Topikal İnsülinin Mukozal İyileşmeye Etkisinin Rat Modeli Üzerinde İncelenmesi

Abstract

Kulekci MC, The effect of topical insulin on mucosal healing in a healty rat model. Hacettepe University Department of Otolaryngology, Ankara, 2019. Topical insulin is a potent, safe, available, and non-carcinogenic growth factor whose effects were proven by in vivo, in vitro animal and human studies. Insulin exerts effects like increasing glucose metabolism, protein synthesis and gene transcription, cell proliferation and migration on cellular level. Since there were no previous studies examining the effect of intranasal topical insulin, we intended to test if similar effects would be observed on sinonasal mucosa. Forty-eight Wistar rats of 10-12 weeks old, weighing between 250-300 grams were subjected to a left nasal mucosal removal via 1.9 mm curette. Half the subjects were treated with 1 cc of 0.9% physiological serum 3 times a day, whereas the other half were applied 1 cc of 5IU/ ml regular insulin diluted with 0.9% physiological serum. Blood glucose levels did not differ statistically before and after the insulin application. After five, ten and fifteen days, subjects were sacrificed and examined for macroscopical and histological findings. Macroscopically, there were no incidence of infection and mucosal synechia. In 5 days groups, the reduction of defect size was 56% in insulin group vs 21% in saline group (p=0.006). In 10 days groups, reduction was 79% in insulin group vs 62% in saline group (p=0.034). In 15 days groups, subjects treated with insulin had complete closure vs 37% full closure in saline group (100% vs %92 epithelial defect reduction, p=0.036). Both inflammation and edema were decreased and less pronounced in insulin group in 15 days (p=0.023; p=0.006, respectively). The results obtained from this study supports the efficacy and safety of topical insulin on wound healing reported in the literature. Our study could lay the foundation of further studies directed at improving healing of human sinonasal mucosa.