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Nutraceutical intervention towards wound healing after cancer surgery

Wound healing, substitution of destroyed or damaged tissue by newly produced one, can classically be divided into four steps: haemostasis, inflammation, cell proliferation and tissue maturation. With each successive phase in the normal sequence of wound healing, the immune system orchestrates a wide variety of processes. Different immune cells have been shown to peak in number and activity at different times during the healing cascade, thus helping distinguish the different stages of the process. As the ardent votaries in the laboratories as well as clinics have witnessed in past decades, enormous efforts have been directed to develop beneficial techniques for achieving speedy recovery minimizing the scar, ensuring function preservation. To avert infection and stimulate a proper healing process, the classical approach for wound management still remains as topical administration of antibacterial or colloidal agents. The healing process may be dismayed by both internal and external factors, viz., necrotic tissue, pathogen contamination, entrapment of non-native materials, comorbidities such as diabetes mellitus, etc., causing a delay in each phase of recovery. Often times, skirmishes brake out when wound closure gets affected by colonization of an invading microbial agent. It turns out that, due to synergistic bacterial development pattern, chronic wound infections are polymicrobial. On the other hand, acute wounds are generally associated with a diminished microbial load, scab formation and immune cells infiltration in the initial phase, while healing is correlated with re-epithelialization, angiogenesis and fibroblast migration.

Growing knowledge of the physiologic role of various nutritional elements has led to the recognition of certain nutrients like amino acids (glutamine etc.), vitamins (A, C, E etc.), antioxidants (beta-carotene, coenzyme Q10 etc.), fatty acids (Omeag-3. medium chain triglycerides etc.), trace elements, minerals etc. in wound management. It is obvious that a higher level of attention and research are required to evaluate the microbial effects on wound-healing ability, potential new therapeutic agents that can regulate the cross-talk between microflora, pathogens and the innate immune response, and lead to wound healing acceleration. Current research has witnessed a major impact of commensal microorganisms, beneficial bacteria, on multiple physiological processes including protection against pathogenic invasion and infection as well as immunomodulatory effects in tissue repair. Of many, Lactic acid bacteria (LAB) and bifidobacteria are some of the most widely studied species that improve host welfare and are most commonly referred to as probiotics.

To this end, Esperer Onco Nutrition (EON) is rejoicing the launch of a new product, namely, Liss WH which is augmented by probiotic blend (Lactobacillus acidophilusLactobacillus caseiLactobacillus fermentum and Bifidobacterium bifidum) having multifarious functions namely, collagen synthesis, H2O2 production, enhanced absorption of dietary vitamin D and E, induction of crucial cytokines (TNFα, IFN-γ, IL-10, etc.), increase in neutrophil infiltration, anti-microbial activity, etc. It is also enriched with natural antioxidants and immuno-nutrients such as β-carotene, coenzyme Q10 and mixed tocopherols which help in the prevention of infections in the surgical wounds, thus speeding up the recovery after cancer surgery. The osmolarity (280 to 300 mosmol /Litre) is suitable for enteral tube feeding and better nutrient absorption. Furthermore, EON intends to extend its research towards exploring nano-nutraceutical intervention for use in surgical wound healing in recent future. EON believes that the combination of nanotechnology with the existing protocol can pave the way for future medication of wound management.

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