Ketogenic diet enhances delayed wound healing in immunocompromised rats: A histological and immunohistochemical study

Background: Wound healing is a complicated process that can be affected by various factors. Glucocorticoids delay the process of wound healing by several mechanisms. The ketogenic diet could aid in the treatment of several skin diseases especially those associated with oxidative stress.Aim of the work: to examine the role of the ketogenic diet in enhancing the delayed wound healing of thin skin in glucocorticoid-immunocompromised ratsMaterial and Methods: Twenty-four adult male albino rats were equally allocated into four groups: Control, excisional wound in normal rats, excisional wound in immunocompromised rats (0.1 mg/kg/day of dexamethasone subcutaneously for 30 days), and excisional wound in immunocompromised rats on ketogenic diet (75 % fat, 20 % protein, and 5 % carbohydrate). Wound samples were obtained on either the 7th or the 14th day and processed for different biochemical, histological, and immunohistochemical techniques.Results: On both the 7th and 14th day, the wound of immunocompromised rats expressed a significant increase in both tissue malondialdehyde and myeloperoxidase compared with normal rats. The mean wound area was significantly larger, while both mean wound healing rate and mean epidermal thickness were significantly dropped compared with normal rats. A significant increase in collagen fiber deposition was associated with a significant reduction of the number of Ki67 positive cells and mean number of VEGF-positive blood vessels. The wound of immunocompromised rats on a ketogenic diet exhibited a significant restoration of most of the studied parameters, particularly on the 14th day.Conclusions: The ketogenic diet enhanced delayed wound healing via suppressing oxidative stress, modulating inflammation and collagen deposition, promoting proliferation, and enhancing angiogenesis particularly on the 14th day.