1
|
Malhotra H, Sharma P, Kamal MA, Kaushik P, Rani N. Concise Review on Scientific Approaches to Burns and Scars. Curr Drug Saf 2024; 19:191-199. [PMID: 37165593 DOI: 10.2174/1574886318666230509143017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2022] [Revised: 02/06/2023] [Accepted: 02/16/2023] [Indexed: 05/12/2023]
Abstract
Burns are large open surgical lesions bathed in virulent pus that result in rupturing of the cutaneous membrane, which has serious consequences such as an extensive loss of proteins, and body fluids, increased chances of infections, and sometimes death. These can be classified based on their penetration levels, i.e., first-degree burns penetrating the epidermis, second-degree burns including both epidermis and dermis, third-degree burns to both layers including the hair follicular cells, sweat glands and various core tissues, fourth-degree burns to adipose tissue, fifth stage burns to muscles, and sixth stage burns to bones. Wound healing/wound repair is a very perplexing process in which the tissues of the affected/burnt area repairs themselves to attain their original form and functionality but develop a scar at the wound site. This article mainly focuses on the algorithms to differentiate various degrees of burns, general first aid approaches to burns and scars, the rationale of treatment of burns, basic mechanisms highlighting the healing processes in humans in terms of free from scar formation as well as with scar formation at their elementary levels including cellular as well as biochemical levels, utility, and progression of pre-clinical data to humans and finally approaches for the improvement of scar formation in man.
Collapse
Affiliation(s)
- Hitesh Malhotra
- Department of Pharmaceutical Science, Guru Gobind Singh College of Pharmacy, Yamuna Nagar (Haryana), India
| | - Prerna Sharma
- Department of Pharmaceutical Science, Guru Gobind Singh College of Pharmacy, Yamuna Nagar (Haryana), India
| | - Mohammad Amjad Kamal
- Institutes for Systems, Chengdu, Genetics, Frontiers Science Center for Disease-related Molecular Network, West China Hospital, Sichuan University, China
- King Fahd Medical Research Center, King Abdulaziz University, Jeddah 21589, Saudi Arabia
- Department of Pharmacy, Faculty of Allied Health Sciences, Daffodil International University, Dhaka 1207, Bangladesh
- 4 Enzymoics, Novel Global Community Educational Foundation, 7 Peterlee place, Hebersham, NSW 2770, Australia
| | - Peeyush Kaushik
- Department of Pharmaceutical Science, Guru Gobind Singh College of Pharmacy, Yamuna Nagar (Haryana), India
| | - Nidhi Rani
- Chitkara College of Pharmacy, Chitkara University, Punjab, India
| |
Collapse
|
2
|
Ramírez O, Pomareda F, Olivares B, Huang YL, Zavala G, Carrasco-Rojas J, Álvarez S, Leiva-Sabadini C, Hidalgo V, Romo P, Sánchez M, Vargas A, Martínez J, Aguayo S, Schuh CMAP. Aloe vera peel-derived nanovesicles display anti-inflammatory properties and prevent myofibroblast differentiation. Phytomedicine 2024; 122:155108. [PMID: 37844380 DOI: 10.1016/j.phymed.2023.155108] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/03/2023] [Revised: 08/30/2023] [Accepted: 09/19/2023] [Indexed: 10/18/2023]
Abstract
BACKGROUND Aloe vera (AV) is a medicinal plant, most known for its beneficial effects on a variety of skin conditions. Its known active compounds include carbohydrates and flavonoids such as quercetin and kaempferol, among others. In the past decade, plant nanovesicles (NVs) have gained considerable interest as interkingdom communicators, presenting an opportunity for clinical standardization of natural products. In this study, we aimed to assess the potential of AVpNVs for the treatment of burn wounds. METHODS AVpNVs were isolated and characterized regarding vesicle yield (nanoparticle tracking analysis) and structure (transmission electron microscopy and atomic force microscopy), as well as their protein content with proteomics. We assessed key characteristics for treating burn wounds in vitro, such as the anti-inflammatory potential in LPS-stimulated macrophages and keratinocytes, and the effect of AVpNVs on myofibroblast differentiation and contraction. KEY FINDINGS AVpNVs presented a homogenous NV population, vesicular shape, and NV-associated protein markers. AVpNVs significantly decreased the secretion of pro-inflammatory cytokines TNFα, IL-1β, and IL-6. Furthermore, AVpNVs inhibited myofibroblast differentiation and significantly decreased their contractile potential in collagen matrices. Observed effects were linked to proteins identified in the isolates through proteomics analysis. CONCLUSION AVpNVs displayed characteristics as an inflammatory modulator, while simultaneously diminishing myofibroblast differentiation and contraction. Novel strategies for burn wound treatment seek to decrease scarring on a cellular and molecular level in the early stages of wound healing, which makes AVpNVs a promising candidate for future plant-vesicle-based treatments.
Collapse
Affiliation(s)
- Orlando Ramírez
- Centro de Medicina Regenerativa, Facultad de Medicina, Clínica Alemana- Universidad del Desarrollo, Santiago, Chile
| | - Florencia Pomareda
- Centro de Medicina Regenerativa, Facultad de Medicina, Clínica Alemana- Universidad del Desarrollo, Santiago, Chile
| | - Belén Olivares
- Centro de Química Medica, Facultad de Medicina, Clínica Alemana-Universidad del Desarrollo, Santiago, Chile
| | - Ya-Lin Huang
- Centro de Medicina Regenerativa, Facultad de Medicina, Clínica Alemana- Universidad del Desarrollo, Santiago, Chile
| | - Gabriela Zavala
- Centro de Medicina Regenerativa, Facultad de Medicina, Clínica Alemana- Universidad del Desarrollo, Santiago, Chile
| | - Javiera Carrasco-Rojas
- Centro de Medicina Regenerativa, Facultad de Medicina, Clínica Alemana- Universidad del Desarrollo, Santiago, Chile
| | - Simón Álvarez
- Centro de Medicina Regenerativa, Facultad de Medicina, Clínica Alemana- Universidad del Desarrollo, Santiago, Chile
| | - Camila Leiva-Sabadini
- Institute for Biological and Medical Engineering, Schools of Engineering, Medicine and Biological Sciences, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Valeria Hidalgo
- Centro de Medicina Regenerativa, Facultad de Medicina, Clínica Alemana- Universidad del Desarrollo, Santiago, Chile
| | - Pablo Romo
- Centro de Medicina Regenerativa, Facultad de Medicina, Clínica Alemana- Universidad del Desarrollo, Santiago, Chile
| | - Matías Sánchez
- Centro de Medicina Regenerativa, Facultad de Medicina, Clínica Alemana- Universidad del Desarrollo, Santiago, Chile
| | - Ayleen Vargas
- Centro de Medicina Regenerativa, Facultad de Medicina, Clínica Alemana- Universidad del Desarrollo, Santiago, Chile
| | - Jessica Martínez
- Centro de Medicina Regenerativa, Facultad de Medicina, Clínica Alemana- Universidad del Desarrollo, Santiago, Chile
| | - Sebastian Aguayo
- Institute for Biological and Medical Engineering, Schools of Engineering, Medicine and Biological Sciences, Pontificia Universidad Católica de Chile, Santiago, Chile; Dentistry School, Faculty of Medicine, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Christina M A P Schuh
- Centro de Medicina Regenerativa, Facultad de Medicina, Clínica Alemana- Universidad del Desarrollo, Santiago, Chile.
| |
Collapse
|
3
|
Bagheri M, Werres M, Fuchs PC, Seyhan H, Lefering R, Grieb G, Schiefer JL. Which Moisturizer to Use in Scar Therapy after Burn Injuries? A Subjective and Objective Skin and Scar Evaluation after Topical Treatment with Dexpanthenol, Aloe Vera, and Plant Oil. Medicina (Kaunas) 2023; 59:1874. [PMID: 37893592 PMCID: PMC10608183 DOI: 10.3390/medicina59101874] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/20/2023] [Revised: 10/09/2023] [Accepted: 10/19/2023] [Indexed: 10/29/2023]
Abstract
Background and Objectives: Good scar management in burn care is essential. Nevertheless, there are no consistent recommendations regarding moisturizers for scar management. Our aim was to investigate and compare the effects of commonly used products on normal skin and burn scars. Materials and Methods: A total of 30 skin-healthy (control group) and 12 patients with burn scars were included in this study. For an intraindividual comparison, each participant received creams consisting of dexpanthenol (P), aloe vera (A), and a natural plant oil (O) with instructions to apply them daily to a previously defined area for at least 28 days. Objective scar evaluation was performed with Visioscan®; Tewameter®; Cutometer®, and the Oxygen To See® device. Subjective evaluation was performed with an "application" questionnaire, the Patient and Observer Scar Assessment Scale (POSAS), and with the "best of three" questionnaire. Results: After (A) a high trend of amelioration of +30%, TEWL was detected on the scar area. Blood flow increased slightly on healthy skin areas after (A) application to +104%. The application of (A) on healthy skin demonstrated a positive effect on the parameters of scaliness (+22%, p < 0.001), softness (+14%, p = 0.046), roughness R1 (+16%, p < 0.001) and R2 (+17%, p = 0.000), volume (+22%, p < 0.001), and surface area (+7%, p < 0.001) within the control group. After (P), a significant improvement of the baseline firmness parameter of +14.7% was detected (p = 0.007). (P) also showed a beneficial effect on the parameters of R1 (+7%, p = 0.003), R2 (+6%, p = 0.001), and volume (+17%, p = 0.001). (O) lead to a statistically significant improvement of volume (+15%, p = 0.009). Overall, most study participants stated (A) to be the "best of three". Conclusions: (A) performed statistically best, and is a well-tolerated moisturizing product. However, further quantitative studies are needed to provide statistically significant clarification for uniform recommendations for scar therapy.
Collapse
Affiliation(s)
- Mahsa Bagheri
- Clinic for Plastic and Hand Surgery, Burn Care Center, University of Witten/Herdecke, Cologne Merheim Medical Center (CMMC), 51109 Cologne, Germany
| | - Michelle Werres
- Clinic for Plastic and Hand Surgery, Burn Care Center, University of Witten/Herdecke, Cologne Merheim Medical Center (CMMC), 51109 Cologne, Germany
| | - Paul C. Fuchs
- Clinic for Plastic and Hand Surgery, Burn Care Center, University of Witten/Herdecke, Cologne Merheim Medical Center (CMMC), 51109 Cologne, Germany
| | - Harun Seyhan
- Clinic for Plastic and Hand Surgery, Burn Care Center, University of Witten/Herdecke, Cologne Merheim Medical Center (CMMC), 51109 Cologne, Germany
| | - Rolf Lefering
- Institute for Research in Operative Medicine (IFOM), Faculty of Health, Witten/Herdecke University, 51109 Cologne, Germany
| | - Gerrit Grieb
- Department of Plastic and Hand Surgery, Burn Center, Medical Faculty, RWTH Aachen University, 52062 Aachen, Germany
- Department of Plastic and Hand Surgery, Hospital Havelhohe, 14089 Berlin, Germany
| | - Jennifer Lynn Schiefer
- Clinic for Plastic and Hand Surgery, Burn Care Center, University of Witten/Herdecke, Cologne Merheim Medical Center (CMMC), 51109 Cologne, Germany
| |
Collapse
|
4
|
Al-Samydai A, Abu Hajleh MN, Mayyas A, Al-Mamoori F, Al-Tawalbe DM, Alqaraleh M, Mousa MA, Aladwan H, Alazab B, Selwadi D, Othman FA, Zaazouee MS, Ragab KM, Al-Halaseh L. Ethnopharmacological Study of Medicinal Plants Used in the Treatment of Skin Burns in the Arab World. J Burn Care Res 2023; 44:1216-1222. [PMID: 36864698 DOI: 10.1093/jbcr/irad030] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/04/2023]
Abstract
Traditional healers are often practiced in rural areas owing to cultural beliefs and are known to provide various forms of healthcare and home remedies. Patients in the Mediterranean region rely on traditional medicine to cure a variety of health concerns, like skin burns. This study was conducted to identify the various practices used by traditional healers for treating skin burns. The survey was conducted in 18 Arab countries, including Syria, Iraq, Jordan, Saudi Arabia, Egypt, United Arab Emirates, Algeria, Bahrain, Palestine, Kuwait, Oman, Qatar, Lebanon, Yemen, Tunisia, Oman, Morocco, and Sudan. Between September 2020 and July 2021, an online questionnaire was administered to 7530 participants from 12 Asian and 5 African countries. The survey was designed to gather information from common medicinal plant users and herbalists on their practices as specialists in using various herbal and medicinal plant products for diagnosis and treatment. Among the participants, 2260 had a scientific background in plant application, and the study included one phytotherapeutic professional. The crude-extraction technique was favored, by Arabic folk, for plant preparation over the maceration and decoction method. Olive oil was the most commonly used product among participants as an anti-inflammation and for scar reduction. Aloe vera, olive oil, sesame, Ceretonia siliqua, lavender, potato, cucumber, shea butter, and wheat flour are used as crude drugs to reduce pain because of their analgesic and cooling effects. The present study is the first database of medicinal plants with burn-healing properties conducted in Arab countries. These plants can be employed in the search for new bioactive substances through pharmacochemical investigations, as well as in the development of new formulations containing a combination of these plants.
Collapse
Affiliation(s)
- Ali Al-Samydai
- Pharmacological and Diagnostic Research Centre, Faculty of Pharmacy, Al-Ahliyya Amman University, Amman, Jordan
| | - Maha N Abu Hajleh
- Department of Cosmetic Science, Pharmacological and Diagnostic Research Centre, Faculty of Allied Medical Sciences, Al-Ahliyya Amman University, Amman, Jordan
| | - Amal Mayyas
- Faculty of Health Science, Pharmacy Department, American University of Madaba, Madaba, Jordan
| | - Farah Al-Mamoori
- Department of Pharmaceutical Sciences, Faculty of Pharmacy, Zarqa University, Zarqa, Jordan
| | - Deniz M Al-Tawalbe
- Department of Medicinal Chemistry and Pharmacognosy, Faculty of Pharmacy, Yarmouk University, Irbid, Jordan
| | - Moath Alqaraleh
- Pharmacological and Diagnostic Research Centre, Faculty of Pharmacy, Al-Ahliyya Amman University, Amman, Jordan
| | - Mohamad Ak Mousa
- Pharmacological and Diagnostic Research Centre, Faculty of Pharmacy, Al-Ahliyya Amman University, Amman, Jordan
| | - Hala Aladwan
- Faculty of Pharmacy, The University of Jordan, Amman, Jordan
| | - Badi'ah Alazab
- Faculty of Pharmacy, The University of Jordan, Amman, Jordan
| | - Dana Selwadi
- Faculty of Pharmacy, The University of Jordan, Amman, Jordan
| | | | | | | | - Lidia Al-Halaseh
- Department of Pharmaceutical Chemistry, Faculty of Pharmacy, Mutah University, Al-Karak, Jordan
| |
Collapse
|
5
|
Rachpirom M, Pichayakorn W, Puttarak P. Box-Behnken design to optimize the cross-linked sodium alginate/mucilage/Aloe vera film: Physical and mechanical studies. Int J Biol Macromol 2023; 246:125568. [PMID: 37392918 DOI: 10.1016/j.ijbiomac.2023.125568] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2023] [Revised: 06/16/2023] [Accepted: 06/24/2023] [Indexed: 07/03/2023]
Abstract
The crosslinked sodium alginate/mucilage/Aloe vera/glycerin was optimized by different ratios of each factor to be an absorption wound dressing base for infected wound healing. Mucilage was extracted from seeds of Ocimum americanum. The Box-Behnken design (BBD) in response surface methodology (RSM) was used to construct an optimal wound dressing base with the target ranges of mechanical and physical properties of each formulation. The independent variables selected were sodium alginate (X1: 0.25-0.75 g), mucilage (X2: 0.00-0.30 g), Aloe vera (X3: 0.00-0.30 g), and glycerin (X4: 0.00-1.00 g). The dependent variables were tensile strength (Y1: low value), elongation at break (Y2: high value), Young's modulus (Y3: high value), swelling ratio (Y4: high value), erosion (Y5: low value), and moisture uptake (Y6: high value). The results showed that the wound dressing base with the most desirable response consists of sodium alginate (59.90 % w/w), mucilage (23.96 % w/w), and glycerin (16.14 % w/w) without Aloe vera gel powder (0.00 % w/w).
Collapse
Affiliation(s)
- Mingkwan Rachpirom
- Department of Pharmacognosy and Pharmaceutical Botany, Faculty of Pharmaceutical Sciences, Prince of Songkla University, Hat-Yai, Songkhla 90112, Thailand; Phytomedicine and Pharmaceutical Biotechnology Research Center, Prince of Songkla University, Hat-Yai, Songkhla 90112, Thailand
| | - Wiwat Pichayakorn
- Department of Pharmaceutical Technology, Faculty of Pharmaceutical Sciences, Prince of Songkla University, Hat-Yai, Songkhla 90112, Thailand
| | - Panupong Puttarak
- Department of Pharmacognosy and Pharmaceutical Botany, Faculty of Pharmaceutical Sciences, Prince of Songkla University, Hat-Yai, Songkhla 90112, Thailand; Phytomedicine and Pharmaceutical Biotechnology Research Center, Prince of Songkla University, Hat-Yai, Songkhla 90112, Thailand.
| |
Collapse
|
6
|
Chelu M, Musuc AM, Popa M, Calderon Moreno J. Aloe vera-Based Hydrogels for Wound Healing: Properties and Therapeutic Effects. Gels 2023; 9:539. [PMID: 37504418 PMCID: PMC10379830 DOI: 10.3390/gels9070539] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2023] [Revised: 06/26/2023] [Accepted: 06/30/2023] [Indexed: 07/29/2023] Open
Abstract
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.
Collapse
Affiliation(s)
| | - Adina Magdalena Musuc
- “Ilie Murgulescu” Institute of Physical Chemistry, 202 Splaiul Independentei, 060021 Bucharest, Romania; (M.C.); (M.P.)
| | | | - Jose Calderon Moreno
- “Ilie Murgulescu” Institute of Physical Chemistry, 202 Splaiul Independentei, 060021 Bucharest, Romania; (M.C.); (M.P.)
| |
Collapse
|
7
|
Tavakoli M, Mirhaj M, Varshosaz J, Salehi S, Mohanna SM, Salehi S, Haghighi V, Kazemi N, Mehrjoo M, Shahriari-Khalaji M. 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. Biomater Adv 2023; 151:213468. [PMID: 37220673 DOI: 10.1016/j.bioadv.2023.213468] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/08/2023] [Revised: 04/15/2023] [Accepted: 05/06/2023] [Indexed: 05/25/2023]
Abstract
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.
Collapse
Affiliation(s)
- Mohamadreza Tavakoli
- Department of Materials Engineering, Isfahan University of Technology, Isfahan 84156-83111, Iran
| | - Marjan Mirhaj
- Department of Materials Engineering, Isfahan University of Technology, Isfahan 84156-83111, Iran
| | - Jaleh Varshosaz
- Department of Pharmaceutics, Novel Drug Delivery Systems Research Centre, School of Pharmacy, Isfahan University of Medical Sciences, Isfahan, Iran.
| | - Saeideh Salehi
- Advanced Materials Research Center, Department of Materials Engineering, Najafabad Branch, Islamic Azad University, Najafabad, Iran
| | - Seyedhosein Mirjalili Mohanna
- Department of Mechanical Engineering, Faculty of Engineering, The University of Sheffield, Sheffield, United Kingdom
| | - Sepideh Salehi
- Department of Medicine, Ernst Moritz Arndt University of Greifswald, Greifswald, Germany
| | - Vida Haghighi
- Department of Biomedical Engineering, Science and Research Branch, Islamic Azad University, Tehran, Iran
| | - Nafise Kazemi
- Advanced Materials Research Center, Department of Materials Engineering, Najafabad Branch, Islamic Azad University, Najafabad, Iran
| | - Morteza Mehrjoo
- Department of Biomedical Engineering, Amirkabir University of Technology, Tehran, Iran; Iran National Cell Bank, Pasteur Institute of Iran, Tehran, Iran
| | - Mina Shahriari-Khalaji
- State Key Laboratory for Modification of Chemical Fibers and Polymer Materials, College of Materials Science and Engineering, Donghua University, Shanghai 201620, China
| |
Collapse
|
8
|
Wang JC, Fort CL, Matl CM, Harvey BD, Demke JC, Thomas JR, Sidle DM. Effects of Essential Oils on Scars and Wound Healing: A Systematic Review. Facial Plast Surg 2023; 39:173-179. [PMID: 36070793 DOI: 10.1055/a-1938-0343] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/14/2022] Open
Abstract
Essential oils (EOs) have been considered as a potential alternative therapy for wound healing and scar reduction. The aim of this article was to provide a comprehensive review examining the effects of EOs on wound healing and scars. PubMed, Cochrane, Ovid, and Embase computerized searches were performed through June 2020. Two independent reviewers conducted data extraction, with search results reviewed by the senior author following the PRISMA protocol. Three manuscripts examining three different EO-containing topical agents were analyzed. Outcomes include healing rate, erythema, pain, pruritus, patient discomfort, physician satisfaction, percent wound reduction, wound/scar surface perimeter area, and qualitative dermatological evaluation. All articles concluded that the EO-containing topical agents resulted in either superior or noninferior outcomes in comparison with controls. Hypericum-Calendula oil obtained lower wound surface perimeter area. Erythema (p = 0.001) was significantly decreased by the peppermint EO-containing topical agent. Physicians also reported greater satisfaction (p < 0.001) in wound appearance with use of the peppermint EO-containing topical agent. A paucity of studies have examined EO use for wound healing and scar reduction. Treatment with EO-containing topical agents resulted in decreased erythema with increased physician satisfaction of wound appearance. Future studies should assess what level of purity is needed for improved results and which EO, or combination of EOs, is most beneficial.
Collapse
Affiliation(s)
- James C Wang
- Department of Otolaryngology - Head and Neck Surgery, Northwestern Medicine, Chicago, Illinois
- Department of Otolaryngology - Head and Neck Surgery, Texas Tech University Health Sciences Center, Lubbock, Texas
| | - Callie L Fort
- School of Medicine, Texas Tech University Health Sciences Center, Lubbock, Texas
| | - Christina M Matl
- School of Medicine, Texas Tech University Health Sciences Center, Lubbock, Texas
| | - Bailey D Harvey
- School of Medicine, Texas Tech University Health Sciences Center, Lubbock, Texas
| | - Joshua C Demke
- Department of Otolaryngology - Head and Neck Surgery, Texas Tech University Health Sciences Center, Lubbock, Texas
| | - J Regan Thomas
- Department of Otolaryngology - Head and Neck Surgery, Northwestern Medicine, Chicago, Illinois
| | - Douglas M Sidle
- Department of Otolaryngology - Head and Neck Surgery, Northwestern Medicine, Chicago, Illinois
| |
Collapse
|
9
|
Moses RL, Prescott TAK, Mas-claret E, Steadman R, Moseley R, Sloan AJ. Evidence for Natural Products as Alternative Wound-Healing Therapies. Biomolecules 2023; 13:444. [PMID: 36979379 PMCID: PMC10046143 DOI: 10.3390/biom13030444] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2022] [Revised: 02/13/2023] [Accepted: 02/15/2023] [Indexed: 03/02/2023] Open
Abstract
Chronic, non-healing wounds represent a significant area of unmet medical need and are a growing problem for healthcare systems around the world. They affect the quality of life for patients and are an economic burden, being difficult and time consuming to treat. They are an escalating problem across the developed world due to the increasing incidence of diabetes and the higher prevalence of ageing populations. Effective treatment options are currently lacking, and in some cases chronic wounds can persist for years. Some traditional medicines are believed to contain bioactive small molecules that induce the healing of chronic wounds by reducing excessive inflammation, thereby allowing re-epithelisation to occur. Furthermore, many small molecules found in plants are known to have antibacterial properties and, although they lack the therapeutic selectivity of antibiotics, they are certainly capable of acting as topical antiseptics when applied to infected wounds. As these molecules act through mechanisms of action distinct from those of clinically used antibiotics, they are often active against antibiotic resistant bacteria. Although there are numerous studies highlighting the effects of naturally occurring small molecules in wound-healing assays in vitro, only evidence from well conducted clinical trials can allow these molecules or the remedies that contain them to progress to the clinic. With this in mind, we review wound-healing natural remedies that have entered clinical trials over a twenty-year period to the present. We examine the bioactive small molecules likely to be in involved and, where possible, their mechanisms of action.
Collapse
|
10
|
Altinkaynak C, Haciosmanoglu E, Ekremoglu M, Hacioglu M, Özdemir N. Anti-microbial, anti-oxidant and wound healing capabilities of Aloe vera-incorporated hybrid nanoflowers. J Biosci Bioeng 2023; 135:321-330. [PMID: 36806412 DOI: 10.1016/j.jbiosc.2023.01.004] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2022] [Revised: 01/10/2023] [Accepted: 01/11/2023] [Indexed: 02/20/2023]
Abstract
The active ingredients of Aloe vera have attracted attention for their potential use in nanotechnology-based medical applications and biomaterial production. It has many therapeutic applications in modern world. This study used Aloe vera extract in different concentrations to synthesize Aloe vera-incorporated hybrid nanoflowers (AV-Nfs). The most uniform morphology in the nanoflowers obtained was at a concentration of 2 mL. The AV-Nfs were well characterized by scanning electron microscopy, X-ray spectroscopy, Fourier transform infrared spectroscopy, and X-ray diffraction (XRD). The highest peroxidase-mimicking activity of the components was 1.488 EU/mg at 60°C and pH 6. The DPPH assay determined the antioxidant activity of the components and the MTT assay tested on CCD-1072Sk fibroblast cell line determined the effect of AV-Nfs on cell proliferation. Separate treatment of AV-Nfs with Cu3(PO4)2·3H2O significantly increased cell proliferation according to free Aloe vera and CuSO4. In vitro wound healing results showed that AV-Nfs could significantly close wounds compared to free Aloe vera. In this study, AV-Nfs showed antimicrobial activity against Staphylococcus epidermidis, Enterococcus faecalis, Escherichia coli and Klebsiella pneumoniae at minimum inhibitory concentration of 625 μg/mL, suggesting that AV-Nfs may be used in wound healing applications with enhanced biological properties. AV-Nfs showed no activity against the yeast Candida albicans.
Collapse
Affiliation(s)
- Cevahir Altinkaynak
- Department of Plant and Animal Production, Avanos Vocational School, Nevsehir Haci Bektas Veli University, 50500 Nevsehir, Turkey.
| | - Ebru Haciosmanoglu
- Department of Biophysics, Faculty of Medicine, Bezmialem Vakif University, 34093 Istanbul, Turkey
| | - Murat Ekremoglu
- Department of Medical Biochemistry, Faculty of Medicine, Istinye University, 34010 Istanbul, Turkey
| | - Mayram Hacioglu
- Department of Pharmaceutical Microbiology, Faculty of Pharmacy, Istanbul University, 34116 Istanbul, Turkey
| | - Nalan Özdemir
- Department of Chemistry, Faculty of Science, Erciyes University, 38039 Kayseri, Turkey
| |
Collapse
|
11
|
Mssillou I, Bakour M, Slighoua M, Laaroussi H, Saghrouchni H, Ez-Zahra Amrati F, Lyoussi B, Derwich E. Investigation on wound healing effect of Mediterranean medicinal plants and some related phenolic compounds: A review. J Ethnopharmacol 2022; 298:115663. [PMID: 36038091 DOI: 10.1016/j.jep.2022.115663] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/30/2022] [Revised: 08/07/2022] [Accepted: 08/19/2022] [Indexed: 06/15/2023]
Abstract
ETHNOPHARMACOLOGICAL RELEVANCE The human skin constitutes a biological barrier against external stress and wounds can reduce the role of its physiological structure. In medical sciences, wounds are considered a major problem that requires urgent intervention. For centuries, medicinal plants have been used in the Mediterranean countries for many purposes and against wounds. AIM OF THIS REVIEW Provides an outlook on the Mediterranean medicinal plants used in wound healing. Furthermore, the wound healing effect of polyphenolic compounds and their chemical structures are also summarized. Moreover, we discussed the wound healing process, the structure of the skin, and the current therapies in wound healing. MATERIALS AND METHODS The search was performed in several databases such as ScienceDirect, PubMed, Google Scholar, Scopus, and Web of Science. The following Keywords were used individually and/or in combination: the Mediterranean, wound healing, medicinal plants, phenolic compounds, composition, flavonoid, tannin. RESULTS The wound healing process is distinguished by four phases, which are respectively, hemostasis, inflammation, proliferation, and remodeling. The Mediterranean medicinal plants are widely used in the treatment of wounds. The finding showed that eighty-nine species belonging to forty families were evaluated for their wound-healing effect in this area. The Asteraceae family was the most reported family with 12 species followed by Lamiaceae (11 species). Tunisia, Egypt, Morocco, and Algeria were the countries where these plants are frequently used in wound healing. In addition to medicinal plants, results showed that nineteen phenolic compounds from different classes are used in wound treatment. Tyrosol, hydroxytyrosol, curcumin, luteolin, chrysin, rutin, kaempferol, quercetin, icariin, morin, epigallocatechin gallate, taxifolin, silymarin, hesperidin, naringin, isoliquiritin, puerarin, genistein, and daidzein were the main compounds that showed wound-healing effect. CONCLUSION In conclusion, medicinal plants and polyphenolic compounds provide therapeutic evidence in wound healing and for the development of new drugs in this field.
Collapse
Affiliation(s)
- Ibrahim Mssillou
- Laboratory of Natural Substances, Pharmacology, Environment, Modeling, Health & Quality of Life (SNAMOPEQ), Faculty of Sciences Dhar El Mahraz, Sidi Mohamed Ben Abdellah University, Fez 30000, Morocco.
| | - Meryem Bakour
- Laboratory of Natural Substances, Pharmacology, Environment, Modeling, Health & Quality of Life (SNAMOPEQ), Faculty of Sciences Dhar El Mahraz, Sidi Mohamed Ben Abdellah University, Fez 30000, Morocco
| | - Meryem Slighoua
- Laboratory of Biotechnology, Health, Agrofood and Environment (LBEAS), Faculty of Sciences Dhar El Mahraz, Sidi Mohamed Ben Abdellah University, Fez, 30000, Morocco
| | - Hassan Laaroussi
- Laboratory of Natural Substances, Pharmacology, Environment, Modeling, Health & Quality of Life (SNAMOPEQ), Faculty of Sciences Dhar El Mahraz, Sidi Mohamed Ben Abdellah University, Fez 30000, Morocco
| | - Hamza Saghrouchni
- Department of Biotechnology, Institute of Natural and Applied Sciences, Çukurova University, 01330 Balcalı/Sarıçam, Adana, Turkey
| | - Fatima Ez-Zahra Amrati
- Laboratory of Biotechnology, Health, Agrofood and Environment (LBEAS), Faculty of Sciences Dhar El Mahraz, Sidi Mohamed Ben Abdellah University, Fez, 30000, Morocco
| | - Badiaa Lyoussi
- Laboratory of Natural Substances, Pharmacology, Environment, Modeling, Health & Quality of Life (SNAMOPEQ), Faculty of Sciences Dhar El Mahraz, Sidi Mohamed Ben Abdellah University, Fez 30000, Morocco
| | - Elhoussine Derwich
- Laboratory of Natural Substances, Pharmacology, Environment, Modeling, Health & Quality of Life (SNAMOPEQ), Faculty of Sciences Dhar El Mahraz, Sidi Mohamed Ben Abdellah University, Fez 30000, Morocco; Unity of GC/MS and GC, City of Innovation, Sidi Mohamed Ben Abdellah University, Fez, 30000, Morocco
| |
Collapse
|
12
|
Darwish MM, Elneklawi MS, Mohamad EA. Aloe Vera coated Dextran Sulfate/Chitosan nanoparticles (Aloe Vera @ DS/CS) encapsulating Eucalyptus essential oil with antibacterial potent property. Journal of Biomaterials Science, Polymer Edition 2022; 34:810-827. [PMID: 36369795 DOI: 10.1080/09205063.2022.2145869] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
The goal of this work is to encapsulate Eucalyptus staigeriana essential oil in biopolymer matrices, to optimize the biological effects and the antibacterial properties of this oil. In this study, Eucalyptus extract was encapsulated in Aloe Vera coated Dextran Sulfate/Chitosan nanoparticles to form a hydrogel with potent properties. In this study, Eucalyptus extract was loaded on to Aloe Vera coated Dextran Sulphate/Chitosan nanoparticles to obtain a nano-hydrogel with potent properties. The characterization of nanoparticles was evaluated using transmission and scanning electron microscopes, dynamic light scattering, Fourier transform infrared spectroscopy, differential scanning calorimetry and antibacterial activity. The E. staigeriana release profile from the prepared nanoparticles was studied in vitro at a pH of 7.4. The results showed that this nano-carrier controls Eucalyptus release. Aloe Vera coated Dextran Sulfate/Chitosan nanoparticles encapsulated with E. staigeriana inhibited the bacteria by 47.27%. These investigations concluded that E. staigeriana loaded Aloe Vera coated Dextran Sulfate/Chitosan hydrogel could be used as a powerful dressing material to accelerate wound healing.
Collapse
Affiliation(s)
- Mirhane Mostafa Darwish
- Biophysics Department, Faculty of Science, Cairo University, Cairo University St., Giza, Egypt.
| | - Mona S Elneklawi
- Biomedical Equipment Department, Faculty of Applied Medical Sciences, October 6 University, 6th of October City, Giza, Egypt
| | - Ebtesam A Mohamad
- Biophysics Department, Faculty of Science, Cairo University, Cairo University St., Giza, Egypt.
| |
Collapse
|
13
|
Sharma S, Alfonso AR, Gordon AJ, Kwong J, Lin LJ, Chiu ES. Second-Degree Burns and Aloe Vera: A Meta-analysis and Systematic Review. Adv Skin Wound Care 2022; 35:1-9. [DOI: 10.1097/01.asw.0000875056.29059.78] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
|
14
|
Muacevic A, Adler JR. A Systematic Review and Meta-Analysis Comparing Burn Healing Outcomes Between Silver Sulfadiazine and Aloe vera. Cureus 2022; 14:e30815. [PMID: 36337821 PMCID: PMC9621733 DOI: 10.7759/cureus.30815] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2022] [Accepted: 10/28/2022] [Indexed: 11/30/2022] Open
Abstract
Burn wounds remain a prevalent problem in the developed and developing world. A multitude of remedies has been tested. This study evaluated the healing time of second- and third-degree burn wounds between silver sulfadiazine (SSD) and Aloe vera (AV). In July 2020, a systematic review of MEDLINE (Ovid) and PubMed (National Library of Medicine) was performed to identify studies that reported healing of second- and third-degree burns using either SSD or AV. Articles meeting the inclusion criteria were screened and carefully analyzed. Our goal was to report the healing time for these burns using SSD and AV. A total of eight studies published between 1988 and 2018 reporting healing of second- and third-degree burns using SSD and AV were included in this review. Six were cohort studies and two were randomized controlled trials. The studies included both animal and human subjects. The meta-analysis demonstrated that the mean time to wound healing favored AV (RR: -1.34, 95% CI: -1.8 to 0.9, p < 0.001). It would seem that time to healing benefitted those burns in which AV was utilized. In conclusion, increased consideration and emphasis should be placed on using AV to aid the healing of second- and third-degree burns.
Collapse
|
15
|
Fadilah NIM, Maarof M, Motta A, Tabata Y, Fauzi MB. The Discovery and Development of Natural-Based Biomaterials with Demonstrated Wound Healing Properties: A Reliable Approach in Clinical Trials. Biomedicines 2022; 10:2226. [PMID: 36140332 PMCID: PMC9496351 DOI: 10.3390/biomedicines10092226] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2022] [Revised: 09/04/2022] [Accepted: 09/06/2022] [Indexed: 11/17/2022] Open
Abstract
Current research across the globe still focuses strongly on naturally derived biomaterials in various fields, particularly wound care. There is a need for more effective therapies that will address the physiological deficiencies underlying chronic wound treatment. The use of moist bioactive scaffolds has significantly increased healing rates compared to local and traditional treatments. However, failure to heal or prolonging the wound healing process results in increased financial and social stress imposed on health institutions, caregivers, patients, and their families. The urgent need to identify practical, safe, and cost-effective wound healing scaffolding from natural-based biomaterials that can be introduced into clinical practice is unequivocal. Naturally derived products have long been used in wound healing; however, clinical trial evaluations of these therapies are still in their infancy. Additionally, further well-designed clinical trials are necessary to confirm the efficacy and safety of natural-based biomaterials in treating wounds. Thus, the focus of this review is to describe the current insight, the latest discoveries in selected natural-based wound healing implant products, the possible action mechanisms, and an approach to clinical studies. We explore several tested products undergoing clinical trials as a novel approach to counteract the debilitating effects of impaired wound healing.
Collapse
|
16
|
Liu E, Gao H, Zhao Y, Pang Y, Yao Y, Yang Z, Zhang X, Wang Y, Yang S, Ma X, Zeng J, Guo J. The potential application of natural products in cutaneous wound healing: A review of preclinical evidence. Front Pharmacol 2022; 13:900439. [PMID: 35935866 PMCID: PMC9354992 DOI: 10.3389/fphar.2022.900439] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2022] [Accepted: 06/28/2022] [Indexed: 11/22/2022] Open
Abstract
Under normal circumstances, wound healing can be summarized as three processes. These include inflammation, proliferation, and remodeling. The vast majority of wounds heal rapidly; however, a large percentage of nonhealing wounds have still not been studied significantly. The factors affecting wound nonhealing are complex and diverse, and identifying an effective solution from nature becomes a key goal of research. This study aimed to highlight and review the mechanisms and targets of natural products (NPs) for treating nonhealing wounds. The results of relevant studies have shown that the effects of NPs are associated with PI3K-AKT, P38MAPK, fibroblast growth factor, MAPK, and ERK signaling pathways and involve tumor growth factor (TNF), vascular endothelial growth factor, TNF-α, interleukin-1β, and expression of other cytokines and proteins. The 25 NPs that contribute to wound healing were systematically summarized by an inductive collation of the six major classes of compounds, including saponins, polyphenols, flavonoids, anthraquinones, polysaccharides, and others, which will further direct the attention to the active components of NPs and provide research ideas for further development of new products for wound healing.
Collapse
Affiliation(s)
- E Liu
- Dermatological Department, Affiliated Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Hongjin Gao
- Dermatological Department, Affiliated Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - YiJia Zhao
- Dermatological Department, Affiliated Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Yaobing Pang
- Dermatological Department, Affiliated Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Yejing Yao
- Neijiang Hospital of Traditional Chinese Medicine, Neijiang, China
| | - Zhengru Yang
- Dermatological Department, Affiliated Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Xueer Zhang
- Dermatological Department, Affiliated Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - YanJin Wang
- Dermatological Department, Affiliated Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Siming Yang
- Dermatological Department, Affiliated Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Xiao Ma
- State Key Laboratory of Southwestern Chinese Medicine Resources, School of Pharmacy, Chengdu University of Traditional Chinese Medicine, Chengdu, China
- *Correspondence: Xiao Ma, ; Jinhao Zeng, ; Jing Guo,
| | - Jinhao Zeng
- TCM Regulating Metabolic Diseases Key Laboratory of Sichuan Province, Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu, China
- *Correspondence: Xiao Ma, ; Jinhao Zeng, ; Jing Guo,
| | - Jing Guo
- Dermatological Department, Affiliated Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu University of Traditional Chinese Medicine, Chengdu, China
- *Correspondence: Xiao Ma, ; Jinhao Zeng, ; Jing Guo,
| |
Collapse
|
17
|
Eivazzadeh-Keihan R, Noruzi EB, Aliabadi HAM, Sheikhaleslami S, Akbarzadeh AR, Hashemi SM, Gorab MG, Maleki A, Cohan RA, Mahdavi M, Poodat R, Keyvanlou F, Esmaeili MS. Recent advances on biomedical applications of pectin-containing biomaterials. Int J Biol Macromol 2022; 217:1-18. [PMID: 35809676 DOI: 10.1016/j.ijbiomac.2022.07.016] [Citation(s) in RCA: 17] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2022] [Revised: 06/13/2022] [Accepted: 07/03/2022] [Indexed: 12/15/2022]
Abstract
There is a growing demand for biomaterials developing with novel properties for biomedical applications hence, hydrogels with 3D crosslinked polymeric structures obtained from natural polymers have been deeply inspected in this field. Pectin a unique biopolymer found in the cell walls of fruits and vegetables is extensively used in the pharmaceutical, food, and textile industries due to its ability to form a thick gel-like solution. Considering biocompatibility, biodegradability, easy gelling capability, and facile manipulation of pectin-based biomaterials; they have been thoroughly investigated for various potential biomedical applications including drug delivery, wound healing, tissue engineering, creation of implantable devices, and skin-care products.
Collapse
Affiliation(s)
- Reza Eivazzadeh-Keihan
- Nanobiotechnology Department, New Technologies Research Group, Pasteur Institute of Iran, Tehran, Iran
| | - Ehsan Bahojb Noruzi
- Faculty of Chemistry, Department of Inorganic Chemistry, University of Tabriz, Tabriz, Iran
| | - Hooman Aghamirza Moghim Aliabadi
- Protein Chemistry Laboratory, Department of Medical Biotechnology, Biotechnology Research Center, Pasteur Institute of Iran, Tehran, Iran; Advanced Chemical Studies Lab, Department of Chemistry, K. N. Toosi University of Technology, Tehran, Iran
| | - Sahra Sheikhaleslami
- Advanced Chemical Studies Lab, Department of Chemistry, K. N. Toosi University of Technology, Tehran, Iran
| | - Ali Reza Akbarzadeh
- Department of Chemistry, Iran University of Science and Technology, Tehran 16846-13114, Iran
| | - Seyed Masoud Hashemi
- Catalysts and Organic Synthesis Research Laboratory, Department of Chemistry, Iran University of Science and Technology, Tehran 16846-13114, Iran
| | - Mostafa Ghafori Gorab
- Catalysts and Organic Synthesis Research Laboratory, Department of Chemistry, Iran University of Science and Technology, Tehran 16846-13114, Iran
| | - Ali Maleki
- Catalysts and Organic Synthesis Research Laboratory, Department of Chemistry, Iran University of Science and Technology, Tehran 16846-13114, Iran.
| | - Reza Ahangari Cohan
- Nanobiotechnology Department, New Technologies Research Group, Pasteur Institute of Iran, Tehran, Iran
| | - Mohammad Mahdavi
- Endocrinology and Metabolism Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran.
| | - Roksana Poodat
- Catalysts and Organic Synthesis Research Laboratory, Department of Chemistry, Iran University of Science and Technology, Tehran 16846-13114, Iran
| | - Faeze Keyvanlou
- Catalysts and Organic Synthesis Research Laboratory, Department of Chemistry, Iran University of Science and Technology, Tehran 16846-13114, Iran
| | - Mir Saeed Esmaeili
- Catalysts and Organic Synthesis Research Laboratory, Department of Chemistry, Iran University of Science and Technology, Tehran 16846-13114, Iran
| |
Collapse
|
18
|
Razia S, Park H, Shin E, Shim KS, Cho E, Kang MC, Kim SY. Synergistic effect of Aloe vera flower and Aloe gel on cutaneous wound healing targeting MFAP4 and its associated signaling pathway: In-vitro study. J Ethnopharmacol 2022; 290:115096. [PMID: 35182666 DOI: 10.1016/j.jep.2022.115096] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/26/2021] [Revised: 01/30/2022] [Accepted: 02/07/2022] [Indexed: 06/14/2023]
Abstract
ETHNOPHARMACOLOGICAL RELEVANCE Aloe vera (L.) Burm. f. (Liliaceae family) is a well-known traditional medicinal plant, that has been used to treat a variety of illnesses, for decades ranging from cancer to skin disorders including wounds. It has been included in the traditional and herbal healthcare systems of many cultures around the world, as well as the pharmacopeia of different countries. Several in vitro and in vivo studies have also confirmed its potential antioxidant, anti-inflammatory, and wound-healing activities, etc. in the consistency of its historical and traditional uses. However, most studies to date are based on the A. vera gel and latex including its wound-healing effects. Very few studies have been focused on its flower, and rarely with its effects on cutaneous wound healing and its molecular mechanism. AIM OF THE STUDY To the best of our knowledge, this is the first study to report on the synergistic effect of the A. vera flower (AVF) and Aloe gel (PAG) on cutaneous wound-healing, as well as revealing its molecular mechanism targeting microfibril-associated glycoprotein 4 (MFAP4) and its associated signaling pathway. METHODS To investigate the synergistic effect of A. vera flower and Aloe gel in cutaneous wound healing, cell viability, and cell migration, as well proliferation assay was performed. This was followed by quantitative real-time polymerase chain reaction and Western blot analyses in wounded conditions to check the effects of this mixture on protein and mRNA levels in normal human dermal fibroblast (NHDF) cells. Moreover, small interfering RNA (siRNA) -mediated knockdown of MFAP4 in NHDF cells was performed followed by migration assay and cell cycle analysis, to confirm its role in cutaneous wound healing. Additionally, HaCaT cells were included in this study to evaluate its migratory and anti-inflammatory effects. RESULTS Based on our obtained results, the PAG and AVF mixture synergistically induced the proliferation, migration, and especially ECM formation of NHDF cells by enhancing the expression of MFAP4. Other extracellular components associated with MFAP4 signaling pathway, such as fibrillin, collagen, elastin, TGF β, and α-SMA, also increased at both the protein and mRNA levels. Subsequently, this mixture initiated the phosphorylation of the extracellular signal-regulated kinase (ERK) and AKT signaling pathways, and the S-phase of the cell cycle was also slightly modified. Also, the mixture induced the migration of HaCaT cells along with the suppression of inflammatory cytokines. Moreover, the siRNA-mediated knockdown highlighted the crucial role of MFAP4 in cutaneous wound healing in NHDF cells. CONCLUSION This study showed that the mixture of PAG and AVF has significant wound healing effects targeting MFAP4 and its associated signaling pathway. Additionally, MFAP4 was recognized as a new potential biomarker of wound healing, which can be confirmed by further in vivo studies.
Collapse
Affiliation(s)
- Sultana Razia
- Department of Life Science, University of Seoul, Seoul, 02504, South Korea; Department of Pharmacy, Jagannath University, Dhaka, 1100, Bangladesh
| | - Hyunsung Park
- Department of Life Science, University of Seoul, Seoul, 02504, South Korea
| | - Eunju Shin
- Univera Co., Ltd., Seoul, 04782, Republic of Korea
| | - Kyu-Suk Shim
- Univera Co., Ltd., Seoul, 04782, Republic of Korea
| | - Eunae Cho
- Univera Co., Ltd., Seoul, 04782, Republic of Korea
| | - Min Chol Kang
- College of Pharmacy, Gachon University, 191 Hambakmoero, Yeonsu-gu, Incheon, 21936, South Korea
| | - Sun Yeou Kim
- College of Pharmacy, Gachon University, 191 Hambakmoero, Yeonsu-gu, Incheon, 21936, South Korea.
| |
Collapse
|
19
|
Mehra L, Mehra S, Tiwari N, Singh T, Rawat H, Belagavi S, Jaimini A, Mittal G. Fabrication, characterization and evaluation of the efficacy of gelatin/hyaluronic acid microporous scaffolds suffused with aloe-vera in a rat burn model. J Biomater Appl 2021; 36:1346-1358. [PMID: 34873947 DOI: 10.1177/08853282211061821] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
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.
Collapse
Affiliation(s)
- Lalita Mehra
- Department of Combat Sciences, 93048DRDO Institute of Nuclear Medicine and Allied Sciences, Delhi, India
| | - Smritee Mehra
- Department of Biotechnology, RinggoldID:231547Manav Rachna International Institute of Research and Studies, Faridabad, Haryana, India
| | - Nidhi Tiwari
- Department of Combat Sciences, 93048DRDO Institute of Nuclear Medicine and Allied Sciences, Delhi, India
| | - Thakuri Singh
- Department of Combat Sciences, 93048DRDO Institute of Nuclear Medicine and Allied Sciences, Delhi, India
| | - Harish Rawat
- Department of Nuclear Medicine, 93048DRDO Institute of Nuclear Medicine and Allied Sciences, Delhi, India
| | - Shreeshail Belagavi
- Department of Cytopathology, 93048DRDO Institute of Nuclear Medicine and Allied Sciences, Delhi, India
| | - Abhinav Jaimini
- Department of Nuclear Medicine, 93048DRDO Institute of Nuclear Medicine and Allied Sciences, Delhi, India
| | - Gaurav Mittal
- Department of Combat Sciences, 93048DRDO Institute of Nuclear Medicine and Allied Sciences, Delhi, India
| |
Collapse
|
20
|
Naini MA, Zargari-samadnejad A, Mehrvarz S, Tanideh R, Ghorbani M, Dehghanian A, Hasanzarrini M, Banaee F, Koohi-hosseinabadi O, Tanideh N, Iraji A, Liou K. Anti-Inflammatory, Antioxidant, and Healing-Promoting Effects of Aloe vera Extract in the Experimental Colitis in Rats. Evidence-Based Complementary and Alternative Medicine 2021; 2021:1-12. [PMID: 34912469 PMCID: PMC8668319 DOI: 10.1155/2021/9945244] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/02/2021] [Revised: 08/27/2021] [Accepted: 10/07/2021] [Indexed: 01/11/2023]
Abstract
Background. Ulcerative colitis is a worldwide chronic gastrointestinal disease characterized by variable extensions of colon mucosal inflammation. The available drugs have an incomplete response with various side effects and socioeconomic impacts. Aloe barbadensis Miller (Aloe vera) is a well-known medicinal plant with diverse pharmacological and therapeutic activities. As a result, in the current study, Aloe vera was selected to evaluate its therapeutic effects on experimental colitis in rats. Methods. This study is intended to evaluate the possible beneficial effect of Aloe vera for the treatment of experimental colitis. Trinitrobenzenesulfonic acid (TNBS) was used to induce experimental colitis in 60 of 70 Wistar rats. The rats were grouped in 7 clusters including healthy control, negative, positive control (received sulfasalazine), and test groups treated with Aloe vera extracts via oral or rectal routes. Macroscopic and histologic factors as well as the biochemical parameters were evaluated on day 7. Results. In the present study, it was found that serum levels of tumor necrosis factor-α (75 vs. 44 pg./ml), interleukin-6 (41 vs. 21 pg/ml), and nitric oxide (24 vs. 6 μm/ml) in TNBS-induced untreated colitis treatment were significantly increased as compared to healthy control. Similar patterns were also observed in malondialdehyde (76.41 vs. 236.35 μg/mg) and myeloperoxidase (4.24 vs. 29.38 U/mg) in colonic tissue. Among different treatments, rectal administration of Aloe vera extract (400 mg/kg) exhibited the best result in which serum concentration of tumor necrosis factor-α (55 pg/ml), interleukin-6 (24 pg/ml), and nitric oxide (10 μm/ml) and the levels of malondialdehyde (102.67 μg/mg), as well as myeloperoxidase (12.29 U/mg) in colon tissue, were reduced as compared to the untreated group. Also, the body weight and colon weight/length ratios were more improved in the treated group with 400 mg/kg Aloe vera extract, rectally. Conclusion. Aloe vera extract exhibited a therapeutic effect in TNBS-induced colitis, and local, rectal administration of Aloe vera extract was more effective than oral administration.
Collapse
|
21
|
Doluoglu OG, Yıldız Y, Tokat E, Ozgur BC, Kılınc MF, Inan MA, Gonul II, Hoscan MB. The Histopathological Effect of Aloe Vera on the Wound Healing Process in a Surgically Created Tubularized Incised Plate Urethroplasty Model on Rats. J INVEST SURG 2021; 35:1062-1066. [PMID: 34747308 DOI: 10.1080/08941939.2021.1999537] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
BACKGROUND Hypospadias is a common congenital anomaly which is determined as an abnormal urethral opening on the ventral face of penis. The purpose of this rat model study was to research the effect of topically applied Aloe vera after a tubularized incised plate urethroplasty (TIPU). METHODS The TIPU model was applied to male Wistar albino rats. A total of 30 rats were randomly grouped into 3 groups of 10. Group I was assigned as the control group, treated with 0.9% saline only twice a day for 15 days. Group II received topical Aloe vera gel once a day and Group III received Aloe vera gel twice a day. Spongiofibrosis was graded as 0: none, 1+:≤10% tissues involved, 2+:10%-49% tissues involved, 3+: ≥ 50% tissues involved. RESULTS A higher degree of fibrosis and inflammation was determined in the Group I subjects than in Groups II and III. Fibrosis of grade 3+ was observed in 33% of the control group and not in any of the two Aloe groups (p = 0.043). Inflammation of grade 3+ was seen in 66.7% of the control group, in 10% of Group II, and in 33% of Group III (p = 0.02). CONCLUSIONS The topical application of Aloe vera to a surgically created tubularized incised plate urethroplasty model decreased inflammation and fibrosis that may affect the success rates of this operation.
Collapse
Affiliation(s)
- Omer Gokhan Doluoglu
- Department of Urology Clinic of Ankara Training and Research Hospital, University of Medical Sciences, Ankara, Turkey
| | - Yıldıray Yıldız
- Department of Urology Clinic of Ankara Training and Research Hospital, University of Medical Sciences, Ankara, Turkey
| | - Eda Tokat
- Department of Urology Clinic of Ankara Training and Research Hospital, University of Medical Sciences, Ankara, Turkey
| | - Berat Cem Ozgur
- Department of Urology Clinic of Ankara Training and Research Hospital, University of Medical Sciences, Ankara, Turkey
| | - Muhammet Fatih Kılınc
- Department of Urology Clinic of Ankara Training and Research Hospital, University of Medical Sciences, Ankara, Turkey
| | - Mehmet Arda Inan
- Department of Pathology, Gazi University Faculty of Medicine, Ankara, Turkey
| | - Ipek Isık Gonul
- Department of Pathology, Gazi University Faculty of Medicine, Ankara, Turkey
| | | |
Collapse
|
22
|
Liu Y, Fan J, Lv M, She K, Sun J, Lu Q, Han C, Ding S, Zhao S, Wang G, Zhang Y, Zang G. Photocrosslinking silver nanoparticles-aloe vera-silk fibroin composite hydrogel for treatment of full-thickness cutaneous wounds. Regen Biomater 2021; 8:rbab048. [PMID: 34513005 PMCID: PMC8419525 DOI: 10.1093/rb/rbab048] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2021] [Revised: 08/05/2021] [Accepted: 08/11/2021] [Indexed: 12/14/2022] Open
Abstract
Damage to the skin causes physiological and functional issues. The most effective treatment approach is the use of wound dressings. Silk fibroin (SF) is a promising candidate biomaterial for regulating wound healing; however, its antibacterial properties and biological activity must be further improved. In this study, a photocrosslinking hydrogel was developed to treat full-thickness cutaneous wounds. The composite hydrogel (Ag–AV–SF hydrogel) was prepared by introducing the silver nanoparticles (AgNPs) and aloe vera (AV) as the modifiers. In vitro study exhibited great antibacterial ability, biocompatibility and cell-proliferation and -migration-promoting capacities. It also showed the pH-response releasing properties which release more AgNPs in a simulated chronic infection environment. The healing effect evaluation in vivo showed the healing-promoting ability of the Ag–AV–SF hydrogel was stronger than the single-modifiers groups, and the healing rate of it reached 97.02% on Day 21, higher than the commercial wound dressing, silver sulfadiazine (SS) cream on sale. Additionally, the histological and protein expression results showed that the Ag–AV–SF hydrogel has a greater effect on the pro-healing regenerative phenotype with M2 macrophages at the early stage, reconstructing the blood vessels networks and inhibiting the formation of scars. In summary, the Ag–AV–SF hydrogel developed in this study had good physical properties, overwhelming antibacterial properties, satisfactory biocompatibility and significantly promoting effect on cell proliferation, migration and wound healing. Overall, our results suggest that the Ag–AV–SF hydrogel we developed has great potential for improving the wound healing in clinical treatment.
Collapse
Affiliation(s)
- Yangkun Liu
- Institute of Life Science, And Laboratory of Tissue and Cell Biology, Lab Teaching & Management Center, Chongqing Medical University, Chongqing 400016, China
| | - JinChuan Fan
- Institute of Life Science, And Laboratory of Tissue and Cell Biology, Lab Teaching & Management Center, Chongqing Medical University, Chongqing 400016, China
| | - MingQi Lv
- Institute of Life Science, And Laboratory of Tissue and Cell Biology, Lab Teaching & Management Center, Chongqing Medical University, Chongqing 400016, China
| | - Kepeng She
- Institute of Life Science, And Laboratory of Tissue and Cell Biology, Lab Teaching & Management Center, Chongqing Medical University, Chongqing 400016, China
| | - Jiale Sun
- Institute of Life Science, And Laboratory of Tissue and Cell Biology, Lab Teaching & Management Center, Chongqing Medical University, Chongqing 400016, China
| | - Qingqing Lu
- Institute of Life Science, And Laboratory of Tissue and Cell Biology, Lab Teaching & Management Center, Chongqing Medical University, Chongqing 400016, China
| | - Changhao Han
- Institute of Life Science, And Laboratory of Tissue and Cell Biology, Lab Teaching & Management Center, Chongqing Medical University, Chongqing 400016, China
| | - SongTao Ding
- Institute of Life Science, And Laboratory of Tissue and Cell Biology, Lab Teaching & Management Center, Chongqing Medical University, Chongqing 400016, China
| | - Shuang Zhao
- Institute of Life Science, And Laboratory of Tissue and Cell Biology, Lab Teaching & Management Center, Chongqing Medical University, Chongqing 400016, China.,Key Laboratory for Biorheological Science and Technology of Ministry of Education, State and Local Joint Engineering Laboratory for Vascular Implants, Bioengineering College of Chongqing University, Chongqing 400030, China
| | - GuiXue Wang
- Key Laboratory for Biorheological Science and Technology of Ministry of Education, State and Local Joint Engineering Laboratory for Vascular Implants, Bioengineering College of Chongqing University, Chongqing 400030, China
| | - YuChan Zhang
- Institute of Life Science, And Laboratory of Tissue and Cell Biology, Lab Teaching & Management Center, Chongqing Medical University, Chongqing 400016, China
| | - GuangChao Zang
- Institute of Life Science, And Laboratory of Tissue and Cell Biology, Lab Teaching & Management Center, Chongqing Medical University, Chongqing 400016, China
| |
Collapse
|
23
|
Deesricharoenkiat N, Jansisyanont P, Chuenchompoonut V, Mattheos N, Thunyakitpisal P. The effect of acemannan in implant placement with simultaneous guided bone regeneration in the aesthetic zone: a randomized controlled trial. Int J Oral Maxillofac Surg 2021; 51:535-544. [PMID: 34429224 DOI: 10.1016/j.ijom.2021.07.017] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2020] [Revised: 05/15/2021] [Accepted: 07/26/2021] [Indexed: 01/16/2023]
Abstract
Acemannan, a linear polysaccharide produced by Aloe vera, has been shown to have important biological effects promoting wound healing and tissue regeneration. The aim of this randomized clinical trial was to investigate the impact of acemannan in guided bone regeneration (GBR) with simultaneous implant placement. Twenty patients were randomly allocated to a test group (deproteinized bovine bone with particulate acemannan (mean size 32.45 μm)) and a control group (deproteinized bovine bone only). Twenty implants were placed with simultaneous GBR. Radiographic measurements were conducted on cone beam computed tomography (CBCT) scans immediately post-surgery and at 3 and 6 months. Vertical and horizontal dimensions of the buccal bone were measured at the implant platform (0) and at points 2, 4, 6, and 8 mm apically. The dimensional reduction of vertical and horizontal buccal bone was significantly smaller in the test group at 3 months postoperative (P < 0.05) at every position measured (0, 2, 4, 6, 8 mm), but the difference was not statistically significant at 6 months. Acemannan was found to be a safe and predictable biomaterial for GBR, which resulted in enhanced dimensional stability of the regenerated tissue at 3 months. However, these results were not replicated at 6 months. Further studies are required to document the long-term efficacy and potential of acemannan use as a supplement in bone regeneration.
Collapse
Affiliation(s)
- N Deesricharoenkiat
- Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Chulalongkorn University, Bangkok, Thailand
| | - P Jansisyanont
- Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Chulalongkorn University, Bangkok, Thailand.
| | - V Chuenchompoonut
- Department of Radiology, Faculty of Dentistry, Chulalongkorn University, Bangkok, Thailand
| | - N Mattheos
- Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Chulalongkorn University, Bangkok, Thailand; Department of Dental Medicine, Karolinska Institute, Stockholm, Sweden
| | - P Thunyakitpisal
- Department of Anatomy, Faculty of Dentistry, Chulalongkorn University, Bangkok, Thailand
| |
Collapse
|
24
|
Yazarlu O, Iranshahi M, Kashani HRK, Reshadat S, Habtemariam S, Iranshahy M, Hasanpour M. Perspective on the application of medicinal plants and natural products in wound healing: A mechanistic review. Pharmacol Res 2021; 174:105841. [PMID: 34419563 DOI: 10.1016/j.phrs.2021.105841] [Citation(s) in RCA: 49] [Impact Index Per Article: 16.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/08/2021] [Revised: 08/14/2021] [Accepted: 08/17/2021] [Indexed: 12/14/2022]
Abstract
Wound is defined as any injury to the body such as damage to the epidermis of the skin and disturbance to its normal anatomy and function. Since ancient times, the importance of wound healing has been recognized, and many efforts have been made to develop novel wound dressings made of the best material for rapid and effective wound healing. Medicinal plants play a great role in the wound healing process. In recent decades, many studies have focused on the development of novel wound dressings that incorporate medicinal plant extracts or their purified active compounds, which are potential alternatives to conventional wound dressings. Several studies have also investigated the mechanism of action of various herbal medicines in wound healing process. This paper attempts to highlight and review the mechanistic perspective of wound healing mediated by plant-based natural products. The findings showed that herbal medicines act through multiple mechanisms and are involved in various stages of wound healing. Some herbal medicines increase the expression of vascular endothelial growth factor (VEGF) and transforming growth factor-β (TGF-β) which play important role in stimulation of re-epithelialization, angiogenesis, formation of granulation tissue, and collagen fiber deposition. Some other wound dressing containing herbal medicines act as inhibitor of tumor necrosis factor-α (TNF-α), interleukin-1β (IL-1β) and inducible nitric oxide synthase (iNOS) protein expression thereby inducing antioxidant and anti-inflammatory properties in various phases of the wound healing process. Besides the growing public interest in traditional and alternative medicine, the use of herbal medicine and natural products for wound healing has many advantages over conventional medicines, including greater effectiveness due to diverse mechanisms of action, antibacterial activity, and safety in long-term wound dressing usage.
Collapse
Affiliation(s)
- Omid Yazarlu
- Mashhad University of Medical Sciences, Department of General Surgery, Mashhad, Iran
| | - Mehrdad Iranshahi
- Biotechnology Research Center, Pharmaceutical Technology Institute, Mashhad University of Medical Sciences, Mashhad, Iran
| | | | - Sara Reshadat
- Department of Internal Medicine, Semnan University of Medical Sciences, Semnan, Iran
| | - Solomon Habtemariam
- Pharmacognosy Research Laboratories and Herbal Analysis Services UK, University of Greenwich, Central Avenue, Chatham-Maritime, Kent ME4 4TB, UK
| | - Milad Iranshahy
- Department of Pharmacognosy, School of Pharmacy, Mashhad University of Medical Sciences, Mashhad, Iran.
| | - Maede Hasanpour
- Biotechnology Research Center, Pharmaceutical Technology Institute, Mashhad University of Medical Sciences, Mashhad, Iran.
| |
Collapse
|
25
|
Verma C, Gupta A, Singh S, Somani M, Sharma A, Singh P, Bhan S, Dey A, Rymbai R, Lyngdoh A, Nonglang FP, Anjum S, Gupta B. Bioactive Khadi Cotton Fabric by Functional Designing and Immobilization of Nanosilver Nanogels. ACS Appl Bio Mater 2021; 4:5449-5460. [PMID: 35006726 DOI: 10.1021/acsabm.1c00159] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
Abstract
The antimicrobial finishing is the most suitable alternative for designing medical textiles for biomedical applications. The present investigation aims at the preparation of skin-contacting khadi cotton fabric that would prevent microbial infection and offer excellent skin compatibility. A simple approach has been followed for the preparation of bioactive nanogels for antimicrobial finishing of the khadi cotton fabric. Bioactive nanogels were synthesized by using aloe vera (AV) as a reducing agent for silver ions in the presence of polyvinyl alcohol (PVA). PVA stabilizes the growth of silver nanoparticles, which is influenced by the variation in the reaction time and the temperature. Nanogels were characterized by transmission electron microscopy and scanning electron microscopy analyses. The nanogels exhibited strong antimicrobial behavior against both Staphylococcus aureus and Escherichia coli, as confirmed by the colony count method. Almost 100% antibacterial behavior was observed for the nanosilver content of 10 mM. The nanogel-finished khadi fabric showed bactericidal properties against both S. aureus and E. coli. The nanogel-finished fabric exhibited high hydrophilicity allowing complete water droplet penetration within 10 s as compared to 136 s in virgin fabric. Moreover, the skin irritation study of the fabric on male Swiss albino mice did not show any appearance of dermal toxicity. These results demonstrated that the bioactive finished khadi fabric is appropriate as skin contacting material in human health care.
Collapse
Affiliation(s)
- Chetna Verma
- Bioengineering Laboratory, Department of Textile & Fibre Engineering, Indian Institute of Technology, New Delhi 110016, India
| | - Anushka Gupta
- Bioengineering Laboratory, Department of Textile & Fibre Engineering, Indian Institute of Technology, New Delhi 110016, India
| | - Surabhi Singh
- Bioengineering Laboratory, Department of Textile & Fibre Engineering, Indian Institute of Technology, New Delhi 110016, India
| | - Manali Somani
- Bioengineering Laboratory, Department of Textile & Fibre Engineering, Indian Institute of Technology, New Delhi 110016, India
| | - Ankita Sharma
- Bioengineering Laboratory, Department of Textile & Fibre Engineering, Indian Institute of Technology, New Delhi 110016, India
| | - Pratibha Singh
- Bioengineering Laboratory, Department of Textile & Fibre Engineering, Indian Institute of Technology, New Delhi 110016, India
| | - Surya Bhan
- Department of Biochemistry, North Eastern Hill University, Shillong 793022, Meghalaya, India
| | - Ankita Dey
- Department of Biochemistry, North Eastern Hill University, Shillong 793022, Meghalaya, India
| | - Ridashisha Rymbai
- Department of Biochemistry, North Eastern Hill University, Shillong 793022, Meghalaya, India
| | - Antonia Lyngdoh
- Department of Biochemistry, North Eastern Hill University, Shillong 793022, Meghalaya, India
| | | | - Sadiya Anjum
- Bioengineering Laboratory, Department of Textile & Fibre Engineering, Indian Institute of Technology, New Delhi 110016, India
| | - Bhuvanesh Gupta
- Bioengineering Laboratory, Department of Textile & Fibre Engineering, Indian Institute of Technology, New Delhi 110016, India
| |
Collapse
|
26
|
Rauwald HW, Maucher R, Dannhardt G, Kuchta K. Dihydroisocoumarins, Naphthalenes, and Further Polyketides from Aloe vera and A. plicatilis: Isolation, Identification and Their 5-LOX/COX-1 Inhibiting Potency. Molecules 2021; 26:4223. [PMID: 34299499 DOI: 10.3390/molecules26144223] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2021] [Revised: 07/01/2021] [Accepted: 07/03/2021] [Indexed: 11/16/2022] Open
Abstract
The present study aims at the isolation and identification of diverse phenolic polyketides from Aloe vera (L.) Burm.f. and Aloe plicatilis (L.) Miller and includes their 5-LOX/COX-1 inhibiting potency. After initial Sephadex-LH20 gel filtration and combined silica gel 60- and RP18-CC, three dihydroisocoumarins (nonaketides), four 5-methyl-8-C-glucosylchromones (heptaketides) from A. vera, and two hexaketide-naphthalenes from A. plicatilis have been isolated by means of HSCCC. The structures of all polyketides were elucidated by ESI-MS and 2D 1H/13C-NMR (HMQC, HMBC) techniques. The analytical/preparative separation of 3R-feralolide, 3′-O-β-d-glucopyranosyl- and the new 6-O-β-d-glucopyranosyl-3R-feralolide into their respective positional isomers are described here for the first time, including the assignment of the 3R-configuration in all feralolides by comparative CD spectroscopy. The chromones 7-O-methyl-aloesin and 7-O-methyl-aloeresin A were isolated for the first time from A. vera, together with the previously described aloesin (syn. aloeresin B) and aloeresin D. Furthermore, the new 5,6,7,8-tetrahydro-1-O-β-d-glucopyranosyl- 3,6R-dihydroxy-8R-methylnaphtalene was isolated from A. plicatilis, together with the known plicataloside. Subsequently, biological-pharmacological screening was performed to identify Aloe polyketides with anti-inflammatory potential in vitro. In addition to the above constituents, the anthranoids (octaketides) aloe emodin, aloin, 6′-(E)-p-coumaroyl-aloin A and B, and 6′-(E)-p-coumaroyl-7-hydroxy-8-O-methyl-aloin A and B were tested. In the COX-1 examination, only feralolide (10 µM) inhibited the formation of MDA by 24%, whereas the other polyketides did not display any inhibition at all. In the 5-LOX-test, all aloin-type anthranoids (10 µM) inhibited the formation of LTB4 by about 25–41%. Aloesin also displayed 10% inhibition at 10 µM in this in vitro setup, while the other chromones and naphthalenes did not display any activity. The present study, therefore, demonstrates the importance of low molecular phenolic polyketides for the known overall anti-inflammatory activity of Aloe vera preparations.
Collapse
|
27
|
Alven S, Khwaza V, Oyedeji OO, Aderibigbe BA. Polymer-Based Scaffolds Loaded with Aloe vera Extract for the Treatment of Wounds. Pharmaceutics 2021; 13:961. [PMID: 34206744 PMCID: PMC8309095 DOI: 10.3390/pharmaceutics13070961] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2021] [Revised: 04/15/2021] [Accepted: 04/15/2021] [Indexed: 12/16/2022] Open
Abstract
The treatment of wounds is one challenging biomedical field due to delayed wound healing common in chronic wounds. Several factors delay wound healing, including microbial infections, malnutrition, underlying physiological conditions, etc. Most of the currently used wound dressing materials suffer from poor antimicrobial properties, poor biodegradability and biocompatibility, and weak mechanical performance. Plant extracts, such as Aloe vera, have attracted significant attention in wound management because of their interesting biological properties. Aloe vera is composed of essential constituents beneficial for the wound healing process, such as amino acids, vitamins C and E, and zinc. Aloe vera influences numerous factors that are involved in wound healing and stimulates accelerated healing. This review reports the therapeutic outcomes of aloe vera extract-loaded polymer-based scaffolds in wound management.
Collapse
Affiliation(s)
| | | | | | - Blessing A. Aderibigbe
- Department of Chemistry, University of Fort Hare, Alice 5700, Eastern Cape, South Africa; (S.A.); (V.K.); (O.O.O.)
| |
Collapse
|
28
|
Retnowati D, Sari R, Hendradi E, Septiani S. The stability and irritability study of the chitosan- Aloe vera spray gel as wound healing. J Basic Clin Physiol Pharmacol 2021; 32:651-656. [PMID: 34214357 DOI: 10.1515/jbcpp-2020-0407] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2020] [Accepted: 03/03/2021] [Indexed: 11/15/2022]
Abstract
OBJECTIVES Chitosan is a natural polysaccharide widely used in various clinical applications including regeneration of skin tissue. Aloe vera has properties in healing burns on the skin, anti-inflammatory effect, and leaves a protective layer on the skin after drying so it provides protection to the wound. The spray gel of chitosan-A. vera was developed as a wound healing that has combined of effect of both component and easy to use. The purpose of this study was to determine the physical stability and irritability of chitosan-A. vera spray gel. METHODS The spray gel stability test was conducted using thermal cycling and centrifugation methods. The organoleptic, viscosity, and pH of the spray were evaluated. The irritation test was performed by Draize Rabbit Test method. RESULTS Chitosan (0.5%)-A. vera (1%) spray gel characteristics has a weak yellow color, clear, and a strong A. vera odor. The pH of the spray gel was 4.88 ± 0.01; and the viscosity was 36.50 ± 0.23 cps. The result from the chitosan (0.5%)-A. vera (1%) spray gel stability test using thermal cycling method showed a decrease of viscosity, but remained stable when evaluated using centrifugation method. There was no difference in the pH and organoleptic observation from both tests. Based on the scoring and analysis of the reaction in rabbit skin, the Primary Irritation Index (PII) obtained was 0.56. CONCLUSIONS The spray gel of chitosan (0.5%)-A. vera (1%) was stable and according to response category from the acute dermal irritation test, it can be concluded that chitosan (0.5%)-A. vera (1%) spray gel had a slightly irritating effect.
Collapse
Affiliation(s)
- Dini Retnowati
- Department of Pharmaceutics, Faculty of Pharmacy, University of Airlangga, Surabaya, Indonesia
| | - Retno Sari
- Department of Pharmaceutics, Faculty of Pharmacy, University of Airlangga, Surabaya, Indonesia
| | - Esti Hendradi
- Department of Pharmaceutics, Faculty of Pharmacy, University of Airlangga, Surabaya, Indonesia
| | - Septiani Septiani
- Department of Pharmaceutics, Faculty of Pharmacy, University of Airlangga, Surabaya, Indonesia
| |
Collapse
|
29
|
Lee H, Choi W, Ro H, Kim G, Lee H. Skin Antiaging Effects of the Fermented Outer Layers of Leaf Skin of Aloe barbadensis Miller Associated with the Enhancement of Mitochondrial Activities of UVb-Irradiated Human Skin Fibroblasts. Applied Sciences 2021; 11:5660. [DOI: 10.3390/app11125660] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
This study is the first to show that increased mitochondrial activities improved the antiaging effects of Aloe vera leaf skin fermented by Lactobacillus plantarum on UVb-irradiated skin fibroblasts. The fermented extract (AF) increased the activities of mitochondrial reductase and the complex II and significantly reduced reactive oxygen species (ROS) production, even under UVb stress conditions, and also increased DPPH free radical scavenging activities compared with the hot water extract of outer layers of aloe leaf (AW) and quercetin itself. AF exerted a synergistic effect with quercetin and bioactive substances derived from the fermentation process. Moreover, mitochondrial activation of UVb-irradiated human skin fibroblasts by 0.3% (w/v) of the AF plays important roles in increasing collagen production up to 125 ± 5.45% and decreasing MMP-1 secretion down to 69.41 ± 2.63% of the control levels. The AF enhanced the upregulation of collagen gene expression, and this change was also greater than those induced by the AW and quercetin. Therefore, this study concludes that fermentation of the skin of aloe leaves increases the activation of mitochondria and inhibits the photo-aging of UVb-irradiated skin fibroblasts.
Collapse
|
30
|
Barbosa R, Villarreal A, Rodriguez C, De Leon H, Gilkerson R, Lozano K. Aloe Vera extract-based composite nanofibers for wound dressing applications. Mater Sci Eng C Mater Biol Appl 2021; 124:112061. [PMID: 33947555 DOI: 10.1016/j.msec.2021.112061] [Citation(s) in RCA: 21] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/05/2021] [Revised: 03/12/2021] [Accepted: 03/20/2021] [Indexed: 01/02/2023]
Abstract
Natural, biocompatible, and biodegradable composite nanofibers made of Aloe vera extract, pullulan, chitosan, and citric acid were successfully produced via Forcespinning® technology. The addition of Aloe vera extract at different weight percent loadings was investigated. The morphology, thermal properties, physical properties, and water absorption of the nanofibers were characterized using scanning electron microscopy (SEM), Fourier transform infrared spectroscopy (FTIR), and thermogravimetric analysis (TGA). The developed nanofiber membranes exhibited good water absorption capabilities, synergistic antibacterial activity against Escherichia coli, and promoted cell attachment and growth. Its porous and high surface area structure make it a potential candidate for wound dressing applications due to its ability to absorb excessive blood and exudates, as well as provide protection from infection while maintaining good thermal stability.
Collapse
Affiliation(s)
- Raul Barbosa
- Department of Mechanical Engineering, University of Texas Rio Grande Valley, Edinburg, TX 78539, USA
| | - Alexa Villarreal
- Department of Mechanical Engineering, University of Texas Rio Grande Valley, Edinburg, TX 78539, USA
| | - Cristobal Rodriguez
- Department of Biology, University of Texas Rio Grande Valley, Edinburg, TX 78539, USA
| | - Heriberto De Leon
- Department of Mechanical Engineering, University of Texas Rio Grande Valley, Edinburg, TX 78539, USA
| | - Robert Gilkerson
- Department of Biology, University of Texas Rio Grande Valley, Edinburg, TX 78539, USA
| | - Karen Lozano
- Department of Mechanical Engineering, University of Texas Rio Grande Valley, Edinburg, TX 78539, USA.
| |
Collapse
|
31
|
Sahebnasagh A, Saghafi F, Ghasemi A, Akbari J, Alipour A, Habtemariam S, Safdari M, Ghaleno HR, Salehifar E. Aloe vera for Prevention of Acute Radiation Proctitis in Colorectal Cancer a Preliminary Randomized, Placebo-Controlled Clinical Trial. J Gastrointest Cancer 2021; 53:318-325. [PMID: 33616843 DOI: 10.1007/s12029-021-00597-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/26/2021] [Indexed: 12/01/2022]
Abstract
OBJECTIVE To examine the preventive effects of Aloe vera in colorectal cancer patients undergoing radiotherapy. MATERIAL AND METHOD Twenty colorectal cancer patients, who received radiation, were randomized to receive Aloe vera 3% or placebo ointment, 1 g twice daily for 6 weeks. At weekly visits, acute radiation proctitis (ARP) was evaluated by Radiation Therapy Oncology Group and clinical presentation criteria as the primary endpoint. We also evaluated secondary endpoints of quality of life, psychosocial status, by applying Hospital Anxiety-Depression (HAD) Scale and laboratory measures of quantitative measurement of C-reactive protein (CRP) as a marker for systemic inflammation. RESULTS There was a significant improvement in the symptom index (before treatment vs. after treatment with Aloe vera) for diarrhea (p = 0.029, median score: 0.5 vs. 0.001). The overall primary and secondary outcomes favored Aloe group, while the measures of toxicity did not achieve a statistical significant difference. The lifestyle score improved significantly with A. vera (p = 004), and they also had a lower depression score in HAD scale (p = 0.008). Furthermore, quantitative CRP decreased significantly during the course of treatment with Aloe vera. CONCLUSION The use of topical formulation of Aloe vera 3% diminishes the severity of ARP in colorectal cancer patients.
Collapse
Affiliation(s)
- Adeleh Sahebnasagh
- Clinical Research Center, Department of Internal Medicine, Faculty of Medicine, North Khorasan University of Medical Sciences, Bojnurd, Iran
| | - Fatemeh Saghafi
- Department of Clinical Pharmacy, School of Pharmacy, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
| | - Arash Ghasemi
- Emam Khomeini Hospital, Mazandaran University of Medical Sciences, Sari, Iran
| | - Jafar Akbari
- Pharmaceutical Research Center, Faculty of Pharmacy, Mazandaran University of Medical Sciences, Sari, Iran
| | - Abbas Alipour
- Faculty of Medicine, Community Medicine Department, Mazandaran University of Medical Sciences, Sari, Iran
| | - Solomon Habtemariam
- Pharmacognosy Research Laboratories and Herbal Analysis Services UK, University of Greenwich, Central Avenue, Chatham-Maritime,, ME4 4TB, Kent, UK
| | - Mohammadreza Safdari
- Department of Orthopedic Surgery, Faculty of Medicine, North Khorasan University of Medical Sciences, Bojnurd, Iran
| | - Hassan Rezai Ghaleno
- Department of Surgery, Faculty of Medicine, Lorestan University of Medical Sciences, Khorramabad, Iran
| | - Ebrahim Salehifar
- Pharmaceutical Sciences Research Center, Faculty of Pharmacy, Hemoglobinopathy Institute, Mazandaran University of Medical Sciences, Sari, Iran.
| |
Collapse
|
32
|
Huang PW, Lu CW, Chu KT, Ho MT. Assessing Thickness of Burn Scars Through Ultrasound Measurement for Patients with Arm Burns. J Med Biol Eng 2021. [DOI: 10.1007/s40846-020-00592-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
|
33
|
Tariq M, Tahir HM, Butt SA, Ali S, Ahmad AB, Raza C, Summer M, Hassan A, Nadeem J. Silk derived formulations for accelerated wound healing in diabetic mice. PeerJ 2021; 9:e10232. [PMID: 33510964 PMCID: PMC7798629 DOI: 10.7717/peerj.10232] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2020] [Accepted: 10/02/2020] [Indexed: 12/15/2022] Open
Abstract
BACKGROUND The present study aimed to prepare effective silk derived formulations in combination with plant extract (Aloe vera gel) to speed up the wound healing process in diabetic mice. METHODS Diabetes was induced in albino mice by using alloxan monohydrate. After successful induction of diabetes in mice, excision wounds were created via biopsy puncture (6 mm). Wound healing effect of silk sericin (5%) and silk fibroin (5%) individually and in combination with 5% Aloe vera gel was evaluated by determining the percent wound contraction, healing time and histological analysis. RESULTS The results indicated that the best biocompatible silk combination was of 5% silk fibroin and 5% Aloe vera gel in which wounds were healed in 13 days with wound contraction: 98.33 ± 0.80%. In contrast, the wound of the control group (polyfax) healed in 19 day shaving 98.5 ± 0.67% contraction. Histological analysis revealed that the wounds which were treated with silk formulations exhibited an increased growth of blood vessels, collagen fibers, and much reduced inflammation. CONCLUSION It can be concluded that a combination of Bombyx mori silk and Aloe vera gel is a natural biomaterial that can be utilized in wound dressings and to prepare more innovative silk based formulations for speedy recovery of chronic wounds.
Collapse
Affiliation(s)
- Muniba Tariq
- Department of Zoology, Government College University Lahore, Lahore, Pakistan
| | | | - Samima Asad Butt
- Department of Zoology, Government College University Lahore, Lahore, Pakistan
| | - Shaukat Ali
- Department of Zoology, Government College University Lahore, Lahore, Pakistan
| | - Asma Bashir Ahmad
- Department of Zoology, Government College University Lahore, Lahore, Pakistan
| | - Chand Raza
- Department of Zoology, Government College University Lahore, Lahore, Pakistan
| | - Muhammad Summer
- Department of Zoology, Government College University Lahore, Lahore, Pakistan
| | - Ali Hassan
- Department of Zoology, Government College University Lahore, Lahore, Pakistan
| | - Junaid Nadeem
- Department of Zoology, Government College University Lahore, Lahore, Pakistan
| |
Collapse
|
34
|
Gok Metin Z, Helvaci A, Gulbahar Eren M. Effects of Aloe vera in adults with mucocutaneous problems: A systematic review and meta-analysis. J Adv Nurs 2020; 77:1105-1126. [PMID: 33336470 DOI: 10.1111/jan.14653] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2020] [Revised: 09/23/2020] [Accepted: 10/27/2020] [Indexed: 11/30/2022]
Abstract
AIMS To analyse the different types of Aloe vera (AV) effects on various mucocutaneous problems among adults. DESIGN A systematic review and meta-analysis. DATA SOURCES An exhaustive scanning of PubMed, Medline, ScienceDirect, and Google Scholar databases was conducted from January 2000-December 2019. REVIEW METHODS Randomized controlled trials (RCTs) publishing reports on the effects of AV in various mucocutaneous problems, psoriasis, burn, wound-healing were included. The standardized mean differences (SMD) with 95% confidence Intervals (CIs) were determined for the main outcomes, heterogeneity was analysed using the I2 test and the risk of bias in the studies was reviewed by the Cochrane risk of bias assessment tool. RESULTS The study included 23 trials with a total of 4,023 participants. Six trials were included in the meta-analysis. The results indicated no significant differences in pain scores as assessed by the Visual Analog Scale (VAS) (SMD = 0.11, 95% CI: -0.37 to 0.59). The Psoriasis Area Severity Index (PASI) scores were significantly lower following AV gel application in two of the studies (SMD = -1.32 95% CI: -1.86 to -0.78). Considering results in a systematic manner, AV accelerated tissue epithelialization and wound-healing process (N = 3), reduced oral mucositis (N = 3), and improved quality of life (N = 1). CONCLUSION AV might have beneficial effects in reducing pain scores and the severity of mucocutaneous problems compared with placebo, especially with limited mild to moderate adverse effects. IMPACT AV may be used as an alternative and integrative approach to reducing symptom severity in mucocutaneous problems and the wound-healing process. High quality and well-designed RCTs are still needed to elucidate the effects of AV in a variety of dosages and forms among adults with mucocutaneous problems.
Collapse
Affiliation(s)
- Zehra Gok Metin
- Internal Medicine Nursing Department, Faculty of Nursing, Hacettepe University, Ankara, Turkey
| | - Aylin Helvaci
- Internal Medicine Nursing Department, Faculty of Nursing, Hacettepe University, Ankara, Turkey
| | - Merve Gulbahar Eren
- Internal Medicine Nursing Department, Faculty of Nursing, Hacettepe University, Ankara, Turkey
| |
Collapse
|
35
|
Lohse J, Pietrantoni P, Tummers C. Management of Thermal Injuries in Donkeys: A Case Report. Animals (Basel) 2020; 10:2131. [PMID: 33212805 PMCID: PMC7696336 DOI: 10.3390/ani10112131] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2020] [Revised: 11/07/2020] [Accepted: 11/10/2020] [Indexed: 11/18/2022] Open
Abstract
Simple Summary Reports or descriptions of medical management of thermal injuries in donkeys is lacking. Four donkeys sustained burn injuries during the wildland–urban interface fire in Valparaiso, Chile, in 2014. The donkeys received first aid care at the scene of the fire, and then were hospitalized and treated for three months for thermal injuries, of various degrees of severity, in several body parts. The clinical findings and treatment of four of the donkeys are described in this paper. All donkeys recovered and were retired to an animal shelter. Abstract Burn injuries are uncommon in large animals and there are no reports of these injuries in donkeys. Burns cause local and systemic effects. Extensive thermal injuries can be challenging to manage and the extent of the burn surface affected will directly impact the severity of the illness and the prognosis. Burns are classified according to the depth of injury into four categories, from first-degree burns, and the least affect to fourth-degree burns, which are the more severely affected patients. This case report describes the medical management of four donkeys that sustained various degrees of external burn injuries during the wildland–urban interface fire in Valparaiso, Chile. The donkeys were treated topically for several weeks and closely monitor for inadequate nutritional intake. Water based topical medications are preferred in burn cases because they can be easily applied and removed without interfering with wound healing. Of note, the caloric demands of these cases can be achieved by increasing the amount of grain, adding fat (i.e., vegetable oil), and free-choice alfalfa hay. All donkeys recovered and were retired to an animal shelter.
Collapse
|
36
|
Kumar N, Jose J. Current developments in the nanomediated delivery of photoprotective phytochemicals. Environ Sci Pollut Res Int 2020; 27:38446-38471. [PMID: 32761528 DOI: 10.1007/s11356-020-10100-y] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/28/2020] [Accepted: 07/10/2020] [Indexed: 06/11/2023]
Abstract
Natural products have been used to protect the skin from harmful UV radiation for decades. Due to the ecotoxicological implications of synthetic sunscreen exposure in aquatic ecosystems, there is a greater need to explore alternative sources of UV filters. Recent research has focused on discovering novel UV absorbing photoprotective molecules from nature. In response to the excessive damage caused by UVB rays, plants induce the production of high concentrations of phytoprotective secondary metabolites and anti-oxidative enzymes. Despite promising UV absorbing and photoprotective properties, plant secondary metabolites have been underutilized in topical delivery due to low solubility and high instability. Numerous phytochemicals have been effectively nanosized, incorporated in formulations, and studied for their sustained effects in photoprotection. The present review outlines recent developments in nanosizing and delivering photoprotective crude plant extract and phytochemicals from a phytochemical perspective. We searched for articles using keywords: "UV damage," "skin photoprotection," "photodamage," and "nano delivery" in varied combinations. We identified and reviewed literature from 43 original research articles exploring nanosized phytochemicals and crude plant extracts with photoprotective activity. Nanosized phytochemicals retained higher amounts of bioactive compounds in the skin and acted as depots for their sustained release. Novel approaches in nanosizing considerably improved the photostability, efficacy, and water resistance of plant secondary metabolites. We further discuss the need for broad-spectrum sunscreen products, potential challenges, and future growth in this area.
Collapse
Affiliation(s)
- Nimmy Kumar
- Department of Pharmacognosy, NITTE Gulabi Shetty Memorial Institute of Pharmaceutical Sciences, NITTE Deemed-to-be University, 575018, Mangalore, India
| | - Jobin Jose
- Department of Pharmaceutics, NITTE Gulabi Shetty Memorial Institute of Pharmaceutical Sciences, NITTE Deemed-to-be University, Mangalore, 575018, India.
| |
Collapse
|
37
|
Salehi M, Zamiri S, Samadian H, Ai J, Foroutani L, Ai A, Khanmohammadi M. Chitosan hydrogel loaded with
Aloe vera
gel and tetrasodium ethylenediaminetetraacetic acid (
EDTA
) as the wound healing material: in vitro and in vivo study. J Appl Polym Sci 2020. [DOI: 10.1002/app.50225] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Affiliation(s)
- Majid Salehi
- Tissue Engineering and Stem Cells Research Center Shahroud University of Medical Sciences Shahroud Iran
- Department of Tissue Engineering, School of Medicine Shahroud University of Medical Sciences Shahroud Iran
| | - Sina Zamiri
- Department of Kinesiology and Health Science York University Toronto Ontario Canada
| | - Hadi Samadian
- Department of Medical Nanotechnology, School of Pharmacy Kermanshah University of Medical Sciences Kermanshah Iran
- Nano Drug Delivery Research Center, Health Technology Institute Kermanshah University of Medical Sciences Kermanshah Iran
| | - Jafar Ai
- Department of Tissue Engineering and Applied Cell Sciences, School of Advanced Technologies in Medicine Tehran University of Medical Sciences Tehran Iran
| | - Laleh Foroutani
- School of Medicine Tehran University of Medical Sciences Tehran Iran
| | - Arman Ai
- School of Medicine Tehran University of Medical Sciences Tehran Iran
| | - Mehdi Khanmohammadi
- Skull Base Research Center, The Five Senses Institute, Hazrat Rasoul Akram Hospital Iran University of Medical Sciences (IUMS) Tehran Iran
| |
Collapse
|
38
|
Panahi Y, Rastgar N, Zamani A, Sahebkar A. Comparing the Therapeutic Effects of Aloe vera and Olive Oil Combination Cream versus Topical Betamethasone for Atopic Dermatitis: A Randomized Double-blind Clinical Trial. J Pharmacopuncture 2020; 23:173-178. [PMID: 33072415 PMCID: PMC7540232 DOI: 10.3831/kpi.2020.23.3.173] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2018] [Revised: 07/31/2020] [Accepted: 08/28/2020] [Indexed: 11/09/2022] Open
Abstract
Objectives Atopic dermatitis (AD) is a prevalent and chronic, pruritic inflammatory skin condition that can influence all age groups. AD is associated with a poor health-related quality of life. This randomized clinical trial was performed to compare the effectiveness of Olivederma (combination of aloe vera and virgin olive oil) or betamethasone regarding disease severity, quality of life, serum IgE and eosinophil count. Methods Thirty-six AD patients were randomly allocated to topical Olivederma or betamethasone, and were followed for 6 weeks. Results Total SCORAD severity scores showed significant decrease in both groups, while it was more prominent in Olivederma group (64.5% improvement in Olivederma vs. 13.5% improvement in Betamethasone, p-value < 0.001). Quality of life (DLQI questionnaire) of AD patients was significantly improved after 6 weeks treatment with Betamethasone (22.3%, p < 0.001) and Olivederma (60.7%, p-value < 0.001). Olivederma group showed a significantly lower DLQI score in comparison with Betamethasone treated patients after 6 weeks of therapy (p < 0.001). Improvements in eosinophil count and serum IgE was observed. Conclusion In summary, this study shows that Olivederma is superior to topical Betamethasone after 6 weeks of therapy with regard to disease severity, quality of life and eosinophil count.
Collapse
Affiliation(s)
- Yunes Panahi
- Pharmacotherapy Department, Faculty of Pharmacy, Baqiyatallah University of Medical Sciences, Tehran, Iran
| | - Nassim Rastgar
- Department of Pharmaceutics, Faculty of Pharmacy, Pharmaceutical Science Branch, Islamic Azad University, Tehran, Iran
| | - Ali Zamani
- Pharmacotherapy Department, Faculty of Pharmacy, Baqiyatallah University of Medical Sciences, Tehran, Iran
| | - Amirhossein Sahebkar
- Halal Research Center of IRI, FDA, Tehran, Iran.,Neurogenic Inflammation Research Center, Mashhad University of Medical Sciences, Mashhad, Iran.,Biotechnology Research Center, Pharmaceutical Technology Institute, Mashhad University of Medical Sciences, Mashhad, Iran.,Polish Mother's Memorial Hospital Research Institute (PMMHRI), Lodz, Poland
| |
Collapse
|
39
|
Sadoyu S, Rungruang C, Wattanavijitkul T, Sawangjit R, Thakkinstian A, Chaiyakunapruk N. Aloe vera and health outcomes: An umbrella review of systematic reviews and meta-analyses. Phytother Res 2020; 35:555-576. [PMID: 32924222 DOI: 10.1002/ptr.6833] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2020] [Revised: 06/24/2020] [Accepted: 07/18/2020] [Indexed: 12/11/2022]
Abstract
This umbrella review aims to summarize the effects of Aloe vera on health outcomes and assess the strength of evidence. PubMed, Scopus, Embase, Cochrane database of systematic reviews, CINAHL, and AMED were searched from inception to October, 2019 for systematic reviews and meta-analyses of clinical trials that investigated the effects of Aloe vera on health outcomes. Two independent reviewers extracted data, assessed the methodological quality, and rated the credibility of evidence according to established criteria. Ten articles reporting 71 unique outcomes of Aloe vera were included. Of these, 47 (67%) were nominally statistically significant based on random-effects model (p ≤ .05). Only 3 outcomes were supported by highly suggestive evidence, whereas 42 outcomes were supported by weak evidence. The highly suggestive evidence supported benefits of Aloe vera in the prevention of second-degree infusion phlebitis (RR: 0.18, 95% CI: 0.10-0.32, p-value: 1.75 × 10-9 ) and chemotherapy-induced phlebitis based on overall incidence (OR: 0.13, 95% CI: 0.08-0.20, p-value: 9.68 × 10-20 ) and incidence of the second degree of severity (OR: 0.10, 95% CI: 0.07-0.14, p-value: 3.41 × 10-35 ). However, the majority of the evidence were limited by small sample size and poor methodological quality. Therefore, despite the overall favorable effect of Aloe vera, more robust studies are needed.
Collapse
Affiliation(s)
- Saranrat Sadoyu
- Department of Pharmacy Practice, Faculty of Pharmaceutical Sciences, Chulalongkorn University, Bangkok, Thailand
| | - Chidchanok Rungruang
- Department of Pharmacy Practice, Faculty of Pharmaceutical Sciences, Chulalongkorn University, Bangkok, Thailand
| | - Thitima Wattanavijitkul
- Department of Pharmacy Practice, Faculty of Pharmaceutical Sciences, Chulalongkorn University, Bangkok, Thailand
| | - Ratree Sawangjit
- Clinical Trials and Evidence-Based Syntheses Research Unit (CTEBs RU), Department of Clinical Pharmacy, Faculty of Pharmacy, Mahasarakham University, Maha Sarakham, Thailand
| | - Ammarin Thakkinstian
- Department of Clinical Epidemiology and Biostatistics, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
| | - Nathorn Chaiyakunapruk
- Department of Pharmacotherapy, College of Pharmacy, University of Utah, Salt Lake City, Utah, USA
| |
Collapse
|
40
|
Ozcan O, Ipekci H, Alev B, Ustundag UV, Sen A, Emekli-Alturfan E, Sener G, Yarat A, Tunali-Akbay T. The effect of Myrtus communis L. ethanol extract on the small intestine and lungs in experimental thermal burn injury. J Therm Biol 2020; 93:102685. [PMID: 33077111 DOI: 10.1016/j.jtherbio.2020.102685] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2020] [Revised: 07/29/2020] [Accepted: 08/06/2020] [Indexed: 11/28/2022]
Abstract
Thermal trauma can damage organs away from the skin burn site and lead to multiple organ dysfunction. Following thermal injury, all tissues are exposed to ischemia, and as a result, resuscitation and reperfusion occur during the burning shock. Burn damage starts systemic inflammatory reactions that produce toxins and reactive oxygen radicals that lead to peroxidation. This study aimed to investigate, for the first time, the possible antioxidant effects of Myrtus communis ethanol extract on burn-induced oxidative distant organ injury orally. The thermal trauma was generated under ether anesthesia by exposing the dorsum of rats to 90 °C water bath for 10 s. 100 mg/kg/day Mrytus communis ethanol extract was applied orally for two days. Malondialdehyde (MDA) and glutathione (GSH) levels, glutatinone-S-transferase (GST), superoxidedismutase (SOD) and catalase (CAT) activities were determined to detect the possible antioxidant effects of myrtle on small intestine and lung tissues. Burn damage significantly increased MDA levels in lung and small intestine tissues, and significantly decreased GSH levels, CAT and GST activities in the small intestine and lung tissues compared to control group. Mrytus communis ethanol extract decreased MDA level and increased GSH level, SOD, CAT and GST activities significantly in either small intestine or lung tissues. Mrytus communis extract may be an ideal candidate to be used as an antioxidant adjunct to improve oxidative distant organ damage to limit the systemic inflammatory response and decreasing the recovery time after thermal injury.
Collapse
Affiliation(s)
- Ozan Ozcan
- Marmara University, Faculty of Dentistry, Basic Medical Sciences, Biochemistry, Istanbul, Turkey.
| | - Hazal Ipekci
- Marmara University, Faculty of Dentistry, Basic Medical Sciences, Biochemistry, Istanbul, Turkey
| | - Burcin Alev
- Marmara University, Faculty of Dentistry, Basic Medical Sciences, Biochemistry, Istanbul, Turkey
| | - Unsal Veli Ustundag
- Marmara University, Faculty of Dentistry, Basic Medical Sciences, Biochemistry, Istanbul, Turkey
| | - Ali Sen
- Marmara University, Faculty of Pharmacy, Department of Pharmacognosy, Istanbul, Turkey
| | - Ebru Emekli-Alturfan
- Marmara University, Faculty of Dentistry, Basic Medical Sciences, Biochemistry, Istanbul, Turkey
| | - Goksel Sener
- Marmara University, Faculty of Pharmacy, Pharmacology, Istanbul, Turkey
| | - Aysen Yarat
- Marmara University, Faculty of Dentistry, Basic Medical Sciences, Biochemistry, Istanbul, Turkey
| | - Tugba Tunali-Akbay
- Marmara University, Faculty of Dentistry, Basic Medical Sciences, Biochemistry, Istanbul, Turkey
| |
Collapse
|
41
|
Abstract
BACKGROUND Burn injuries are an important health problem. They occur frequently in the head and neck region. The face is the area central to a person's identity that provides our most expressive means of communication. Topical interventions are currently the cornerstone of treatment of burns to the face. OBJECTIVES To assess the effects of topical interventions on wound healing in people with facial burns of any depth. SEARCH METHODS In December 2019 we searched the Cochrane Wounds Specialised Register; the Cochrane Central Register of Controlled Trials (CENTRAL); Ovid MEDLINE (including In-Process & Other Non-Indexed Citations); Ovid Embase and EBSCO CINAHL Plus. We also searched clinical trials registries for ongoing and unpublished studies, and scanned reference lists of relevant included studies as well as reviews, meta-analyses and health technology reports to identify additional studies. There were no restrictions with respect to language, date of publication or study setting. SELECTION CRITERIA Randomised controlled trials (RCTs) that evaluated the effects of topical treatment for facial burns were eligible for inclusion in this review. DATA COLLECTION AND ANALYSIS Two review authors independently performed study selection, data extraction, risk of bias assessment and GRADE assessment of the certainty of the evidence. MAIN RESULTS In this first update, we included 12 RCTs, comprising 507 participants. Most trials included adults admitted to specialised burn centres after recent burn injuries. Topical agents included antimicrobial agents (silver sulphadiazine (SSD), Aquacel-Ag, cerium-sulphadiazine, gentamicin cream, mafenide acetate cream, bacitracin), non-antimicrobial agents (Moist Exposed Burn Ointment (MEBO), saline-soaked dressings, skin substitutes (including bioengineered skin substitute (TransCyte), allograft, and xenograft (porcine Xenoderm), and miscellaneous treatments (growth hormone therapy, recombinant human granulocyte-macrophage colony-stimulating factor hydrogel (rhGMCS)), enzymatic debridement, and cream with Helix Aspersa extract). Almost all the evidence included in this review was assessed as low or very low-certainty, often because of high risk of bias due to unclear randomisation procedures (i.e. sequence generation and allocation concealment); lack of blinding of participants, providers and sometimes outcome assessors; and imprecision resulting from few participants, low event rates or both, often in single studies. Topical antimicrobial agents versus topical non-antimicrobial agents There is moderate-certainty evidence that there is probably little or no difference between antimicrobial agents and non-antimicrobial agents (SSD and MEBO) in time to complete wound healing (hazard ratio (HR) 0.84 (95% confidence interval (CI) 0.78 to 1.85, 1 study, 39 participants). Topical antimicrobial agents may make little or no difference to the proportion of wounds completely healed compared with topical non-antimicrobial agents (comparison SSD and MEBO, risk ratio (RR) 0.94, 95% CI 0.68 to 1.29; 1 study, 39 participants; low-certainty evidence). We are uncertain whether there is a difference in wound infection (comparison topical antimicrobial agent (Aquacel-Ag) and MEBO; RR 0.38, 95% CI 0.12 to 1.21; 1 study, 40 participants; very low-certainty evidence). No trials reported change in wound surface area over time or partial wound healing. There is low-certainty evidence for the secondary outcomes scar quality and patient satisfaction. Two studies assessed pain but it was incompletely reported. Topical antimicrobial agents versus other topical antimicrobial agents It is uncertain whether topical antimicrobial agents make any difference in effects as the evidence is low to very low-certainty. For primary outcomes, there is low-certainty evidence for time to partial (i.e. greater than 90%) wound healing (comparison SSD versus cerium SSD: mean difference (MD) -7.10 days, 95% CI -16.43 to 2.23; 1 study, 142 participants). There is very low-certainty evidence regarding whether topical antimicrobial agents make a difference to wound infection (RR 0.73, 95% CI 0.46 to 1.17; 1 study, 15 participants). There is low to very low-certainty evidence for the proportion of facial burns requiring surgery, pain, scar quality, adverse effects and length of hospital stay. Skin substitutes versus topical antimicrobial agents There is low-certainty evidence that a skin substitute may slightly reduce time to partial (i.e. greater than 90%) wound healing, compared with a non-specified antibacterial agent (MD -6.00 days, 95% CI -8.69 to -3.31; 1 study, 34 participants). We are uncertain whether skin substitutes in general make any other difference in effects as the evidence is very low certainty. Outcomes included wound infection, pain, scar quality, adverse effects of treatment and length of hospital stay. Single studies showed contrasting low-certainty evidence. A bioengineered skin substitute may slightly reduce procedural pain (MD -4.00, 95% CI -5.05 to -2.95; 34 participants) and background pain (MD -2.00, 95% CI -3.05 to -0.95; 34 participants) compared with an unspecified antimicrobial agent. In contrast, a biological dressing (porcine Xenoderm) might slightly increase pain in superficial burns (MD 1.20, 95% CI 0.65 to 1.75; 15 participants (30 wounds)) as well as deep partial thickness burns (MD 3.00, 95% CI 2.34 to 3.66; 10 participants (20 wounds)), compared with antimicrobial agents (Physiotulle Ag (Coloplast)). Miscellaneous treatments versus miscellaneous treatments Single studies show low to very low-certainty effects of interventions. Low-certainty evidence shows that MEBO may slightly reduce time to complete wound healing compared with saline soaked dressing (MD -1.7 days, 95% CI -3.32 to -0.08; 40 participants). In addition, a cream containing Helix Aspersa may slightly increase the proportion of wounds completely healed at 14 days compared with MEBO (RR 4.77, 95% CI 1.87 to 12.15; 43 participants). We are uncertain whether any miscellaneous treatment in the included studies makes a difference in effects for the outcomes wound infection, scar quality, pain and patient satisfaction as the evidence is low to very low-certainty. AUTHORS' CONCLUSIONS There is mainly low to very low-certainty evidence on the effects of any topical intervention on wound healing in people with facial burns. The number of RCTs in burn care is growing, but the body of evidence is still hampered due to an insufficient number of studies that follow appropriate evidence-based standards of conducting and reporting RCTs.
Collapse
Affiliation(s)
| | - M Jenda Hop
- Burn Centre, Maasstad Hospital, Association of Dutch Burn Centres, Rotterdam, Netherlands
| | - Marianne K Nieuwenhuis
- Burn Centre, Martini Hospital, Association of Dutch Burn Centres, Groningen, Netherlands
| | - Irma Mmh Oen
- Burn Centre, Maasstad Hospital, Association of Dutch Burn Centres, Rotterdam, Netherlands
| | - Esther Middelkoop
- Plastic Reconstructive and Hand Surgery, Amsterdam Movement Sciences and Association of Dutch Burn Centers, Red Cross Hospital, Amsterdam, Netherlands
| | - Margriet E Van Baar
- Burn Centre, Maasstad Hospital, Association of Dutch Burn Centres, Rotterdam, Netherlands
| |
Collapse
|
42
|
Abbasi MS, Rahmati J, Ehsani AH, Takzare A, Partoazar A, Takzaree N. Efficacy of a Natural Topical Skin Ointment for Managing Split-Thickness Skin Graft Donor Sites: A Pilot Double-blind Randomized Controlled Trial. Adv Skin Wound Care 2020; 33:1-5. [PMID: 32544119 DOI: 10.1097/01.ASW.0000666916.00983.64] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVE To evaluate the safety and efficacy of a new topical skin ointment with natural ingredients (aloe vera, honey, and peppermint) for dressing skin graft donor sites. DESIGN A double-blind, placebo-controlled, randomized clinical trial. PATIENTS AND INTERVENTION Researchers enrolled patients who were referred for split-thickness skin graft after burns or surgical wounds on the scalp or face area. For each patient, a thin layer of skin (depth, 0.04 mm; approximate size, less than 15 × 7 cm) was harvested from the thigh by a plastic surgeon with an electric or manual dermatome. The donor sites were divided and randomized to receive either natural ointment or petroleum jelly as a topical agent to dressing. Topical agents were applied on donor site wounds on days 0, 4, 7, and 14. MAIN OUTCOME MEASURES Wound size, pain, erythema, pruritus, patient discomfort, complications, and physician satisfaction were evaluated at each visit. MAIN RESULTS Among 28 patients, there was no significant difference between the two treatment agents regarding the rate of wound healing (P = .415), pain (P = .081), pruritus (P = .527), and patient discomfort (P = .616). The ointment was superior to petroleum jelly in reducing wound erythema (P = .001) and was associated with significantly better treatment satisfaction (P < .001). CONCLUSIONS The natural topical ointment investigated in this study may be an acceptable alternative to petroleum jelly in caring for split-thickness donor skin graft donor site wounds to effectively promote wound healing, prevent infection and scarring, reduce pain, and comfort the patient.
Collapse
|
43
|
Nguyen JK, Masub N, Jagdeo J. Bioactive ingredients in Korean cosmeceuticals: Trends and research evidence. J Cosmet Dermatol 2020; 19:1555-1569. [DOI: 10.1111/jocd.13344] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2020] [Accepted: 02/10/2020] [Indexed: 11/27/2022]
Affiliation(s)
- Julie K. Nguyen
- Department of Dermatology SUNY Downstate Medical Center Brooklyn NY USA
- Dermatology Service VA New York Harbor Healthcare System – Brooklyn Campus Brooklyn NY USA
| | - Natasha Masub
- Department of Dermatology SUNY Downstate Medical Center Brooklyn NY USA
- Dermatology Service VA New York Harbor Healthcare System – Brooklyn Campus Brooklyn NY USA
| | - Jared Jagdeo
- Department of Dermatology SUNY Downstate Medical Center Brooklyn NY USA
- Dermatology Service VA New York Harbor Healthcare System – Brooklyn Campus Brooklyn NY USA
| |
Collapse
|
44
|
Iacopetti I, Perazzi A, Martinello T, Gemignani F, Patruno M. Hyaluronic acid, Manuka honey and Acemannan gel: Wound-specific applications for skin lesions. Res Vet Sci 2020; 129:82-89. [PMID: 31954318 DOI: 10.1016/j.rvsc.2020.01.009] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2019] [Revised: 01/09/2020] [Accepted: 01/10/2020] [Indexed: 12/11/2022]
Abstract
Healing of open wounds is of great medical importance. Wound healing is a complex process that aims to restore the function and structure of damaged tissue. This study was conducted to compare secondary intention healing of wounds treated daily with a topical application of commercially available hyaluronic acid (HA), Manuka honey (MH), Acemannan gel (AG), or a placebo. Bilateral wounds were surgically created on the backs of six sheep. At two and six weeks post-wound creation, biopsies were obtained to perform histological, immunohistochemical, and molecular analyses of the wound site. Daily clinical evaluations were performed and weekly photographs were taken of the wounds. HA treatment promoted a physiological progression of the healing process in all wound healing phases, while stimulating an abundant cutaneous adnexa and promoting rapid healing, representing the most compelling treatment. MH-treated wounds were slightly dry. However, the main effect of MH was to promote cell proliferation and neovascularization, with an overall pro-inflammatory effect. Results suggest that MH treatment enhances the healing process. AG treatment dehydrated the wounds and stimulated late granulation tissue and cell proliferation. Moreover, AG-treated wounds produced a mild late pro-inflammatory and neovascularization effect. Our data indicate that AG treatment can have a positive influence on moist wounds with abundant granulation tissue and exudate.
Collapse
Affiliation(s)
- I Iacopetti
- Department of Animal Medicine, Production and Health, University of Padova, viale dell'Università 16, 35020 Legnaro-Agripolis, Padova, Italy
| | - A Perazzi
- Department of Animal Medicine, Production and Health, University of Padova, viale dell'Università 16, 35020 Legnaro-Agripolis, Padova, Italy
| | - T Martinello
- Department of Comparative Biomedicine and Food Science, University of Padova, viale dell'Università 16, 35020 Legnaro-Agripolis, Padova, Italy
| | - F Gemignani
- Private practitioner, Winchester, United Kingdom
| | - M Patruno
- Department of Comparative Biomedicine and Food Science, University of Padova, viale dell'Università 16, 35020 Legnaro-Agripolis, Padova, Italy.
| |
Collapse
|
45
|
Bootdee K, Nithitanakul M. Poly(d,l-lactide-co-glycolide) nanospheres within composite poly(vinyl alcohol)/aloe vera electrospun nanofiber as a novel wound dressing for controlled release of drug. INT J POLYM MATER PO 2019. [DOI: 10.1080/00914037.2019.1706512] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Affiliation(s)
- Kittima Bootdee
- The Petroleum and Petrochemical College, Chulalongkorn University, Pathumwan, Bangkok, Thailand
- Center of Excellence on Petrochemical and Materials Technology, Chulalongkorn University Research Building, Pathumwan, Bangkok, Thailand
| | - Manit Nithitanakul
- The Petroleum and Petrochemical College, Chulalongkorn University, Pathumwan, Bangkok, Thailand
- Center of Excellence on Petrochemical and Materials Technology, Chulalongkorn University Research Building, Pathumwan, Bangkok, Thailand
| |
Collapse
|
46
|
Lang TC, Zhao R, Kim A, Wijewardena A, Vandervord J, Xue M, Jackson CJ. A Critical Update of the Assessment and Acute Management of Patients with Severe Burns. Adv Wound Care (New Rochelle) 2019; 8:607-633. [PMID: 31827977 PMCID: PMC6904939 DOI: 10.1089/wound.2019.0963] [Citation(s) in RCA: 27] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2019] [Accepted: 04/18/2019] [Indexed: 12/14/2022] Open
Abstract
Significance: Burns are debilitating, life threatening, and difficult to assess and manage. Recent advances in assessment and management have occurred since a comprehensive review of the care of patients with severe burns was last published, which may influence research and clinical practice. Recent Advances: Recent advances have occurred in the understanding of burn pathophysiology, which has led to the identification of potential biomarkers of burn severity, such as protein C. There is new evidence about the potential superiority of natural colloids over crystalloids during fluid resuscitation, and new evidence about components of initial and perioperative management, including an improved understanding of pain following burns. Critical Issues: The limitations of the clinical examination highlight the need for imaging and biomarkers to assist in estimations of burn severity. Fluid resuscitation reduces mortality, although there is conjecture over the ideal method. The subsequent perioperative period is associated with significant morbidity and the evidence for preventing and treating pain, infection, and fluid overload while maximizing wound healing potential is described. Future Directions: Promising developments are ongoing in imaging technology, histopathology, biomarkers, and wound healing adjuncts such as hyperbaric oxygen therapy, topical negative pressure therapy, stem cell treatments, and skin substitutes. The greatest benefit from further research on management of patients with burns would most likely be derived from the elucidation of optimal fluid resuscitation protocols, pain management protocols, and surgical techniques from randomized controlled trials.
Collapse
Affiliation(s)
- Thomas Charles Lang
- Department of Anesthesia, Prince of Wales and Sydney Children's Hospitals, Randwick, Australia
| | - Ruilong Zhao
- Sutton Laboratories, The Kolling Institute, St. Leonards, Australia
| | - Albert Kim
- Department of Critical Care Medicine, Royal North Shore Hospital, St. Leonards, Australia
| | - Aruna Wijewardena
- Department of Burns, Reconstructive and Plastic Surgery, Royal North Shore Hospital, St. Leonards, Australia
| | - John Vandervord
- Department of Burns, Reconstructive and Plastic Surgery, Royal North Shore Hospital, St. Leonards, Australia
| | - Meilang Xue
- Sutton Laboratories, The Kolling Institute, St. Leonards, Australia
| | | |
Collapse
|
47
|
|
48
|
Abstract
Wounds are a common medical infliction. With the increase in microbial resistance and a shift of interest towards complementary medicines, essential oils have been shown to be beneficial in suppressing microbial growth. However, in practice, essential oils are more often diluted into a base due to the risk of topical adverse effects, such as dermatitis. There is a lack of collated evidence-based information on toxicity and efficacy of carrier oils. The current information on the subject matter is restricted to generic, aroma-therapeutic books and pamphlets, based on anecdotal evidence rather than an experimental approach. Therefore, this review aimed at identifying the recommended carrier oils used in dermatology and thereafter collating the scientific evidence to support the use of carrier oils together with essential oils recommended for dermatological use. Aloe vera gel had multiple studies demonstrating the ability to enhance wound healing; however, several other carrier oils have been largely neglected. It was observed that the extracts for certain plant species had been used to justify the use of the carrier oils of the same plant species. This is an inaccurate cross assumption due to the difference in chemical composition and biological activities. Lastly, despite these carrier oils being recommended as a base for essential oils, very little data was found on the interactive profile of the carrier oil with the essential oil. This review provides a platform for further studies, especially if essential oils are to receive credence in the scientific field.
Collapse
Affiliation(s)
- Ané Orchard
- Department of Pharmacy and Pharmacology, Faculty of Health Sciences, University of the Witwatersrand, 7 York Road, Parktown, 2193, South Africa
| | - Sandy F van Vuuren
- Department of Pharmacy and Pharmacology, Faculty of Health Sciences, University of the Witwatersrand, 7 York Road, Parktown, 2193, South Africa.
| |
Collapse
|
49
|
Yaghini J, Naghsh N, Sadeghi SM, Soltani S. Gingival Inflammatory Indices and Dental Stain Index after Using Aloe Vera-Green Tea Mouthwash, Matrica Mouthwash, or 0.2% Chlorhexidine Mouthwash Compared with Placebo in Patients with Gingival Inflammation. Open Dent J 2019. [DOI: 10.2174/1874210601913010214] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Introduction:
The purpose of this study was to evaluate and compare the effects of composition of aloe vera-green tea, matrica, and chlorhexidine on gingival inflammatory indices and dental stain index.
Materials & Methods:
In this double-blinded placebo-controlled clinical trial, anti-inflammatory, anti-plaque formation, and dental staining effects of two herbal mouthwashes, including aloe vera-green tea and matrica in comparison with chlorhexidine in 60 patients with plaque induced gingivitis referring to Isfahan University of Medical Sciences, School of Dentistry were evaluated. The indices evaluated in this study were plaque index (Silness and Loe), gingival index (Loe and Silness), bleeding on probing index (Ainamo and Bay) and dental stain index (Lobene stain index). They were evaluated on the first day of using mouthwashes and two weeks later. The obtained data were analyzed using SPSS software version 22. One-way ANOVA, Tukey post hoc, and paired t and Chi-square tests (α=0.05) were used as appropriate.
Results:
There was no significant difference between the four groups in terms of the mean values of plaque index, gingival index, BOP index, and stain index before the application of mouthwash. However, after mouthwash application, the mean values of indices were significantly different between the four groups. Aloe vera-green tea and chlorhexidine mouthwashes reduced plaque index, gingival index, and bleeding on probing index significantly and there was no significant difference between these two mouthwashes (P>0.05). The effect of matrica mouthwash on plaque index and gingival index was significantly lower than aloe vera-green tea and chlorhexidine (P<0.05). The mean reduction in BOP index was not significantly different between the aloe vera-green tea, chlorhexidine, and matrica groups. Regarding dental stain index, both herbal mouthwashes caused significantly lower dental stain in comparison with chlorhexidine (P<0.05).
Conclusion:
The results of the present study show that aloe vera-green tea mouthwash may be an effective mouthwash owing to its antiplaque and anti-inflammatory properties and may be an ideal substitute for chlorhexidine.
Clinical Trial:
The clinical trial code: IR.MUI.REC.1395.3.573
Collapse
|
50
|
Ashkani-Esfahani S, Khoshneviszadeh M, Noorafshan A, Miri R, Rafiee S, Hemyari K, Kardeh S, Koohi Hosseinabadi O, Fani D, Faridi E. The Healing Effect of Plantago Major and Aloe Vera Mixture in Excisional Full Thickness Skin Wounds: Stereological Study. World J Plast Surg 2019. [PMID: 30873362 DOI: 10.29252/wjps.8.1.51.] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/26/2022] Open
Abstract
BACKGROUND Previous studies indicated that both Plantago major and Aloe vera have anti-inflammatory, tissue regeneration, antioxidant, and immune-stimulatory effects. It is assumed that a mixture of these two herbal medicines may provide a potent material in treatment of skin wound injuries. Therefore, in this study we investigated the effects of Plantago major and Aloe vera mixture in the process of wound healing in rat models according to stereological parameters. METHODS In an experiential study, 36 male Sprague-Dawley rats (200±20 g) were randomly assigned into three groups (n=12): The control group which received no treatment, gel base treated group, and the 5% Plantago major and 5% Aloe vera mixture gel treated group (PA group). Treatments were done every 24 hrs for 15 days. Wound closure rate, volume densities of the collagen bundles and the vessels, vessel's length density and mean diameter, and fibroblast populations were estimated using stereological methods. RESULTS PA treated group showed faster wound closure rate in comparison with control and gel-base groups (p<0.05). Numerical density of fibroblasts, volume density of collagen bundles, mean diameter, and volume densities of the vessels in PA group were significantly higher than the control and the gel-base treated groups (p<0.05). CONCLUSION We showed that Plantago major and Aloe vera mixture has the ability to improve wound healing by enhancing fibroblast proliferation, collagen bundle synthesis and re-vascularization in skin injuries.
Collapse
Affiliation(s)
| | - Mahsima Khoshneviszadeh
- Medicinal and Natural products Chemistry Research Center, Shiraz university of Medical Sciences, Shiraz, Iran
| | - Ali Noorafshan
- Histomorphometry and Stereology Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Ramin Miri
- Medicinal and Natural products Chemistry Research Center, Shiraz university of Medical Sciences, Shiraz, Iran
| | - Shima Rafiee
- Student Research Committee, Shiraz university of Medical Sciences, Shiraz, Iran
| | - Kimia Hemyari
- Student Research Committee, International branch, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Sina Kardeh
- Student Research Committee, Shiraz university of Medical Sciences, Shiraz, Iran.,Burn and Wound Healing Research Center, Division of Plastic and Reconstructive Surgery, Department of Surgery, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Omid Koohi Hosseinabadi
- Center of Comparative and Experimental Medicine, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Dorna Fani
- Student Research Committee, Shiraz university of Medical Sciences, Shiraz, Iran
| | - Elnaz Faridi
- Student Research Committee, International branch, Shiraz University of Medical Sciences, Shiraz, Iran
| |
Collapse
|