Citric acid treatment of post operative wound infections in HIV/AIDS patients

South African Medicinal Plants Traditionally Used for Wound Treatment: An Ethnobotanical Systematic Review

Microbial contamination of chronic wounds complicates their treatment. Traditional knowledge systems and the diversity of indigenous medicinal plants create a haven for traditional medicine practices in South Africa (SA). This systematic review aims to present a comprehensive ethnobotanical report of traditional medicines used in the documented empirical wound healing studies in SA. Google Scholar, PubMed, Medline EBSCOhost, Science Direct, and Scopus were sourced using the keywords/terminologies "South Africa", "medicinal plants", "traditional medicine" "indigenous", "skin", "wound", "ethnobotany", "survey", "interview", and "treatment" in different combinations. Relevant and unpublished records were retrieved from the Global Electronic Thesis Database. The searching process identified 32,419 records, of which 4005 studies were screened. Following the removal of 1795 duplicates, the remaining 2210 sources were screened by title and abstract, and 133 full-text reports were accessed and evaluated. Plants traditionally used for wound-healing purposes comprised 222 species belonging to 71 families, namely Asteraceae (predominantly the Helichrysum species), Asphodelaceae, Fabaceae, Solanaceae, and Euphorbiaceae. Plant organs used for medicinal remedies included leaves, roots, and bark prepared as poultices, infusions, decoctions, gel/ointments/lotions, and pastes. This review provides a valuable reference for future phytochemical and pharmacological studies and highlights the need for further ethnobotanical research to treat wounds in SA.

The efficacy and safety of acids as topical antimicrobial agents: a review

OBJECTIVE

Infected wounds, refractory to conventional therapy, are a major burden on the healthcare system. Available data show that many commonly used antiseptic agents may be toxic to the cells involved in the healing process and may affect the normal tissue repair. The topical use of different acids to control wound infections effectively and promote healing is well known. The present review aims to summarise the safety and efficacy of various acids as topical agents for treating wound infections.

METHOD

A literature search was performed in PubMed and manually from other sources (cross references and journal sites).

RESULTS

We reviewed 116 articles, from which data from 86 relevant articles were analysed. The studies showed that various organic acids were clinically effective in treating wound infections.

CONCLUSION

This study found that various organic acids can act as a substitute for antiseptics to control wound infections refractory to conventional antibiotic therapy and local wound care. Various organic acids differ in efficacy, safety and limitations as topical agents to control wound infections and promote healing. Some acids deliver better results than others, particularly in those cases in which antibiotics and routine antiseptic agents yield little lasting success, especially in controlling hospital strains with multiple antibiotic resistance. Among topically used acids, citric acid and acetic acid are associated with better results.

Advances and Challenges in Immune-Modulatory Biomaterials for Wound Healing Applications

Wound healing progresses through three distinct stages: inflammation, proliferation, and remodeling. Immune regulation is a central component throughout, crucial for orchestrating inflammatory responses, facilitating tissue repair, and restraining scar tissue formation. Elements such as mitochondria, reactive oxygen species (ROS), macrophages, autophagy, ferroptosis, and cytokines collaboratively shape immune regulation in this healing process. Skin wound dressings, recognized for their ability to augment biomaterials' immunomodulatory characteristics via antimicrobial, antioxidative, pro- or anti-inflammatory, and tissue-regenerative capacities, have garnered heightened attention. Notwithstanding, a lack of comprehensive research addressing how these dressings attain immunomodulatory properties and the mechanisms thereof persists. Hence, this paper pioneers a systematic review of biomaterials, emphasizing immune regulation and their underlying immunological mechanisms. It begins by highlighting the importance of immune regulation in wound healing and the peculiarities and obstacles faced in skin injury recovery. This segment explores the impact of wound metabolism, infections, systemic illnesses, and local immobilization on the immune response during healing. Subsequently, the review examines a spectrum of biomaterials utilized in skin wound therapy, including hydrogels, aerogels, electrospun nanofiber membranes, collagen scaffolds, microneedles, sponges, and 3D-printed constructs. It elaborates on the immunomodulatory approaches employed by these materials, focusing on mitochondrial and ROS modulation, autophagic processes, ferroptosis, macrophage modulation, and the influence of cytokines on wound healing. Acknowledging the challenge of antibiotic resistance, the paper also summarizes promising plant-based alternatives for biomaterial integration, including curcumin. In its concluding sections, the review charts recent advancements and prospects in biomaterials that accelerate skin wound healing via immune modulation. This includes exploring mitochondrial transplantation materials, biomaterial morphology optimization, metal ion incorporation, electrostimulation-enabled immune response control, and the benefits of composite materials in immune-regulatory wound dressings. The ultimate objective is to establish a theoretical foundation and guide future investigations in the realm of skin wound healing and related materials science disciplines.

Exploring salivary metabolome alterations in people with HIV: towards early diagnostic markers

Background

The human immunodeficiency virus (HIV) remains a critical global health issue, with a pressing need for effective diagnostic and monitoring tools.

Methodology

This study explored distinctions in salivary metabolome among healthy individuals, individuals with HIV, and those receiving highly active antiretroviral therapy (HAART). Utilizing LC-MS/MS for exhaustive metabolomics profiling, we analyzed 90 oral saliva samples from individuals with HIV, categorized by CD4 count levels in the peripheral blood.

Results

Orthogonal partial least squares-discriminant analysis (OPLS-DA) and other analyses underscored significant metabolic alterations in individuals with HIV, especially in energy metabolism pathways. Notably, post-HAART metabolic profiles indicated a substantial presence of exogenous metabolites and changes in amino acid pathways like arginine, proline, and lysine degradation. Key metabolites such as citric acid, L-glutamic acid, and L-histidine were identified as potential indicators of disease progression or recovery. Differential metabolite selection and functional enrichment analysis, combined with receiver operating characteristic (ROC) and random forest analyses, pinpointed potential biomarkers for different stages of HIV infection. Additionally, our research examined the interplay between oral metabolites and microorganisms such as herpes simplex virus type 1 (HSV1), bacteria, and fungi in individuals with HIV, revealing crucial interactions.

Conclusion

This investigation seeks to contribute understanding into the metabolic shifts occurring in HIV infection and following the initiation of HAART, while tentatively proposing novel avenues for diagnostic and treatment monitoring through salivary metabolomics.

Role of an acidic environment in the treatment of diabetic foot infections: A review

Management of diabetic foot ulcers is the biggest challenge to the clinician, as conventional antibiotic therapies and local wound care have their own limitations. They are not effective for control of infections and promotion of healing because of cytotoxic effects. In view of cytotoxicity of routinely used topical antiseptic agents, this article focuses on the search of an ideal topical antiseptic agent that is safe and effective in controlling infectious agents and also in promoting the healing process. This review focuses on the use of various acids such as citric, acetic, hyaluronic, and hypochlorous acids as topical agents in diabetic foot infections. This article also focuses on the different roles of acids in the treatment of diabetic foot infections.

Citric acid treatment of oral ulcers refractory to conventional treatment: a case study

Oral ulcers are painful sores that appear in the mouth. Most of them are usually harmless and clear up on their own. Sometimes, they are non-responsive and difficult to manage. This report describes the case of an 80-year-old female patient with chronic oral ulcers of three years duration and which were refractory to conventional therapy. The ulcers were subsequently treated using 3% citric acid as a sole topical agent, applied three times a day that resulted in complete healing of oral ulcers by day 10 of treatment. The findings of this case report suggest that topical citric acid is a possible alternative treatment for chronic oral ulcers unresponsive to conventional treatment.

Toxicological effects of pet food ingredients on canine bone marrow-derived mesenchymal stem cells and enterocyte-like cells

We developed an in vitro method to assess pet food ingredients safety. Canine bone marrow-derived mesenchymal stem cells (BMSC) were differentiated into enterocyte-like cells (ELC) to assess toxicity in cells representing similar patterns of exposure in vivo. The toxicological profile of clove leave oil, eugenol, guanosine monophosphate (GMP), GMP + inosine monophosphate, sorbose, ginger root extract, cinnamon bark oil, cinnamaldehyde, thyme oil, thymol and citric acid was assessed in BMSC and ELC. The LC50 for GMP + inosine monophosphate was 59.42 ± 0.90 and 56.7 ± 3.5 mg ml(-1) for BMSC and ELC; 56.84 ± 0.95 and 53.66 ± 1.36 mg ml(-1) for GMP; 0.02 ± 0.001 and 1.25 ± 0.47 mg ml(-1) for citric acid; 0.077 ± 0.002 and 0.037 ± 0.01 mg ml(-1) for cinnamaldehyde; 0.002 ± 0.0001 and 0.002 ± 0.0008 mg ml(-1) for thymol; 0.080 ± 0.003 and 0.059 ± 0.001 mg ml(-1) for thyme oil; 0.111 ± 0.002 and 0.054 ± 0.01 mg ml(-1) for cinnamon bark oil; 0.119 ± 0.0004 and 0.099 ± 0.011 mg ml(-1) for clove leave oil; 0.04 ± 0.001 and 0.028 ± 0.002 mg ml(-1) for eugenol; 2.80 ± 0.11 and 1.75 ± 0.51 mg ml(-1) for ginger root extract; > 200 and 116.78 ± 7.35 mg ml(-1) for sorbose. Lemon grass oil was evaluated at 0.003-0.9 in BMSC and .03-0.9 mg ml(-1) in ELC and its mechanistic effect was investigated. The gene toxicology studies showed regulation of 61% genes in CYP450 pathway, 37% in cholestasis and 33% in immunotoxicity pathways for BMSC. For ELC, 80% for heat shock response, 69% for beta-oxidation and 65% for mitochondrial energy metabolism. In conclusion, these studies provide a baseline against which differential toxicity of dietary feed ingredients can be assessed in vitro for direct effects on canine cells and demonstrate differential toxicity in differentiated cells that represent gastrointestinal epithelial cells.

Safety assessment of potential food ingredients in canine hepatocytes

This research aimed to develop in vitro methods to assess hazard of canine food ingredients. Canine hepatocytes were harvested and cell viability of clove-leaf oil (CLO), eugenol (EUG), lemongrass oil (LGO), guanosine monophosphate (GMP), inosine monophosphate (IMP), sorbose, ginger-root extract (GRE), cinnamon-bark oil (CBO), cinnamaldehyde (CINA), thymol oil (TO), thymol (THYM), and citric acid were assessed with positive controls: acetaminophen (APAP), aflatoxin B1 and xylitol. Molecular Toxicology PathwayFinder array (MTPF) analyzed toxicity mechanisms for LGO. LC50 for APAP was similar among human (3.45), rat (2.35), dog (4.26 mg/ml). Aflatoxin B1 had an LC50 of 4.43 (human), 5.78 (rat) and 6.05 (dog) µg/ml; xylitol did not decrease viability. LC50 of CLO (0.185 ± 0.075(SD)), EUG (0.165 ± 0.112), LGO (0.220 ± 0.012), GRE (1.54 ± 0.31) mg/ml; GMP (166.03 ± 41.83), GMP + IMP (208.67 ± 15.27) mM; CBO (0.08 ± 0.03), CINA (0.11 ± 0.01), TO (0.21 ± 0.03), THYM (0.05 ± 0.01), citric acid (1.58 ± 0.08) mg/ml, while sorbose was non-toxic. LGO induced upregulation of 16 and down-regulation of 24 genes, which CYP and heat shock most affected. These results suggest that in vitro assays such as this may be useful for hazard assessment of food ingredients for altered hepatic function.