Effect of aged garlic extract on wound healing: a new frontier in wound management

Investigation of Antiproliferative Effects of Combinations of White and Black Garlic Extracts with 5-Fluorouracil (5-FU) on Caco-2 Colorectal Adenocarcinoma Cells

Garlic is rich in bioactive compounds that are effective against colon cancer cells. This study tests the antioxidant and antiproliferative effects of cold-extracted white and black garlic extracts. Black garlic extracted in water (SSU) exhibits the highest antioxidant activity, phenolic content, and flavonoid content, while black garlic extracted in ethanol (SET) shows the lowest values. Caspase-3 activity is notably higher in the white garlic extracted in methanol (BME), white garlic extracted in methanol combines with 5-FU, black garlic extracted in ethanol (SET), black garlic extracted in ethanol combines with 5-fluorouracil (5-FU), and 5-FU treatments compare to the control group (p > 0.05). BME+5-FU displays the highest caspase-8 activity (p < 0.05). A decrease in NF-κB levels is observed in the SET+5-FU group (p>0.05), while COX-2 activities decrease in the BME, SET+5-FU, SET, and 5-FU groups (p>0.05). Wound healing increases in the BME, BME+5-FU, SET+5-FU, and 5-FU groups (p < 0.05). In conclusion, aqueous black garlic extract may exhibit pro-oxidant activity despite its high antioxidant capacity. It is worth noting that exposure to heat-treated food and increased sugar content may lead to heightened inflammation and adverse health effects. This study is the first to combine garlic with chemo-preventive drugs like 5-FU in Caco-2 cells.

Evaluation of Cytotoxicity of Allium sativum (Garlic Extract) against Human Dental Pulp Fibroblasts

Background

Vital pulp therapy procedures in primary dentition focuses on preservation and maintenance of pulp tissue that has been compromised due to caries, trauma, etc. Several pulp dressing materials have been used in primary teeth and some natural materials from the field of traditional medicine have also been introduced as medicaments in vital pulp therapy. The understanding of biologic and cytotoxic properties of newer materials is important for safe clinical usage. The biologic compatibility of these newer materials is imperative to limit or avoid tissue irritation or degeneration.

Aim

To evaluate the cytotoxic effects of Allium sativum on cultured human primary dental pulp fibroblasts.

Materials and methods

Primary pulp fibroblasts were cultured from the pulp tissue obtained from extracted deciduous primary canines and central incisor teeth. The freshly prepared concentrations of 1000, 500, 250, 125, and 62.5 µg/mL A. sativum extract were added to the 96-well plate in triplicates to which culture medium containing fourth passage cell suspension was added previously. Cells without treatment served as control, while cells treated with 5% dimethyl sulfoxide (DMSO) served as toxic control. After the addition of experimental and control agents, cells were incubated for 24 and 48 hours at 37°C in 5% CO2 atmosphere. After the incubation period, 3-(4,5-dimethyl-2-thiazolyl)-2,5-diphenyltetrazolium bromide (MTT) assay was performed to determine the number of viable cells. Absorbance was read with a microplate reader at 570 nm wavelength and the relative viability of dental pulp fibroblasts at various concentrations was expressed as color intensity of the experimental wells relative to that of control. The percentage of cell viability was also calculated accordingly.

Results

The MTT assay results revealed that A. sativum extract, in all the concentrations tested at both the time intervals maintained a cell viability of greater than 90%. At 24 hours, the mean absorbance value of untreated control wells was recorded as 0.84400 ± 0.00916 with 100% cell viability. Among all the concentrations of garlic extract tested, highest mean absorbance value of 0.83933 ± 0.00550 with 99.44% cell viability was recorded for 62.5 µg/mL concentration. At 48 hours, the mean absorbance value of untreated control wells was recorded as 1.22767 ± 0.01106 with 100% cell viability, and the highest mean absorbance value of 1.22567 ± 0.01006 with 99.83% cell viability was recorded for 62.5 µg/mL concentration. The cell viability did not seem to be affected by the concentration of A. sativum extract at 24 hours. However, at 48 hours, the sensitivity of the cells was observed to be dependent on the concentration of A. sativum with a decrease in the viability of cells noted with the increase in concentration.

Conclusion

A. sativum extract is noncytotoxic in nature and preserves the vitality of cultured human primary dental pulp fibroblasts making it a suitable material for use in vital pulp therapy procedures of primary teeth.

How to cite this article

Devaraju R, Reddy D, Paul ST, et al. Evaluation of Cytotoxicity of Allium sativum (Garlic Extract) against Human Dental Pulp Fibroblasts. Int J Clin Pediatr Dent 2024;17(2):143-148.

A review on the effect of garlic on diabetes, BDNF, and VEGF as a potential treatment for diabetic retinopathy

BACKGROUND

Garlic is one of the favorite herbs in traditional medicine that has been reported to have many medicinal features. The aim of the current study is to review the latest documents on the effect of garlic on diabetes, VEGF, and BDNF and, finally, to review the existing studies on the effect of garlic on diabetic retinopathy.

MAIN TEXT

The therapeutic effect of garlic on diabetes has been investigated in various studies. Diabetes, especially in advanced stages, is associated with complications such as diabetic retinopathy, which is caused by the alteration in the expression of molecular factors involved in angiogenesis, neurodegeneration, and inflammation in the retina. There are different in-vitro and in-vivo reports on the effect of garlic on each of these processes. Considering the present concept, we extracted the most related English articles from Web of Science, PubMed, and Scopus English databases from 1980 to 2022. All in-vitro and animal studies, clinical trials, research studies, and review articles in this area were assessed and classified.

RESULT AND CONCLUSION

According to previous studies, garlic has been confirmed to have beneficial antidiabetic, antiangiogenesis, and neuroprotective effects. Along with the available clinical evidence, it seems that garlic can be suggested as a complementary treatment option alongside common treatments for patients with diabetic retinopathy. However, more detailed clinical studies are needed in this field.

Traditional Plants Used in Southern Brazil as a Source to Wound Healing Therapies

In southern Brazil, the biodiversity is great and the traditional use of medicinal plants for wound healing has been documented in ethnobotanical studies and pharmacological studies have assessed their wound properties and phytochemistry. Therefore, this study evaluated ethnobotanical surveys regarding medicinal plants used in southern Brazil for wound healing and studies about the healing properties of these plants published between 2000 and 2022. To retrieve articles related to the study, Web of Science, PubMed (NLM), Open Access Journals, Scielo, Lilacs, and Google Scholar, with keywords including medicinal plants, wound healing, and South of Brazil, have been used. As a result, 73 medicinal plants belonging to 39 families were found in ethnobotanical surveys as a traditional resource used for wound healing in southern Brazil, 15 of which were cited more than once. Besides, 14 of these 15 plants were also used as healing agents worldwide. The most cited plant with healing actions in southern Brazil was Symphytum officinale L. (comfrey). From 2000 to date, 44 articles scientifically demonstrated the wound-healing effects of the southern Brazilian plants found in ethnobotanical surveys reviewed. The folk medicine of southern Brazil presents a variety of medicinal plants for wound-healing purposes, and scientific data were found for some of those plants. However, the wound-healing properties of many plants have yet to be investigated, and the current literature still needs more phytochemical information about the plants studied. Aside from this, the future focus should be on the standardization of herbal extracts, and further research is required to investigate the pharmacological mechanisms. Clinical research in this area remains in its infancy and warrants more robust further clinical studies.

Phytochemistry and Pharmacology of Medicinal Plants Used by the Tenggerese Society in Java Island of Indonesia

The archipelagic country of Indonesia is inhabited by 300 ethnic groups, including the indigenous people of Tengger. Based on the reported list of medicinal plants used by the Tengger community, we have reviewed each of them for their phytochemical constituents and pharmacological activities. Out of a total of 41 medicinal plants used by the Tengerrese people, 33 species were studied for their phytochemical and pharmacological properties. More than 554 phytochemicals with diverse molecular structures belonging to different chemical classes including flavonoids, terpenoids, saponins and volatiles were identified from these studied 34 medicinal plants. Many of these medicinal plants and their compounds have been tested for various pharmacological activities including anti-inflammatory, antimicrobial, wound healing, headache, antimalarial and hypertension. Five popularly used medicinal plants by the healers were Garcinia mangostana, Apium graveolens, Cayratia clematidea, Drymocallis arguta and Elaeocarpus longifolius. Only A. graviolens were previously studied, with the outcomes supporting the pharmacological claims to treat hypertension. Few unexplored medicinal plants are Physalis lagascae, Piper amplum, Rosa tomentosa and Tagetes tenuifolia, and they present great potential for biodiscovery and drug lead identification.

Wound Healing and Antioxidant Properties of 80% Methanol Leaf Extract of Verbascum sinaiticum (Scrophulariaceae): An Ethiopian Medicinal Plant

Wounds account for severe morbidity, socioeconomic distress, and mortality around the globe. For several years, various herbal products are used to expedite and augment the innate wound healing process. In Ethiopian folkloric medicine, Verbascum sinaiticum L. (V. sinaiticum) is commonly applied as a wound-healing agent. The present study investigated the potential wound healing and antioxidant properties of hydroalcoholic leaf extract of V. sinaiticum. The 80% methanol extract, formulated as 5% (w/w) and 10% (w/w) ointments, was evaluated in excision and incision wound models using nitrofurazone and simple ointment as positive and negative controls, respectively. Parameters such as wound contraction, period of epithelialization, and tensile strength were determined. Moreover, its in vitro antioxidant property was evaluated using a DPPH assay. In the excision model, both doses (5% and 10% w/w) of the extract showed a significant ( $p<0.001$ ) wound healing efficacy compared to the negative control as evidenced by enhanced wound contraction rate and shorter epithelialization time records. In the incision model, the lower dose (5% w/w) ointment formulation of the extract exhibited the maximum increment in tensile strength (85.6%) that was significant ( $p<0.001$ ) compared to negative and untreated controls. Animals treated with 5% w/w ointment, furthermore, showed a significantly ( $p<0.05$ ) higher percentage of tensile strength than nitrofurazone treated ones. Moreover, the hydroalcoholic extract of the plant showed a noticeable free radical scavenging property. The result of the present study upholds the folkloric use of V. sinaiticum in the treatment of wounds.

Methanol extract from the seeds of Persea americana displays antibacterial and wound healing activities in rat model

ETHNOPHARMACOLOGICAL RELEVANCE

Persea americana Miller (Lauraceae) known as "pear" in Cameroon is comestible by the fruit. The leaves of the plant are traditionally used in the treatment of microbial infections, malaria, diabetes, high blood pressure, to stimulate uterine contractions and relief painful menstruations. The leaves and stem bark are also used to cure malaria and typhoid fever. Fresh pulps are used to lower cholesterol, prevents mental strain and cardiovascular diseases whilst the seeds are used against intestinal worms and skin infections.

AIM OF THE STUDY

This study aimed to investigate the antibacterial activity and wound healing efficacy of methanol extract of Persea americana seed on an excision wound infected with Staphylococcus aureus using a rat model and characterise the mode of action of this extract.

MATERIALS AND METHODS

The antibacterial activities of the methanol extract were done against a panel of bacteria using broth microdilution method. The phytochemical analysis as well as the antioxidant activities were evaluated using colorimetric methods. The mode of action of P. americana was studied by targeting bacterial membranes, cytoplasmic contents, and the formation of biofilms. The therapeutic effect of the methanol extract was evaluated on an excision wound infected with Staphylococcus aureus.

RESULTS

The methanol extract of P. americana seed displayed antibacterial properties MIC varying from 64 to 128 μg/mL which can be linked to its total phenolic, flavonoid and tannin contents. The antibacterial activity of the extract is due to the bacterial biofilm inhibition and the perturbation of the bacterial membrane through the leakage of intracellular materials, the inhibition of H⁺-ATPases pumps. The gel based on P. americana extract showed a significant increase in the percentage of wound closure and had a significant reduction of the number of Colony Forming Units (CFU) of S. aureus at the infection site. The plant has antioxidant activity for wound healing which is lower than vitamin C. The toxicological report showed that the gel-based extract had negligible irritation on the skin and non-irritating to the eye, and therefore can be consider safe for use.

CONCLUSION

The present study revealed the antibacterial and wound healing properties of the MEPa and could possibly be used to tackle bacterial infections.

The clinical and radiographic evaluation of Allium sativum oil (garlic oil) in comparison with mineral trioxide aggregate in primary molar pulpotomy

BACKGROUND

Mineral trioxide aggregate (MTA) is known as a common biomaterial for pulpotomy of primary molars, with limitation including high cost, difficult handling, and long setting time. This study was conducted to compare the clinical and radiographic success rate of Allium sativum oil and MTA in pulpotomy of primary molar teeth.

MATERIALS AND METHODS

This randomized, controlled, clinical trial was performed on a group of children with at least two symptom-free primary molars requiring pulpotomy. A total of 90 teeth were randomly assigned into two groups: After pulp amputation and hemostasis, Group I received MTA as medication in the pulp chamber and Group II received Allium sativum oil over the pulp stumps. Pulp chamber was then filled with reinforced ZOE paste (zinc oxide eugenol) and teeth were restored using stainless steel crowns. The follow-up scheme of 6, 12, and 18 months was set, and teeth evaluation was conducted by a calibrated pediatric dentist based on the modified criteria proposed by Zurn and Seale. The results were analyzed using the generalized estimating equation analysis with the P = 0.05 as the level of significance.

RESULTS

The clinical success rate was 100% in both groups after all follow-ups. The radiographic success rate was, however, 91.1% after 6.75. 6% after 12 and 18 months in Group II while it was 95.6% after 6, 91.1% after 12 and 18 months in Group I in those follow-up points. The difference between the two groups was not statistically significant.

CONCLUSION

According to the results, Allium sativum oil has a high clinical and radiographic success rate comparable to those of MTA.

Antibacterial and Therapeutic Potentials of the Capsicum annuum Extract against Infected Wound in a Rat Model with Its Mechanisms of Antibacterial Action

The wound healing process is essential to reform the damaged tissue and prevent its invasion by pathogens. The present study aims at evaluating the antibacterial and therapeutic properties of the Capsicum annuum L. (Solanaceae) extract against infected wound in a rat model with its mechanisms of antibacterial action. The fruit extract was prepared by maceration in methanol. The broth microdilution method was used to investigate the antibacterial activity of the methanol extract of C. annuum fruits. The therapeutic effect of the extract gel was performed on an excision wound infected with Staphylococcus aureus using a rat model. The total phenol, flavonoid, and tannin contents as well as the antibacterial mechanisms of action of the extract were determined using spectrophotometric methods. The C. annuum fruit extract showed antibacterial properties which can be linked to its total phenolic, flavonoid, and tannin contents. The antibacterial activity is due to the inhibition of the biofilm formation, ATPases/H+ proton pump, and dehydrogenase activity as well as the alteration of the bacterial cell membrane through the leakage of nucleic acids, reducing sugars and proteins. The extract gel showed a significant (p < 0.05) increase in the percentage of wound closure and eradicated S. aureus at the infection site. The extract gel was nonirritating to the skin and slightly irritating to the eyes and should be used with caution. Overall, the findings of the present study support the traditional use of the studied plant in the treatment of wounds and infectious diseases associated with the tested bacteria.

The impacts of garlic and voluntary training alone or together on myocardial miR-126 and miR-210 gene expressions and angiogenesis in healthy rats

Introduction: microRNAs (miRs) play a critical role in both physiological and pathological processes. Recent studies have shown that garlic and exercise training have many beneficial effects in different disorders including cardiovascular disease. However, their mechanisms have not been fully understood. This study sought to investigate the impact of garlic and voluntary training alone or together on themiR-126 and miR-210 gene expressions and cardiac angiogenesis. Methods: Male Wistar rats were divided into four groups (n=7): (1) Control, (2) Garlic, (3) Exercise, and (4) Garlic+ Exercise. Animals were gavaged with raw fresh garlic homogenate (250 mg/kg body weight/day) or were subjected to voluntary training alone or together for about 6 weeks. The expressions of miR-126 and miR-210 in the heart tissue were measured by real-time PCR and lipid profile in serum was assessed by enzymatic kits. Angiogenesis was determined by immuno staining detection of PECAM-1 and CD31 in the heart tissue. Results: Garlic and exercise up-regulated myocardial miR-126 (P < 0.01), miR-210 (P < 0.001)expressions, and angiogenesis (P < 0.001) which was evidenced by higher CD31 expression. Besides, combination of garlic and exercise amplified their effects on those parameters (P < 0.001). Moreover, both voluntary exercise and garlic alone (P < 0.01) or together (P < 0.001) markedly modulated serum lipid profile. Conclusion: Voluntary exercise and garlic treatment for 6 weeks enhanced myocardial angiogenesis. These alterations were partly due to the increment of miR-126 and miR-210 expressions in the heart tissue in relation to improvement in lipid profile.

Potential Health Benefit of Garlic Based on Human Intervention Studies: A Brief Overview

Garlic is a polyphenolic and organosulfur enriched nutraceutical spice consumed since ancient times. Garlic and its secondary metabolites have shown excellent health-promoting and disease-preventing effects on many human common diseases, such as cancer, cardiovascular and metabolic disorders, blood pressure, and diabetes, through its antioxidant, anti-inflammatory, and lipid-lowering properties, as demonstrated in several in vitro, in vivo, and clinical studies. The present review aims to provide a comprehensive overview on the consumption of garlic, garlic preparation, garlic extract, and garlic extract-derived bioactive constituents on oxidative stress, inflammation, cancer, cardiovascular and metabolic disorders, skin, bone, and other common diseases. Among the 83 human interventional trials considered, the consumption of garlic has been reported to modulate multiple biomarkers of different diseases; in addition, its combination with drugs or other food matrices has been shown to be safe and to prolong their therapeutic effects. The rapid metabolism and poor bioavailability that have limited the therapeutic use of garlic in the last years are also discussed.

Phytochemicals in Garlic Extract Inhibit Therapeutic Enzyme DPP-4 and Induce Skeletal Muscle Cell Proliferation: A Possible Mechanism of Action to Benefit the Treatment of Diabetes Mellitus

Diabetes mellitus is a severe health problem in Mexico, and its prevalence is increasing exponentially every year. Recently, DPP-4 (dipeptidyl peptidase-4) inhibitors have become attractive oral anti-hyperglycemic agents to reduce the pathology of diabetes. Gliptin’s family, such as sitagliptin, vildagliptin, and alogliptin, are in clinical use to treat diabetes mellitus but possess side effects. Therefore, there is a specific need to look for new therapeutic scaffolds (biomolecules). Garlic bulb is widely used as a traditional remedy for the treatment of diabetes. The garlic extracts are scientifically proven to control glucose levels in patients with diabetes, despite the unknown mechanism of action. The aim of the study is to investigate the antidiabetic effects of ultrasonication assisted garlic bulb extract. To achieve this, in-vitro assays such as DPP-4 inhibitory and antioxidant activities were investigated. Further, functional group analysis using FTIR and identification of phytochemicals using mass spectrometry analysis was performed. The results showed that 70.9 µg/mL of garlic bulb extract inhibited 50% DPP-4 activity. On top of that, the garlic extract exhibited a 20% scavenging activity, equivalent to 10 µg/mL of ascorbic acid. Molecular docking simulations on identified phytochemicals using mass spectrometry revealed their potential binding at the DPP-4 druggable region, and therefore the possible DPP-4 inhibition mechanism. These results suggest that prepared garlic extract contains phytochemicals that inhibit DPP-4 and have antioxidant activity. Also, the prepared extract induces skeletal muscle cell proliferation that demonstrates the antidiabetic effect and its possible mechanism of action.

Effect of Topical Garlic on Wound Healing and Scarring: A Clinical Trial

BACKGROUND

Historically, garlic containing compounds have been used on wounds to improve healing and ward off infection. Researchers have tested many of these ancient ointments, discovering that garlic is a common ingredient in those that are effective.

OBJECTIVE

To determine the efficacy of topical garlic on surgical wounds compared with Vaseline by analysis of visual analog scales and digital photograph analysis.

MATERIALS AND METHODS

Seventeen patients with 2 skin excisions applied a 30% garlic ointment to one surgical wound and Vaseline to the other surgical wound twice daily. They were followed up at 2 weeks and 4 weeks post-op. Digital photographs were taken of the sites, and wound visual analog scales were filled out by the patient and the physician.

RESULTS

Patients and the onsite physician stated the garlic site healed better in 59% and 65% of the wounds, respectively, at 2 weeks. At 4 weeks, the patients and the onsite physician stated the garlic site healed better in 76% and 88% of wounds, respectively. Digital photograph analysis revealed less erythema at the garlic sites (p-value = .02).

CONCLUSION

Surgical wounds treated with 30% garlic ointment healed with more cosmetically appealing scars than the Vaseline-treated sites.

Clinical and Radiographic Evaluation of Allium sativum Oil (Garlic Oil) in Comparison with Formocresol in Primary Molar Pulpotomy

BACKGROUND

Given the side effects of formocresol as a common substance in dental pulpotomy, its substitution with a safe substance seems mandatory.

AIM

To compare the clinical and radiographic success of Allium sativum oil and formocresol in the pulpotomy of the primary molars.

MATERIALS AND METHODS

A randomized, split-mouth, double-blind, controlled clinical trial was conducted on children with at least two asymptomatic primary molars requiring pulpotomy. A total of 90 teeth were examined in this study. They were randomly divided into two groups: the A. sativum (ALL) group (n = 45) and the formocresol (FC) group (n = 45). After pulpotomy, A. sativum oil was applied to the radicular pulp in the ALL groups and formocresol in the FC group. The pulp chamber was then filled with reinforced Zinc oxide Eugenol and finally restored by a stainless steel crown. Three and six months after the intervention, the teeth were evaluated by a colleague based on a modified criteria system. The results were analyzed using Wilcoxon's test.

RESULTS

The clinical success rate was 100% in both groups after 3 and 6 months. The radiographic success rate in the ALL group and the FC group after 3 and 6 months was 82.2% and 80% and 88.9% and 84.4%, respectively. The difference between the two groups was not statistically significant (P = 0.46).

CONCLUSION

According to the results of this study, A. sativum oil can be used in the pulpotomy of the primary molars.

Wound healing evaluation of self-nanoemulsifying drug delivery system containing Piper cubeba essential oil

The objective of this work was to characterize and evaluate wound healing potential of Piper cubeba oil (PO) via self-nanoemulsifying drug delivery system (SNEDDS) in comparison with standard gentamycin. PO loaded SNEDDS was prepared by low energy emulsification technique and characterized for thermodynamic stability, self-emulsification power and various physico-chemical parameters. An optimal formula of PO SNEDDS was subjected to wound healing evaluation, collagen determination and histomorphological examination in female Wistar rats as compared with pure PO and standard antibiotic/gentamycin. An optimal formula of PO SNEDDS showed significant wound healing effects in Wistar female rats in comparison with pure PO. However, wound healing effects of optimized SNEDDS were comparable with standard gentamycin. An optimized formulation also indicated significant enhancement in collagen content (0.82 mg/g) in comparison with pure PO (0.53 mg/g) and negative control (0.33 mg/g). While, the collagen content of SNEDDS (0.82 mg/g) treated rats were comparable with standard gentamycin treated animals (0.98 mg/g). Histopathological examinations of optimized SNEDDS treated animals showed no signs of inflammatory cells which indicated that prepared SNEDDS was safe and nontoxic to rats. The results obtained in this work showed the potential application of SNEDDS in enhancement of the wound healing activity of PO upon oral administration.

In Vivo Wound Healing and Anti-Inflammatory Activities of Leaf Latex of Aloe megalacantha Baker (Xanthorrhoeaceae)

BACKGROUND

Aloe megalacantha Baker (Xanthorrhoeaceae) is one of the Aloe species widely distributed in Ethiopia. The leaf latex of the plant is used for treatment of wounds, inflammation, and other multiple ailments in Ethiopian traditional medicine.

PURPOSE

The aim of this study was to evaluate in vivo wound healing and anti-inflammatory activities of the leaf latex of Aloe megalacantha in mice.

METHODS

The wound healing activity of the leaf latex of the plant was studied topically by incorporating the latex in simple ointment base in a concentration of 5% (w/w) and 10% (w/w) using excision and incision models. In these models, wound contraction, period of epithelialization, and breaking strength of the wounded skin were determined. Carrageenan induced inflammation of paw model was also used to assess the anti-inflammatory activity of the leaf latex at doses of 200 mg/kg, 400mg/kg, and 600 mg/kg. The level of inflammation suppressions were measured at 1, 2, 3, and 4 hrs after carrageenan injection, and then the percentages of inflammation inhibition were computed as compared with the negative control.

RESULT

In both wound models, mice treated with 5% (w/w) and 10% (w/w) latex ointment showed a significant (p<0.05) increment in the rate of wound contraction, reduction in epithelialization time, and higher skin breaking strength. Besides, the latex also exhibited a dose-dependent significant (p<0.05) reductions of inflammation as compared to negative control groups.

CONCLUSION

The overall results of this study demonstrate that the leaf latex of A. megalacantha possesses wound healing and anti-inflammatory activities which can scientifically substantiate the traditional use of the plant as a wound healing agent.

Mechanism of Action of Topical Garlic on Wound Healing

BACKGROUND

Allicin, the active component of garlic, has been shown to have antimicrobial and anti-inflammatory properties. Garlic has also been used historically by many cultures to heal wounds. Several animal studies have shown that garlic extracts increase the rate of wound healing and decrease the rate of infection.

OBJECTIVE

Fibroblasts play a key role in wound healing. Here we hypothesize that fibroblasts are being activated by allicin, leading to more organized and rapid wound repair.

MATERIALS AND METHODS

Six rats were each given 2 surgical wounds. One side was treated with a 30% garlic ointment while the other was treated with Vaseline for two weeks. A biopsy was taken from each scar site and histopathology with Immunohistochemistry was performed to quantify the number of fibroblasts and proliferating fibroblasts in each site.

RESULTS

The wound biopsies had more proliferating fibroblasts in the scars treated with the 30% garlic ointment than in the scars treated with Vaseline with a p-value of 0.0175 at two weeks post op and 0.081 at 6 week post op.

CONCLUSION

This data tells us that allicin is acting on fibroblasts as there were more proliferating fibroblasts in the garlic treated sites than in the other sites.

Aged garlic extract ameliorates immunotoxicity, hematotoxicity and impaired burn-healing in malathion- and carbaryl-treated male albino rats

Malathion and carbaryl are the most widely used organophosphate and carbamate insecticides, respectively, especially in developing countries; they pose a potential health hazard for both humans and animals. Here, we evaluated the protective effects of an odorless (free from allicin) Kyolic aged garlic extract (AGE, containing 0.1% S-allylcysteine; 200 mg/kg body weight) on the toxicity induced by 0.1 LD₅₀ of malathion (89.5 mg/kg body weight) and/or carbaryl (33.9 mg/kg body weight) in male Wistar rats. Doses were orally administered to animals for four consecutive weeks. The present study showed that AGE completely modulated most adverse effects induced by malathion and/or carbaryl in rats including the normocytic normochromic anemia, immunosuppression, and the delay in the skin-burning healing process through normalizing the count of blood cells (erythrocytes, leucocytes and platelets), hemoglobin content, hematocrit value, blood glucose-6-phosphodehydrogenase activity, weights and cellularity of lymphoid organs, serum γ-globulin concentration, and the delayed type of hypersensitivity response to the control values, and accelerating the inflammatory and proliferative phases of burn-healing. In addition, AGE completely modulated the decrease in serum reduced glutathione (GSH) concentration and the increase in clotting time in malathion alone and carbaryl alone treated rats. Moreover, AGE induced a significant increase (P < 0.001) in serum GSH concentration (above the normal value) and accelerating burn-healing process in healthy rats. In conclusion, AGE was effective in modulating most adverse effects induced in rats by malathion and carbaryl, and hence may be useful as a dietary adjunct for alleviating the toxicity in highly vulnerable people to insecticides intoxication. © 2016 Wiley Periodicals, Inc. Environ Toxicol 32: 789-798, 2017.

Oxidative stress responses in Wistar rats on subacute exposure to pharmaceutical wastewater

Water pollution has been a major concern for agrarian societies like Pakistan. Pharmaceutical industries are amongst the foremost contributor to industrial waste. Present study addresses the generation of oxidative stress caused by 2 months exposure to pharmaceutical wastewater in rats and their response to oral treatment with vitamin E, a potent antioxidant. The rats were randomized into five groups (n = 5) named as negative control, pharmaceutical wastewater (PEW) 100 %, PEW 10 %, PEW 1 %, and PEW 100 % + vitamin E. Oxidative damage in rats was evaluated by estimation of the activities of total superoxide dismutase (T-SOD), catalase (CAT), and the concentration of hydrogen peroxide (H₂O₂) in the liver, kidney, and blood/plasma. Exposure to pharmaceutical wastewater significantly decreased the activities of T-SOD and CAT and concentration of H₂O₂ in the liver and kidney and blood/plasma. Exposure to 100 % pharmaceutical wastewater exhibited a maximum decline in T-SOD activity, and activity was reduced to only 63.57 U/mL, 32.65, and 43.57 U/mg of protein in the plasma, kidney, and liver, respectively. Exposure to wastewater minimized activity CAT to 89.25 U/g of hemoglobin, 54.36, and 62.95 U/mg of protein in the blood, kidney, and liver, respectively. Treatment with vitamin E significantly increased the activity of T-SOD and CAT. However, increase in concentration of H₂O₂ was also observed in vitamin E exposed rats. Histopathology of the kidney revealed coagulative necrosis of renal epithelial cells and peritubular congestion. Endocardium showed infiltration of inflammatory cells and cellular breakdown in some areas. Lung sections exhibited atelectasis and emphysema of alveoli suggesting decline in lung function. The anatomy of the liver was also compromised due to severe degeneration and cellular swelling. The present study concluded that pharmaceutical wastewater induced severe oxidative stress in Wistar rats and ensued in histopathological lesions in several vital organs suggesting its high toxicity. Non-enzymatic antioxidant vitamin E may ameliorate oxidative stress induced by pharmaceutical wastewater.

Wound healing effects of nanoemulsion containing clove essential oil

The aim of this study was to investigate the wound healing effects of clove oil (CO) via its encapsulation into nanoemulsion. Optimized nanoemulsion (droplet size of 29.10 nm) was selected for wound healing investigation, collagen determination, and histopathological examination in rats. Optimized nanoemulsion presented significant would healing effects in rats as compared to pure CO. Nanoemulsion also presented significant enhancement in leucine content (0.61 mg/g) as compared to pure CO (0.50 mg/g) and negative control (0.31 mg/g). Histopathology of nanoemulsion treated rats showed no signs of inflammatory cells. These results suggested that nanoemulsion of CO was safe and nontoxic.

Diabetes mellitus and its management with medicinal plants: A perspective based on Iranian research

ETHNOPHARMACOLOGICAL RELEVANCE

Complementary and alternative medicine has been increasingly used to treat chronic illnesses, such as diabetes mellitus. However, various limitations in terms of their application and efficacies exist. Furthermore, there is still much to be done to discover the right herbal medicine for diabetes.

AIM OF THE STUDY

This paper aims to evaluate previous herbal studies on the management of diabetes mellitus, to address their strengths and weaknesses and propose a general framework for future studies.

APPROACH AND METHODS

Data sources such as PubMed, ScienceDirect, Scopus, SpringerLink, and Wiley were searched, limited to Iran, using 36 search terms such as herbal, traditional, medicine, and phytopharmacy in combination with diabetes and related complications. Reviewed articles were evaluated regarding the use of botanical nomenclature and included information on (1) identity of plants and plant parts used, (2) the processing procedure, and (3) the extraction process. The main outcomes were extracted and then surveyed in terms of the efficacies of herbs in the management of diabetes mellitus. Then a comparative study was performed between Iranian and non-Iranian studies with respect to herbs best studied in Iran.

RESULTS

Of the 82 herbs studied in Iran, only six herbs were endemic and 19 were studied in detail. Although most of the reviewed herbs were found to decrease the level of blood glucose (BG) and/or glycated hemoglobin (HbA1C) in both Iranian and non-Iranian studies, information on their pharmacological mechanisms is scarce. However, the level of HbA1C was measured in a limited number of clinical trials or animal studies. Available information on both short- and long-term use of studied herbs on diabetes related complications and functions of involved organs as well as comorbid depression and/or simultaneous changes in lifestyle is also insufficient. Furthermore, little or no information on their phytochemical, toxicological, and herb-drug interaction properties is available. It is worth noting that the efficacy of the reviewed herbs has been studied scarcely in both humans and animals regarding both Iranian and non-Iranian studies. A significant number of reviewed articles failed to cite the scientific name of herbs and include information on the processing procedure and the extraction process.

CONCLUSIONS

Treatment of diabetes mellitus as a multifactorial disease using herbal medicines requires a comprehensive approach. In order to discover the right herbal medicine for the management of diabetes many other important factors than the levels of BG, HbA1C and insulin should be considered. According to our criteria, all the reviewed herbs suffered from inadequate investigation in human, animal and in vitro models in this respect, whereas they are worth investigating further. However, more research on endemic plants and the traditional history of herbal medicine is warranted. In our opinion, the pharmacological, toxicological, and phytochemical information should be obtained before clinical trials. Furthermore, information such as botanical scientific nomenclature, side effects, and toxicity will improve the quality and validity of publications in herbal research. In particular, designing a database covering all valid information about herbs and/or diseases will decrease unnecessary costs and increase the efficiency of research.

Evaluation of wound healing and anti-inflammatory activity of the rhizomes of Rumex abyssinicus J. (Polygonaceae) in mice

Background

Rumex abyssinicus Jacq (Polygonaceae) is widely used in Ethiopia for treatment of wound and other diseases. Although reports are available in the literature on some of the claimed activities, nothing has so far been reported about the wound healing activity of R. abyssinicus. Thus, this work was initiated to investigate the wound healing and anti-inflammatory activities of 80 % methanol extract of the rhizomes of R. abyssinicus in mice.

Methods

Following extraction of the rhizomes of the plant with 80 % methanol, the extract was formulated as ointment (5 % & 10 % w/w) with simple ointment base B.P. The ointment was then evaluated for wound healing activity using excision and incision wound models. Parameters, including wound contraction, epithelization time and hydroxyproline content were determined using the excision model, whereas tensile strength was measured from the incision model. In parallel, anti-inflammatory activity of the rhizome was evaluated with carrageenan induced hind paw edema model by dissolving the 80 % methanol extract in 1 % carboxyl methyl cellulose and administering orally in various doses (250, 500 and 750 mg/kg).

Results

Wound treated with 5 % and 10 % (w/w) hydroalcoholic extract ointment exhibited significant wound healing activity in both models, as evidenced by increased wound contraction, shorter epithelization time, higher tissue breaking strength and increased hydroxyproline content. The hydroalcoholic extract also produced dose-related significant reduction (p < 0.05–0.001) of inflammation.

Conclusions

The results of this study demonstrated that the hydroalcoholic extract of the rhizomes of R. abyssinicus facilitated wound healing at least in part via its anti-inflammatory activity, supporting its traditional claim as a wound healing agent.

Evaluation of the wound healing property of Commiphora guidottii Chiov. ex. Guid

Background

The traditional use of the oleo-gum-resin of Commiphora guidottii Chiov. ex. Guid., which is commonly called scented myrrh, for topical treatment of wound is well documented. The major objective of the present study was to investigate the essential oil and resin obtained from C. guidottii for their potential wound healing properties. Due to their influence on the wound healing process, the anti-inflammatory and antimicrobial activities of scented myrrh have also been investigated.

Methods

Powdered oleo-gum-resin of C. guidottii was steam-distilled to obtain essential oil, and the resin was extracted from the marc with MeOH and filtered. The TLC fingerprint profile of the resin has been recorded by using silica gel GF₂₅₄ as stationary phase. The essential oil components were identified and quantified by GC-MS. Ointments prepared from the essential oil (4 % v/w) and the resin (5 % w/w) were used for wound healing activity tests. Toxicity of the formulated ointments was investigated according to Draize skin irritation test. Acute anti-inflammatory effect in mice was evaluated using carrageenan induced mouse hind paw oedema model. Antimicrobial activity tests were carried out using disk diffusion and broth dilution techniques against 21 pathogenic bacterial and 4 fungal strains.

Results

Ointment formulations of both the oil and resin were found to be non-irritant at the concentrations used and showed significant (p < 0.05-0.001) increase in wound contraction rate, shorter epithelization time and higher skin breaking strength as compared to the negative control. Overall, the antibacterial and antifungal activities of the oil and resin were comparable with the standard antibiotics ciprofloxacin and griseofulvin, respectively.

Conclusion

The results confirm that scented myrrh possesses genuine wound healing activity supporting the traditional use of the plant.

Ethnobotanical study on traditional use of medicinal plants in South-Western Serbia, Zlatibor district

ETHNOPHARMACOLOGICAL RELEVANCE

This paper provides significant ethnobotanical information on medicinal plant uses in the Zlatibor district, South-Western Serbia.

MATERIALS AND METHODS

A survey was performed using questionnaires with 220 informants (mean age 47, 79% female, 21% male). In addition, the use value and the relative importance of species were determined and the informant consensus factor was calculated for the medicinal plants included in the study. Intended plants usage was compared with previous ethnobotanical literature, with reference to the neighboring areas of Zlatibor district.

RESULTS

The informants provided data for 69 medicinal plants belonging to 36 families. Rosaceae, Lamiaceae and Asteraceae were the predominant locally used families. The species with the highest use value were Mentha piperita, Matricaria chamomilla, Hypericum perforatum and Achillea millefolium. The most frequently reported medicinal uses were ones for treating gastrointestinal ailments, respiratory problems and skin diseases. Usually, the administration was primarily oral followed by topical applications. All different plant parts were utilized, however leaves were the most exploited parts of the plants.

CONCLUSIONS

Folk medicine in South-Western Serbia, Zlatibor district is intended mainly as a mode of primary health care in healing of minor illnesses. The results indicate a slight reduction in the ethnobotanical and medical knowledge in this area, when compared with neighboring regions.

Assessment of the cytotoxic and anti-viral potential of aqueous extracts from different parts of Acacia nilotica (Linn) Delile against Peste des petits ruminants virus

Peste des petits ruminants virus (PPRV); a negative sense single stranded RNA enveloped virus that causes Peste des petits ruminants (PPR), is dramatically affecting the health status of ruminants all around the world resulting in extensive economical losses in livestock sector. Acacia nilotica (Linn) Delile; a tannin-rich medicinal plant distributed throughout subcontinent, is traditionally used as food for ruminants and possesses anti-viral potential against different RNA viruses. In the current study, aqueous extracts from the bark, leaves and pods of A. nilotica (Linn) Delile indica were evaluated for their cytotoxicity and anti-viral activities against PPRV by adopting MTT colorimetric assay and anti-viral assay using Vero cell line. Aqueous extract from the leaves presented significantly better (P<0.05) anti-PPRV activities in comparison to pods extract. On the contrary, bark extract did not show any anti-viral activity. The data presented in the study could pave a way toward the discovery of novel anti-viral chemicals in the plants against PPRV and other viral diseases.

Exploratory study using proton induced X-ray emission analysis and histopathological techniques to determine the toxic burden of environmental pollutants

The aim of this novel research was to determine the toxic burden of increased elements in water resources on the inhabitant wild animals (squirrels, turtles, bats), using particle induced x-ray emission (PIXE) and histopathological approaches. PIXE analysis of skin, muscle, lung, liver and kidney revealed significant increase in Al, Cl, Fe, Mg, Mn, Si and V. Moreover, data clearly reflect a significant (P < 0.001) deposition of toxic elements (Al, Cl, Fe and K) in the lung producing interstitial/proliferative pneumonitis, intra-alveolar hemorrhages, and thickening of alveolar capillary walls. The results obtained from the liver samples emphasized that majority of the animals were intoxicated with Cl, Mg, S, Si and V, which have produced profound deterioration and swelling of the hepatocytes. Likewise, histopathology of the kidney sections spotlighted severe nephritis and degenerative changes, which could be associated with the elevated amount of Al, Cl and Mg. This data undoubtedly provide relevant information on the heavy burden of toxic elements and their pathological outcomes in wild animals and highlight their potential risks for human exposure. Thus, the information provided is critical for developing effective strategies in dealing with health hazards associated with elemental exposures.

Roles of hydrogen sulfide in the pathogenesis of diabetes mellitus and its complications

SIGNIFICANCE

Diabetes and its complications represent a major socioeconomic problem.

RECENT ADVANCES

Changes in the balance of hydrogen sulfide (H(2)S) play an important role in the pathogenesis of β-cell dysfunction that occurs in response to type 1 and type 2 diabetes. In addition, changes in H(2)S homeostasis also play a role in the pathogenesis of endothelial injury, which develop on the basis of chronically or intermittently elevated circulating glucose levels in diabetes.

CRITICAL ISSUES

In the first part of this review, experimental evidence is summarized implicating H(2)S overproduction as a causative factor in the pathogenesis of β-cell death in diabetes. In the second part of our review, experimental evidence is presented supporting the role of H(2)S deficiency (as a result of increased H(2)S consumption by hyperglycemic cells) in the pathogenesis of diabetic endothelial dysfunction, diabetic nephropathy, and cardiomyopathy.

FUTURE DIRECTIONS

In the final section of the review, future research directions and potential experimental therapeutic approaches around the pharmacological modulation of H(2)S homeostasis in diabetes are discussed.

Treatment of venous ulcers with the herbal-based ointment Herbadermal®: a prospective non-randomized pilot study

BACKGROUND

Venous ulcers (ulcus cruris venosum) are a common chronic disease that requires continuing treatment and significantly influences a patient's way of life. The therapeutic effects of the ointment Herbadermal on epithelialization and microbial flora of venous ulcers in 25 patients (10 men and 15 women) were tested over a 7-week period. The major components of the ointment are extracts of garlic, St. John's wort, and calendula.

MATERIAL AND METHODS

The patients were over 18 years of age, with ulceration of the lower leg no longer than 2 months or recurrent ulceration during the last 6 months. The involved patients did not use any other phytomedicines or supportive therapies. Parameters were evaluated before the treatment and every 2 weeks during the period of 7 weeks. The total treatment response was evaluated on the basis of epithelialization, granulation, fibrin deposits, exudation, and edema.

RESULTS

The percentage of epithelialization was 99.1% after 7 weeks, without significant effects on the microbial flora.

CONCLUSION

This combination of extracts can be recommended as topical treatment for wound healing because of its epithelizing, anti-erythematous, and anti-edematous properties.

Garlic in dermatology

Garlic (Allium sativum L. fam. Alliaceae) is one of the best-researched, best-selling herbal remedies and is also commonly used for treating various health problems. Garlic is widely known for its biological properties and plays an important role as an antioxidant. The purpose of this review is to gather and summarize all dermatologic-oriented in vitro and in-vivo experiments and clinical trials on garlic preparations. Extensive literatures search was carried out and twenty three studies were included. The results suggest that oral administration of garlic is effective on immunologic properties, cutaneous microcirculation, protection against UVB and cancer treatment. Additionally, topical application of garlic extract can potentially be effective on psoriasis, alopecia areata, keloid scar, wound healing, cutaneous corn, viral and fungal infection, leishmaniasis, skin aging and rejuvenation. Clinical effectiveness of oral and topical garlic extract is not sufficiently and meticulously explored as so far.

Mechanisms of angiogenesis: role of hydrogen sulphide

1. Hydrogen sulphide (H(2)S) has recently been recognized as a gasotransmitter that regulates angiogenesis in vitro and in vivo under physiological and ischaemic conditions. 2. In the present review, the mechanisms underlying angiogenesis are summarized briefly and the most recent progress in H(2)S-induced angiogenesis in vivo and in vitro is described. The anti-angiogenic effects of garlic extracts, which may serve as substrates for H(2)S-generating enzymes in vivo, are also discussed. 3. Hydrogen sulphide increases cell growth, migration and the formation of tube-like structures in cultured endothelial cells. These effects are dependent on activation of the phosphatidylinositol 3-kinase-Akt-survivin signalling pathway. Neovascularization in vivo has also been demonstrated to be promoted in the mouse Matrigel plug assay, as well as in chicken chorioallantoic membranes. In a rat unilateral hindlimb ischaemic model, treatment with sodium hydrosulphide (NaHS), an H(2)S donor, promotes significant angiogenesis and improves regional blood flow. These effects may be mediated by interactions between upregulated vascular endothelial growth factor (VEGF) in skeletal muscle cells and VEGF receptor 2 and the downstream signalling element Akt in vascular endothelial cells. However, H(2)S does not exhibit a pro-angiogenic effect at a high concentrations/doses. 4. Based on the studies reviewed in the present article, we assume that, at physiologically relevant doses/concentrations, H(2)S/HS(-) promote angiogenesis at least partly via the VEGF signalling pathway. At high doses, H(2)S/HS(-) may act on additional cellular targets to evoke mechanisms that counteract the pro-angiogenic pathways. More studies need to be performed analysing the general interactions between H(2)S/HS(-) and other molecules, including other gasotransmitters, such as nitric oxide and carbon monoxide (CO).