title: Macrophage stimulating agent soluble yeast β-1,3/1,6-glucan as a topical treatment of diabetic foot and leg ulcers: A randomized, double blind, placebo-controlled phase II study.
abstract: OBJECTIVE
  Dysregulated inflammatory response is believed to be an important factor in the pathogenesis of several late complications of diabetes mellitus. β-Glucans are potent inducers of immune function. The present randomized, double blind, two-center, placebo-controlled study was undertaken to explore safety, tolerability and efficacy of soluble β-1,3/1,6-glucan (SBG) as a local treatment of diabetic foot ulcers.
  
  
  METHODS
  A total of 60 patients with type 1 or 2 diabetes and lower extremity ulcers (Wagner grade 1-2, Ankle/Brachial Index ≥0.7) received SBG or a comparator product (methylcellulose) locally three times weekly up to 12 weeks in addition to conventional management scheme. A total of 54 patients completed the study.
  
  
  RESULTS
  A tendency for shorter median time to complete healing in the SBG group was observed (36 vs 63 days, P = 0.130). Weekly percentage reduction in ulcer size was significantly higher in the SBG group than in the methylcellulose group between weeks 1-2, 3-4 and 5-6 (P < 0.05). The proportion of ulcers healed by week 12 was also in favor of SBG (59% vs 37%, P = 0.09), with a significantly higher healing incidence in the SBG group at week 8 (44% vs 17%, P = 0.03). SBG was safe and well tolerated. There was a clinically significant difference regarding the incidence of serious adverse events in favor of the SBG treatment.
  
  
  CONCLUSIONS
  Local treatment of diabetic lower extremity ulcers with β-1,3/1,6-polyglucose shows good safety results. This β-glucan preparation shows promising potential as a treatment accelerating cutaneous healing. Further studies are required to confirm this effect. This trial was registered with ClinicalTrials.gov (no. NCT00288392).
authors.affiliation: University of Tromsø Tromsø Norway.
authors.forename: Svetlana N
authors.initials: SN
authors.lastname: Zykova
authors.affiliation: Northern State Medical University Arkhangelsk Russia.
authors.forename: Ksenia A
authors.initials: KA
authors.lastname: Balandina
authors.affiliation: North-Western State Medical University named after I.I. Mechnikov Saint-Petersburg Russia.
authors.forename: Natalia V
authors.initials: NV
authors.lastname: Vorokhobina
authors.affiliation: North-Western State Medical University named after I.I. Mechnikov Saint-Petersburg Russia.
authors.forename: Alla V
authors.initials: AV
authors.lastname: Kuznetsova
authors.affiliation: Biotec Pharmacon ASA Tromsø Norway.
authors.forename: Rolf
authors.initials: R
authors.lastname: Engstad
authors.affiliation: Northern State Medical University Arkhangelsk Russia.
authors.forename: Tatiana A
authors.initials: TA
authors.lastname: Zykova
keywords: Diabetic foot; Wound healing; β‐Glucans