Topical application ofCinnamon verumessential oil accelerates infected wound healing process by increasing tissue antioxidant capacity and keratin biosynthesis

Evaluation of Aloe Vera Gel Combined with Cinnamon Oil with Antibacterial Activity for Wound Healing Application

Treatment of chronic wounds has been shifted to traditional approaches due to surge in antibiotic resistance. Wounds that fail to heal satisfactorily may result in the amputation of the organ. In this research work, cinnamon oil (CO) and aloe vera (AV) that have been traditionally used as antibacterial agents are combined in a unique gel (COVA) and its antibacterial activity has been evaluated through in vitro and in vivo studies. Antibacterial activity was measured through disk diffusion and agar dilution method against Pseudomonas aeruginosa and Staphylococcus aureus. To check antibacterial and wound healing activity, diabetic excision wound healing rat model was used. Wound closure, wound contraction, tissue hydroxyproline content, antioxidant capacity (TAC), and malondialdehyde (MDA) level were monitored. The minimum inhibitory concentrations of CO + AV for bacterium P. aeruginosa and S. aureus were 100 and 200 µg/ml, respectively. After 14 days, the wounds covered with COVA therapy reached to nearly full wound closure (79% wound contraction) compared to control. The collagen content and level of TAC increased significantly (P < 0.05) in treated groups; therefore, 25% fast healing was observed in wounds treated with CO and AV gel combined. Reduced levels of tissue MDA were observed in all treated groups and specially wound covered with COVA (0.43 mM/mg in control vs 0.25 mM/mg in COVA). Histopathological examination also supported the outcomes. Significantly elevated increase in the level of hydroxyproline was found in rats of COVA treatment group (37.1 ± 0.44). Combination of CO and AV can be potentially used to prevent infection in wound; as these herbal agents not only inhibit the growth of pathogenic bacteria but also accelerate tissue repair.

Application of Cinnamomum burmannii Essential Oil in Promoting Wound Healing

Skin wounds, leading to infections and death, have a huge negative impact on healthcare systems around the world. Antibacterial therapy and the suppression of excessive inflammation help wounds heal. To date, the application of wound dressings, biologics and biomaterials (hydrogels, epidermal growth factor, stem cells, etc.) is limited due to their difficult and expensive preparation process. Cinnamomum burmannii (Nees & T. Nees) Blume is an herb in traditional medicine, and its essential oil is rich in D-borneol, with antibacterial and anti-inflammatory effects. However, it is not clear whether Cinnamomum burmannii essential oil has the function of promoting wound healing. This study analyzed 32 main components and their relative contents of essential oil using GC-MS. Then, network pharmacology was used to predict the possible targets of this essential oil in wound healing. We first proved this essential oil's effects in vitro and in vivo. Cinnamomum burmannii essential oil could not only promote the proliferation and migration of skin stromal cells, but also promote M2-type polarization of macrophages while inhibiting the expression of pro-inflammatory cytokines. This study explored the possible mechanism by which Cinnamomum burmannii essential oil promotes wound healing, providing a cheap and effective strategy for promoting wound healing.

Formulation of novel bioactive gelatin inspired by cinnamaldehyde for combating multi-drug resistant bacteria: Characterization, molecular docking, pharmacokinetic analyses, and in vitro assessments

This study set out to formulate antibacterial and antioxidant gelatin boosted by cinnamaldehyde for combating multi-drug resistant bacteria previously obtained from chronic wounds. Towards this end, gelatin amine groups were conjugated with carbonyl groups of cinnamaldehyde, producing cinnamyl-gelatin Schiff bases. The physicochemical attributes of cinnamyl-gelatin Schiff bases were probed concerning alterations in chemical structures and microstructures compared to native gelatin. Besides, cinnamyl-gelatin Schiff bases exhibited higher thermal stability than gelatin, with a diminishing in solubility due to increases in hydrophobicity features. Interestingly, cinnamyl-gelatin derivatives exerted antibacterial activities versus multi-drug resistant Gram-negative and Gram-positive bacteria, showing maximum growth inhibition at the highest concentration of cinnamaldehyde incorporated into gelatin. The scavenging activities of gelatin against DPPH and ABTS•+ were promoted in cinnamyl-gelatin derivatives from 11.93 ± 0.6 % to 49.9 ± 2.5 % and 12.54 ± 0.63 % to 49.9 ± 3.12 %, respectively. Remarkably, cinnamyl-gelatin derivatives induced the proliferation of fibroblast cells, implying their prospective applications in tissue engineering. Molecular docking and pharmacokinetic investigations disclosed the potential antibacterial mechanisms of cinnamyl-gelatin derivatives alongside their biopharmaceutical applications. Altogether, these findings suggest that cinnamyl-gelatin derivatives could be utilized to tailor antibacterial-free antibiotics and antioxidant wound dressings against virulent bacteria to promote chronic wound recovery.

Comparative efficacy of Salix aegyptiaca's active compound versus phenytoin in healing full-thickness rat skin wounds: An animal model study

BACKGROUND

Wound healing poses a challenging therapeutic scenario, requiring diverse clinical approaches.

OBJECTIVES

This study aims to assess the wound-healing potential of Salix aegyptiaca's flower ointment compared to phenytoin, considering the active constituents of S. aegyptiaca and its traditional usage.

METHODS

Initially, the active components of S. aegyptiaca were isolated and identified through the GC-MS technique. Subsequently, for the experimental intervention, thirty-five rats were divided into five distinct groups: control (C), phenytoin (F), and three S. aegyptiaca ointment groups at different concentrations (5 % - S5, 25 % - S25, and 50 % - S50). Anesthesia was administered, and wounds were induced on the animals' necks following a standard procedure. These wounds were then treated for a duration of 21 days. Wound healing progress was quantified, and histopathological assessments were conducted using hematoxylin and eosin staining and Mason's trichrome staining.

RESULTS

The main active compounds of S. aegyptiaca, namely n-hexadecanoic acid and oleic acid, were identified via GC-MS analysis. Although the initial group weights did not show a significant difference (P = 0.271), a significant variation was observed in the final weights (P = 0.003). The S50 group exhibited a lower wound healing rate than the S25 group on the 7th and 14th days but surpassed it on the 21st day (C < F < S5≈S25

CONCLUSION

The findings highlight the superior wound-healing efficacy of 50 % S. aegyptiaca ointment over phenytoin ointment.

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Key Words

• Ointment
• Phenytoin
• Salix aegyptiaca
• Skin
• Wound healing

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MESH Headings

• Rats
• Animals
• Phenytoin/pharmacology
• Phenytoin/therapeutic use
• Ointments/pharmacology
• Ointments/therapeutic use
• Salix
• Skin/injuries
• Wound Healing
• Models, Animal
• Soft Tissue Injuries

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Affiliation(s)

Pouria Rafiei Graduate of Faculty of Veterinary Sciences, Sanandaj Branch, Islamic Azad University, Sanandaj, Iran
Mahdieh Raeeszadeh Department of Basic Sciences, Sanandaj Branch, Islamic Azad University, Sanandaj, Iran.
Peyman Mohammadzadeh Department of Pathobiology Sciences, Sanandaj Branch, Islamic Azad University, Sanandaj, Iran

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In-Silico Selection of Wound-Healing Plant Secondary Molecules and Their Pro-Healing Activities on Experimental Models

This study explored the potential of plant-derived molecules (PDMs) as a medicinal treatment for skin wounds. To assess their healing properties, 34 potential drug molecules (PDMs) and ten therapeutic targets were subjected to molecular docking and dynamics analysis, with allantoin used as a standard compound. Although aristolochic acid had the most potent inhibitory effect, its toxicity made it unsuitable for testing on cells and mice. Therefore, β-caryophyllene (BC) and caryophyllene oxide (BCoxide) were chosen for further testing. The results showed that BC-treated HaCat cells had significantly improved scratch area closure, and both BC and BCoxide treatment produced positive effects such as reduced dermal cellularity and mast cells, decreased levels of inflammation markers IL-6 and TNF-α, and an increase in collagen deposition in mice tissues. However, these treatments did not accelerate wound healing. This study suggests that the PDMs selected based on in-silico results have significant potential for pro-healing abilities. It is essential to conduct further research to confirm our findings.

Antibacterial and anti-corona virus (229E) activity of Nigella sativa oil combined with photodynamic therapy based on methylene blue in wound infection: in vitro and in vivo study

Microbial skin infections, antibiotic resistance, and poor wound healing are major problems, and new treatments are needed. Our study targeted solving this problem with Nigella sativa (NS) oil and photodynamic therapy based on methylene blue (MB-PDT). Antibacterial activity and minimum inhibitory concentration (MIC) were determined via agar well diffusion assay and broth microdilution, respectively. Transmission electron microscopy (TEM) proved deformations in Staphylococcus aureus ATCC 6538. Gas chromatography-mass spectrometry identified useful compounds that were suggested to be responsible for the potency of the oil. NS oil was tested as an antivirus against low pathogenic coronavirus (229E). Therapies examined, MB-PDT, NS, and MB-PDT + NS oil, to accelerate wound healing. The antibacterial efficacy against S. aureus was promising, with a MIC of 12.5% and TEM showing injured cells treated with NS oil. This oil inhibited 229E virus up to 42.85% and 32.14%. All tested therapies were successful in accelerating wound healing. The most successful was combined therapy (MB-PDT + NS oil), with a faster healing time. The combined therapy (MB-PDT + NS oil) reduced bacterial counts, which may be a key factor in accelerating wound healing. Skin wound histology was investigated; blood hematology and biochemical analysis did not change significantly after the safe combination treatment. A combination treatment could facilitate healing in a simple and inexpensive way in the future. Based on the results of the in vitro and in vivo studies, it was determined that NS oil had antibacterial and anti-corona virus activity when used in conjunction with photodynamic treatment based on methylene blue to treat wound infections.

Effect of PCL nanofiber mats coated with chitosan microcapsules containing cinnamon essential oil for wound healing

INTRODUCTION

Cinnamon is one of the most common spices that has been studied for its anti-inflammatory, antioxidant, and antibacterial properties in wound healing. The purpose of this study was to evaluate the effectiveness of polycaprolactone nanofiber mats coated with chitosan microcapsules loaded with cinnamon essential oil in wound healing.

MATERIAL AND METHODS

For this purpose, chitosan microcapsules containing cinnamon essential oil (µCS-CiZ) were prepared by ion gelation and PCL nanofibers by electrospinning. The size of the µCS-CiZ and the morphology of nanofibers were evaluated by DLS and FESEM methods. In order to evaluate wound healing, 48 rats in 4 groups of Control, µCS-CiZ, PCL, and PCL + µCS-CiZ and were examined on days 7, 14, and 21 in terms of macroscopy (wound closure rate) and histology (edema, inflammation, vascularity, fibrotic tissue, and re-epithelialization).

RESULTS

The particle size of the µCS-CiZ and the diameter of the nanofibers were estimated at about 6.33 ± 1.27 μm and 228 ± 33 nm, respectively. On day 21, both µCS-CiZ and PCL groups showed a significant decrease in wound size compared to the control group (P < 0.001). The PCL + µCS-CiZ group also showed a significant decrease compared to the µCS-CiZ (P < 0.05) and PCL groups (P < 0.05). Histological results showed further reduction of edema, inflammation, and vascularity in granulation tissue and appearance of moderate to marked fibrotic tissue in PCL + µCS-CiZ group compared with the other groups.

CONCLUSION

The results of the study showed that the combined use of PCL + µCS-CiZ indicates a synergistic effect on improving wound healing.

Recent Advances in Using Natural Antibacterial Additives in Bioactive Wound Dressings

Wound care is a global health issue with a financial burden of up to US $96.8 billion annually in the USA alone. Chronic non-healing wounds which show delayed and incomplete healing are especially problematic. Although there are more than 3000 dressing types in the wound management market, new developments in more efficient wound dressings will require innovative approaches such as embedding antibacterial additives into wound-dressing materials. The lack of novel antibacterial agents and the misuse of current antibiotics have caused an increase in antimicrobial resistance (AMR) which is estimated to cause 10 million deaths by 2050 worldwide. These ongoing challenges clearly indicate an urgent need for developing new antibacterial additives in wound dressings targeting microbial pathogens. Natural products and their derivatives have long been a significant source of pharmaceuticals against AMR. Scrutinising the data of newly approved drugs has identified plants as one of the biggest and most important sources in the development of novel antibacterial drugs. Some of the plant-based antibacterial additives, such as essential oils and plant extracts, have been previously used in wound dressings; however, there is another source of plant-derived antibacterial additives, i.e., those produced by symbiotic endophytic fungi, that show great potential in wound dressing applications. Endophytes represent a novel, natural, and sustainable source of bioactive compounds for therapeutic applications, including as efficient antibacterial additives for chronic wound dressings. This review examines and appraises recent developments in bioactive wound dressings that incorporate natural products as antibacterial agents as well as advances in endophyte research that show great potential in treating chronic wounds.

Molecular mechanism of the anti-inflammatory effects of plant essential oils: A systematic review

ETHNOPHARMACOLOGICAL RELEVANCE

Plant essential oils (PEOs) extracted from aromatic compounds of the plant contain complex mixtures of volatile and lipophilic bioactive compounds. In ancient Egypt, Arabia, Greece, and China, PEOs were traditional used in aromatherapy for various health disorders, including pain and inflammation.

AIM OF THE STUDY

In this review, we provide an overview of the anti-inflammatory effects of PEOs and the underlying mechanisms associated with anti-inflammatory effects using in vitro and in vivo models. Further, clinical trials associated with PEOs were explored.

MATERIALS AND METHODS

The literature search was performed using various web-based tools and databases like Google Scholar, Web of Science, PubMed, CNKI and SCOPUS. The keywords used for conducting the literature review were general terms like "essential oils" followed by (AND) the subject of interest like "in vitro and/or in vivo anti-inflammatory models," "inflammatory response," "inflammatory indicators," "pro-inflammatory cytokines," "signaling pathway," "anti-inflammatory mechanism," "toxicology and side effects" and "clinical trials." The articles selected were published between 2017 and 2022. The articles prior to 2017 were only considered if they were associated with molecular mechanisms or signaling pathways involved in the inflammatory responses.

RESULTS

In vitro and in vivo inflammation models have been used to study the anti-inflammatory effects of 48 PEOs. Studies have reported that PEOs targets and inhibit multiple dysregulated signaling pathways associated with inflammation, including Toll-like receptors, nuclear transcription factor-κ B, mitogen-activated protein kinases, Nod-like receptor family pyrin domain containing 3, and auxiliary pathways like the nuclear factor erythroid 2-related factor 2/antioxidant response element and Janus kinase/signal transducers and activators of transcription) signaling pathways.

CONCLUSION

PEOs extracted from different plant materials had varied qualitative and quantitative compositions of biologically active compounds. Different anti-inflammatory potentials and different molecular signal transduction have been attributed to PEOs-derived bioactive compounds with different chemical structures. The data on therapeutic efficacy and the long-term side effects of PEOs as an anti-inflammatory drug are still unknown due to the lack of clinical trials on PEOs. There is still insufficient evidence to draw conclusions on anti-inflammatory properties of PEOs without promising outcomes from clinical trials.

Immunomodulatory Effects of Cinnamaldehyde in Staphylococcus aureus-Infected Wounds

Cinnamaldehyde (CNM) is an essential-oil component with reported anti-infective, anti-inflammatory, and healing effects, making it an interesting compound for the treatment of wound infection. Herein, we evaluated the effects of topical administration of CNM in experimental wounds infected by Staphylococcus aureus. Swiss mice (n = 12/group) were randomly allocated into three groups (CON: animals with uninfected lesions; Sa: animals with untreated infected lesions; Sa + CNM: animals with infected wounds and treated with CNM). Excisional lesions (64 mm²) were induced at the dorsal area followed by the addition of S. aureus (80 μL of a 1.5 × 10⁸ CFU/mL bacterial suspension). The wounds were treated with CNM (200 μg/wound/day) or vehicle (2% DMSO) for 10 days. Skin samples were taken on the 3^rd or 10^th treatment day for quantification of inflammatory mediators, bacterial load, immunophenotyping, and histological analysis. The treatment with CNM improved the healing process and attenuated the severity of skin lesions infected by S. aureus. These effects were associated with significant decreases in bacterial loads in CNM-treated wounds. The levels of neutrophils, TNF-α, IL-6, NO, and VEGF were decreased in the lesions treated with CNM. Taken together, these data provide further evidence of the effectiveness of CNM for the treatment of skin infections.

Recent advances to combat ESKAPE pathogens with special reference to essential oils

Biofilm-associated bacteria, especially ESKAPE pathogens (Enterococcus faecium, Staphylococcus aureus, Klebsiella pneumoniae, Acinetobacter baumannii, Pseudomonas aeruginosa, and Enterobacter spp.), are a serious challenge worldwide. Due to the lack of discovery of novel antibiotics, in the past two decades, it has become necessary to search for new antibiotics or to study synergy with the existing antibiotics so as to counter life-threatening infections. Nature-derived compounds/based products are more efficient than the chemically synthesized ones with less resistance and lower side effects. In this descriptive review, we discuss the most promising therapeutics for the treatment of ESKAPE-related biofilms. The first aspect includes different types of natural agents [botanical drugs, essential oils (EOs), antimicrobial peptides, bacteriophages, and endolysins] effective against ESKAPE pathogens. The second part of the review deals with special references to EOs/essential oil components (EOCs) (with some exclusive examples), mode of action (via interfering in the quorum-sensing pathways, disruption of biofilm and their inhibitory concentrations, expression of genes that are involved, other virulence factors), existing in literature so far. Moreover, different essential oils and their major constituents were critically discussed using in vivo models to target ESKAPE pathogens along with the studies involving existing antibiotics.

In Silico, In Vitro, and In Vivo Wound Healing Activity of Astragalus microcephalus Willd

Methods

The methanolic root extract was prepared by maceration, and flavonoids were evaluated by LC/MS. In silico examination was performed based on the LC/MS results, and the binding affinity of these compounds to estrogen receptors (ERs) α and β was evaluated. Wound healing evaluation in both in vitro (NHDF cell line, by 500 μg/ml concentration of the extract, 24 h) and in vivo (Wistar rat, topical daily treated with 1.5% of the extract ointment, 21 days) conditions in comparison to control groups was conducted. Rats' control groups included silver sulfadiazine, Vaseline, and the nontreated groups.

Results

Eleven flavonoids were detected using LC/MS. The in silico study showed that formononetin, kaempferol-based structures, quercetin-3-O-neohesperidoside, and calycosin-7-O-beta-D-glucoside had a high affinity (<-6.3) to ERs α and β. Wound closing measurement showed significant improvement in the group treated with the extract in both in vitro and in vivo assays compared to the control groups. Histopathological results confirmed these findings; inflammation factors decreased, and fibroblast proliferation, fibrosis, and epithelization increased, especially in the extract group.

Conclusion

This study shows that Astragalus microcephalus has wound healing activity in vitro and in vivo with low toxicity due to the presence of flavonoids, especially isoflavonoids, which show a high affinity to bind to ERs α and β in the skin tissue.

Synthesis and Characterization of Novel Patchouli Essential Oil Loaded Starch-Based Hydrogel

Starch hydrogels are highly available, biocompatible and biodegradable materials that have promising applications in medical and pharmaceutical industries. However, their applications are very limited due to their poor mechanical properties and fragility. Here, we investigated, for the first time, conventional corn and waxy corn starch-based hydrogels for loading patchouli essential oil. The essential oil extracted by supercritical carbon dioxide with a yield reached 8.37 ± 1.2 wt.% (wet sample) at 80 °C temperature and 10 MPa pressure. Patchouli essential oil exhibited a 23 to 28 mm zone of inhibition against gram-positive and gram-negative bacteria. Waxy starch hydrogels had better properties in term of viscosity, water evaporation stability and the delivery of essential oil than conventional starch hydrogels. The viscosity and spreadability of a 6% waxy starch sample were 15,016 ± 59 cP and 4.02 ± 0.34 g·cm/s, respectively, compared with those of conventional starch hydrogel (13,008 ± 29 cP and 4.59 ± 0.88 g·cm/s). Waxy starch-based hydrogels also provided slower in vitro biodegradation behavior and sustained release of essential oil compared with conventional starch hydrogels. All the samples were biocompatible and non-cytotoxic to fibroblast cells; the addition of patchouli essential oil enhances the proliferation of the cells. The enhanced viscosity, good antibacterial and improved biocompatibility results of prepared hydrogels confirm their suitability for wound healing applications.

Promotive effects of four herbal medicine ARCC on wound healing in mice and human

Background

Traditional Chinese medicine (TCM) had been extensively used in China for wound management and had shown great potential in wound treatment while its mechanism is still needed to be addressed.

Objective

The present study sought to investigate the therapuetic effect of the TCM ARCC on acute and chronic wounds.

Methods

Here, using the ultra‐low temperature preparation method, the mixed ultramicro powder prepared with Angelica (A), Angelica (R), Calcined Gypsum (C) and Caleramide (C) named as ARCC. The effects of ARCC on wound healing in adult and aged mice were comparatively evaluated through a full‐thickness skin defect model. In addition, we randomly selected 10 patients aged 55 to 70 years from a cohort of 500 patients with diabetic feet to assess their prognosis.

Results

As the results showed that the healing rate had delayed in aged mice compared to adult mice, while ARCC prominently augmented the healing process in aged mice. Moreover, ARCC treatment wounds in aged mice showed accelerated re‐epithelization, enhanced granulation tissue formation, and increased vascularization, which was similar to that of adult mice. Furthermore, ARCC also achieved therapeutic effects in diabetic foot patients, accelerating wound healing. The results found that foot ulcers improved significantly 7 days after the ARCC administration, and 80% of patients were healed within 1 month.

Discussion

In the present study, ARCC was found to have therapeutic effects on both acute and chronic wounds in animal models. ARCC also demonstrated therapeutic effects in diabetic feet, which promoted wound healing, prevented wound infection, and avoided the risk of further surgery or amputation. All these evidences suggested ARCC was a promising approach for wound treatment.

Conclusions

ARCC might be recommended as a promising therapeutic medication in diabetic and chronic refractory wounds.

The ameliorative effects of cinnamon oil against ethanol-induced gastric ulcer in rats by regulating oxidative stress and promoting angiogenesis

Cinnamon is one of the herbal resources belonging to the Lauraceae family, is commonly used in traditional medicine and as a flavoring agent. It has antioxidant and anti-inflammatory activities. Therefore, the present study was performed to evaluate the gastroprotective effect of cinnamon on ethanol-induced gastric ulcer in comparison to omeprazole. In Wistar rats, gastric ulcers were induced using one oral dose of 70% ethanol (5 ml/kg b. w.) Cinnamon oil at doses of 2.5 ml/kg body weight and omeprazole (a reference drug) at a dose of 20 mg/kg body weight were orally administrated daily for 7 days before ulcer induction. 1 h after ethanol administration blood samples were collected and then the stomachs of sacrificed rats were subjected to biochemical, macroscopic and histological, and immunohistochemical studies. Oral administration of cinnamon oil significantly attenuated gastric ulcer as revealed by a significant increase in the gastric levels of enzymatic and non-enzymatic antioxidants namely CAT, SOD, GSH-Px, and GSH with a concomitant reduction in MDA level compared with those in the ethanol group. Pre-treatment of cinnamon oil markedly improved the level of TNF-α and PGE content. Furthermore, cinnamon oil pre-treatment significantly increased the immunoreactivity of VEGF while decreasing the immunoreactivity of COX-II. These results were further supported by histopathological findings which revealed the curing effect of cinnamon oil on the microscopic changes induced by ethanol toxicity. Cinnamon oil showed a potential gastroprotective effect on ethanol-induced gastric ulcer comparable to the gastroprotective effect of omeprazole, and its effect may be mediated through suppression of oxidative stress and gastric inflammation and promotion of angiogenesis.

Comparison effects of platelet-rich plasma on healing of infected and non-infected excision wounds by the modulation of the expression of inflammatory mediators: experimental research

INTRODUCTION

Microbial invasion in soft tissue is believed to cause infectious wounds and increase healthcare costs, anxiety, and distress. The current study was conducted to evaluate the effects of topical use of platelet-rich plasma (PRP) on infected wound-healing process in rats.

METHODS

Following the induction of a circular wound, the animals were divided into three groups, including (1) standard control: infected wounds treated with mupirocin (SDCL), (2) non-infected wounds treated with PRP (PRP), and (3) infected group in which the rats were infected with Staphylococcus epidermidis and Pseudomonas aeruginosa and treated with PRP (INF + PRP). To evaluate the effects of PRP on the wound-healing rate, total bacterial count, histopathological assessment, the serum concentrations of sialic acid, C-reactive protein, haptoglobin, and fibrinogen were assessed. Additionally, IL-1β, IL-6, TNF-α, IL-3, NF-κB, iNOS, PDGF, and EGF mRNA level expressions were assessed employing the qRT-PCR method.

RESULTS

The results indicated that topical application of PRP could significantly decrease total bacterial count, the level of C-reactive protein, and pro-inflammatory cytokines (IL-1β, IL-6, and TNF-α) compared to the SDCL group. The administration of PRP also promoted re-epithelization rate by increasing the expression of EGF mRNA level.

CONCLUSION

We could recommend the use of PRP for the treatment of infected wounds owing to its efficiency in decreasing colonization of tissue bacteria, tissue inflammation, and stimulating wound heal-up.

Effects of sub-acute co-exposure to WIFI (2.45 GHz) and Pistacia lentiscus oil treatment on wound healing by primary intention in male rabbits

Background

The bioeffects of WIFI on cutaneous wound healing remains unexplored. In addition, several medicinal plant products including lentisk oil have been shown to interfere with wound healing process. Since the use of this oil is increasing, the co‐exposure (WIFI‐Lentisk oil) assessment is of paramount importance.

Objectives

We aimed in the present study to investigate the effects of WIFI exposure as well as the application of Pistacia lentiscus oil on sutured wounds (SW).

Methods

New Zealand male rabbits (n = 24) were used and randomly divided into four groups of six animals each: a control group (SW) and three experimental groups (i) a first group exposed to WIFI (2.45 GHz, 6 h/day) during 16 days (SWW); (ii) a second group exposed to WIFI (2.45 GHz, 6 h/day) during 16 days and treated with lentisk oil (SWWL) and (iii) a third group not exposed to WIFI but treated with lentisk oil (SWL). The wound healing was evaluated by monitoring clinical parameters (temperature, food intake, relative weight variation, and macroscopic aspect) and histology.

Results

The mean food intake was higher in the SWWL group compared to the three other groups (p < 0.001) and higher in the SWL group compared to the SW group (p = 0.014). The exposition to WIFI (SWW group) or lentisk oil application (SWL group) can promote the collagen deposition and ameliorate the general aspect of wounds. By contrast, the co‐exposure to WIFI and lentisk oil (SWWL) results in antagonist effects and extends the inflammatory phase of wound healing.

Conclusions

Wounds treated topically with Pistacia lentiscus oil should not be exposed to WIFI.

Nanophyto-gel against multi-drug resistant Pseudomonas aeruginosa burn wound infection

Burn wound is usually associated by antibiotic-resistant Pseudomonas aeruginosa infection that worsens and complicates its management. An effective approach is to use natural antibiotics such as cinnamon oil as a powerful alternative. This study aims to investigate topical nanostructured lipid carrier (NLC) gel loaded cinnamon oil for Pseudomonas aeruginosa wound infection. A 2⁴ full factorial design was performed to optimize the formulation with particle size 108.48 ± 6.35 nm, zeta potential -37.36 ± 4.01 mV, and EE% 95.39 ± 0.82%. FTIR analysis revealed no excipient interaction. Poloxamer 407 in a concentration 20% w/w NLC gel was prepared for topical application. Drug release exhibited an initial burst release in the first five hours, followed by a slow, sustained release of up to five days. NLC-cinnamon gel has a significant ability to control the drug release with the lowest minimum inhibitory concentration again P. aeruginosa compared to other formulations (p < .05). In vivo study also showed NLC-cinnamon gel effectively healed the infected burned wound after a six-day treatment course with better antibacterial efficacy in burned animal models. Histological examination ensured the tolerability of NLC-cinnamon gel. The results suggest that nanoparticle-based cinnamon oil gel is a promising natural product against antibiotic-resistant strains of P. aeruginosa in wound infection.

Alternative Approaches for the Management of Diabetic Foot Ulcers

Diabetic foot ulcers (DFU) represent a growing public health problem. The emergence of multidrug-resistant (MDR) bacteria is a complication due to the difficulties in distinguishing between infection and colonization in DFU. Another problem lies in biofilm formation on the skin surface of DFU. Biofilm is an important pathophysiology step in DFU and may contribute to healing delays. Both MDR bacteria and biofilm producing microorganism create hostile conditions to antibiotic action that lead to chronicity of the wound, followed by infection and, in the worst scenario, lower limb amputation. In this context, alternative approaches to antibiotics for the management of DFU would be very welcome. In this review, we discuss current knowledge on biofilm in DFU and we focus on some new alternative solutions for the management of these wounds, such as antibiofilm approaches that could prevent the establishment of microbial biofilms and wound chronicity. These innovative therapeutic strategies could replace or complement the classical strategy for the management of DFU to improve the healing process.

Assessing the mechanisms of action of natural molecules/extracts for phase-directed wound healing in hydrogel scaffolds

Hydrogels are proving to be very versatile as wound healing devices. In addition to their capabilities of providing a moist cellular environment and adaptive mechanical properties mimicking the extracellular matrix, they allow the incorporation of small molecules, which have potential impacts on cellular behaviour, in their nanostructures. This strategy can allow for specific targeting of the different stages of wound healing namely hemostasis, inflammation, and proliferative and remodelling phases. The latter include interlinked processes such as angiogenesis, collagen synthesis, growth factor release, collagen maturation and re-epithelialization. In this review, we attempt to match the mechanisms of action of natural molecules/extracts to the different stages of wound healing so that they can be used in a novel approach of multiphase-directed tissue regeneration using loaded hydrogel scaffolds.

Perspective on the application of medicinal plants and natural products in wound healing: A mechanistic review

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.

Quercus infectoria gall extract aids wound healing in a streptozocin-induced diabetic mouse model

OBJECTIVE

Quercus infectoria galls have commonly been used for different therapeutic purposes. This study was conducted to investigate the effects of topical application of an ointment prepared from Quercus infectoria gall hydroethanolic extract on open wound healing in a streptozocin-induced diabetic BALB/c mouse model.

METHOD

After induction of diabetes, two circular wounds (5mm) were created on the dorsum of the mice which were then divided into three groups. The mice were treated with soft yellow paraffin (control-sham group) and therapeutic doses of 5% and 10% of an ointment prepared from Quercus infectoria, respectively. To evaluate the effects of the therapeutic ointment on the wound healing process, wound area, histological parameters, mRNA levels of vascular endothelial growth factor (VEGF), Bcl-2 and p53, plasma levels of interleukin-6 (IL-6) and tumour necrosis factor (TNF)-α, and tissue antioxidant capacity were investigated.

RESULTS

The mice (n=54) were divided into three equal groups. Wound area and concentrations of IL-6 and TNF-α were significantly decreased in both ointment-treated groups compared to the control group (p<0.05). Moreover, angiogenesis, fibroblast distribution per mm² of wound tissue, collagen deposition, rapid re-epithelialisation, and the expression of VEGF, Bcl-2 and p53 mRNA, were significantly increased (p<0.05). The administration of the ointment reduced malondialdehyde concentration and increased total antioxidant capacity compared with the control group (p<0.05).

CONCLUSION

Our study suggests that an ointment prepared from Quercus infectoria gall hydroethanolic extract accelerated open wound healing in a diabetic animal model by shortening the inflammatory phase, inducing apoptosis, up-regulating the expression of Bcl-2 and p53 mRNA, antioxidant properties and cellular proliferation.

Comparison of Antibacterial Activity and Wound Healing in a Superficial Abrasion Mouse Model of Staphylococcus aureus Skin Infection Using Photodynamic Therapy Based on Methylene Blue or Mupirocin or Both

Background: Antibiotic resistance and impaired wound healing are major concerns in S. aureus superficial skin infections, and new therapies are needed. Antimicrobial photodynamic therapy (aPDT) is a new therapeutic approach for infections, but it also improves healing in many wound models. Objective: To compare the antimicrobial activity and the effects on wound healing of aPDT based on Methylene Blue (MB-aPDT) with mupirocin treatment, either alone or in combination, in superficial skin wounds of S. aureus-infected mice. Additionally, to evaluate the clinical, microbiological, and cosmetic effects on wound healing. Materials and Methods: A superficial skin infection model of S. aureus was established in SKH-1 mice. Infected wounds were treated with MB-aPDT, MB-aPDT with a daily topical mupirocin or only with mupirocin. No treatment was carried out in control animals. Daily clinical and microbiological examinations were performed until complete clinical wound healing. Histopathological studies and statistical analysis were performed at the end of the study. Results: MB-aPDT treatment induced the best wound healing compared to mupirocin alone or to mupirocin plus MB-aPDT. Superficial contraction at 24 h and a greater reduction in size at 48 h, quicker detachment of the crust, less scaling, and absence of scars were observed. Histopathological studies correlated with clinical and gross findings. By contrast, mupirocin showed the highest logaritmic reduction of S. aureus. Conclusions: MB-aPDT and mupirocin treatments are effective in a murine superficial skin infection model of S. aureus. One session of MB-aPDT was the best option for clinical wound healing and cosmetic results. The addition of mupirocin to MB-aPDT treatment improved antimicrobial activity; however, it did not enhance wound healing. No synergistic antibacterial effects were detected.

Essential Oils: Pharmaceutical Applications and Encapsulation Strategies into Lipid-Based Delivery Systems

Essential oils are being studied for more than 60 years, but a growing interest has emerged in the recent decades due to a desire for a rediscovery of natural remedies. Essential oils are known for millennia and, already in prehistoric times, they were used for medicinal and ritual purposes due to their therapeutic properties. Using a variety of methods refined over the centuries, essential oils are extracted from plant raw materials: the choice of the extraction method is decisive, since it determines the type, quantity, and stereochemical structure of the essential oil molecules. To these components belong all properties that make essential oils so interesting for pharmaceutical uses; the most investigated ones are antioxidant, anti-inflammatory, antimicrobial, wound-healing, and anxiolytic activities. However, the main limitations to their use are their hydrophobicity, instability, high volatility, and risk of toxicity. A successful strategy to overcome these limitations is the encapsulation within delivery systems, which enable the increase of essential oils bioavailability and improve their chemical stability, while reducing their volatility and toxicity. Among all the suitable platforms, our review focused on the lipid-based ones, in particular micro- and nanoemulsions, liposomes, solid lipid nanoparticles, and nanostructured lipid carriers.

Investigation of Healing Effects of Cinnamic Acid in a Full-Thickness Wound Model in Rabbit

Background: Wounds represent a major global problem for health care systems, clinicians, patients, and their families. Cinnamic Acid (CA) is a naturally occurring phenolic compound that possesses anti-inflammatory, antimicrobial, and antioxidant properties. Objectives: This study aimed to investigate the effects of CA on skin wound-healing in the animal model. Methods: Full-thickness wounds were created on the back of white New Zealand rabbits of both sexes. Animals were divided into six groups (six animals and 12 wounds in each group). Negative control received no treatment, while positive control was treated with phenytoin cream, vehicle group with eucerin, and test groups with 0.1, 1, and 10% CA ointments. The healing activity of CA was evaluated by determining the wound closure rate and hydroxyproline content of wound tissue samples. In addition, the histopathological study of tissue samples of different groups was performed using hematoxylin and eosin staining. Results: The rate of wound closure and hydroxyproline levels of tissue samples in animals treated with CA 0.1% were significantly (P < 0.05) higher than those of no-treatment and vehicle-treated groups. Histological study revealed the increased number of fibroblasts and hair follicles, increased reepithelialization rate, and enhanced neovascularization in CA 0.1%-treated group when compared to no-treatment and vehicle groups. Conclusions: Cinnamic acid at low concentrations (< 1%) is potent for skin wound-healing and could be used as a safe and effective topical healing agent. Further studies are needed to confirm our findings.

Antibiotic-free combinational hyaluronic acid blend nanofibers for wound healing enhancement

An innovative approach in the functionalization of nanofibers (NFs) for wound healing relies on non-antibiotic combinational therapy to subdue microbial invasion while reducing antimicrobial resistance and enhancing healing. Despite great potentials, wound healing efficacy of NFs embedding antimicrobial metal nanoparticles (NPs)/essential oils has been scarcely documented. We developed combinational NFs using an electrospinnable hyaluronic acid/polyvinyl alcohol/polyethylene oxide blend embedding a new ZnO NPs/cinnamon essential oil (CEO) antimicrobial combination. Fourier transform infrared, X-ray diffraction and transmission electron microscopy confirmed the presence of HA and distribution of ZnO NPs and CEO within NFs. Results for mean diameter, thermal stability, hydrophilicity, tensile strength, in vitro biodegradability, and cytocompatibility of crosslinked combinational NFs were intermediate between those of their singly loaded counterparts. All NFs inhibited the growth of Staphylococcus aureus (S. aureus). Compared with singly loaded NFs, combinational NFs showed the greatest healing efficacy of full thickness S. aureus inoculated incision wounds in rats in terms of bacterial inhibition following a single application, healing speed, and quality of skin structure recovery as verified by morphological, microbiological, and histopathological studies. Results highlighted the potentials of metal NPs/essential oil functionalization of nanofibrous wound dressings as an emerging antibiotic-free combinational approach for more effective and safer wound healing.

Wound healing cream formulated with Kalanchoe pinnata major flavonoid is as effective as the aqueous leaf extract cream in a rat model of excisional wound

Leaves of Kalanchoe pinnata are used worldwide for healing skin wounds. This study aimed to develop and compare two creams containing a leaf aqueous extract of K. pinnata (KP; 6%) and its major flavonoid [quercetin 3-O-α-L-arabinopyranosyl-(1→2)-α-L-rhamnopyranoside] (0.15%). Both creams were topically evaluated in a rat excision model for 15 days. On the 12^th day, groups treated with KP leaf-extract and KP major flavonoid creams exhibited 95.3 ± 1.2% and 97.5 ± 0.8% of healing, respectively (positive control = 96.7 ± 0.8%; negative control = 76.1 ± 3.8%). Both resulted in better re-epithelialization and denser collagen fibres. Flavonol glycosides are the main phenolics in KP leaf-extract according to HPLC-ESI-MS/MS analysis. KP major flavonoid plays a fundamental role in the wound healing. The similar results found for both creams indicate that the use of KP crude extract should be more profitable than the isolated compound.

Phytochemical and pharmacological review of Cinnamomum verum J. Presl-a versatile spice used in food and nutrition

Cinnamomum verum is the widely used spice for its medicinal and culinary uses since ages. It is native to Sri Lanka and southern India but also distributed in many Asian, Caribbean, Australian and African countries. It is widely used in food preparations and industrial products like candies, chewing gums, mouthwash and toothpaste. It is also used to treat asthma, bronchitis, diarrhea, headache, inflammation and cardiac disorders. Cinnamaldehyde, eugenol, caryophyllene, cinnamyl acetate and cinnamic acid are the major compounds found in its essential oil. These compounds exhibit a wide range of pharmacological activities including antioxidant, antimicrobial, anti-inflammatory, anticancer, antidiabetic, wound healing, anti-HIV, anti-anxiety and antidepressant, etc. This review highlights its comprehensive and up-to-date information on taxonomy, ethnomedicinal uses, phytochemical composition, pharmacological and toxicity activities. Structure-activity relationship, mechanism of action and some research gaps has also been provided. Owing to its immense medicinal importance, more well-designed in-vivo and clinical studies are required.

Topical administration of hydroethanolic extract of Trifolium pratense (red clover) accelerates wound healing by apoptosis and re-epithelialization

We investigated the wound healing effects of an ointment prepared from a hydroethanolic extract of Trifolium pratense (red clover) in Wistar rats. An animal model was prepared by making 314 mm² full thickness skin excisions in all animals. Rats were divided into four experimental groups. Group 1 was a non-intervention control. Groups 2, 3 and 4 were treated topically with ointments containing 1.5, 3.0 and 6% (w/v) T. pretense extract, respectively. We evaluated the effects of these ointments by histological analysis of collagen production, epidermis thickness, fibroblast distribution and wound contraction ratio, and also by estimating expression of Bax, Bcl-2 and p53. Collagen production, epidermis thickness, fibroblast distribution and wound contraction ratio were significantly increased in groups 2 - 4 compared to group 1. Groups 2 - 4 also exhibited significantly increased levels of Bcl-2 mRNA and reduced mRNA levels of Bax and p53 compared to group 1. Groups 2 - 4 exhibited accelerated healing by up-regulating Bcl-2 expression, reducing p53 and Bax levels, and by promoting the proliferative phase of healing. We suggest that a hydroethanolic extract of T. pratense in commercial ointments may be useful for promoting wound healing.

Accelerated healing by topical administration of Salvia officinalis essential oil on Pseudomonas aeruginosa and Staphylococcus aureus infected wound model

BACKGROUND

Salvia officinalis L. (Lamiaceae) is known to have antibacterial properties possibly conducive to the healing process of infected wounds.

PURPOSE

The present study aimed to evaluate the effects of an ointment containing Salvia officinalis essential oil (SOO) on an infected wound model.

METHODS

Essential oil hydrodistillated from the dried leaves of the plant was analyzed by GC-FID and GC-MS. After creating two full-thickness cutaneous wounds, mice were classified into four groups, control, and animals treated with 2 % mupirocin® (standard positive drug), and 2 % and 4 % (w/w) of SOO. In order to evaluate the effects of SOO on the wound healing phases, the expression levels of interleukin-6 (IL-6), interleukin-1β (IL-1β), tumor necrosis factor-α (TNF-α), cyclin-D1, Bcl-2, fibroblast growth factor-2 (FGF-2) and vascular endothelial growth factors (VEGF) were analyzed using qRT-PCR. Immunohistochemistry analysis, tissue total antioxidant capacity (TAC) and malondialdehyde (MDA) were further assessed in all groups.

RESULTS

Concerning essential oil, the main compounds were found to be cis-thujone (26.8 %), camphor (16.4 %), trans-thujone (14.1 %) and 1,8-cineole (10.8 %). Our findings showed that the topical application of SOO was able to shorten the inflammatory phase and accelerate the cellular proliferation, re-vascularization, collagen deposition and re-epithelialization in comparison to the control group (p < 0.05). Moreover, increased mRNA levels of FGF-2 and VEGF, and up-regulation of cyclin-D1 and Bcl-2 were observed following the topical application of SOO compared to the control group (p < 0.05). The expression levels of IL-6, IL-1β and TNF-α were reduced in animals treated with SOO on days 3, 7 and 14 (p < 0.05).

CONCLUSIONS

Administration of SOO increased the TAC level and reduced the MDA content and levels of IL-1β and TNF-α. It is concluded that SOO is able to accelerate the wound healing process by regulating the expression of pro-inflammatory cytokines, growth factors, and antioxidant properties.

The Effects of Essential Oils and Terpenes in Relation to Their Routes of Intake and Application

Essential oils have been used in multiple ways, i.e., inhaling, topically applying on the skin, and drinking. Thus, there are three major routes of intake or application involved: the olfactory system, the skin, and the gastro-intestinal system. Understanding these routes is important for clarifying the mechanisms of action of essential oils. Here we summarize the three systems involved, and the effects of essential oils and their constituents at the cellular and systems level. Many factors affect the rate of uptake of each chemical constituent included in essential oils. It is important to determine how much of each constituent is included in an essential oil and to use single chemical compounds to precisely test their effects. Studies have shown synergistic influences of the constituents, which affect the mechanisms of action of the essential oil constituents. For the skin and digestive system, the chemical components of essential oils can directly activate gamma aminobutyric acid (GABA) receptors and transient receptor potential channels (TRP) channels, whereas in the olfactory system, chemical components activate olfactory receptors. Here, GABA receptors and TRP channels could play a role, mostly when the signals are transferred to the olfactory bulb and the brain.