Thorac Cardiovasc Surg 2017; 65(05): 367-374
DOI: 10.1055/s-0035-1570373
Original Thoracic
Georg Thieme Verlag KG Stuttgart · New York

Can Sericin Prove Useful as a Pleurodesis Agent or Tissue Glue?

Alkin Yazicioglu
1   Turkiye Yuksek Ihtisas Training and Research Hospital, Thoracic Surgery and Lung Transplantation Clinic, Ankara, Turkey
Funda Demirag
2   Department of Pathology, Ataturk Chest Disease and Thoracic Surgery Training and Research Hospital, Ankara, Turkey
Ibrahim Onur Alici
1   Turkiye Yuksek Ihtisas Training and Research Hospital, Thoracic Surgery and Lung Transplantation Clinic, Ankara, Turkey
Erdal Yekeler
1   Turkiye Yuksek Ihtisas Training and Research Hospital, Thoracic Surgery and Lung Transplantation Clinic, Ankara, Turkey
Nurettin Karaoglanoglu
1   Turkiye Yuksek Ihtisas Training and Research Hospital, Thoracic Surgery and Lung Transplantation Clinic, Ankara, Turkey
› Author Affiliations
Further Information

Publication History

19 August 2015

19 November 2015

Publication Date:
12 January 2016 (online)


Background Sericin is a natural, gum-like, macromolecule protein, synthesized from silkworms for the formation of cocoon shells. The aim of the present study is to describe the effects of sericin when used for pleurodesis and/or as tissue glue.

Methods Adult, male, 12-week-old Wistar albino rats, weighing 257 to 395 g were used in the present study (n = 12). The animals were randomly divided into two equal groups as the sericin and the control group. After intramuscular administration of the anesthetic agent, the rats were intubated and mechanically ventilated. A left thoracotomy was performed and 30 mg sericin powder was instilled into the thoraxes of the sericin group. The remaining rats were allocated to a sham thoracotomy group. The animals were housed in individual cages, fed ad-libitum, and sacrificed 8 days after. After sacrifice, the left hemithoraxes were removed en bloc and underwent histopathologic examination.

Results Masson trichrome staining was applied on the visceral pleura sections of all the animals. Each animal specimen (n = 6, 100%) in the control group showed minimal collagen deposition, while only one rat (16.67%) in the sericin group had minimal collagen deposition. However, in the sericin group, five animals (83.33%) showed dense collagen deposition, fibroblastic activity, and fibrosis. According to the test method, independent t-test, developing fibroblastic activity and fibrosis are statistically significant between the two groups (p < 0.01). There were no foreign-body reactions and no evidence of biological glue on the specimens in the sericin group. The rats in the sericin group had lower inflammatory reactions compared with those in the control group. Emphysema was observed in two rats (33.33%) in the sericin group and in four rats (66.67%) in the control group. Therefore, sericin was found to be associated with an increase in fibroblastic activity and fibrosis in visceral pleura without exerting any adverse effect on the lung parenchyma.

Conclusion Sericin is a new and researchable protein for chest diseases and thoracic surgery. To develop an effect of dense collagen deposition, fibroblastic activity, and fibrosis in the visceral pleura, without significant adverse effects, is remarkable. Therefore, sericin may be useful as a pleurodesis agent or natural biological glue in the future. Sericin treatment can add value to the disciplines of pulmonology and thoracic surgery.


This abstract has been presented as a poster session in American Thoracic Society, 2015 Conference, which was held at Denver, Colorado, United States, between 15 and 20 May, 2015.

  • References

  • 1 Aramwit P, Sangcakul A. The effects of sericin cream on wound healing in rats. Biosci Biotechnol Biochem 2007; 71 (10) 2473-2477
  • 2 Tatemastu K, Sezutsu H, Tamura T. Utilization of transgenic silkworms for recombinant protein production. J Biotechnol Biomaterial 2012; S9: 004
  • 3 Sarovart S, Sudatis B, Meesilpa P, Grady BP, Magaraphan R. The use of sericin as an antioxidant and antimicrobial for polluted air treatment. Rev Adv Mater Sci. 2003; 5 (03) 193-198
  • 4 Padamwar MN, Pawar AP. Silk sericin and its applications: a review. J Sci Ind Res (India) 2004; 63 (04) 323-329
  • 5 Turbiani FRB, Tomadon JJ, Seixas FL, Gimenes ML. Properties and structure of sericin films: effect of the crosslinking degree. Chem Eng T 2011; 24: 1489-1494
  • 6 Nagai N, Murao T, Ito Y, Okamoto N, Sasaki M. Enhancing effects of sericin on corneal wound healing in rat debrided corneal epithelium. Biol Pharm Bull 2009; 32 (05) 933-936
  • 7 Teramoto H, Kameda T, Tamada Y. Preparation of gel film from Bombyx mori silk sericin and its characterization as a wound dressing. Biosci Biotechnol Biochem 2008; 72 (12) 3189-3196
  • 8 Festing MF, Altman DG. Guidelines for the design and statistical analysis of experiments using laboratory animals. ILAR J 2002; 43 (04) 244-258
  • 9 Demirel N, Gurler S. Practical approaches to the determination of the sample size in clinical studies. Kafkas Univ Vet Fak Derg 2010; 16 (02) 205-211 . DOI:10.9775/kvfd.2009.527
  • 10 . Accessed September 17, 2015
  • 11 . Accessed September 17, 2015
  • 12 Tsubouchi K, Igarashi Y, Takasu Y, Yamada H. Sericin enhances attachment of cultured human skin fibroblasts. Biosci Biotechnol Biochem 2005; 69 (02) 403-405
  • 13 Gabrielli F, Potenza C, Puddu P, Sera F, Masini C, Abeni D. Suture materials and other factors associated with tissue reactivity, infection, and wound dehiscence among plastic surgery outpatients. Plast Reconstr Surg 2001; 107 (01) 38-45
  • 14 Calkins CM, St Peter SD, Balcom A, Murphy PJ. Late abscess formation following indirect hernia repair utilizing silk suture. Pediatr Surg Int 2007; 23 (04) 349-352
  • 15 Terada S, Sasaki M, Yanagihara K, Yamada H. Preparation of silk protein sericin as mitogenic factor for better mammalian cell culture. J Biosci Bioeng 2005; 100 (06) 667-671
  • 16 Aramwit P, Kanokpanont S, Nakpheng T, Srichana T. The effect of sericin from various extraction methods on cell viability and collagen production. Int J Mol Sci 2010; 11 (05) 2200-2211
  • 17 Terada S, Nishimura T, Sasaki M, Yamada H, Miki M. Sericin, a protein derived from silkworms, accelerates the proliferation of several mammalian cell lines including a hybridoma. Cytotechnology 2002; 40 (1–3): 3-12
  • 18 Ahmed L, Ip H, Rao D, Patel N, Noorzad F. Talc pleurodesis through indwelling pleural catheters for malignant pleural effusions: retrospective case series of a novel clinical pathway. Chest 2014; 146 (06) e190-e194
  • 19 Adewole OO, De Keukeleire T, Phillips AS, Erhabor G, Noppen M. Effectiveness of thoracoscopic talc pleurodesis in the management of complicated spontaneous pneumothorax. J Bronchology Interv Pulmonol 2015; 22 (01) 48-51
  • 20 Verma A, Taha A, Venkateswaran S, Tee A. Effectiveness of medical thoracoscopy and thoracoscopic talc poudrage in patients with exudative pleural effusion. Singapore Med J 2015; 56 (05) 268-273
  • 21 Cox SE, Katlic MR. Non-intubated video-assisted thoracic surgery as the modality of choice for treatment of recurrent pleural effusions. Ann Transl Med 2015; 3 (08) 103-106
  • 22 Gonzalez AV, Bezwada V, Beamis Jr JF, Villanueva AG. Lung injury following thoracoscopic talc insufflation: experience of a single North American center. Chest 2010; 137 (06) 1375-1381
  • 23 Rehse DH, Aye RW, Florence MG. Respiratory failure following talc pleurodesis. Am J Surg 1999; 177 (05) 437-440
  • 24 Froudarakis ME, Klimathianaki M, Pougounias M. Systemic inflammatory reaction after thoracoscopic talc poudrage. Chest 2006; 129 (02) 356-361
  • 25 Arellano-Orden E, Romero-Falcon A, Juan JM, Ocaña Jurado M, Rodriguez-Panadero F, Montes-Worboys A. Small particle-size talc is associated with poor outcome and increased inflammation in thoracoscopic pleurodesis. Respiration 2013; 86 (03) 201-209
  • 26 Feito BA, Rath AM, Longchampt E, Azorin J. Experimental study on the in vivo behaviour of a new collagen glue in lung surgery. Eur J Cardiothorac Surg 2000; 17 (01) 8-13
  • 27 Petter-Puchner AH, Simunek M, Redl H, Puchner KU, Van Griensven M. A comparison of a cyanoacrylate glue (Glubran) vs. fibrin sealant (Tisseel) in experimental models of partial pulmonary resection and lung incision in rabbits. J Invest Surg 2010; 23 (01) 40-47
  • 28 Zhao Y, Yan X, Ding F, Yang Y, Gu X. The effects of different sterilization methods on silk fibroin. J Biomed Sci Eng 2011; 4 (05) 397-402