The effect of the boron-based gel on the treatment of diabetic foot ulcers: A prospective, randomized controlled trial

Formulations with Boric Acid or Aryl-Organoboron Compounds for Treating Diabetic Foot Ulcers

Boron-containing compounds (BCCs) have been proposed for the treatment of diabetes and its complications. Recent studies have reported an improvement in the design and development of pharmaceutical formulations (often gels) containing boric acid applied to the foot ulcers of humans diagnosed with diabetes. The proposed mechanisms of action of boric acid include antimicrobial effects, the modulation of inflammation and metabolism, and the induction of cell differentiation. On the other hand, recent studies have suggested that boronic acids are potent antibacterial and antifungal compounds, effective modulators of inflammation, and inducers of vascular regeneration as well as inducers of healing, and they confer attractive properties such as adhesion, interaction, and the formation of complexes in formulations. Moreover, only a handful of studies conducted in animals have suggested the effective role of some BCCs as potent enhancers of wound healing, including their actions on induced and/or infected wounds in animals with disrupted metabolism. Also, it should be mentioned that no strong interactions between boric acid and the boronic acids present in formulations have been described. The developed combination could act as an additive and complementary therapy in the treatment of diabetic ulcers in humans. Further studies are required to support the hypothesis that this combination acts through diverse mechanisms to improve healing while avoiding or limiting a local or disseminated infection. Furthermore, the safety of BCCs used for foot ulcers should be established, as should the role of these formulations as a complementary therapy in current protocols for treating patients with diabetic foot ulcers.

Exploring the role of boron-containing compounds in biological systems: Potential applications and key challenges

BACKGROUND

Boron, a naturally abundant trace element, plays a crucial role in various biological processes and influences important physiological functions such as bone health, immune response, and cellular metabolism. Its applications span diverse scientific fields including anatomy, pharmacology, reproduction, medicine, and agriculture.

OBJECTIVES

This review examines the diverse functions of boron-compounds in biological systems and highlights their therapeutic potential, challenges associated with toxicity, and mechanisms underlying their biological interactions.

METHODS

In this paper, the literature on boron action was reviewed, paying special attention to studies that examined the effects of boron on health and its therapeutic applications in multiple areas.

RESULTS

Boron exhibits broad therapeutic potential by affecting several pathways. However, excessive consumption can cause toxicity and negatively impact health. Current research only partially elucidates the mechanisms of boron's biological effects, so further studies are needed.

CONCLUSION

Understanding boron's interactions in biological systems is critical to optimizing its application in healthcare and ensuring safety. Future research will improve our knowledge of boron's biological effects and promote innovative therapeutic applications.

An Overview of Recent Clinical Trials for Diabetic Foot Ulcer Therapies

Diabetic foot ulcers (DFUs) are a major complication of diabetes, leading to high mortality, reduced quality of life, neuropathy, ischemia, infection, and amputation risks. The prevalence of these ulcers is only on the rise as more people suffer from type 2 diabetes and obesity. The current wound management involves wound dressings, offloading, debridement, and infection control, but more must be done to keep up with the rising prevalence of DFUs and the strain they put on patients and the healthcare system. To find recent therapeutic advances in DFU treatment, we searched PubMed for novel therapeutics from the past 5 years. We found a diversity of promising interventions, including advanced wound dressings and topicals, physical energy-based therapies, regenerative scaffolds, and growth factor- and cell-based therapies. Recent therapies hold significant promise in healing more DFUs faster and more effectively. Providers should consider employing safe, novel therapeutics when standard dressings are not effective.

An overview of current developments and methods for identifying diabetic foot ulcers: A survey

Diabetic foot ulcers (DFUs) present a substantial health risk across diverse age groups, creating challenges for healthcare professionals in the accurate classification and grading. DFU plays a crucial role in automated health monitoring and diagnosis systems, where the integration of medical imaging, computer vision, statistical analysis, and gait information is essential for comprehensive understanding and effective management. Diagnosing DFU is imperative, as it plays a major role in the processes of diagnosis, treatment planning, and neuropathy research within automated health monitoring and diagnosis systems. To address this, various machine learning and deep learning‐based methodologies have emerged in the literature to support healthcare practitioners in achieving improved diagnostic analyses for DFU. This survey paper investigates various diagnostic methodologies for DFU, spanning traditional statistical approaches to cutting‐edge deep learning techniques. It systematically reviews key stages involved in diabetic foot ulcer classification (DFUC) methods, including preprocessing, feature extraction, and classification, explaining their benefits and drawbacks. The investigation extends to exploring state‐of‐the‐art convolutional neural network models tailored for DFUC, involving extensive experiments with data augmentation and transfer learning methods. The overview also outlines datasets commonly employed for evaluating DFUC methodologies. Recognizing that neuropathy and reduced blood flow in the lower limbs might be caused by atherosclerotic blood vessels, this paper provides recommendations to researchers and practitioners involved in routine medical therapy to prevent substantial complications. Apart from reviewing prior literature, this survey aims to influence the future of DFU diagnostics by outlining prospective research directions, particularly in the domains of personalized and intelligent healthcare. Finally, this overview is to contribute to the continual evolution of DFU diagnosis in order to provide more effective and customized medical care.

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Boron-containing compounds as labels, drugs, and theranostic agents for diabetes and its complications

Diabetes is a disease with a high global burden. Current strategies have failed to limit the advancement and impact of the disease. Successful early diagnosis and treatment will require the development of new agents. In this sense, boron-containing compounds have been reported as agents with the ability to reduce glycemia and lipidemia. They have also been used for labeling and measuring carbohydrates and other molecules linked to the initial stages of diabetes and its progression. In addition, certain boron compounds bind to molecules related to diabetes development and their biological activity in the regulation of elevated glycemia. Finally, it should be noted that some boron compounds appear to exert beneficial effects on diabetes complications such as accelerating wound healing while ameliorating pain in diabetic patients.

The efficacy of topical sodium pentaborate formulation on hemorrhoid disease: A randomized, double-blind, placebo-controlled trial

Background

The topical application of boron has been significantly associated with intensifying wound healing. Using 3% boric acid in deep wounds significantly contributes to wound healing and reduces the duration of hospitalization in the intensive care. The objective of this study was to assess the therapeutic impact of a topical gel containing sodium pentaborate pentahydrate on the management of wounds resulting from grade 1 to 3 hemorrhoids.

Methods

In this randomized double-blind placebo-controlled trial, we applied a topical gel consisting of sodium pentaborate pentahydrate 3% on 206 eligible patients with the diagnosis of grade 1, 2, and 3 hemorrhoid diseases. Then patients were randomly allocated to two groups of sodium pentaborate pentahydrate or placebo gel with a ratio of 1:1 and received the allocated gel for four weeks. Patient hemorrhoid symptoms severity, hemorrhoid degree, and anoscopy findings were compared before and after the trial.

Results

Before the intervention, symptom severity (p > 0.05) and anoscopy findings (p = 0.815) were similar between the two groups. Subsequent to the intervention, a majority of patients in the intervention group experienced a reduction in anal itching compared to the placebo group [adjusted mean difference (aMD) 95% CI: -1.98 (-2.2 to -1.8), p = 0.007]. Moreover, resting pain [aMD (95% CI): -1.37 (-1.6 to -1.1), p = 0.015], pain during defecation [aMD (95% CI): -2.19 (-2.4 to -2.0), p = 0.005], feeling a lump in the anus (aMD (95% CI): -0.71 (-1.2 to -0.2), p = 0.011), bleeding during defecation (41.7% vs. 66.9%, p = 0.027), and hemorrhoid degree (p < 0.001) in the intervention group was less than the placebo group.

Conclusion

Our findings indicate the effectiveness of the study gel on hemorrhoid symptoms and anoscopy findings in patients.