Aloe Vera for Tissue Engineering Applications

Aloe Barbadensis Miller (Aloe Vera)

Aloe Barbadensis Miller (Aloe Vera, AV) is a widely recognized for its diverse health-promoting, skin care, and medicinal properties. This narrative review provides a comprehensive overview of AV's bioactive compounds, pharmacological activities, potential applications, its toxic and adverse effects, as well as the clinical evidence supporting AV's efficacy in disease prevention. AV contains over 200 bioactive compounds, with the inner clear gel of the leaves containing the majority of these compounds. These include phenolic acids (274.5-307.5 mg/100 g), flavonoids. (3.63-4.70 g/kg), polysaccharides (3.82-6.55 g/kg), saponins, alkaloids, terpenoids, and anthraquinone derivatives. Findings from clinical studies involving both humans and animals highlight the therapeutic potential of AV across diverse health domains. The studies demonstrate AV's efficacy in reducing blood glucose levels, exhibiting antioxidant and immunomodulatory effects, inducing apoptosis in cancer cells, protecting the liver from damage, and displaying antimicrobial properties. In the fields of dermatology and dentistry, AV has also been observed to promote skin and oral health. However, it is imperative to acknowledge potential risks, adhere to recommended dosages, and seek guidance from healthcare experts before employing AV as a natural therapeutic option. Moreover, considering safety concerns, further well-designed randomized controlled trials are necessary to substantiate the potential benefits of AV and comprehensively assess any associated risks.

Investigations on physiochemical and biomedical properties of Aloe vera - Sterculia gum copolymeric dressings impregnated with antibiotic-anesthetic drugs to enhance wound healing

Recently, various innovative advancements have been made in carbohydrate research to design versatile materials for biomedical applications. The current research focuses on the development of copolymeric hydrogel wound dressings (HWD) using a combination of aloe vera (AV) - sterculia gum (SG) - poly (vinylsulfonic acid) (VSA)-based with the aim to enhancing their efficacy in drug delivery (DD) applications. These hydrogel dressings were encapsulated with levofloxacin and lidocaine to address both microbial infection and pain. Copolymers were characterized by FESEM, SEM, EDS, AFM, 13C NMR, FTIR, XRD, and TGA-DTG analysis. Hydrogel exhibited a fluid absorption capacity of 4.52 ± 0.12 g per gram of polymeric dressing in simulated wound conditions. The hydrogels displayed a sustained release of drugs, demonstrating a non-Fickian diffusion mechanism. Polymer dressings revealed antibacterial, mucoadhesive, antioxidant, biocompatible and non-cytotoxic properties. Additionally, HWD displayed permeability to O2 and water vapour, yet was impermeable to microbial penetration. Overall, the findings of physiological, biochemical and drug delivery properties demonstrated the suitability of materials for wound dressing applications.

Comprehensive Review on Herbal Medicine: Emphasis on Current Therapy and Role of Phytoconstituents for Cancer Treatment

INTRODUCTION

Cancer poses a significant public health challenge in both developed and developing nations, with a rising global incidence of patients facing the threat of death due to abnormal cell proliferation.

AIM

Review explores the utilization of different parts of herbal medicinal plants and their active pharmaceutical constituents in the prevention and treatment of various types of cancer.

METHODOLOGY

Various anticancer medicinal plants have been identified, demonstrating their therapeutic effects by inhibiting cancer-stimulating enzymes and hormones, activating DNA repair processes, boosting the synthesis of protective stimulants, reducing the formation of free radicals, and enhancing individual immunity. Data for this study were gathered from diverse online bibliographic and databases, including Google, Google Scholar, Mendeley, Springer Link, Research Gate, and PubMed.

RESULT

Herbal drugs have a huge contribution to the inhibition of the progression of cancer.A large volume of clinical studies has reported the beneficial effects of herbal medicines on the survival, immune modulation, and quality of life (QOL) of cancer patients, when these herbal medicines are used in combination with conventional therapeutics.

CONCLUSION

The latest medicines for the clinical purpose (Above 50 %) are derived from herbal products. Furthermore, combination of these herbs with nanotechnology shows promise in treating specific carcinomas.

Aloe vera-based biomaterial ink for 3D bioprinting of wound dressing constructs

This study emphasizes the development of a multifunctional biomaterial ink for wound healing constructs. The biomaterial ink benefits from Aloe vera's intrinsic biocompatible, biodegradable, antioxidant, antimicrobial, anti-inflammatory, and immunomodulatory attributes, thus alleviating the need for supplementary substances employed to combat infections and stimulate tissue regeneration. Moreover, this biomaterial ink seeks to address the scarcity of standardized printable materials possessing adequate biocompatibility and physicochemical properties, which hinder its widespread clinical adoption. The biomaterial ink was synthesized via ionic crosslinking to enhance its rheological and mechanical characteristics. The findings revealed that Aloe vera substantially boosted the hydrogel's viscoelastic behavior, enabling superior compressive modulus and the extrusion of fine filaments. The bioprinted constructs exhibited desirable resolution and mechanical strength while displaying a porous microstructure analogous to the native extracellular matrix. Biological response demonstrated no detrimental impact on stem cell viability upon exposure to the biomaterial ink, as confirmed by live/dead assays. These outcomes validate the potential of the developed biomaterial ink as a resource for the bioprinting of wound dressings that effectively foster cellular proliferation, thereby promoting enhanced wound healing by leveraging Aloe vera's inherent properties.

Optimization of foaming process for development of modified aloe polysaccharide (MAP) juice and powder using foam-mat drying

The present study was performed to optimize the modified aloe polysaccharide (MAP) foaming process and to determine the effect of drying process parameters on the quality of obtained MAP powder. The studied process parameters were glycerol monostearate (GMS), carboxymethyl cellulose (CMC), and whipping time (WT) which was varied between 1 and 4% w/v, 0.1-0.5% w/v, and 1-5 min, respectively. The optimized values of foaming process parameters were 3.87% GMS, 0.39% CMC, and 4.89 min WT with a desirability of 0.889. The optimized foamed MAP juice was dried at different foam thicknesses (FT) (1, 3, and 5 mm) and drying temperatures (DT) (50, 60, and 70 °C) to develop MAP powder and compared with non-foamed aloe powder developed under the same drying condition. Based on functional properties, the best GMS foamed MAP powder was achieved at 50 °C DT and 1 mm FT, recording powder yield (16%), solubility (20.85%), and polysaccharide content (282 mg/L).

Graphical abstract

Supplementary Information

The online version contains supplementary material available at 10.1007/s10068-023-01354-6.

Effects of using collagen and aloe vera grafted fibroin scaffolds on osteogenic differentiation of rat bone marrow mesenchymal stem cells in SBF-enriched cell culture medium

In the study, collagen and aloe vera were grafted onto silk fibroin with two different methods, and 3D-microporous scaffolds (1F5C4A1 and 2F5C4A1) were formed by lyophilization. Three osteogenic cultures were started by seeding rat bone marrow mesenchymal stem cells (MSCs) and pre-induced MSC (osteoblast (OB)) on biopolymeric scaffolds. The osteogenic medium was enriched with 10% (v/v) simulated body fluid (SBF) to promote mineralization and osteogenic differentiation in one of the MSC cultures and the OB culture. X-ray diffraction (XRD), scanning electron microscopy (SEM), scanning electron microscopy- energy dispersive spectrum (SEM-EDS) analyses on cellular samples and histochemical (alizarin red, safranin-O, alcian blue) and immunohistochemical (anti-collagen-1, anti-osteocalcin, anti-osteopontin) staining showed that bone-like mineralization was occurred by both chemically and cellular activity. In addition, pre-osteogenic induction of MSCs in 2D-cultured was found to promote osteogenesis more rapidly when started 3D-cultured. These results indicated that enrichment of the cell culture medium with SBF is sufficient forin vitromineralization rather than using high concentrations of SBF. The findings showed that OB cells on the 2F5C4A1 scaffold obtained the best osteogenic activity. Still, other culture media with 10% SBF content could be used for bone tissue engineering under osteogenic induction.

Regenerative potential of a novel aloe vera modified tricalcium silicate cement as a pulp capping material: An animal study

This study compared the histologic response of a pulp capping material Matreva MTA modified with different concentrations of aloe vera (AV) solutions to Biodentine cement. Ninety dogs' teeth were included and categorized according to the capping material into five groups (18 teeth each); Group I (Biodentine), group II (Matreva MTA), group III (Matreva MTA 10% AV), group IV (Matreva MTA 20% AV) and group V (Matreva MTA 30% AV). The histopathological findings were recorded at 2, 4, and 8 weeks. Matreva MTA and Biodentine groups showed the highest inflammatory cell count compared to the AV-modified Matreva MTA groups at 2- and 4-week intervals (p>0.05). Moreover, the AV-modified Matreva MTA and Biodentine groups showed higher dentin bridge thickness compared to unmodified Matreva MTA at different follow-up periods (p<0.05). AV can significantly enhance the in vivo bioactivity of Matreva MTA, inducing mild inflammation and good dentine bridge formation comparable to Biodentine.

Tissue succulence in plants: Carrying water for climate change

Tissue succulence in plants involves the storage of water in one or more organs or tissues to assist in maintaining water potentials on daily or seasonal time scales. This drought-avoidance or drought-resistance strategy allows plants to occupy diverse environments including arid regions, regions with rocky soils, epiphytic habitats, and saline soils. Climate-resilient strategies are of increasing interest in the context of the global climate crisis, which is leading to hotter and drier conditions in many regions throughout the globe. Here, we describe a short history of succulent plants, the basic concepts of tissue succulence, the anatomical diversity of succulent morphologies and associated adaptive traits, the evolutionary, phylogenetic, and biogeographical diversity of succulent plants, extinction risks to succulents due to poaching from their natural environments, and the myriad uses and applications of economically important succulent species and the products derived from them. Lastly, we discuss current prospects for engineering tissue succulence to improve salinity and drought tolerance in crops.

Biopolymer collagen-chitosan scaffold containing Aloe vera for chondrogenic efficacy on cartilage tissue engineering

The chondrogenic efficacy of aloe vera blended collagen-chitosan (COL-CS-AV) porous scaffold was investigated using articular chondrocytes in a standard condition. Cytocompatibility was analyzed using fluorescent dyes (calcein AM/ethidium bromide) and the viable cells were quantified by MTT assay. Glycosaminoglycan (GAG) content of ECM was estimated by using 1, 9-Dimethyl methylene Blue (DMMB). The total RNA content was quantified and the cartilage specific genes (col2a1, Acan) were amplified by reverse transcription-PCR from the cell lysate of the scaffolds. Histological examination was made using Haematoxylin and Eosin (H&E), safranin-O, masson's trichrome, alcian blue, and alizarin red to stain the specific component of ECM secreted on the construct. The cartilage specific collagen type II was estimated by immunohistochemistry using monoclonal type II collagen antibody. The results of these studies proved that COL-CS-AV scaffold has more chondrogenic efficacy than COL-CS, thus the aloe vera blend COL-CS-AV scaffold might be used as suitable candidate for cartilage tissue engineering.

Aloe vera-Based Hydrogels for Wound Healing: Properties and Therapeutic Effects

Aloe vera-based hydrogels have emerged as promising platforms for the delivery of therapeutic agents in wound dressings due to their biocompatibility and unique wound-healing properties. The present study provides a comprehensive overview of recent advances in the application of Aloe vera-based hydrogels for wound healing. The synthesis methods, structural characteristics, and properties of Aloe vera-based hydrogels are discussed. Mechanisms of therapeutic agents released from Aloe vera-based hydrogels, including diffusion, swelling, and degradation, are also analyzed. In addition, the therapeutic effects of Aloe vera-based hydrogels on wound healing, as well as the reduction of inflammation, antimicrobial activity, and tissue regeneration, are highlighted. The incorporation of various therapeutic agents, such as antimicrobial and anti-inflammatory ones, into Aloe vera-based hydrogels is reviewed in detail. Furthermore, challenges and future prospects of Aloe vera-based hydrogels for wound dressing applications are considered. This review provides valuable information on the current status of Aloe vera-based hydrogels for the delivery of therapeutic agents in wound dressings and highlights their potential to improve wound healing outcomes.

Multifunctional and biodegradable methacrylated gelatin/Aloe vera nanofibers for endodontic disinfection and immunomodulation

Currently employed approaches and materials used for vital pulp therapies (VPTs) and regenerative endodontic procedures (REPs) lack the efficacy to predictably achieve successful outcomes due to their inability to achieve adequate disinfection and/or lack of desired immune modulatory effects. Natural polymers and medicinal herbs are biocompatible, biodegradable, and present several therapeutic benefits and immune-modulatory properties; thus, standing out as a clinically viable approach capable of establishing a conducive environment devoid of bacteria and inflammation to support continued root development, dentinal bridge formation, and dental pulp tissue regeneration. However, the low stability and poor mechanical properties of the natural compounds have limited their application as potential biomaterials for endodontic procedures. In this study, Aloe vera (AV), as a natural antimicrobial and anti-inflammatory agent, was incorporated into photocrosslinkable Gelatin methacrylate (GelMA) nanofibers with the purpose of developing a highly biocompatible biomaterial capable of eradicating endodontic infection and modulating inflammation. Stable GelMA/AV nanofibers with optimal properties were obtained at the ratio of (70:30) by electrospinning. In addition to the pronounced antibacterial effect against Enterococcus faecalis, the GelMA/AV (70:30) nanofibers also exhibited a sustained antibacterial activity over 14 days and significant biofilm reduction with minimal cytotoxicity, as well as anti-inflammatory properties and immunomodulatory effects favoring healing. Our results indicate that the novel GelMA/AV (70:30) nanofibers hold great potential as a biomaterial strategy for endodontic infection eradication and enhanced healing.

Preparation and Characterization of Polycaprolactone (PCL) Antimicrobial Wound Dressing Loaded with Pomegranate Peel Extract

In recent years, medicinal plant extracts have received remarkable attention due to their wound-healing properties. In this study, polycaprolactone (PCL) electrospun nanofiber membranes incorporated with different concentrations of pomegranate peel extract (PPE) were prepared. The results of the SEM and FTIR experiments demonstrated that the morphology of nanofiber is smooth, fine, and bead-free, and the PPE was well introduced into the nanofiber membranes. Moreover, the outcomes of the mechanical property tests demonstrated that the nanofiber membrane made of PCL and loaded with PPE exhibited remarkable mechanical characteristics, indicating that it could fulfill the essential mechanical requisites for wound dressings. The findings of the in vitro drug release investigations indicated that PPE was instantly released within 20 h and subsequently released gradually over an extended period by the composite nanofiber membranes. Meanwhile, the DPPH radical scavenging test confirmed that the nanofiber membranes loaded with PPE exhibited significant antioxidant properties. Antimicrobial experiments showed higher PPE loading, and the nanofiber membranes showed higher antimicrobial activity against Staphylococcus aureus, Escherichia coli, and Candida albicans. The results of the cellular experiments showed that the composite nanofiber membranes were nontoxic and promoted the proliferation of L929 cells. In summary, electrospun nanofiber membranes loaded with PPE can be used as a wound dressing.

Formulation of pH-responsive highly swellable hydrogel scaffolds for controlled release of tramadol HCl: characterization and biocompatibility evaluation

Introduction: The objective of current project was to formulate a system for controlled delivery of Tramadol HCl (TRD), an opioid analgesic used in the treatment of moderate to severe pain. Methods: For this purpose, a pH responsive AvT-co-poly hydrogel network was formulated through free radical polymerization by incorporating natural polymers i.e., aloe vera gel and tamarind gum, monomer and crosslinker. Formulated hydrogels were loaded with Tramadol HCl (TRD) and evaluated for percent drug loading, sol-gel fraction, dynamic and equilibrium swelling, morphological characteristics, structural features and in-vitro release of Tramadol HCl. Results and Discussions: Hydrogels were proved to be pH sensitive as remarkable dynamic swelling response ranging within 2.94g/g-10.81g/g was noticed at pH 7.4 as compared to pH 1.2. Percent drug loading was in the range of 70.28%-90.64% for all formulations. Thermal stability and compatibility of hydrogel components were validated by DSC analysis and FTIR spectroscopy. Controlled release pattern of Tramadol HCl from the polymeric network was confirmed as maximum release of 92.22% was observed for over a period of 24 hours at pH 7.4. Moreover, oral toxicity studies were also conducted in rabbits to investigate the safety of hydrogels. No evidence of any toxicity, lesions and degeneration was reported, confirming the biocompatibility and safety of grafted system.

Asymmetric tri-layer sponge-nanofiber wound dressing containing insulin-like growth factor-1 and multi-walled carbon nanotubes for acceleration of full-thickness wound healing

To more closely resemble the structure of natural skin, multi-layered wound dressings have been developed. Herein, a tri-layer wound dressing was prepared containing a polyacrylamide (PAAm)-Aloe vera (Alo) sponge that had been incorporated with insulin-like growth factor-1 (IGF1) to provide a porous absorbent layer, which was able to promote angiogenesis. Alo nanofibers with multi-walled carbon nanotubes (MWCNT) were electrospun into the bottom layer to increase cell behavior, and a small film of stearic acid was put as a top layer to avoid germy penetration. In comparison to bilayer dressing, the tensile strength increased by 17.0 % (from 0.200 ± 0.010 MPa to 0.234 ± 0.022 MPa) and the elastic modulus by 45.6 % (from 0.217 ± 0.003 MPa to 0.316 ± 0.012 MPa) in the presence of Alo nanofibers containing 0.5 wt% of MWCNT at the bottom layer of Trilayer0.5 dressing. The release profile of IGF1, the antibacterial activity and the degradability of different wound dressings were investigated. Trilayer0.5 indicated the highest cell viability, cell adhesion and angiogenic potential among the prepared dressing materials. In-vivo rat model revealed that the Trilayer0.5 dressing treated group had the highest rate of wound closure and wound healing within 10 days compared to other groups.

Development and evaluation of pH sensitive semi-interpenetrating networks: assessing the impact of itaconic acid and aloe vera on network swelling and cetirizine release

Hydrogels are crosslinked three-dimensional networks, and their properties can be easily tuned to target the various segments of the gastrointestinal tract (GIT). Cetirizine HCl (CTZ HCl) is an antihistaminic drug, which when given orally can upset the stomach. Moreover, this molecule has shown maximum absorption in the intestine. To address these issues, we developed a pH-responsive semi-interpenetrating polymer network (semi-IPN) for the delivery of CTZ HCl to the lower part of the GIT. Initially, 10 different formulations of itaconic acid-grafted-poly (acrylamide)/aloe vera [IA-g-poly (AAm)/aloe vera] semi-IPN were developed by varying the concentration of IA and aloe vera using the free radical polymerization technique. Based on swelling and sol-gel analysis, formulation F5 containing 0.3%w/w aloe vera and 6%w/w IA was chosen as the optimum formulation. The solid-state characterization of the optimized formulation (F5) revealed a successful incorporation of CTZ HCl in semi-IPN without any drug-destabilizing interaction. The in vitro drug release from F5 showed limited release in acidic media followed by a controlled release in the intestinal environment for over 72 h. Furthermore, during the in vivo evaluation, formulation F5 did not affect the hematological parameters, kidney, and liver functions. Clinical observations did not reveal any signs of illness in rabbits treated with hydrogels. Histopathological images of vital organs of treated animals showed normal cellular architecture. Thus, the results suggest a non-toxic nature and overall potential of the developed formulation as a targeted drug carrier.

High-Content Aloe vera Based Hydrogels: Physicochemical and Pharmaceutical Properties

The present research focuses on the physicochemical and pharmacotechnical properties of new hydrogels obtained using allantoin, xanthan gum, salicylic acid and different concentrations of Aloe vera (5, 10, 20% w/v in solution; 38, 56, 71 wt% in dry gels). The thermal behavior of Aloe vera composite hydrogels was studied using DSC and TG/DTG analyses. The chemical structure was investigated using different characterization methods (XRD, FTIR and Raman spectroscopies) and the morphology of the hydrogels was studied SEM and AFM microscopy. Pharmacotechnical evaluation on tensile strength and elongation, moisture content, swelling and spreadability was also completed. Physical evaluation confirmed that the appearance of the prepared Aloe vera based hydrogels was homogeneous and the color varied from pale beige to deep opaque beige with increasing Aloe vera concentration. All other evaluation parameters, e.g., pH, viscosity, spreadability and consistency were found to be adequate in all hydrogel formulations. SEM and AFM images show that the structure of the hydrogels condensed into homogeneous polymeric solids with the addition of Aloe vera, in accordance with the decrease in peak intensities observed via XRD analysis. These results suggest interactions between the hydrogel matrix and Aloe vera as observed via FTIR and TG/DTG and DSC analyses. Considering that Aloe vera content higher than 10% (w/v) did not stimulate further interactions, this formulation (FA-10) can be used for further biomedical applications.

Recent progress in the manipulation of biochemical and biophysical cues for engineering functional tissues

Tissue engineering (TE) is currently considered a cutting-edge discipline that offers the potential for developing treatments for health conditions that negatively affect the quality of life. This interdisciplinary field typically involves the combination of cells, scaffolds, and appropriate induction factors for the regeneration and repair of damaged tissue. Cell fate decisions, such as survival, proliferation, or differentiation, critically depend on various biochemical and biophysical factors provided by the extracellular environment during developmental, physiological, and pathological processes. Therefore, understanding the mechanisms of action of these factors is critical to accurately mimic the complex architecture of the extracellular environment of living tissues and improve the efficiency of TE approaches. In this review, we recapitulate the effects that biochemical and biophysical induction factors have on various aspects of cell fate. While the role of biochemical factors, such as growth factors, small molecules, extracellular matrix (ECM) components, and cytokines, has been extensively studied in the context of TE applications, it is only recently that we have begun to understand the effects of biophysical signals such as surface topography, mechanical, and electrical signals. These biophysical cues could provide a more robust set of stimuli to manipulate cell signaling pathways during the formation of the engineered tissue. Furthermore, the simultaneous application of different types of signals appears to elicit synergistic responses that are likely to improve functional outcomes, which could help translate results into successful clinical therapies in the future.

Physico-mechanical and ex vivo analysis of aloe-alginate hydrogels for cervical cancer treatment

A leading cancer diagnosis in women worldwide is cervical cancer, with current treatments all posing a risk of serious side effects. Less toxic, but effective treatments are sought after. Aloe vera ( barbadensis miller), known for its beneficial properties, has been studied for cancer treatment. While aloe gel has been shown to exhibit anti-cancer activity, it cannot form a hydrogel alone. Therefore, an interpenetrating network comprising alginate blended with aloe was examined as a cervical cancer treatment. We hypothesized the antioxidant properties of aloe gel would decrease cancer cell viability while the alginate hydrogel would improve mucoadhesion. We further hypothesized the antioxidant activity of aloe gel would induce cancer cell death at levels similar to common chemotherapeutics, and aimed to determine if these chemotherapeutic behaviors are constructive or destructive. Material and adhesive properties, drug encapsulation, and cancer cell viability were investigated and validated. The effect of aloe-alginate hydrogels on cervical cancer cell viability was not significantly different compared to aloe-blends containing doxorubicin (DOX), indicating that the aloe alone decreased cancer cell viability rendering the additional cytotoxic therapeutic not impactful as an adjuvant therapy. This study provides insight into the potential of natural biopolymers for treating cervical cancer without systemic toxic compounds.

Aloe vera and ofloxacin incorporated chitosan hydrogels show antibacterial activity, stimulate angiogenesis and accelerate wound healing in full thickness rat model

Burns are potentially fatal and physically debilitating injuries, causing psychological and physical scars and result in chronic disabilities. A well vascularized wound bed is required to achieve complete and scar free wound closure. For many centuries, a variety of herbal plants have been used for wound healing, among these aloe vera (AV) has been found to be very effective in wound healing. Secondly, the main reason for delayed wound healing is bacterial infections. Ofloxacin (OX) has been reported as an active antibacterial drug for topical infections and it is effective against both positive and negative bacterial strains. In current research three different concentrations of OX (0.5, 2.5, and 5 mg) were loaded into chitosan (CS)/AV based hydrogels prepared by freeze gelation. The surface morphology of prepared CS/AV based OX loaded hydrogels were evaluated by scanning electron microscopy (SEM). In drug release analysis, 0.5 mg OX loaded hydrogel showed a sustained drug release behavior over 3 days period. An effective dose dependent antibacterial activity was exhibited by OX loaded hydrogels. Alamar Blue cells viability assay revealed that 0.5 mg OX hydrogel (CA 0.5 OX) showed comparatively better 3 T3 fibroblast cells proliferation as compared to CA 2.5 OX (2.5 mg OX) and CA 5 OX hydrogel (5 mg OX). Moreover, all OX loaded hydrogels showed good angiogenic activity in CAM bioassay while higher angiogenic potential was observed from CA 0.5 OX containing comparatively lower concentration of OX. These OX incorporated CS/AV based hydrogels are promising wound dressings for future clinical use.

The Therapeutic Wound Healing Bioactivities of Various Medicinal Plants

The skin serves as the body's first line of defense, guarding against mechanical, chemical, and thermal damage to the interior organs. It includes a highly developed immune response that serves as a barrier against pathogenic infections. Wound healing is a dynamic process underpinned by numerous cellular activities, including homeostasis, inflammation, proliferation, and remodeling, that require proper harmonious integration to effectively repair the damaged tissue. Following cutaneous damage, microorganisms can quickly enter the tissues beneath the skin, which can result in chronic wounds and fatal infections. Natural phytomedicines that possess considerable pharmacological properties have been widely and effectively employed forwound treatment and infection prevention. Since ancient times, phytotherapy has been able to efficiently treat cutaneous wounds, reduce the onset of infections, and minimize the usage of antibiotics that cause critical antibiotic resistance. There are a remarkable number of wound-healing botanicals that have been widely used in the Northern Hemisphere, including Achiella millefolium, Aloe vera, Althaea officinalis, Calendula officinalis, Matricaria chamomilla, Curcuma longa, Eucalyptus, Jojoba, plantain, pine, green tea, pomegranate, and Inula. This review addresses the most often used medicinal plants from the Northern Hemisphere that facilitate the treatment of wounds, and also suggests viable natural alternatives that can be used in the field of wound care.

Antiamnesic Effects of Feralolide Isolated from Aloe vera Resin Miller against Learning Impairments Induced in Mice

Feralolide, a dihydroisocoumarin, was isolated from the methanolic extract of resin of Aloe vera. The present study aims to investigate the in vivo ability of feralolide to ameliorate memory impairment induced by scopolamine using a battery of in vitro assays, such as antioxidant and acetylcholinesterase (AChE) and butyrylcholinesterase (BuChE) inhibition, and in vivo animal models, including elevated plus maze, Morris water maze, passive avoidance, and novel object recognition tests. Feralolide caused a concentration-dependent inhibition of AChE and BuChE enzymes with IC50 values of 55 and 52 μg/mL, respectively, and antioxidant activity against 2,2-diphenyl-1-picrylhydrazyl (DPPH) and 2, 2′-azinobis-3-ethylbenzothiazoline-6-sulfonic acid (ABTS) with IC50 values 170 and 220 μg/mL, respectively. Feralolide reversed the scopolamine-induced amnesia as indicated by a dose-dependent decrease in escape latency, path length, and passing frequency in the Morris water maze test compared with the relevant control. The compound also significantly increased the discrimination index in a dose-dependent manner in NORT and decreased transfer latency in EPM, reflective of its memory-enhancing effect. Furthermore, feralolide also caused significant dose-dependent elevation in the step-down latency (SDL) in the passive avoidance test. The results indicated that feralolide might be a helpful memory restorative mediator in treating cognitive disorders such as Alzheimer’s disease.

Wool Keratin Nanofibers for Bioinspired and Sustainable Use in Biomedical Field

Keratin is a biocompatible and biodegradable protein as the main component of wool and animal hair fibers. Keratin-based materials support fibroblasts and osteoblasts growth. Keratin has been extracted by sulphitolysis, a green method (no harmful chemicals) with a yield of 38-45%. Keratin has been processed into nanofibers from its solutions by electrospinning. Electrospinning is a versatile and easy-to-use technique to generate nanofibers. It is an eco-friendly and economical method for the production of randomly and uniaxially oriented polymeric nanofibers. Thanks to their high specific surface area, nanofibers have great potential in the biomedical field. Keratin nanofibers have received significant attention in biomedical applications, such as tissue engineering and cell growth scaffolds, for their biocompatibility and bio-functionality. Accordingly, we propose an extensive overview of recent studies focused on the optimization of keratinbased nanofibers, emphasizing their peculiar functions for cell interactions and the role of additive phases in blends or composite systems to particularize them as a function of specific applications (i.e., antibacterial).

Effects of Carbon Nanomaterials and Aloe vera on Melanomas—Where Are We? Recent Updates

Melanoma is an aggressive skin cancer that affects approximately 140,000 people worldwide each year, with a high fatality rate. Available treatment modalities show limited efficacy in more severe cases. Hence, the search for new treatment modalities, including immunotherapies, for curing, mitigating, and/or preventing cancer is important and urgently needed. Carbon nanoparticles associated with some plant materials, such as Aloe vera, have shown appealing antineoplastic activity, derived mainly from the compounds aloin, aloe-emodin, barbaloin acemannan, and octapeptide, thus representing new possibilities as antitumor agents. This systematic review aims to arouse interest and present the possibilities of using Aloe vera combined with carbon-based nanomaterials as an antineoplastic agent in the treatment and prevention of melanoma. Limitations and advances in melanoma treatment using functionalized carbon nanomaterials are discussed here. Moreover, this review provides the basis for further studies designed to fully explore the potential of carbon nanomaterials associated with Aloe vera in the treatment of various cancers, with a focus on melanoma.

New Amorphous Hydrogels with Proliferative Properties as Potential Tools in Wound Healing

The study and discovery of bioactive compounds and new formulations as potential tools for promoting the repair of dermoepidermal tissue in wound healing is of continuing interest. We have developed a new formulation of amorphous hydrogel based on sodium alginate (NaAlg); type I collagen, isolated by the authors from silver carp tails (COL); glycerol (Gli); Aloe vera gel powder (AV); and silver nanoparticles obtained by green synthesis with aqueous Cinnamomum verum extract (AgNPs@CIN) and vitamin C, respectively. The gel texture of the amorphous hydrogels was achieved by the addition of Aloe vera, demonstrated by a rheological analysis. The evaluations of the cytotoxicity and cell proliferation capacity of the experimental amorphous hydrogels were performed against human foreskin fibroblast Hs27 cells (CRL-1634-ATCC). The developed gel formulations did not show a cytotoxic effect. The hydrogel variant containing AgNPs@CIN in a concentration of 8 µg Ag/gel formulation and hydrogel variant with vitamin C had proliferative activity. In addition, the antibacterial activity of the hydrogels was evaluated against S. aureus ATCC 6538, Ps. aeruginosa ATCC 27853, and E. coli ATCC 25922. The results demonstrated that the gel variant based on AgNPs@CIN in a concentration of 95 µg Ag/gel formulation and the hydrogel based on vitamin C show antibacterial activity. Therefore, the developed hydrogels with AgNPs@CIN and vitamin C could be promising alternatives in wound healing.

Aloe vera incorporated starch-64S bioactive glass-quail egg shell scaffold for promotion of bone regeneration

Simultaneous promotion of osteoconductive and osteoinductive characteristics through combining bioactive glasses with natural polymers is still a challenge in bone tissue engineering. Starch, 64S bioactive glass (BG), aloe vera (AV) and quail eggshell powder (QE) were utilized to achieve biodegradable, bioactive, biocompatible and mechanically potent multifunctional scaffolds, using freeze-drying mechanism. Cell viability for starch-BG-AV-QE scaffolds at 3 and 7 day intervals was reported to be over 95 %. Acridine orange staining was employed to study live/dead cells cultured on the scaffolds. The high sufficiency of starch-BG-AV-QE scaffolds in osteogenic differentiation and extracellular matrix mineralization was confirmed through alkaline phosphatase activity and alizarin red staining assessments after 7 and 14 days of cell culture. High compressive strength, managed biodegradability and expression of osteocalcin and osteopontin as late markers of osteogenic differentiation were also reached in the range of 30-75 % for starch-BG-AV-QE scaffolds. Hence, starch-BG-AV-QE scaffolds with ideal physico-mechanical and biological characteristics can be considered as promising candidates for promotion of bone regeneration.

Promoting keratocyte stem like cell proliferation and differentiation by aligned polycaprolactone-silk fibroin fibers containing Aloe vera

There is a long history behind applying biological macromolecules like Aloe vera (AV) in regenerative medicine; endowed with anti-inflammatory and antimicrobial activities besides improving immune activity, AV has always been of particular interest to regenerate/reconstruct injuries and burns. In the present study, aligned electrospun polycaprolactone (PCL)-silk fibroin (SF) fibers containing different percentages of AV (0, 2.5, 5, and 7.5%wt) were fabricated for stromal regeneration. The results illustrated that a uniform bead-free structure was obtained, and the AV incorporation decreased the mean fiber diameter from 552 down to 182 nm and led to more alignment in the fibers. The Young's modulus raised from 4.96 to 5.26 MPa by higher amount of AV up to 5%wt. It is noteworthy that both the fiber alignment and AV affected the scaffolds' transparency and water uptake to increase. The human stromal keratocyte cells (hSKC)s culture revealed that the addition of AV and morphological properties of scaffolds encouraged cell adhesion and proliferation. The mRNA expression level for keratocan and ALDH3A1 and immunocytochemistry F-actin revealed the positive effect of AV on hSKCs differentiation. Our study indicated the promising potential of AV as a biological macromolecule for stromal tissue regeneration.

In Silico Analysis of Glycosaminoglycan-Acemannan as a Scaffold Material on Alveolar Bone Healing

OBJECTIVE

 This study aimed to analyze interaction between glycosaminoglycan-acemannan as a scaffold material and toll-like receptor-2 (TLR-2) receptor, which predicted the osteogenesis potency on alveolar bone healing (in silico analysis).

MATERIALS AND METHODS

 Docking interaction between glycosaminoglycan-acemannan and TLR-2 receptor using the Molegro Virtual Docker (MVD) program. The compounds of glycosaminoglycan-acemannan and TLR-2 receptor with the structure in the form of two- and three-dimensional images were analyzed, as well as the most stable structure. It was observed the interaction of the ligand on the cavity of the TLR-2 receptor structure. The energy required for the ligand and receptor interaction (Moldock score) was calculated with MPD program.

RESULTS

 The chemical structure shows that glycosaminoglycan-acemannan is capable binding to the TLR-2 receptor with hydrogen bonds and strong steric interaction. The docking results were detected for five cavities where the compound binds to the TLR-2 receptor. The Moldock score of the ligand on the CAS-LYS-LEU-ARG-LYS-ILE-MSE[A] ligand was -95,58 Kcal/mol, that of acemannan was -91,96 Kcal/mol, and for glycosaminoglycan -61,14 Kcal/mol.

CONCLUSION

 The compound of glycosaminoglycan-acemannan as a scaffold material is able to bind with a TLR-2 target receptor, which predicted osteogenesis activity on alveolar bone healing supported by in silico analysis.

Understanding the cellular response of human tenon fibroblast on polycaprolactone-Aloe vera blend fiber

The signalling response is determined by the cell's reaction to different biochemical and biophysical inputs such as stiffness, topological, and structural alignment. The surface patterns at the nano-scale can be an influential factor in cell signalling behaviour. It is important to understand the cellular response to the biophysical cues for biomedical applications. Biomaterials have an important role in regenerative tissue engineering. In this study, we have fabricated electrospun polycaprolactone (PCL) and PCL-Aloe vera (PCL-AV) nanofibrous matrix and studied its effect on the human tenon fibroblast (HTF) cellular and morphological changes. The electrospun fibers were characterized using Scanning Electron Microscope (SEM), Fourier Transform Infrared spectroscopy (FTIR), Atomic Force Microscopy (AFM) and Brunaur, Emette and Teller (BET) analysis for their morphology, composition, topography, surface area and porosity. The results revealed fiber size, roughness and porosity has been altered by addition of AV. The HTF cell viability, proliferation and expression of focal adhesion proteins, such as FAK, Ezrin, Vasp and Cofilin on the PCL-AV fiber matrix were examined. The results showed a change in cellular morphology and a significant change in the cofilin phosphorylation on PCL-AV nanofiber. The influence of Aloe vera composition on the nano-dimension of the PCL has made a significant impact on the cellular morphology at both gene and protein levels. This observation suggests that AV composition in the nanofiber can significantly influence the HTF cellular adhesions.

Bio-Hybrid Hydrogels Incorporated into a System of Salicylic Acid-pH/Thermosensitive Nanocarriers Intended for Cutaneous Wound-Healing Processes

In this paper, the preparation method of bio-hybrid hydrogels incorporated into a system of salicylic acid-pH/thermosensitive nanocarriers to speed up the wound-healing process was developed. This combination creates a dual drug delivery system, which releases the model hydrophobic active substance—salicylic acid—in a gradual and controlled manner for an extended time. Our research team has determined the various properties of bio-hybrid hydrogels based on their physicochemical (swelling degree, and degradation), structural (FT-IR), morphological (SEM), and mechanical (elongation tests) traits. Moreover, empty pH/thermosensitive nanocarriers and their salicylic acid-containing systems were characterized using the following methods: DLS, TG/DTG, and DSC. Additionally, salicylic acid release profiles directly from thermosensitive nanocarriers were compared to the bio-hybrid matrix. These studies were conducted in PBS (pH = 7.4) for 7 days using the USP4 method. To evaluate the antibacterial properties of the obtained materials, the inhibition of growth of Staphylococcus aureus, Escherichia coli, Candida albicans, and Aspergillus niger—as the main microorganisms responsible for human infections—were tested. The obtained results indicated that the pH/thermosensitive nanocarrier–salicylic acid system and bio-hybrid hydrogels are characterized by antibacterial activity against both S. aureus and E. coli.

Fabrication, characterization and evaluation of the efficacy of gelatin/hyaluronic acid microporous scaffolds suffused with aloe-vera in a rat burn model

Burn induced injuries are commonly encountered in civilian and military settings, leading to severe morbidity and mortality. Objective of this study was to construct microporous bioactive scaffolds of gelatin-hyaluronic acid suffused with aloe-vera gel (Gela/HA/AvG), and to evaluate their efficacy in healing partial-thickness burn wounds. Scaffolds were characterized using Fourier transform-infrared spectroscopy, Scanning electron microscopy, and Thermo-gravimetric analysis to understand intermolecular interactions and morphological characteristics. In-vitro fluid uptake ability and hemolytic index of test scaffolds were also determined. In-vitro collagenase digestion was done to assess biodegradability of scaffolds. Wound retraction studies were carried out in Sprague Dawley rats inflicted with partial-thickness burn wounds to assess and compare efficacy of optimized scaffolds with respect to negative and positive control groups. In-vivo gamma scintigraphy using Technetium-99m labeled Immunoglobulin-G (^99mTc-IgG) as imaging agent was also performed to validate efficacy results. Histological and immunohistochemical comparison between groups was also made. Scaffolds exhibited mircoporous structure, with pore size getting reduced from 41.3 ± 4.3 µm to 30.49 ± 5.7 µm when gelatin conc. was varied from 1% to 5%. Optimized test scaffolds showed sustained in-vitro swelling behavior, were biodegradable and showed hemolytic index in range of 2.4-4.3%. Wound retraction study along with in-vivo gamma scintigraphy indicated that Gela/HA/AvG scaffolds were not only able to reduce local inflammation faster but also accelerated dermis regeneration. Immunohistochemical analysis, in terms of expression levels of epidermal growth factor and fibroblast growth factor-2 also corroborated in-vivo efficacy findings. Gela/HA/AvG scaffolds, therefore, can potentially be developed into an effective dermal regeneration template for partial-thickness burn wounds.

Safety and Efficacy of Proctosoll Allevia in the Management of Haemorrhoidal Disease in Adults: A Prospective Randomized Clinical Trial

INTRODUCTION

Hemorrhoidal Disease (HD) is a very common anorectal disorder that affects millions of people around the world and represents a major medical and socioeconomic problem. The aim of the present study was to assess the safety and efficacy of Proctosoll Allevia® in patients affected by symptomatic HD in comparison with the results obtained from a control group.

MATERIALS AND METHODS

From January to February 2019, all the patients referred to the outpatient clinic of Rajalakshmi Hospital, who were complaining of first or second degree hemorrhoidal symptoms, were enrolled in the study. They were randomly assigned to either of the 2 arms. Group 1: patients were treated with the Proctosoll Allevia® and were under a controlled diet. Group 2: patients were only under a controlled diet without any treatment - control group.

RESULTS

A total of 51 subjects were screened and 45 (13 F- 32 M) enrolled in the study. All the patients treated with topical application of the cream showed a statistically significant improvement of symptoms within 14 days from the beginning of the therapy if compared to patients who were treated only with a controlled diet. No major adverse events associated with the use of the new product were recorded.

CONCLUSION

The treatment of I-II degree symptomatic HD with Proctosoll Allevia® has demonstrated to be promising with a good profile of tolerability, safety and efficacy.

Pharmacodynamics of Aloe vera and acemannan in therapeutic applications for skin, digestion, and immunomodulation

Scientific studies of Aloe vera have tentatively explained therapeutic claims from a mechanistic perspective. Furthermore, in vitro outcomes demonstrate that the breakage of acemannan chains into smaller fragments enhances biological effects. These fragments can intravenously boost vaccine efficacy or entrain the immune system to attack cancer cells by mannose receptor agonism of macrophage or dendritic cells. With oral consumption, epithelialisation also occurs at injured sites in the small intestine or colon. The main advantage of dietary acemannan is the attenuation of the digestive process, increasing satiety, and slowing the release of sugars from starches. In the colon, acemannan is digested by microbes into short-chain fatty acids that are absorbed and augment the sensation of satiety and confer a host of other health benefits. In topical applications, an acemannan/chitosan combination accelerates the closure of wounds by promoting granular tissue formation, which creates a barrier between macrophages or neutrophils and the wound dressing. This causes M2 polarisation, reversal of inflammation, and acceleration of the re-epithelialisation process. This review summarises and explains the current pharmacodynamic paradigm in the context of acemannan in topical, oral, and intravenous applications. However, due to contradictory results in the literature, further research is required to provide scientific evidence to confirm or nullify these claims.

Wound healing applications of creams and "smart" hydrogels

Although superficial wounds are often easy to treat for healthy individuals, there are some more severe types of wounds (burns, ulcers, diabetic wounds, etc.) that are a challenge for clinicians. A good therapeutic result is based on the delivery of a treatment at the right time, for the right patient. Our goal was to sum up useful knowledge regarding wound healing and wound treatments, based on creams and hydrogels with various active ingredients. We concluded that both preparations have application in preventing infections and promoting healing, but their efficacy is clearly conditioned by the type, depth, severity of the wound and patient profile. However, due to their superior versatility and capability of maintaining the integrity and functionality of the active ingredient, as well as it is controlled release at site, hydrogels are more suited for incorporating different active ingredients. New wound healing devices can combine smart hydrogel dressings with physical therapies to deliver a more efficient treatment to patients if the indications are appropriate.

Evaluation of bioactive release kinetics from crosslinked chitosan films with Aloe vera

Thermocompression was employed to prepare citric acid-crosslinked chitosan films with Aloe vera (AV) as bioactive compound. Films were easy to handle and mechanical properties did not change with the addition of AV up to 10 wt%, although both TS and EAB decreased for the films with 15 wt% AV, indicating that high AV contents would hinder intermolecular interactions among the formulation components. Maillard reaction occurred between chitosan and citric acid at the processing temperature used (115 °C), while physical interactions took place with AV, as shown by FTIR analysis. All films were insoluble but displayed hydration and limited swelling due to both physical and chemical interactions promoted by AV and citric acid, respectively. A slow AV release, governed by a Fickian diffusion controlled mechanism, and an increase of surface hydrophilicity, which favors cell adhesion, were observed.

Antimicrobial core-shell electrospun nanofibers containing Ajwain essential oil for accelerating infected wound healing

Treatment of skin injuries is still facing major challenges, such as chronicity and infections, particularly those caused by multi-drug resistance pathogens. An effective treatment of such wounds should accelerate the wound healing process while preventing bacterial contamination. Here, a novel core-shell nanofiber mat was fabricated comprising gelatin/polyvinyl alcohol (as a core) and aloe vera/arabinose/polyvinylpyrrolidone (as a shell) for accelerating the healing process of bacteria-infected wounds. Trachyspermum Ammi (Ajwain) essential oil (EO), as a potent and natural antimicrobial agent against microorganisms, was incorporated into the core of nanofiber mats using coaxial electrospinning. The microscopy images demonstrated the successful fabrication of the core-shell structure with a uniform fiber size of 564 ± 106.35 nm. Moreover, Ajwain EO-loaded nanofiber mat (core-shell/EO) provided excellent antimicrobial activity and antioxidant ability. The in vitro and ex vivo release of Ajwain EO from the fabricated nanofiber mat corroborated a prolonged release profile. Furthermore, in vivo antibacterial activity, wound closure, and histomorphological examinations showed the high efficacy of the core-shell/EO mat in the treatment of Staphylococcus aureus-infected full-thickness rat wounds compared to standard control treatment with a gauze. Overall, these results represent the core-shell/EO mat's potential as a newly developed wound dressing for bacteria-infected full-thickness skin injuries.

Direct ink writing of aloe vera/cellulose nanofibrils bio-hydrogels

Direct-ink-writing (DIW) of hydrogels has become an attractive research area due to its capability to fabricate intricate, complex, and highly customizable structures at ambient conditions for various applications, including biomedical purposes. In the current study, cellulose nanofibrils reinforced aloe vera bio-hydrogels were utilized to develop 3D geometries through the DIW technique. The hydrogels revealed excellent viscoelastic properties enabled extruding thin filaments through a nozzle with a diameter of 630 μm. Accordingly, the lattice structures were printed precisely with a suitable resolution. The 3D-printed structures demonstrated significant wet stability due to the high aspect ratio of the nano- and microfibrils cellulose, reinforced the hydrogels, and protected the shape from extensive shrinkage upon drying. Furthermore, all printed samples had a porosity higher than 80% and a high-water uptake capacity of up to 46 g/g. Altogether, these fully bio-based, porous, and wet stable 3D structures might have an opportunity in biomedical fields.

Safety evaluation of Aloe vera soft capsule in acute, subacute toxicity and genotoxicity study

Aloe vera has been widely used in health and nutritional supplements in Chinese herbal medicine. Furthermore, Aloe vera production has been an emerging industry for making cosmetics and functional food. However, the reported adverse effects raised questions as to whether Aloe vera and its products were safe enough to be used in medicine and health care. In view of this, the safety evaluation of Aloe vera products before marketing is very important. The present study aimed to assess the toxicological profile of Aloe vera soft capsule (ASC), through acute, subacute toxicity and genotoxicity tests. Male and female ICR mice were received by oral gavage 15000 mg/kg bodyweight of ASC in the acute toxicity test. Male and female SD rats were fed on diet blended with different doses of ASC (equivalent to 832.5, 1665 and 3330 mg/kg bodyweight of ASC) for the subacute toxicity test. In the acute toxicity study, no mortality or behavioral changes were observed, indicating the LD₅₀ was higher than 15000 mg/kg bodyweight. In the subacute toxicity test, no significant changes were observed in bodyweight, food consumption, hematological, biochemical or histopathological parameters in the rats exposed. These data suggested that ASC used in this study did not produce any marked subacute toxic effects up to a maximum concentration of 3330 mg/kg bodyweight. In the genotoxicity study, ASC showed no mutagenic activity in the Ames test and no evidence of potential to induce bone marrow micronucleus or testicular chromosome aberrations in ICR mice exposed to 10000 mg/kg bodyweight. Collectively, ASC could be considered safe before it was marketed as a laxative and moistening health food.

Immunobiology and Application of Aloe Vera-Based Scaffolds in Tissue Engineering

Aloe vera (AV), a succulent plant belonging to the Liliaceae family, has been widely used for biomedical and pharmaceutical application. Its popularity stems from several of its bioactive components that have anti-oxidant, anti-microbial, anti-inflammatory and even immunomodulatory effects. Given such unique multi-modal biological impact, AV has been considered as a biomaterial for regenerative medicine and tissue engineering applications, where tissue repair and neo-angiogenesis are vital. This review outlines the growing scientific evidence that demonstrates the advantage of AV as tissue engineering scaffolds. We particularly highlight the recent advances in the application of AV-based scaffolds. From a tissue engineering perspective, it is pivotal that the implanted scaffolds strike an appropriate foreign body response to be well-accepted in the body without complications. Herein, we highlight the key cellular processes that regulate the foreign body response to implanted scaffolds and underline the immunomodulatory effects incurred by AV on the innate and adaptive system. Given that AV has several beneficial components, we discuss the importance of delving deeper into uncovering its action mechanism and thereby improving material design strategies for better tissue engineering constructs for biomedical applications.

The role of phytochemicals in sepsis: A mechanistic and therapeutic perspective

Sepsis and septic shock are still a leading cause of mortality and morbidity in intensive care units worldwide. Sepsis is an uncontrolled and excessive response of the innate immune system toward the invading infectious microbes, characterized by the hyper-production of pro-inflammatory mediators such as interleukin (IL)-1β, IL-6, tumor-necrosis factor (TNF)-α, and high-mobility group box 1 (HMGB1). In severe sepsis, the overwhelming production of pro-inflammatory cytokines and reactive oxygen species may compromise organ function and lead to the induction of abnormal apoptosis in different organs, resulting in multiple organ dysfunction syndrome and death. Hence, compounds that are able to attenuate inflammatory responses may have therapeutic potential for sepsis treatment. Understanding the pathophysiology and underlying molecular mechanisms of sepsis may provide useful insights in the discovery and development of new effective therapeutics. Therefore, numerous studies have invested much effort into elucidating the mechanisms involved with the onset and development of sepsis. The present review mainly focuses on the molecules and signaling pathways involved in the pathogenicity of sepsis. Additionally, several well-known natural bioactive herbal compounds and phytochemicals, which have shown protective and therapeutic effects with regard to sepsis, as well as their mechanisms of action, are presented. This review suggests that these phytochemicals are able to attenuate the overwhelming inflammatory responses developed during sepsis by modulating different signaling pathways. Moreover, the anti-inflammatory and cytoprotective activities of phytochemicals make them potent compounds to be included as complementary therapeutic agents in the diets of patients suffering from sepsis in an effort to alleviate sepsis and its life-threatening complications, such as multi-organ failure.

The Delivery of the Novel Drug 'Halicin' Using Electrospun Fibers for the Treatment of Pressure Ulcer against Pathogenic Bacteria

Pressure ulcer or bedsore is a form of skin infection that commonly occurs with patients admitted to the hospital for an extended period of time, which might lead to severe complications in the absence of medical attention, resulting in infection either by drug-sensitive or drug-resistant bacteria. Halicin, a newly discovered drug effective against several bacterial strains, including multidrug-resistant bacteria, was investigated to reduce bacterial infection burden. This study aims to formulate halicin into electrospun fibers to be applied in bedsores as antibacterial dressing to assess its efficacy against gram-positive (Staphylococcus aureus) and gram-negative bacteria (Escherichia coli and Acinetobacter baumannii) by studying the minimum inhibitory concentration (MIC) and bacterial zone of inhibition assays. The diameters of inhibition growth zones were measured, and the results have shown that the drug-loaded fibers were able to inhibit the growth of bacteria compared to the halicin discs. The release profile of the drug-loaded fibers exhibited a complete release of the drug after 2 h. The results demonstrated that the drug-loaded fibers could successfully release the drug while retaining their biological activity and they may be used as a potential antimicrobial dressing for patients with pressure ulcers caused by multidrug resistant bacteria.

Lanthanides-Substituted Hydroxyapatite/Aloe vera Composite Coated Titanium Plate for Bone Tissue Regeneration

PURPOSE

To develop the surface-treated metal implant with highly encouraged positive properties, including high anti-corrosiveness, bio-activeness and bio-compatibleness for orthopedic applications.

METHODS

In this work, the surface of commercially pure titanium (Ti) metal was treated with bio-compatible polydopamine (PD) by merely immersing the Ti plate in PD solution. The composite of trivalent lanthanide minerals (La3+, Ce3+ and Gd3+)-substituted hydroxyapatite (MHAP) with Aloe vera (AV) gel was prepared and coated on the PD-Ti plate by electrophoretic deposition (EPD) method. The choice of trivalent lanthanide ions is based on their bio-compatible nature and bone-seeking properties. The formation of the PD layer, composites, and composite coatings on Ti plate and PD-Ti surface was confirmed by FT-IR, XRD, SEM and HR-TEM observations. In-vitro assessments such as osteoblasts like MG-63 cell viability, alkaline phosphatase activity and mineralization ability of the MHAP/AV composite were tested, and the composite-coated plate was implanted into a rat bone defect model for in-vivo bone regeneration studies.

RESULTS

The coating ability of the MHAP/AV composite was highly preferred to PD-treated Ti plate than an untreated Ti plate due to the metal absorption ability of PD. This was confirmed by SEM analysis. The in-vitro and in-vivo studies show the better osteogenic ability of MHAP/AV composite at 14th day and 4th week of an experimental period, respectively.

CONCLUSION

The osteoblast ability of the fabricated device without producing any adverse effect in the rat model recommends that the fabricated device would serve as a better platform on the hard tissue regeneration for load-bearing applications of orthopedics.