Effects of an Orabase Formulation with Ethanolic Extract of Malva sylvestris L. in Oral Wound Healing in Rats

Natural and Synthetic Drugs Approached for the Treatment of Recurrent Aphthous Stomatitis Over the Last Decade

Recurrent aphthous stomatitis (RAS) refers to a sore and frequently recurring inflammation of the oral tissues, distinguished by the presence of small ulcers that cause significant discomfort and cannot be attributed to any underlying disease. Different treatments have been used for RAS. This review aims to provide a comprehensive overview of the treatment options over the past decade for recurrent aphthous stomatitis (RAS), encompassing both natural and synthetic treatments. It will utilize clinical efficacy studies conducted in vivo and in vitro, along with a focus on the pharmaceutical approach through advancements in drug delivery development. We conducted a thorough literature search from 2013 to 2023 in prominent databases such as PubMed, Scopus, and Cochrane, utilizing appropriate keywords of recurrent aphthous stomatitis, and treatment. A total of 53 clinical trials with 3022 patients were included, with 35 using natural materials in their research and a total of 16 articles discussing RAS treatment using synthetic materials. All the clinical trials showed that natural and synthetic medicines seemed to benefit RAS patients by reducing pain score, ulcer size, and number of ulcers and shortening the healing duration.

The effect of biopolymer gel derived from sugarcane on healing of traumatic oral ulcers: an experimental study

PURPOSE

The extracellular polysaccharide (EPS) is produced by the bacterium Zoogloea sp. and plays a positive role in tissue repair. The purpose of this study was to clinically and histologically compare the effects of EPS in the healing of traumatic oral ulcers in rats with the effects of triamcinolone.

METHODS

Ulcers were induced in the oral mucous of 45 male Wistar rats, divided into three groups: control group, treated with triamcinolone, and treated with biopolymer gel. In the clinical evaluation, we considered the weight variation of the animals and the size of the lesion area, at baseline and on treatment days 1, 3 and 7. The histological parameters evaluated were the type and intensity of the inflammatory infiltration, the presence of necrosis and foreign body granuloma and the degree of re-epithelialization of the lesion.

RESULTS

The reduction of the lesion area was greater in the animals treated with EPS, with no difference in the intensity of the inflammatory infiltration between the groups on days 3 and 7 of treatment.

CONCLUSIONS

The results suggest that topical application of EPS in traumatic oral ulcers of rats promotes faster repair than triamcinolone ointment, without increasing the intensity of inflammatory infiltration under the lesion.

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.

Alginate/Chitosan-Based Hydrogel Film Containing α-Mangostin for Recurrent Aphthous Stomatitis Therapy in Rats

Recurrent aphthous stomatitis (RAS) is a prevalent clinical disorder that causes mouth ulcers. Furthermore, corticosteroid treatment has been widely utilized for RAS therapy; however, it has side effects on the oral mucosa that limit its application. This study aimed to develop a novel RAS therapy with the natural ingredient α-mangostin, delivered by alginate and chitosan polymers-based hydrogel film (α-M Alg/Chi-HF). To prepare α-M Alg/Chi-HF, the solvent evaporation and casting methods were used, then characterized by using SEM, FTIR, and XRD. Based on the characterization studies, the α-M in α-M/EtOH Alg/Chi-HF with ethanol (EtOH) was found to be more homogenous compared to α-M in Alg/Chi-HF with distilled water (H2O) as a casting solvent. The in vitro viability study using NIH3T3 cells showed 100% viability of α-M Alg/Chi-HF (EtOH) and Alg/Chi-HF after 24 h incubation, indicating well tolerability of these hydrogel films. Interestingly, the in vivo studies using male white rats (Rattus norvegicus Berkenhout) proved that α-M/EtOH Alg/Chi-HF with a recovery of 81.47 ± 0.09% in seven days significantly more effective RAS therapy compared to control. These results suggest that α-M/EtOH Alg/Chi-HF has the potential as an alternative for RAS therapy.

Efficacy of methanolic extracts of some medicinal plants on wound healing in diabetic rats

Background

Materials and methods

Results

Conclusion

Effectiveness of Nutritional Ingredients on Upper Gastrointestinal Conditions and Symptoms: A Narrative Review

Nutritional ingredients, including various fibers, herbs, and botanicals, have been historically used for various ailments. Their enduring appeal is predicated on the desire both for more natural approaches to health and to mitigate potential side effects of more mainstream treatments. Their use in individuals experiencing upper gastrointestinal (GI) complaints is of particular interest in the scientific space as well as the consumer market but requires review to better understand their potential effectiveness. The aim of this paper is to review the published scientific literature on nutritional ingredients for the management of upper GI complaints. We selected nutritional ingredients on the basis of mentions within the published literature and familiarity with recurrent components of consumer products currently marketed. A predefined literature search was conducted in Embase, Medline, Derwent drug file, ToXfile, and PubMed databases with specific nutritional ingredients and search terms related to upper GI health along with a manual search for each ingredient. Of our literature search, 16 human clinical studies including nine ingredients met our inclusion criteria and were assessed in this review. Products of interest within these studies subsumed the categories of botanicals, including fiber and combinations, and non-botanical extracts. Although there are a few ingredients with robust scientific evidence, such as ginger and a combination of peppermint and caraway oil, there are others, such as melatonin and marine alginate, with moderate evidence, and still others with limited scientific substantiation, such as galactomannan, fenugreek, and zinc-l-carnosine. Importantly, the paucity of high-quality data for the majority of the ingredients analyzed herein suggests ample opportunity for further study. In particular, trials with appropriate controls examining dose-response using standardized extracts and testing for specific benefits would yield precise and effective data to aid those with upper GI symptoms and conditions.

Effects of natural extracts in the treatment of oral ulcers: A systematic review of evidence from experimental studies in animals

Background

To evaluate the clinical and histopathological effects of natural extracts in the treatment of oral ulcers induced in animal experimental models.

Material and Methods

We carried out a search in the Medline, Scopus, WoS and Embase databases from the start of the databases to December 2020, and also made a manual search of the references. The search and selection were carried out by two researchers independently. The inclusion criteria were: experimental studies in animal models, in english, which complied with the study object.

Results

A total of 705 articles were identified. After selection by title, abstract and full text, 19 articles were finally included. Natural extracts of Jasminum grandiflorum, Ficus deltoidea, curcumin and Bixina orellana provoked a significantly greater reduction in the size of the ulcer. Extracts of Salvatora persica, Musa acuminate, Ganoderma lucidum mycelia and Bixina Orellana, as well as preparations of Kouyanqing Granule and curcumin, were able to reduce levels of pro-inflammatory cytokines and increase the expression and serum levels of growth factors and anti-inflammatory cytokines. Extracts of Piper sarmentosus, Cannabis sativa and Bletilla striata provoked a reduction in the severity of the histological inflammation. No significant differences were observed compared to controls in the treatments with extracts of Cannabis sativa, Aloe barbadensus Miller and Malva sylvestris in reducing the area of the oral ulcers.

Conclusions

Most of the natural extracts described in this review presented a positive clinical and histological effect on the cicatrisation of oral ulcers induced in animal models.

Key words:Recurrent aphthous stomatitis, oral ulcer, plants, herbs, extracts, medicine, treatment.

Development and Evaluation of a Novel Oral Mucoadhesive Ointment Containing Pomegranate Peel Extract as an Adjuvant for Oral Hygiene of Dogs

Herbal therapies are used worldwide to treat a variety of health conditions, including dental conditions in veterinary medicine. In this context, the use of medicinal plant-based formulations as potential therapeutics and preventatives in veterinary dentistry is worth highlighting. The objective of the present study was to develop a mucoadhesive ointment formulation, named orabase, that contained pomegranate extract for use in the oral cavity of dogs, with the aim of improving their oral hygiene. The hydroalcoholic extracts of pomegranate peels was incorporated into the orabase in 3 different concentrations. The formulations were subjected to in vitro microbiological testing by a modified disc-diffusion method to study the susceptibility of microorganisms collected from the oral cavities of the dogs. The samples were taken from the buccal mucosa of dogs having the same management and diet. The most effective formulation was submitted to physicochemical tests to evaluate the functionality of the product, namely pH, swelling index, spreadability, and mechanical properties (hardness, cohesiveness, and adhesiveness). The formulation containing 25.0% w/w of the extract was considered most suitable for the intended use as it showed antiseptic activity and demonstrated a swelling index of approximately 35% in the first 20 minutes of the test, high spreadability, and suitable mechanical properties. The results suggest that the product obtained from pomegranate peel extract is a viable option for use to improve oral hygiene, helping to reduce the bacterial component of dental plaque in dogs.

Malva species: Insights on its chemical composition towards pharmacological applications

Malvaceae family is typical from the Mediterranean region, contains 240 genera and more than 4,200 species. They are most commonly used as ornamental plants, although they can also be conceived as a food resource and remedy for various diseases, such as digestive, respiratory, genitourinary, throat infections, and skeletal and skin disorders, as also injuries where they are profoundly applied for skin care and as antiseptic and demulcent. They also possess diuretic, lenitive, spasmolytic, and laxative effects, besides to be used as antidiarrheal. Thus, the present review provides in-depth data on Malva spp. potential applications and phytochemical composition for food and pharmaceutical industries. Habitat and cultivation conditions and the clinical reports related to its biological effects are also emphasized. Malva spp. possess a wide variety of chemical constituents (such as polysaccharides, coumarins, flavonoids, polyphenols, vitamins, terpenes, and tannins) found in different plant organs, especially in leaves and flowers, connected to their biological activity. In general, Malva spp. have rather moderate antimicrobial activity, high antiinflammatory and wound healing activities, strong antioxidant activity, and anticancer properties. Results from in vitro and in vivo experiments encourage more in-depth studies, namely clinical trials, towards to improve knowledge on the use of Malva spp. for the treatment of various health conditions in humans.

Topical chlorhexidine, povidone-iodine and erythromycin in the repair of traumatic ulcers on the rat tongue: Clinical, histological and microbiological evaluation

OBJECTIVE

This study investigated the effect of topical application of 0.12% chlorhexidine, 10% povidone-iodine and 50% erythromycin on the optimization of healing process of traumatic ulcers made on ventral tongue of rats.

DESIGN

Forty-Eight Wistar rats were randomly divided into four groups: control, chlorhexidine (Chx), povidone-iodine (PvI) and erythromycin (Er). An ulcer of 5 mm in diameter was made on the ventral tongue of the animals. After 24 h, a microbiological sample was taken and daily application of the substances started. Six animals each group were euthanized at 4 days and the others at 8 days postoperative, totaling three and seven days of treatment. Prior to euthanasia, a new microbiological collection was performed.

RESULTS

The experimental groups showed less area of residual ulcer. A significant difference was seen between the PvI and Chx in relation to the control after three days of treatment (p < 0.05). Although the experimental groups displayed greater newly formed epithelial area, there was no significant difference compared to the control (p > 0.05). Er exhibed the lowest inflammation scores after seven days of treatment (p < 0.05). PvI showed reduction of microorganisms at both times and under aerobic (p < 0.01 at 3 days and p < 0.001 at 7 days) and microaerophilic (p < 0.05) conditions. Er significantly reduced the count of microorganisms in aerobic condition when compared to control group (p < 0.05 at 3 days and p < 0.01 at 7 days).

CONCLUSIONS

All drugs promoted reduction of the microorganisms at the site of the injury, which may have a direct effect on the tissue repair process.

Natural Treatments for Fissure in Ano Used by Traditional Persian Scholars, Razi (Rhazes) and Ibn Sina (Avicenna)

Most cases of chronic fissure do not respond to medical treatment. Razi and Ibn Sina were 2 of the best-known scientists of ancient Persia. The purpose of this study was to find out new scientific evidence in modern medicine about their recommendations, in order to find certain clues to conduct useful researches in the future. First, treatments of anal fissure mentioned by Razi and Ibn Sina were reviewed. Then, literature search was made in electronic databases including PubMed, Scopus, and Google Scholar. Management of anal fissure according to Razi's and Ibn Sina's practices is done based on 3 interventions: lifestyle modifications, drug treatments, and manual procedures. Almost all remedies suggested by Razi and Ibn Sina have shown their effects on fissure in ano via several mechanisms of action in many in vitro and in vivo studies; Still there is lack of human studies on the subject.