has stalled. Although the gel provides an environment conducive to moist wound healing the active agent, beta-glucans, activate the innate immune response.. Using a Markov cohort simulation model, data were extrapolated from a double-blind randomised trial to evaluate the economic benefits of the soluble beta-glucan (SBG) gel in the treatment of diabetic foot ulcers (DFUs).. Over an annual budget cycle, SBG gel is expected to heal 94% of wounds compared with 78% when given standard care. It also healed wounds more quickly, with the average expected healed weeks 34.4 in the SBG gel group, compared with 24.7 methylcellulose dressing group. In our model this leads to a cost saving over an annual budget cycle of £503 per patient. Note: healed weeks refers to the number of weeks when the wound has healed during the 12-week period and should not be confused with weeks to healing.. The shorter healing time associated with the SBG gel treatment leads to a cost saving because fewer weeks of treatment are required to heal the wound, suggesting this is a promising new cost-effective option for the treatment of DFUs.

Topics: Administration, Cutaneous; Bandages; beta-Glucans; Cohort Studies; Computer Simulation; Cost-Benefit Analysis; Gels; Humans; Markov Chains; Methylcellulose; Randomized Controlled Trials as Topic; Treatment Outcome; Wound Healing; Wounds and Injuries

The aim of this evaluation is to assess the effects of a wound healing gel in a wounds of different aetiologies.. Data was recorded on the wound surface area, tissue type, and patient level of wound pain at baseline (0) and at weeks 1, 2, 3, 4, and 8.. Of the total 39 patients enrolled in the study, 26 patients who complied with the protocol criteria completed the minimum four-week study period. During the 12-week evaluation period, seven of the 26 wounds fully healed and an additional eight wounds showed a reduction in size of more than 50 %. Of the remaining 11, five wounds showed moderate healing progression and six wounds did not respond to treatment. Following the 12 week evaluation time point clinicians reported that a further three wounds healed-a 38 % healing rate.. The results give promise that this advanced gel, containing a macrophage activating substance, can be a tool in re-activating healing in stalled wounds where standard of care is no longer giving the desired healing progression.

Topics: Administration, Cutaneous; Adult; Aged; Aged, 80 and over; beta-Glucans; Female; Gels; Humans; Male; Middle Aged; Pain; Pain Measurement; Prospective Studies; Wound Healing; Wounds and Injuries

Previous studies in our laboratory have demonstrated the downregulation of surface expression of scavenger receptor (SR) and upregulation of CD14 in the presence of endotoxemia, which directly correlates to the excessive inflammatory response in lung injuries. This study aims to analyze the dynamics of the expressions of SR and CD14 in traumatic endotoxemia, and to investigate the receptor mechanism of immunomodulator, carboxymethyl-beta-1, 3-glucan (CMG), on the protection of traumatic infections.. By using a sublethal fracture plus endotoxemia model, experimental mice were assigned to sham group (Sham), trauma group (T), traumatic endotoxemia group (TE), and traumatic endotoxemia plus CMG group (TE + C). Alveolar macrophages were isolated from each group. Expressions of SR and CD14 were examined at the cell and tissue levels by immunohistochemistry assay. The effects of CMG on the phagocytosis of alveolar macrophages, tissue injury, and mortality were also determined.. Expressions of SR and CD14 in lungs and livers decreased and increased, respectively. Alteration of SR and CD14 levels was more evident in lungs than in livers in posttraumatic endotoxemia. CMG up-regulated the SR expression in lipopolysaccharide-stimulated alveolar macrophages, alleviated the tissue injury, reduced mice mortality, and increased the opsonin-independent phagocytosis of Staphylococcus aureus, which was inhibited by SR mono-antibody.. Significant correlation was found between inflammatory responses and the imbalance between SR and CD14 in posttraumatic endotoxemia. The more dramatic changes in lungs might be related to the sequential preferred injury in uncontrolled inflammation. CMG could be a promising bioactive reagent in immunomodulating sepsis.

Topics: Animals; beta-Glucans; Endotoxemia; Escherichia coli; Female; Lipopolysaccharide Receptors; Liver; Lung; Macrophages, Alveolar; Male; Mice; Phagocytosis; Receptors, Scavenger; Staphylococcus aureus; Up-Regulation; Wounds and Injuries

A diverse set of transcripts called 185/333 is strongly expressed in sea urchins responding to immune challenge. Optimal alignments of full-length 185/333 cDNAs requires the insertion of large gaps that define 25 blocks of sequence called elements. The presence or absence of individual elements also defines a specific element pattern for each message. Individual sea urchins were challenged with pathogen associated molecular patterns (PAMPs) (lipopolysaccharide, beta-1,3-glucan, or double stranded RNA), and changes in the 185/333 message repertoire were followed over time.. Each animal expressed a diverse set of 185/333 messages prior to challenge and a 0.96 kb message was the predominant size after challenge. Sequence analysis of the cloned messages indicated that the major element pattern expressed in immunoquiescent sea urchins was either C1 or E2.1. In contrast, most animals responding to lipopolysaccharide, beta-1,3-glucan or injury, predominantly expressed messages of the E2 pattern. In addition to the major patterns, extensive element pattern diversity was observed among the different animals before and after challenge. Nucleotide sequence diversity of the transcripts increased in response to beta-1,3-glucan, double stranded RNA and injury, whereas diversity decreased in response to LPS.. These results illustrate that sea urchins appear to be able to differentiate among different PAMPs by inducing the transcription of different sets of 185/333 genes. Furthermore, animals may share a suite of 185/333 genes that are expressed in response to common pathogens, while also maintaining a large number of unique genes within the population.

Topics: Animals; beta-Glucans; Gene Expression Profiling; Gene Expression Regulation; Gene Rearrangement; Genes; Genetic Variation; Immunity, Innate; Lipopolysaccharides; Molecular Sequence Data; Proteoglycans; RNA, Double-Stranded; RNA, Messenger; Strongylocentrotus purpuratus; Wounds and Injuries