The scientific study of herbal wound healing therapies: Current state of play

Determination of the Effectiveness of Topical Product of Commiphora Mukul Oleo Gum Resin on Dermal Wound Healing: An Experimental Study

In Persian Medicine, many plants have been used in wound healing for thousands of years, and recent evidence indicates the beneficial effects of plant extracts on healing skin wounds. Commiphora mukul oleo gum resin has been considered for a long time due to its various properties such as milk-enhancing, diuretic, and healing the mouth and larynx wounds. The present study aimed to evaluate the effect of Commiphora mukul oleo gum resin on wound healing in rats. Forty-two albino Wistar rats have randomly divided into six groups: The first group was without treatment, the second group was treated with Eucerin, the third group was treated with phenytoin cream %1, the fourth to sixth groups were treated with Commiphora mukul ointment 2%, 4%, and 8% respectively. Treatment was performed once a day for 14 days, and the wound area was measured daily. At the end of the experiment, blood samples were taken to measure vascular endothelial growth factor (VEGF) and platelet-derived growth factor (PDGF). The histological evaluation and the strength test of the repaired tissue were performed. The results showed that seven days after treatment, the wound area decreased significantly in the groups treated with mukul gum extract compared to the control groups (p0.05). At the end of the experiment, there was no significant difference in wound area reduction between the groups. Commiphora mukul gum extract increased VEGF and significantly improved skin elasticity. The results of this study indicate the Wound healing potential of Commiphora mukul.

Dihydroisocoumarins, Naphthalenes, and Further Polyketides from Aloe vera and A. plicatilis: Isolation, Identification and Their 5-LOX/COX-1 Inhibiting Potency

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.

Extract of Aloe vera (Aloe barbadensis Miller) Enhances the Growth, Protein Contents, and Gastrosomatic Index (GaSI) of Common Carp Cyprinus carpio

Aquaculture is a growing agribusiness, and large-scale microbial infection frequently leads to considerable economic losses, as there are very few approved drugs available to counteract such a problem. Aloe vera is a natural therapeutic plant with biological activities, for example, antimicrobial, anticancer, mitigating, and immunomodulatory properties. Thus, an experiment was conducted to understand the effects of dietary Aloe vera on survival, growth performance, protein utilization, gastrosomatic index, and gut histomorphological studies in common carp in laboratory conditions. Aloe vera leaves were collected, washed, shade-dried, and homogenized to get a filtrate, which was extracted in ethanol (70%) using the Soxhlet apparatus. The carp with an average weight of 1.73 ± 0.14 g was divided randomly into 5 treatments (control and other 4 treated groups) with the extract of 0.0%, 0.2%, 0.4%, 0.8%, and 1.6% in the diet with 3 replicates and the stocking density was 25 fish per each replicate. Sampling was done on the 30th, 60th, and 90th days, and the results show that percent weight gain, specific growth rate, protein efficiency ratio, and feed conversion efficiency were significantly high in the treated diet compared to the control (0.0%). Gastrosomatic index, condition factors, and gut histology found better performance in common carp group fed 0.4% and 0.8% of Aloe vera after 90 days. In conclusion, it was found that Aloe vera extract between the amount of 0.4% and 0.8% is better for fish growth for common carp.

Herbs as old potential treatments for lymphedema management: A systematic review

INTRODUCTION

Herbs have been reported to be effective in reducing lymphedema burden. This paper aimed to review literature reporting on herbs for lymphedema treatment.

METHODS

A systematic review was performed using the PRISMA guideline. Clinical studies on herbal intervention and lymphedema were included. Evidence on the effectiveness of herbal interventions for desired outcomes including reduction of edema volume, other symptoms, quality of life and inflammation were collected and assessed in detail.

RESULTS

In all twenty studies were included in this review. Of these 14 studies were randomized clinical trials and the rest were prospective pilot studies. Herbal treatment was reported for breast cancer-related lymphedema in most studies and coumarin was the most reported herb that used for lymphedema management. Edema volume reduction (17 out of 20) and symptoms improvement (15 out of 20) were the outcomes reported in most studies.

CONCLUSION

Phytochemicals can be a promising pharmacotherapy for lymphedema management. However, further evidence is needed to establish definite effectiveness for the use of herbal remedies for lymphedema management.

Agronomic Cultivation, Chemical Composition, Functional Activities and Applications of Pereskia Species - A Mini Review

BACKGROUND

The exploration of the plant biodiversity as a natural source to obtain sustainable food products and new bioactive pharmaceutical compounds has been growing significantly due to their abundance, safety and economy. Natural pharmaceutical and edible compounds present some advantages when compared to synthetic ones, such as being chemically inert and widely available. In this sense, plants of the genus Pereskia belonging to the Cactaceae family, have been studied. It is an unconventional wild edible plant that contains a large amount of protein and minerals. Studies have demonstrated their biological activities and potential application in different areas such as pharmaceutical, medicinal and food.

OBJECTIVE

This review is focused on the chemical composition, functional properties, applications on pharmaceutical, nutraceutical and food areas and formulation techniques to enhance the stability and bioavailability of bioactive compounds from the underutilized wild edible plant known as ora-pro-nobis (Pereskia aculeata or Pereskia grandifolia).

CONCLUSION

The latest studies involving ora-pro-nobis demonstrated its great potential due to its biological activities, which could stimulate further investigations. The utilization of this plant as a natural source to supplement the diet, or to prepare new food products and pharmaceutical formulations is an attractive approach to explore and fully realize the potential of the rich biodiversity found in Brazil and in other countries.

Acemannan and Fructans from Aloe vera (Aloe barbadensis Miller) Plants as Novel Prebiotics

The nutraceutical properties of Aloe vera have been attributed to a glucomannan known as acemannan. Recently information has been published about the presence of fructans in Aloe vera but there are no publications about acemannan and fructans as prebiotic compounds. This study investigated in vitro the prebiotic properties of these polysaccharides. Our results demonstrated that fructans from Aloe vera induced bacterial growth better than inulin (commercial FOS). Acemannan stimulated bacterial growth less than fructans, and as much as commercial FOS. Using qPCR to study the bacterial population of human feces fermented in a bioreactor simulating colon conditions, we found that fructans induce an increase in the population of Bifidobacterium spp. Fructans produced greater amounts of short chain fatty acids (SCFA), while the branched-chain fatty acids (BCFA) did not increase with these polysaccharides. Acemannan increased significantly acetate concentrations. Therefore, both Aloe vera polysaccharides have prebiotic potentials.

Review: African medicinal plants with wound healing properties

ETHNOPHARMACOLOGICAL RELEVANCE

Wounds of various types including injuries, cuts, pressure, burns, diabetic, gastric and duodenal ulcers continue to have severe socio-economic impact on the cost of health care to patients, family and health care institutions in both developing and developed countries. However, most people in the developing countries, especially Africa, depend on herbal remedies for effective treatment of wounds. Various in vitro and in vivo parameters are used for the evaluation of the functional activity of medicinal plants by using extracts, fractions and isolated compounds. The aim of the review is to identify African medicinal plants with wound healing properties within the last two decades.

MATERIALS AND METHODS

Electronic databases such as PubMed, Scifinder(®) and Google Scholar were used to search and filter for African medicinal plants with wound healing activity. The methods employed in the evaluation of wound healing activity of these African medicinal plants comprise both in vivo and in vitro models. In vivo wound models such as excision, incision, dead space and burn wound model are commonly employed in assessing the rate of wound closure (contraction), tensile strength or breaking strength determination, antioxidant and antimicrobial activities, hydroxyproline content assay and histological investigations including epithelialisation, collagen synthesis, and granulation tissue formation. In in vitro studies, single cell systems are mostly used to study proliferation and differentiation of dermal fibroblasts and keratinocytes by monitoring typical differentiation markers like collagen and keratin.

RESULTS

In this study, 61 plants belonging to 36 families with scientifically demonstrated or reported wound healing properties were reviewed. Various plant parts including leaves, fruits, stem bark and root extracts of the plants are used in the evaluation of plants for wound healing activities.

CONCLUSION

Although, a variety of medicinal plants for wound healing can be found in literature, there is a need for the isolation and characterization of the bioactive compounds responsible for the wound healing properties. Also, cytotoxicity studies should be performed on the promising agents or bioactive fractions or extracts.

Assessment of circular wound healing in rats after exposure to 808-nm laser pulses during specific healing phases

BACKGROUND AND OBJECTIVES

Low-level laser therapy (LLLT), is an important application modality for the advancement of wound healing processes. In this study, histological and morphometric analyses have been made to understand and compare effects of high-power 808-nm pulses on circular skin wounds among groups irradiated immediately after wounding and groups irradiated at specific stages of the healing period.

STUDY DESIGN

Experimental groups were as follows: Laser Therapy (LT) was received as three sessions of laser irradiation (6.38 J/cm2, 1.276 W/cm2, 808 nm) immediately after wounding (Inflammatory group, n = 12), 24 hours post-wounding (Proliferative group, n = 12), and 72 hours post-wounding (Remodeling group, n = 12); the Control group (n = 12) received no irradiation. Histological analyses were performed on the 3rd, 7th, and 14th days post-wounding.

RESULTS

Mean wound diameters were 5 mm for all groups. On Day 7, wound diameters were measured as 2.99 ± 0.17, 2.95 ± 0.3, 2.52 ± 0.11, and 2.41 ± 0.34 mm for the Control, Inflammatory, Proliferative, and Remodeling groups, respectively. At 2 weeks post-wounding, dermal tissue in the Inflammatory and Proliferative groups closed superficially, while 1.30 ± 0.1 mm and 1.30 ± 0.06 mm openings remained in the Control and Remodeling groups, respectively. Mean wound healing rates (WHR) for all treatment groups were found to differ significantly from the control group (P < 0.05). Upon comparing the Proliferative group with the other treatment groups, a significant difference was found. However, no significant difference was found between the Inflammatory and Remodeling groups, with the former having a slightly higher mean value.

CONCLUSION

Histological and morphometric results showed that high-power, low-energy application has the best effect when first applied 24 hours post-wounding (late inflammatory, early proliferative stage) as demonstrated by increases in granulation tissue, fibroblasts and collagen deposition, which lead to faster rates of wound contraction and thus accelerated healing.

Naturally derived biofunctional nanofibrous scaffold for skin tissue regeneration

Significant wound healing activity of Aloe vera (AV) and higher elastic strength of Silk fibroin (SF) along with mammalian cell compatibility makes AV and SF an attractive material for tissue engineering. The purpose of the present work was to combine their unique properties, with the advantage of electrospinning to prepare a hybrid transdermal biomaterial for dermal substitutes. The physico-chemical characterization of the developed scaffold showed finer morphology expressing amino and esteric groups with improved hydrophilic properties and favorable tensile strain of 116% desirable for skin tissue engineering. Their biological response showed favorable fibroblast proliferation compared to control which almost increased linearly by (p<0.01) 34.68% on day 3, (p<0.01) 19.13% on day 6, and (p<0.001) 97.86% on day 9 with higher expression of CMFDA, collagen and F-actin proteins. The obtained results prove that the nanofibrous scaffold with synergistic property of AV and SF would be a potential biomaterial for skin tissue regeneration.

Efficacy of Daphne oleoides subsp. kurdica used for wound healing: identification of active compounds through bioassay guided isolation technique

ETHNOPHARMACOLOGICAL RELEVANCE

In Turkish traditional medicine, the aerial parts of Daphne oleoides Schreber subsp. kurdica (DOK) have been used to treat malaria, rheumatism and for wound healing. The aim was to evaluate the ethnopharmacological usage of the plant using in vivo and in vitro pharmacological experimental models, and to perform bioassay-guided fractionation of the 85% methanolic extract of DOK for the isolation and identification of active wound-healing component(s) and to elucidate possible mechanism of the wound-healing activity.

MATERIALS AND METHODS

In vivo wound-healing activity was evaluated by the linear incision and the circular excision wound models. Anti-inflammatory and antioxidant activities, which are known to support the wound healing process, were also assessed by the Whittle method and the DPPH (2,2-diphenyl-1-picrylhydrazyl) radical-scavenging assays, respectively. The total phenolic content of the extract and subextracts was estimated to establish any correlation between the phenolic content and the antioxidant activity. The methanolic extract of DOK was subjected to various chromatographic separation techniques leading to the isolation and identification of the active component(s). Furthermore, in vitro hyaluronidase, collagenase and elastase enzymes inhibitory activity assays were conducted on the active components to explore the activity pathways of the remedy.

RESULTS

After confirmation of the wound-healing activity, the methanolic extract was subjected to successive solvent partitioning using solvents of increasing polarity creating five subextracts. Each subextract was tested on the same biological activity model and the ethyl acetate (EtOAc) subextract had the highest activity. The EtOAc subextract was subjected to further chromatographic separation for the isolation of components 1, 2 and 3. The structures of these compounds were elucidated as daphnetin (1), demethyldaphnoretin 7-O-glucoside (2) and luteolin-7-O-glucoside (3). Further in vivo testing revealed that luteolin-7-O-glucoside was responsible for the wound-healing activity of the aerial parts. It was also found to exert significant anti-inflammatory, antioxidant, anti-hyaluronidase and anti-collagenase activities.

CONCLUSION

The present study explored the wound-healing potential of Daphne oleoides subsp. kurdica. Through bioassay-guided fractionation and isolation techniques, luteolin-7-O-glucoside was determined as the main active component of the aerial parts. This compound exerts its activity through inhibition of hyaluronidase and collagenase enzymes activity as well as interfering with the inflammatory stage.

Wound healing efficacy of Jatyadi Taila: in vivo evaluation in rat using excision wound model

ETHNOPHARMACOLOGICAL RELEVANCE

In traditional Indian medicinal treatise there are several Ayurvedic formulations mentioned which have been claimed as potential wound healing agents like Madhu Ghrita and Jatyadi Taila. Jatyadi Taila (JT) is a medicated oil formulation (Taila) popularly used in the treatment of various topical wounds.

AIM OF THE STUDY

Though JT has its composition recorded in ancient Ayurvedic texts, there have been minimal attempts to standardize its use in the management of wound. The current work evaluates the wound healing efficacy of JT and also provides evidence of the dermal absorption kinetics of Karanjin from JT.

MATERIALS AND METHODS

JT was subjected to preliminary phytochemical evaluation. Therapeutically active marker components β-sitosterol, lupeol and karanjin were detected and separated using HPTLC. As a part of safety evaluation, skin irritation potential of JT was evaluated on rabbit skin. Excision wound model in rats were used to evaluate the wound healing efficacy of JT. Histopathological and biochemical evaluations of excised skin tissues at wound sites were carried out. The HPTLC method developed was also validated to evaluate the pharmacokinetics of Karanjin from JT after topical application on pinna of rabbit.

RESULTS

Preliminary phytochemical evaluation of JT revealed presence of flavonoids, essential oils, tannins, glycosides, steroids and alkaloids while resins were found to be absent. HPTLC confirmed the presence of karanjin, lupeol and β-sitosterol in JT. JT was found to be non-irritant when applied to the skin of rabbits. Topical application of JT on excision wounds caused significantly faster reduction in wound area as compared to the application of modern topical formulation (Neosporin(®)) and untreated control wounds. Animals treated with JT showed significant increase in protein, hydroxyproline and hexosamine content in the granulation tissue when compared with the untreated controls. Wound healing potential of JT was found to be dose dependant. HPTLC method was successfully used to evaluate the pharmacokinetics of Karanjin after topical application of JT on rabbit pinna.

CONCLUSIONS

Current work demonstrates a modern approach towards standardization of the use of traditional topical formulation JT. The results justify the traditional claim of JT for its use in the management of wounds.

Healing activity of laser InGaAlP (660nm) in rats

PURPOSE: To evaluate the effect the healing activity of diode laser Indium Gallium Aluminum Phosphorus (InGaAlP) ë660nm on healing of surgical wounds in rats. METHODS: Fifty-four female Wistar rats were used, divided into three groups (n=18) and subdivided into three subgroups (n=6) to be studied in 5, 10 and 15th days after surgical procedures. The wound was induced in the dorsal-cervical using punch. The lesions were irradiated on alternate days with InGaAlP laser, the energy densities of 3J/cm² (L3) or 6J/cm² (L6). The control group received no irradiation. At 5, 10 and 15th days after surgery the animals were euthanized and the repair area was removed and histological sections were stained with hematoxylin-eosin and picrossírius. We evaluated macroscopic and histological lesions in the times cited, as well as morphometric analysis of angiogenesis and collagen content. RESULTS: The wound healing activity InGaAlP laser was evidenced by increased angiogenesis group L3 and L6 in relation to control group (CG) at the 5th day (p=0.0001) and decreased polymorphonuclear infiltrate and hemorrhage (p=0.045 and p=0.07 respectively) in the groups L3 and L6 in relation to control group (GC). On the 10 and 15th days was also observed in groups treated with laser L3 and L6 stimulation was pronounced fibroplasia (p=0.0003 and p=0.034 respectively) when compared with the control group (CG). CONCLUSION: The InGaAlP laser acted positively on the healing of skin wounds in rats.

Effects of Aloe vera cream on posthemorrhoidectomy pain and wound healing: results of a randomized, blind, placebo-control study

OBJECTIVE

Aloe vera is an herbal medicine, which has wound healing effects in burn injury. This study assessed the effects of Aloe vera cream in reducing postoperative pain, postdefection pain, and its promotion of wound healing after open hemorrhoidectomy.

DESIGN

A prospective, randomized, double-blind, placebo-controlled trial was conducted comparing the effects of a cream containing Aloe vera versus a placebo cream on posthemorrhoidectomy pain. The study preparations were applied by patients to the surgical site 3 times per day for 4 weeks after hemorrhoidectomy. Pain was assessed with a visual analog scale immediately postoperatively and at hours 12, 24, and 48 after surgery and at weeks 2 and 4. Wound healing was examined and evaluated at the end of 2 and 4 weeks. The use of analgesics was recorded.

RESULTS

Forty-nine (49) patients were randomly assigned to receive aloe (n = 24) or placebo (n = 25). Patients in the topical aloe cream group had significantly less postoperative pain at hours 12, 24, and 48 hours and at 2 weeks. Aloe cream reduced the pain after defecation in 24 and 48 hours postsurgery (p < 0.001). Wound healing at the end of the second postoperative week was significantly greater in the aloe group compared with the placebo group (p < 0.001). Patients required fewer additional analgesics posthemorrhoidectomy (p < 0.001).

CONCLUSIONS

Application of Aloe vera cream on the surgical site is effective in reducing postoperative pain both on resting and during defecation, healing time, and analgesic requirements in the patients compared with the placebo group.

Naturally Occurring Isohexenylnaphthazarins and Wound Healing: Experimental Study in Dogs

Background:

The healing efficacy of isohexenylnaphthazarins (IHN) has been well proved on chronic or contaminated wounds.

Objective:

To evaluate the wound healing activity of an experimental ointment containing IHN on acute and noncontaminated wounds in dogs. Methods: In each of six beagle dogs, four full-thickness skin defects were created bilaterally: one 2 × 2 cm defect on the lateral aspect of each arm for subjective evaluation, laser Doppler flowmetry (LDF), and planimetry and three 1.5 × 1.5 cm defects on opposite sides of the dorsal midline for histologic evaluation. Wounds on the left were treated with an ointment based on IHN and on the right with another based on petroleum jelly (Vaseline) and beeswax.

Results:

Wound size decreased significantly in both sides. The significantly increased percentage of epithelialization was higher ( p = .0274) in the petroleum jelly–treated wounds on day 20. Tissue perfusion (LDF) increased significantly bilaterally in the center of the wound but only in the IHN-treated side cranial to the wound. Histologically, angiogenesis was significantly higher ( p = .0431) on day 5 in the IHN-treated wounds compared with the petroleum jelly–treated wounds. Collagen production increased significantly bilaterally.

Conclusion:

The IHN-based ointment promoted some of the proliferative processes, but it did not enhance the overall wound healing of acute, surgically created wounds in dogs.