EFFECT OF PROBIOTIC ORAL ADMINISTRATION ON SKIN WOUND HEALING IN RATS

Immunological aspects of probiotics for improving skin diseases: Influence on the Gut-Brain-Skin Axis

The interplay between gut microbiota and human health, both mental and physical, is well-documented. This connection extends to the gut-brain-skin axis, linking gut microbiota to skin health. Recent studies have underscored the potential of probiotics and prebiotics to modulate gut microbiota, supported by in vivo and clinical investigations. In this comprehensive review, we explore the immunological implications of probiotics in influencing the gut-skin axis for the treatment and prevention of skin conditions, including psoriasis, acne, diabetic ulcers, atopic dermatitis, and skin cancer. Our analysis reveals that probiotics exert their effects by modulating cytokine production, whether administered orally or topically. Probiotics bolster skin defenses through the production of antimicrobial peptides and the induction of keratinocyte differentiation and regeneration. Yet, many questions surrounding probiotics remain unanswered, necessitating further exploration of their mechanisms of action in the context of skin diseases.

The role of probiotics in tissue engineering and regenerative medicine

Tissue engineering and regenerative medicine (TERM) as an emerging field is a multidisciplinary science and combines basic sciences such as biomaterials science, biology, genetics and medical sciences to achieve functional TERM-based products to regenerate or replace damaged or diseased tissues or organs. Probiotics are useful microorganisms which have multiple effective functions on human health. They have some immunomodulatory and biocompatibility effects and improve wound healing. In this article, we describe the latest findings on probiotics and their pro-healing properties on various body systems that are useable in regenerative medicine. Therefore, this review presents a new perspective on the therapeutic potential of probiotics for TERM.

A systematic review of natural products for skin applications: Targeting inflammation, wound healing, and photo-aging

BACKGROUND

Every day the skin is constantly exposed to several harmful factors that induce oxidative stress. When the cells are incapable to maintain the balance between antioxidant defenses and reactive oxygen species, the skin no longer can keep its integrity and homeostasis. Chronic inflammation, premature skin aging, tissue damage, and immunosuppression are possible consequences induced by sustained exposure to environmental and endogenous reactive oxygen species. Skin immune and non-immune cells together with the microbiome are essential to efficiently trigger skin immune responses to stress. For this reason, an ever-increasing demand for novel molecules capable of modulating immune functions in the skin has risen the level of their development, particularly in the field of natural product-derived molecules.

PURPOSE

In this review, we explore different classes of molecules that showed evidence in modulate skin immune responses, as well as their target receptors and signaling pathways. Moreover, we describe the role of polyphenols, polysaccharides, fatty acids, peptides, and probiotics as possible treatments for skin conditions, including wound healing, infection, inflammation, allergies, and premature skin aging.

METHODS

Literature was searched, analyzed, and collected using databases, including PubMed, Science Direct, and Google Scholar. The search terms used included "Skin", "wound healing", "natural products", "skin microbiome", "immunomodulation", "anti-inflammatory", "antioxidant", "infection", "UV radiation", "polyphenols", "polysaccharides", "fatty acids", "plant oils", "peptides", "antimicrobial peptides", "probiotics", "atopic dermatitis", "psoriasis", "auto-immunity", "dry skin", "aging", etc., and several combinations of these keywords.

RESULTS

Natural products offer different solutions as possible treatments for several skin conditions. Significant antioxidant and anti-inflammatory activities were reported, followed by the ability to modulate immune functions in the skin. Several membrane-bound immune receptors in the skin recognize diverse types of natural-derived molecules, promoting different immune responses that can improve skin conditions.

CONCLUSION

Despite the increasing progress in drug discovery, several limiting factors need future clarification. Understanding the safety, biological activities, and precise mechanisms of action is a priority as well as the characterization of the active compounds responsible for that. This review provides directions for future studies in the development of new molecules with important pharmaceutical and cosmeceutical value.

The effect of probiotic supplementation on episiotomy wound healing among primiparous women: a triple-blind randomized clinical trial

BACKGROUND

Probiotics increase the defense power of immune system and accelerate the wound healing process by anti-inflammatory mechanisms at the wound site. The present study aimed at evaluating the effect of Lactobacillus casei oral supplementation on episiotomy wound healing among primiparous women.

METHODS

This triple-blind randomized clinical trial was performed on 74 primiparous women delivered in Alzahra Hospital, Tabriz, Iran. Participants with mediolateral episiotomy (incision length equal to and less than 5 cm) were randomly assigned to the probiotic and placebo groups. The probiotic group received Lactobacillus casei 431 with 1.5 * 10⁹ colony-forming unit /capsule once a day from the day after birth to 14 days. Wound healing as a primary outcome was measured by Redness, Edema, Ecchymosis, Discharge, Approximation and pain as a secondary outcome by the Visual Analogue Scale before discharge, 5 ± 1 and 15 ± 1 days after birth. The data were analyzed using independent t-test and repeated measures one way analysis of variance.

RESULTS

The mean (standard deviation: SD) score of wound healing in the probiotic group altered from 4.91(1.86) before discharge to 1.55 (0.99) during 5 ± 1 days after birth and reached to 0.95 (0.27) during 15 ± 1 days after birth. Further, the mean (SD) score of wound healing in the placebo group altered from 4.62 (1.99) before discharge to 2.80 (1.20) during 5 ± 1 days after birth and reached to 1.45(0.71) during 15 ± 1 days after birth (adjusted mean difference: -0.50, confidence interval 95%: -0.96 to -0.05, P = 0.03).

CONCLUSION

Lactobacillus casei oral supplementation is effective in healing episiotomy wounds. It is suggested to evaluate the effect of topical use of Lactobacillus casei on episiotomy repair and pain in further studies.

TRIAL REGISTRATION

Iranian Registry of Clinical Trials (IRCT): IRCT20170506033834N7. Date of registration: 11/08/2021.

The role of probiotics as wound healers: an overall view

A wound is an injury to the skin or damage to the body tissue. The healing process differs between various kinds of wounds. Treatment of hard-to-heal (chronic) wounds becomes challenging for healthcare practitioners, especially if patients have underlying health complications such as diabetes. Infection of wounds is another factor that interferes with the healing process and extends its duration. Active research is being conducted into the development of advanced wound dressing technologies. These wound dressings are intended to manage the exudate, reduce bacterial infection and speed up the healing process. Probiotics have been receiving much attention because of their potential application in the clinical field, especially in diagnostics and treatment strategies of various infectious and non-infectious diseases. The host immune-modulatory response and antimicrobial activity of probiotics are expanding their role in the development of improved wound dressing technology.

Role of Lactiplantibacillus plantarum UBLP-40, Lactobacillus rhamnosus UBLR-58 and Bifidobacterium longum UBBL-64 in the Wound Healing Process of the Excisional Skin

The probiotics Lactiplantibacillus plantarum UBLP-40, Lactobacillus rhamnosus UBLR-58 and Bifidobacterium longum UBBL-64 seem to promote wound healing when applied topically. Our aim was to investigate their effect on the mRNA expression of pro-inflammatory, healing and angiogenetic factors during the healing process of a standardized excisional wound model in rats. Rats subjected to six dorsal skin wounds were allocated to Control; L. plantarum; combined formula of L. rhamnosus plus B. longum; L. rhamnosus; and B. longum treatments, applied every two days, along with tissue collection. The pro-inflammatory, wound-healing, and angiogenetic factors of mRNA expression were assessed by qRT-PCR. We found that L. plantarum exerts a strong anti-inflammatory effect in relation to L. rhamnosus-B. longum, given alone or in combination; the combined regime of L. rhamnosus-B. longum, works better, greatly promoting the expression of healing and angiogenic factors than L. plantarum. When separately tested, L. rhamnosus was found to work better than B. longum in promoting the expression of healing factors, while B. longum seems stronger than L. rhamnosus in the expression of angiogenic factors. We, therefore, suggest that an ideal probiotic treatment should definitively contain more than one probiotic strain to speed up all three healing phases.

Both live and heat-killed Bifidobacterium animalis J-12 alleviated oral ulcers in LVG golden Syrian hamsters by gavage by directly intervening in the intestinal flora structure

Live and heat-killed Bifidobacterium has been proven to have anti-inflammatory and antioxidant effects. In this study, we evaluated the effects of live and heat-killed Bifidobacterium animalis J-12 (J-12) on the oral ulceration of LVG golden Syrian hamsters after buccal membrane injection with methyl viologen dichloride. Results showed that interleukin-1β, glutathione, and malondialdehyde in serum were downregulated by the gavage of live and heat-killed J-12 bacteria. The J-12 live and heat-killed bacteria can reduce the expression of matrix metalloproteinase-9 by reducing the expression of nuclear factor kappa-B, thus reducing the expression of anti-inflammatory factors lipoxin A4 and prostaglandin E2. Reducing the expression of caspase-3 and adenosine diphosphate ribose polymerase resulted in a reduction of ulcer tissue DNA damage. In addition, regulating the structure of the intestinal flora prevented the process of oral ulcer formation. This study shows that J-12 can reduce the risk of oral ulcer formation while also having a positive effect on inhibiting existing oral ulcer growth.

The Probiotic Strains Bifidοbacterium lactis, Lactobacillus acidophilus, Lactiplantibacillus plantarum and Saccharomyces boulardii Regulate Wound Healing and Chemokine Responses in Human Intestinal Subepithelial Myofibroblasts

Bifidobacterium lactis, Lactobacillus acidophilus, Lactiplantibacillus plantarum and Saccharomyces boulardii are common probiotic supplements. Colonic subepithelial myofibroblasts (cSEMFs) are actively involved in mucosal wound healing and inflammation. cSEMFs, isolated from healthy individuals, were stimulated with 102 or 104 cfu/mL of these probiotic strains alone and in combination, and their effect on chemokine and wound healing factor expression was assessed by qRT-PCR, ELISA and Sircol Assay, and on cSEMFs migration, by Wound Healing Assay. These strains remained viable and altered cSEMFs’ inflammatory and wound healing behavior, depending on the strain and concentration. cSEMFs treated with a combination of the four probiotics had a moderate, but statistically significant, increase in the mRNA and/or protein expression of chemokines CXCL1, CXCL2, CXCL4, CXCL8, CXCL10, CCL2 and CCL5, and healing factors, collagen type I and III, fibronectin and tissue factor. In contrast, when each strain was administered alone, different effects were observed, with greater increase or decrease in chemokine and healing factor expression, which was balanced by the mixture. Overall, this study highlights that the use of multiple probiotic strains can potentially alert the gut mucosal immune system and promote wound healing, having a better effect on mucosal immunity than the use of single probiotics.

Sputum Microbiota in Coal Workers Diagnosed with Pneumoconiosis as Revealed by 16S rRNA Gene Sequencing

Coal worker’s pneumoconiosis (CWP) is an occupationally induced progressive fibrotic lung disease. This irreversible but preventable disease currently affects millions across the world, mainly in countries with developed coal mining industries. Here, we report a pilot study that explores the sputum microbiome as a potential non-invasive bacterial biomarker of CWP status. Sputum samples were collected from 35 former and active coal miners diagnosed with CWP and 35 healthy controls. Sequencing of bacterial 16S rRNA genes was used to study the taxonomic composition of the respiratory microbiome. There was no difference in alpha diversity between CWP and controls. The structure of bacterial communities in sputum samples (β diversity) differed significantly between cases and controls (pseudo-F = 3.61; p = 0.004). A significant increase in the abundance of Streptococcus (25.12 ± 11.37 vs. 16.85 ± 11.35%; p = 0.0003) was detected in samples from CWP subjects as compared to controls. The increased representation of Streptococcus in sputum from CWP patients was associated only with the presence of occupational pulmonary fibrosis, but did not depend on age, and did not differ between former and current miners. The study shows, for the first time, that the sputum microbiota of CWP subjects differs from that of controls. The results of our present exploratory study warrant further investigations on a larger cohort.

Novel Wound Dressing Based on Postbiotic/Chitosan Film Accelerates Cutaneous Wound Healing

Background: Wound healing is a complex and overlapping process involving immune cells, cytokines, and growth factors. Objectives: This study aimed to design and evaluate a novel wound dressing based on postbiotic/chitosan in accelerating wound healing. Methods: Lactobacillus reuteri PTCC1655 was cultured, and the cell-free supernatant (postbiotic) was obtained by medium centrifugation. The films were prepared using the solvent casting method and evaluated in terms of water absorption index, water vapor transmission rate, and antimicrobial properties. Forty-five male Wistar rats were subjected to a full-thickness excisional wound to assess the wound healing potential. The rats were randomly divided into ctrl-, chitosan, and postbiotic groups. The time-course histological and gene expression analysis was performed to compare the dressing efficacy. Results: The films showed proper water absorption and water vapor transmission rate and inhibited the pathogens commonly associated with wound infection. The postbiotic film improved wound healing by modulating the inflammatory phase, increasing collagen and elastin deposition, and enhancing angiogenesis based on the histological results. The gene expression assay showed that the postbiotic film accelerated wound healing by improving the expression of inflammatory mediators (IL-6 and TNF-α) and anti-inflammatory mediators (TGF-β and VEGF). Conclusions: The cell-free supernatant/chitosan/polyethylene glycol (CFS/CS/PEG) biodegradable film could be introduced as a novel dressing for cutaneous wound healing. This transparent film enhances cutaneous wound healing by modulating infiltrated immunity cells and expressing inflammatory/anti-inflammatory cytokines.

Hematology of dairy cows with purulent-necrotic processes in the digital area treated with Subtilin ointment

The objective of this study was to investigate the effect of Subtilin ointment on the hematology of dairy cows when used to treat inflammation and necrotic tissue in the digital area. Holstein-Friesian cows were allocated to 2 groups of 10 animals each. The first group consisted of clinically healthy cows and the second group consisted of cows with a purulent-necrotic lesion in the digital area. To make a comparative analysis, blood samples of healthy and diseased cows were taken and tested before treatment with Subtilin ointment and 10 days after treatment. The blood of the diseased cows had more leukocytes (53.38%), lymphocytes (46.81%), erythrocytes (15.78%), granulocytes (64.56%), and platelets (34.76%), and a higher mean cell volume (of 8.37%) and increased level of monocytes/eosinophils (65.12%) than did the blood of clinically healthy cows. At the same time, there were no evident changes in the level of erythrocytes, hemoglobin, mean cell hemoglobin, mean cell hemoglobin concentration, and percentage of lymphocytes in either clinically healthy or diseased cows. The hematology of diseased cows treated with Subtilin ointment demonstrated positive dynamics in the healing of ulcerative processes.

Avoidance of milk and dairy products after oral surgery-is such a recommendation still valid? A cross-sectional study among German and international oral and maxillofacial surgeons and dental practitioners with review of the literature

PURPOSE

For prevention of wound-healing complications, patients in German-speaking countries are traditionally advised to avoid consumption of milk and dairy products after oral surgery. In the absence of national and international guidelines, this study investigates scientific evidence and compares international practice, frequency scale, and rationale behind such recommendation.

METHODS

Comparison of a German cross-sectional mono-center-questionnaire pilot study and a survey among international oral and maxillofacial surgeons (OMFS), specialized oral surgeons and general dentists, evaluating international practice regarding post-operative dietary and nutrition recommendations. Our literature review further assessed scientific evidence for relevant effects of probiotics, prebiotics, and/or synbiotics.

RESULTS

Among German study participants, 56% (n = 64/114) advise patients to avoid milk and dairy products, with 42% of OMFS (n = 38) and 65% (n = 76) of the general dentists recommending abstention (p = .027). In striking contrast, such recommendation could not be identified in our international survey (n = 143) (t test, p < .001) nor in the literature. There were significant differences between German and international study participants regarding the rationale for dietary recommendations, with dental schools and literature most frequently indicated as sources (Fisher's exact test, p < .001).

CONCLUSION

The hypothesis of a harmful effect of the consumption of milk and dairy products after dentoalveolar surgery could not be supported by evidence. The recommendation to avoid dairy products post-surgery was identified as a specific phenomenon practiced almost exclusively in German-speaking countries. Corresponding recommendations, most probably based on a now irrelevant risk of contracting tuberculosis from milk products, can at present no longer be substantiated.

Effects of oral probiotics administration on the expression of transforming growth factor β and the proinflammatory cytokines interleukin 6, interleukin 17, and tumor necrosis factor α in skin wounds in rats

BACKGROUND

Cytokines and growth factors play key roles during the tissue repair process. We aim to evaluate the effect of perioperative oral of probiotics, on the healing process in skin wound in rats, by histological aspects, and by the expression of TGF-β, and the pro-inflammatory cytokines IL6, IL7, and TNF-α.

METHODS

72 adult male Wistar rats were split into two groups control (n = 36) and probiotic group (n = 36). Each group was subdivided into three subgroups with 12 animals each according to euthanasia day: 3rd, 7th, and 10th postoperative(PO) day.

RESULTS

Wound contraction was faster with the use of probiotics (p = .013). Also fibrosis was significantly higher in the Probiotic group in the 7th PO day (p = .028). In the probiotic group, there was a reduction of TNF-α at 3th PO day (p = .023); and a reduction of IL6 in 7th PO day (p = .030). There was also a reduction of the expression of IL-17 in 3rd PO day (p = .039) and 7rd PO day (P = .024). In contrast, TGF-β was lower in the 10th PO day (p = .031) in the probiotic group as compared to controls, indicating that the increase of the fibrosis caused negative feedback with the TGF-β.

CONCLUSION

Probiotics are associated with a shorter inflammatory phase by attenuating the expression of cytokines IL-6 and TNF-α and accelerating the reduction of IL-17 and TGF-β, leading to faster and improved cutaneous healing in rats.

The differences in the number of fibroblasts and blood vessels after the topical and systemic administration of Lactobacillus casei Shirota probiotics for the treatment of traumatic ulcers in Wistar rats (Rattus norvegicus)

Background and Aim

The use of drugs as a therapy for traumatic ulcers may lead to drug resistance and other side effects. Lactobacillus casei Shirota can affect the number of fibroblasts and blood vessels in wound healing. The aim of this study was to investigate the difference in the number of fibroblast cells and blood vessels after the topical and systemic administration of L. casei Shirota probiotics in Wistar rats with traumatic ulcer.

Materials and Methods

Overall, 36 healthy male Wistar rats aged 2-3 months old and weighing 175-250 g in body weight were used as a sample. Traumatic ulcer was made on the labial fornix incisive inferior. The subject rats were divided into groups: (1) A control group over 3 days, (2) a group that used distilled water over 7 days, (3) a group that underwent topical treatment over 3 days, (4) a group that used probiotics administered topically over 7 days, (5) a group that underwent systemic treatment over 3 days, and (6) a group that took oral probiotics for the traumatic ulcers over 7 days. The number of fibroblasts and blood vessels was observed through a hematoxylin-eosin examination.

Results

Based on the results of the study, a significant difference was observed in the number of fibroblasts (p=0.00) and blood vessels (p=0.018) in the 3-day topical group that underwent a 3-day systemic administration of probiotics compared with the number of fibroblast cells in the 7-day topical group and 7-day systemic group (p=0.00).

Conclusion

Overall, significant differences were observed in the number of fibroblasts and blood vessels in Wistar rats with traumatic ulcer after undergoing the topical and systemic administration of L. casei Shirota probiotics.

Probiotic Activity of Staphylococcus epidermidis Induces Collagen Type I Production through FFaR2/p-ERK Signaling

Collagen type I is a key structural component of dermis tissue and is produced by fibroblasts and the extracellular matrix. The skin aging process, which is caused by intrinsic or extrinsic factors, such as natural aging or free radical exposure, greatly reduces collagen expression, thereby leading to obstructed skin elasticity. We investigated the effective fermentation of Cetearyl isononanoate (CIN), a polyethylene glycol (PEG) analog, as a carbon source with the skin probiotic bacterium Staphylococcus epidermidis (S.epidermidis) or butyrate, as their fermentation metabolites could noticeably restore collagen expression through phosphorylated extracellular signal regulated kinase (p-ERK) activation in mouse fibroblast cells and skin. Both the in vitro and in vivo knockdown of short-chain fatty acid (SCFA) or free fatty acid receptor 2 (FFaR2) considerably blocked the probiotic effect of S. epidermidis on p-ERK-induced collagen type I induction. These results demonstrate that butyric acid (BA) in the metabolites of fermenting skin probiotic bacteria mediates FFaR2 to induce the synthesis of collagen through p-ERK activation. We hereby imply that metabolites from the probiotic S. epidermidis fermentation of CIN as a potential carbon source could restore impaired collagen in the dermal extracellular matrix (ECM), providing integrity and elasticity to skin.

EFFECT OF SUPPLEMENTATION WITH PROBIOTICS ON COLONIC ANASTOMOSES IN RATS: MORPHOLOGICAL AND TENSIOMETRIC STUDY

Background:

The use of probiotics positively modifies the composition and function of intestinal flora, improving the quality of intestinal anastomosis.

Aim:

To evaluate the impact of probiotic use on intestinal anastomosis of rats.

Method:

Thirty-six adult male Wistar rats (Rattus norvegicus albinus, Rodentia Mammalia) were used, with body weight ranging from 220-320 g. The animals were housed and acclimated individually in boxes receiving water and ration ad libitum. After initial acclimatization, the control group received perioperative ration ad libitum for 12 days (seven preoperatively and five postoperatively) associated with the maltodextrin formula at a dose of 250 mg/day in isocaloric and isovolumetric form. Likewise, the probiotic group received oral supplementation of probiotics dose of 250 mg/day, associated with isocaloric and isovolumetric diet. The probiotic chosen for this study was composed of strains (doses 1x10⁹ CFU/g)¹²Lactobacillus paracasei LPC-37, Bifidobacterium lactis HN0019, Lactobacillus rhamnosus HN001 and Lactobacillus acidophilus NCFM. Probiotics or placebo were administered orally with the aid of a dosimeter spatula. Both groups underwent two colostomies, one in the right colon and the second in rectosigmoid, followed by reanastomosis with eight separate 6-0 mononylon stitches. The sacrifice took place on the fifth day. The parameters evaluated included tensile strength, histology and collagen densitometry.

Results:

The rate of intestinal fistula for the control and probiotic groups were, respectively, 22.22% and 11.11% (p=0.6581).Perioperative supplementation with probiotics increased collagen deposition of types I and III (p<0.0001), improved maximum traction force and maximum rupture force, p=0.0250 and p=0.0116 respectively, fibrosis area (p<0.0001), and area of the inflammatory infiltrate (p=0.0115).

Conclusions:

The use of probiotics had a positive impact on the quality of intestinal anastomosis.