Local Probiotic Therapy with Lactobacillus plantarum Mitigates Scar Formation in Rabbits after Burn Injury and Infection

Abstract

Background: Infection is the most common complication in burn-injured patients and is believed to contribute to the hypertrophic scarring frequently observed in such injury. Pseudomonas aeruginosa is a common pathogen in burn wound infection. We examined the effect of local probiotic therapy with Lactobacillus plantarum on the severity of the scarring following burn wounding and infection with P. aeruginosa in a rabbit model. Methods: Full-thickness burn wounds were inoculated with control vehicle or L. plantarum; wounds were then challenged with bioluminescent P. aeruginosa. The time course of the ensuing infection was monitored by quantification of the emitted light. After allowing wounds to contract to near completion, they were harvested and analyzed for markers of scar formation. Results: Application of L. plantarum curtailed both the severity and the length of the pseudomonal infection. Probiotic therapy significantly reduced both Type I collagen mRNA concentrations and total collagen protein accumulation in infected wounds, consistent with reduced scarring. Surprisingly, the probiotic showed a nearly equivalent effect in uninfected wounds. Masson's trichrome staining confirmed these findings histologically. Conclusions: Lactobacillus plantarum shows exciting potential as a therapeutic agent to both counteract burn wound infection and to alleviate scarring even in the absence of infection.

New Nanotechnologies for the Treatment and Repair of Skin Burns Infections

“…This regenerative process is potentially hampered by infection, which can be of fungal or bacterial origin, with the most prevalent microorganisms being Staphylococcus aureus (gram-positive bacteria), Pseudomonas aeruginosa [36,37] (gram-negative bacteria) and Candida spp. (fungi) [3].…”

“…(fungi) [3]. Infection constitutes a major concern, as the production of a biofilm in the extracellular matrix protects the microorganisms against conventional antibiotics and is highly associated with hypertrophic scar [37]. After a burn injury, with the thermal destruction of the skin and the haemostasis phase, the burn wound surface takes the form of an avascular necrotic tissue with high protein content, which results in impaired immune cells migration and provides a favourable environment to microbial invasion and colonization.…”

The Cutaneous Microbiome and Wounds: New Molecular Targets to Promote Wound Healing

“…in vitro, but also demonstrated inhibition of Pseudomonas colonization and improved tissue repair in a burn mouse model [ 101 ]. In the presence of infection, L. plantarum containing probiotics reduced collagen accumulation in Pseudomonas infected burn wounds, ultimately decreasing the extent of scarring [ 102 ]. In chronic wounds, a randomized clinical trial revealed the potential advantageous healing properties of probiotics in DFUs with significant reductions in ulcer length and depth, in addition to improved glycemic control [ 103 ].…”

Efficacy of Using Probiotics with Antagonistic Activity against Pathogens of Wound Infections: An Integrative Review of Literature

“…e studies investigated burn wounds, ischemic wounds, and skin lesions. ree studies each used mouse [61,68,78] and rat models [76,80,81] and two studies used rabbit models [77,79]. Local application of probiotics was used for six studies and only two studies included local injections [61,78] of probiotics.…”