Diabetes mellitus is a common metabolic disorder that affects more than 190 million people worldwide.1,2) The prevalence of type 2 diabetes mellitus is increasing rapidly, and currently affects the health of millions of humans now, and will continue to do so in the near future. Among the factors that are responsible for the increasing prevalence of this disease are obesity, the consumption of energy-dense diets and low levels of physical activity.3) Type 2 diabetes results from the failure of pancreatic beta cells to adequately compensate for obesity and insulin resistance.
4)Ocular complications secondary to type 2 diabetes mellitus are a well-known cause of diabetic keratopathy. 5) Diabetic keratopathy is an entity that includes slow healing or loose adhesion of the corneal epithelium after wounding in diabetic patients. Histologically, it involves a thickening of the corneal epithelial basement membrane and morphologic changes in the corneal epithelium and endothelium. [6][7][8][9][10][11] Clinically, the damage to the corneal epithelium during vitreous surgery and retinal photocoagulation sometimes induces vision-threatening corneal complications, such as persistent epithelial defects in diabetic patients.12) It has been reported that such diabetic keratopathy is experienced by 50% or more of diabetic patients.
13)The corneal wound repair process involves cell adhesion, migration, proliferation, matrix deposition and tissue remodeling.14) Many of these biological processes are mediated by growth factors, cytokines and other mediators released in injured tissues or cells.15) These growth factors have been recognized as important mediators of proper wound repair, 16) and treatment with growth factors such as platelet-derived growth factor-BB, and recombinant human epidermal growth factor has been shown to be beneficial for patients with chronic pressure ulcers or non-healing diabetic ulcers. [17][18][19][20] However, for reasons of effectiveness, safety and stable supply, a potent wound-healing agent for human corneal wounds has not yet been introduced, and the development of effective and safe corneal wound-healing drugs is highly anticipated.Proteins such as fibroin and sericin are the main constituents of silk, with fibroin contributing 70 to 80% and sericin 20 to 30% of the total cocoon weight.21) When cocoons or raw silk are used for textiles, the sericin is mostly removed from the cocoon and disposed of unused. However, sericin has recently been investigated for its activities in biotechnological fields. 22,23) We reported that sericin instillation has a potent effect in promoting wound healing and wound-size reduction in rats.24) Therefore, it is possible that sericin may be applied as eye drops for corneal wound repair in diabetic patients. In this study, we investigated the enhancing effects of sericin on corneal wound healing in the debrided corneal epithelium of Otsuka Long-Evans Tokushima Fatty (OLETF) rats, a model for human type 2 diabetes.
MATERIALS AND METHODS
Animals and Reagents Male Long-Eva...