Ficus septica exudate, a traditional medicine used in Papua New Guinea for treating infected cutaneous ulcers: in vitro evaluation and clinical efficacy assessment by cluster randomised trial

BACKGROUND AND OBJECTIVES

Infected cutaneous ulcers are major health problems for children living in rural areas of Papua New Guinea. The inaccessibility of affected populations and lack of access to basic healthcare, make a local plant-based therapy an attractive treatment option. We assessed Ficus septica exudate in biological assays relevant to wound healing. We then carried out a clinical trial to determine the exudate's efficacy in healing small cutaneous ulcers compared with Savlon antiseptic cream, and soap and water washing.

METHODS

Pre-clinical in vitro assessment of the exudate was carried out using assays to monitor the pro-inflammatory responses of M1 macrophages and neutrophils, antibacterial assays using known ulcer pathogens, an Ames test for mutagenicity and LC-MS chemical analysis of the exudate. An open label cluster-randomised clinical trial was performed, enrolling participants from three different clusters with skin lesions less than 1 cm in diameter. Each cluster comprising 50 participants was randomly assigned to one of three treatment arms namely topical exudate, topical Savlon antiseptic cream, and standard care (soap and water treatment), all administered daily for 2 days. The primary outcome was clinical healing/improvement measured at days 7 and 14, assessed by three dermatologists using blinded photographs. The primary analysis was assessed as non-inferiority of F. septica treatment based on the risk difference for healing/improvement.

RESULTS

In vitro, the exudate which is rich in the alkaloid ficuseptine, was found to be non-mutagenic whilst also inhibiting pro-inflammatory responses and exhibiting antibacterial activity. When administered to participants enrolled in the clinical trial, no significant differences were observed between the healing efficacy of F. septica exudate and the two comparator treatments (Savlon antiseptic cream and soap/water treatment). At day 14, but not at day 7, the efficacy of F. septica exudate for healing/improving the ulcers was non-inferior to Savlon antiseptic cream or water/soap treatment.

CONCLUSIONS

F. septica exudate is non-mutagenic and has both bactericidal and anti-inflammatory properties. When applied topically to small cutaneous ulcers, the exudate has a healing effect that is non-inferior to Savlon antiseptic cream and standard treatment with soap and water at day 14. Our findings, which should be confirmed in larger clinical trials, have important public health implications.

Characterization of stress processes of Phaffia rhodozyma stress-resistant mutant

A carotenoid-less Phaffia rhodozyma mutant (MCP 325) exhibited significantly higher resistance to oxidative stressors such as menadione, H2O2 and K2Cr2O7 than its astaxanthin-producing parental strain (MCP 324). The absence of carotenoids in the mutant did not explain this phenomenon. The cause of the decreased superoxide, hydroxyl radical and glutathione contents, the increased peroxide concentration and the elevated specific activity of catalase under uninduced conditions may be a second mutation. Peroxide treatment induced specific catalase activity in the mutant but not in the parental strain. Regulation of these processes led to the result that, in spite of the mutations, the two strains exhibited the same multiplication rate and generation time.

Relationship of retinoid and carotenoid metabolism with caecotrophy in rabbits

The relationship of retinoid and carotenoid metabolism with caecotrophy was studied in adult female New Zealand White rabbits kept in individual metabolic cages. Caecotrophy was prevented by the use of plastic collars. The dry matter, crude protein, fibre, fat and ash contents of hard and soft faecal samples were determined. The retinoid (retinol and retinyl palmitate) and carotenoid (canthaxanthin, beta-carotene, beta-cryptoxanthin, lutein and zeaxanthin) levels of the blood, liver, kidney, caecal content and faeces were also measured by high-performance liquid chromatography (HPLC). The prevention of caecotrophy resulted in a significant decrease of blood retinol (P < 0.001) and retinyl palmitate (P < 0.01) concentration but it did not cause any significant change in the retinol and retinyl palmitate contents of the liver and kidney. The caecal content (25.78 +/- 6.87 microg/g) and the soft faeces (34.52 +/- 10.48 microg/g) contained the retinoids in similar amounts. Various carotenoids were found in considerable amounts in different types of faeces, while in the tissues (blood, liver and kidney) these pigments did not occur in substantial amounts. Total carotenoid concentration was similar in the caecal content (11.23 microg/g) and in the caecotroph (13.85 microg/g). On the basis of the results it can be assumed that the retinoid content of rabbit feed could be lowered in the presence of adequate caecal function and caecotrophy.

Supramolecular assemblies of carotenoids

Carotenoid self-assemblies were formed by aqueous dilution of ethanolic solutions. The four 3',6'-epimers of capsanthol ((all-E,3R,5'R)-3,3',6'-trihydroxy-beta,kappa-carotene) give rise to right- and left-handed card-pack and head-to-tail types of self-assemblies detected by exciton couplets appearing in the CD spectra. Slow kinetics of formation followed for some of the aggregates indicate the complexity of the process. The exciton signals do not appear from equimolar mixtures of related compounds that produce identical type of aggregates of opposite sense on their own. Transformation of self-assembly may reflect the population of kappa-ring rotamers.

[Carotenoid contents of herbal teas]

Carotenoid composition of 14 herbal tea consumed by Herbaria was investigated by HPLC method. The main components were lutein (36-49%) cis-luteins (2-20%) and beta-carotene (3-25%). alpha- and beta-cryptoxanthin, alpha-carotene and some 5,6-epoxy-carotenoids (neoxanthin, violaxanthin, antheraxanthin) were detected. The chlorophyll content was also measured.

Color and chirality: carotenoid self-assemblies in flower petals

As a novel phenomenon, optical activity--often very strong--has been detected by circular dichroism (CD) spectroscopy in carotenoid-containing living flowers of several species belonging to different families. Using natural pure xanthophyll esters, very similar CD spectra were obtained in vitro, proving the ability of these molecules to form chiral self-assemblies. The relationship between the ultrastructure of the chromoplast, its chemical composition and the optical activity is discussed. The applicability of CD spectroscopy for studying intact plant tissue is emphasized.

(9Z)-capsanthin-5,6-epoxide, a new carotenoid from the fruits of Asparagus falcatus

From the fruits of Asparagus falcatus a novel minor (Z)-carotenoid has been isolated and, on the basis of spectral data interpretation, characterized as (9Z)-capsanthin-5,6-epoxide [(9Z,3S,5R,6S,3'S,5'R)-5,6-epoxy-3,3'-dihydroxy-5,6-dihydro-beta,kappa-caroten-6'-one, (1)]. In addition, seven other (Z)-carotenoids [namely, (9Z)-, (9'Z)-, (13Z)-, and (13'Z)-capsanthins, (9Z)- and (13Z)-capsorubins, and (9Z)-violaxanthin], which have been previously described from other plants, were isolated and identified.

Chiral detection of carotenoid assemblies

Carotenoid assemblies were produced by aqueous dilution of ethanolic solutions. UV/VIS and CD spectroscopy revealed the formation of J- and H-types of aggregates of both right- and left-handed kinds. Simulation of UV/VIS spectra of the aggregates showed characteristic differences between the two types. 6'-Epimers of capsanthol ((all-E,3R,3'S,5'R)-beta,kappa-carotene-3,3',6'-triols) formed assemblies with increased chirality in dilute solution. While the absorption of 6'R-capsanthol giving H-type aggregate does not depend on the concentration, 6'S-capsanthol yielding J-type assembly showed concentration-dependent absorption intensity. Dilute aggregate of 6'R-capsanthol is characterized by an extremely large A value of -6,600. The transformation of J- to H-type assembly was observed in the mixtures of the epimers producing an intermediate kind of aggregate. A hypothetical structure for H-type assemblies is proposed.

Carotenoid composition in the fruits of red paprika (Capsicum annuum var. lycopersiciforme rubrum) during ripening; biosynthesis of carotenoids in red paprika

The changes in the carotenoid pigments of the Capsicum annuum var. lycopersiciforme rubrum during maturation have been investigated quantitatively by means of a HPLC technique. In all of the chromatograms, 40 peaks were detected; 34 carotenoids were identified. The total carotenoid content of the ripe fruits was about 1.3 g/100 g of dry weight, of which capsanthin constituted 37%, zeaxanthin was 8%, cucurbitaxanthin A was 7%, capsorubin constituted 3.2%, and beta-carotene accounted for 9%. The remainder was composed of capsanthin 5,6-epoxide, capsanthin 3,6-epoxide, 5,6-diepikarpoxanthin, violaxanthin, antheraxanthin, beta-cryptoxanthin, and several cis isomers and furanoid oxides. The possible biosynthetic routes for the formation of minor carotenoids containing 3,5,6-trihydroxy-beta-, 3,6-epoxy-beta-, and 6-hydroxy-gamma-end groups are described.

Carotenoid composition in the fruits of Asparagus officinalis

The carotenoid pigments of the ripe and unripe fruits of Asparagus officinalis were investigated by means of an HPLC technique. Capsanthin, capsorubin, capsanthin 5,6-epoxide, antheraxanthin, violaxanthin, neoxanthin, mutatoxanthin epimers, zeaxanthin, lutein, beta-cryptoxanthin, beta-carotene, and some cis isomers were found. Carotenoids with 3,5,6-trihydroxy and 3,6-epoxy beta-end groups could not be deleted.

[Potentially bioactive pyrimidine derivatives. 1. 2-Amino-4-aryl-8-arylidene-3,4,5,6,7,8-hexahydroquinazoline]

Six condensed 2-amino-4-arylpyrimidines (1a-f) were synthesized by the base catalyzed reaction of some monoarylidenecycloalkanones and guanidine. The reaction of 2,6-diarylidenecyclohexanones with guanidine yielded 2-amino-4-aryl-3,4,5,6,7,8-hexahydroquinazolines which were stable only as salts 3a-j. The oxidation of 3a-j led to 2-amino-4-aryl-8-arylidene-5,6,7,8-tetrahydroquinazolines 4a-j.