An investigation of misoprostol in the promotion of wound healing

Compendium of Conventional and Targeted Drug Delivery Formulation Used for the Treatment and Management of the Wound Healing

Wound healing is a complex and dynamic phenomenon that involves the restoration of normal physiology and functioning of injured tissue. The process of wound healing is primarily regulated by various cytokines, inflammatory mediators, and growth factors at the molecular level. Any intervention in the normal wound healing process leads to further tissue damage, which in turn leads to delayed wound healing. Several natural, synthetic drugs and their combinations were used to restored and accelerate the wound healing process. However, the conventional delivery carriers were not much effective, and thus, nowadays, nanocarriers are gaining much popularity since they are playing a pivotal role in drug delivery. Since nanocarriers have their own applicability and benefits (enhance the bioavailability, site-specific targeting) so, they can accelerate wound healing more efficiently. This review briefly discussed about the various events that take place during the wound healing process with emphasis on various natural, synthetic, and combination drug therapy used for accelerating wound healing and the role of nanotechnology-based approaches in chronic wound healing.

Effect of a Misoprostol/Phenytoin Gel on Experimentally Induced Wounds in Brook Trout-A Preliminary Study

Topical treatment for wound management in fish is challenging due to their aquatic life. The objective of the present study was to assess the effect of a topical gel containing misoprostol and phenytoin on the healing of skin wounds in Brook Trout Salvelinus fontinalis. Four 16- × 8-mm, full-thickness wounds were created in each trout. Fish were randomly assigned either to the misoprostol/phenytoin group (14 fish) or to the untreated control group (5 fish). In fish from the misoprostol/phenytoin group, two randomly selected wounds were topically treated with a misoprostol/phenytoin gel, while the other two wounds were left without topical treatment. Follow-up and treatment were performed every 5 d for 120 d. Different macroscopic healing indexes were recorded over time, and histological characteristics of each wound were scored at the end of the study. Treatment with misoprostol/phenytoin was associated with delayed epithelialization and wound maturation in comparison with contralateral untreated wounds. The treatment was also associated with lower histological inflammation scores and increased dermal neovascularization. The untreated wounds of fish in the misoprostol/phenytoin group showed delayed maturation and decreased healing speed and had lower inflammation scores and increased neovascularization compared to untreated control wounds. Topical treatment of wounds in Brook Trout with misoprostol/phenytoin gel at the concentration used had a local and systemic deleterious effect on wound healing. The results of the present study do not support the use of this gel at this dosage for the treatment of wounds in Brook Trout.

A randomized, double-blind, placebo-controlled trial of misoprostol for oral mucositis secondary to high-dose chemotherapy

PURPOSE

Misoprostol, a synthetic analog of prostaglandin E1, has anti-inflammatory and mucosa-protecting properties. The objective of this study was to evaluate the efficacy of misoprostol oral rinse in reducing the severity of oral mucosal injury caused by high-dose chemotherapy.

METHODS

The study used a randomized, double-blind, placebo-controlled, parallel-group design. Oncology patients receiving myeloablative high-dose chemotherapy, in preparation for a hematopoietic stem cell transplant, were randomized to misoprostol or placebo rinse. The primary outcome measure was the severity of oral mucositis, measured using the modified Oral Mucositis Index. Additional outcome measures included the severity of mouth pain (measured using a Visual Analog Scale and the Pain Affect Faces Scale), duration of hospital stay, and days on total parenteral nutrition.

RESULTS

This study was originally planned to accrue 160 subjects but was terminated early due to revised sponsor research priorities. The intent-to-treat population consisted of 22 subjects randomized to misoprostol rinse and 26 subjects randomized to placebo rinse. There was no significant difference between the two groups in mucositis or pain severity. In both groups, duration of hospital stay was approximately 19 days, and number of days on total parenteral nutrition was 17-18 days. There were no serious adverse events attributable to misoprostol rinse.

CONCLUSIONS

Although this study did not find a beneficial effect of a misoprostol rinse in mucositis secondary to high-dose chemotherapy, the small sample size limits the strength of this conclusion. Given the proposed importance of the prostaglandin pathway in the pathogenesis of oral mucositis, additional studies are warranted.