Curcumin accelerates cutaneous wound healing via multiple biological actions: The involvement of TNF-α, MMP-9, α-SMA, and collagen

Daily crowding stress has limited, yet detectable effects on skin and head kidney gene expression in surgically tagged atlantic salmon (Salmo salar)

To ensure welfare-friendly and effective internal tagging, the tagging process should not cause a long-term burden on individuals given that tagged fish serve as representatives for the entire population in telemetry applications. To some extent, stress is inevitable within regular aquaculture practices, and thus, the consequences of long-term stress should be described in terms of their effects on internal tagging. In fish, stressors activate the Hypothalamus-Pituitary-Interrenal (HPI) and Brain-Sympathetic-Chromaffin Cell (BSC) axes, leading to neuroimmunoendocrine communication and paracrine interactions among stress hormones. The interrelation between wound healing and stress is complex, owing to their shared components, pathways, and energy demands. This study assessed 14 genes (mmp9, mmp13, il-2, il-4, il-8a, il-10, il-12, il-17d, il-1b, tnfa, ifng, leg-3, igm, and crh) in the skin (1.5 cm from the wound) and head kidney over eight weeks. These genes, associated with cell signaling in immunity, wound healing, and stress, have previously been identified as influenced and regulated by these processes. Half of a group of Atlantic salmon (n = 90) with surgically implanted dummy smart-tags were exposed to daily crowding stress. The goal was to investigate how this gene panel responds to a wound alone and then to the combined effects of wounding and daily crowding stress. Our observations indicate that chronic stress impacts inflammation and impedes wound healing, as seen through the expression of matrix metalloproteinases genes in the skin but not in the head kidney. This difference is likely due to the ongoing internal wound repair, in contrast to the externally healed wound incision. Cytokine expression, when significant in the skin, was mainly downregulated in both treatments compared to control values, particularly in the study's first half. Conversely, the head kidney showed initial cytokine downregulation followed by upregulation. Across all weeks observed and combining both tissues, the significantly expressed gene differences were 12 % between the Wound and Stress+ groups, 28 % between Wound and Control, and 25 % between Stress+ and Control. Despite significant fluctuations in cytokines, sustained variations across multiple weeks are only evident in a few select genes. Furthermore, Stress+ individuals demonstrated the most cytokine correlations within the head kidney, which may suggest that chronic stress affects cytokine expression. This investigation unveils that the presence of stress and prolonged activation of the HPI axis in an eight weeklong study has limited yet detectable effects on the selected gene expression within immunity, wound healing, and stress, with notable tissue-specific differences.

Absorbable and biodegradable enzyme-crosslinked gelatin/alginate semi-IPN hydrogel wound dressings containing curcumin

Effective wound management presents a substantial financial and time-related obstacle for healthcare institutions. Enhancing healthcare involves implementing innovative wound treatment methods to minimize healing time and expenses. This study is centered on the development of a non-toxic wound dressing using only two natural polymers and an enzyme. By adding 10 % wt microbial transglutaminase, the mechanical properties of the dressing were improved. This formulation increased the swelling rate by 70 %, deswelling rate by 15 %, conversion rate by 9 %, and networking rate by 20 %. Additionally, the non-toxic dressing showed a cell viability rate of 106 %. In drug delivery tests, explosive release behavior was observed, which is advantageous for open wounds. Cell staining experiments were also carried out to evaluate wound behavior in terms of collagen formation, granulation, and inflammation. The results suggest that the optimized hydrogel has great potential as a wound dressing. Its excellent absorption, antioxidant, and biocompatibility characteristics enhance tissue granulation rate and reduce wound treatment time by half compared to conventional methods, while also minimizing scarring risk. This innovative treatment, which eliminates the need for frequent changes, is beneficial for both secondary intentions and severe open wounds requiring bottom-up healing.

Exploring the underlying pharmacological, immunomodulatory, and anti-inflammatory mechanisms of phytochemicals against wounds: a molecular insight

BACKGROUND

Numerous cellular, humoral, and molecular processes are involved in the intricate process of wound healing.

PHARMACOLOGICAL RELEVANCE

Numerous bioactive substances, such as ß-sitosterol, tannic acid, gallic acid, protocatechuic acid, quercetin, ellagic acid, and pyrogallol, along with their pharmacokinetics and bioavailability, have been reviewed. These phytochemicals work together to promote angiogenesis, granulation, collagen synthesis, oxidative balance, extracellular matrix (ECM) formation, cell migration, proliferation, differentiation, and re-epithelialization during wound healing.

FINDINGS AND NOVELTY

To improve wound contraction, this review delves into how the application of each bioactive molecule mediates with the inflammatory, proliferative, and remodeling phases of wound healing to speed up the process. This review also reveals the underlying mechanisms of the phytochemicals against different stages of wound healing along with the differentiation of the in vitro evidence from the in vivo evidence There is growing interest in phytochemicals, or plant-derived compounds, due their potential health benefits. This calls for more scientific analysis and mechanistic research. The various pathways that these phytochemicals control/modulate to improve skin regeneration and wound healing are also briefly reviewed. The current review also elaborates the immunomodulatory modes of action of different phytochemicals during wound repair.

lncRNA CDKN2B-AS1 regulates collagen expression

The long noncoding RNA CDKN2B-AS1 harbors a major coronary artery disease risk haplotype, which is also associated with progressive forms of the oral inflammatory disease periodontitis as well as myocardial infarction (MI). Despite extensive research, there is currently no broad consensus on the function of CDKN2B-AS1 that would explain a common molecular role of this lncRNA in these diseases. Our aim was to investigate the role of CDKN2B-AS1 in gingival cells to better understand the molecular mechanisms underlying the increased risk of progressive periodontitis. We downregulated CDKN2B-AS1 transcript levels in primary gingival fibroblasts with LNA GapmeRs. Following RNA-sequencing, we performed differential expression, gene set enrichment analyses and Western Blotting. Putative causal alleles were searched by analyzing associated DNA sequence variants for changes of predicted transcription factor binding sites. We functionally characterized putative functional alleles using luciferase-reporter and antibody electrophoretic mobility shift assays in gingival fibroblasts and HeLa cells. Of all gene sets analysed, collagen biosynthesis was most significantly upregulated (Padj=9.7 × 10- 5 (AUC > 0.65) with the CAD and MI risk gene COL4A1 showing strongest upregulation of the enriched gene sets (Fold change = 12.13, Padj = 4.9 × 10- 25). The inflammatory "TNFA signaling via NFKB" gene set was downregulated the most (Padj=1 × 10- 5 (AUC = 0.60). On the single gene level, CAPNS2, involved in extracellular matrix organization, was the top upregulated protein coding gene (Fold change = 48.5, P < 9 × 10- 24). The risk variant rs10757278 altered a binding site of the pathogen responsive transcription factor STAT1 (P = 5.8 × 10- 6). rs10757278-G allele reduced STAT1 binding 14.4% and rs10757278-A decreased luciferase activity in gingival fibroblasts 41.2% (P = 0.0056), corresponding with GTEx data. CDKN2B-AS1 represses collagen gene expression in gingival fibroblasts. Dysregulated collagen biosynthesis through allele-specific CDKN2B-AS1 expression in response to inflammatory factors may affect collagen synthesis, and in consequence tissue barrier and atherosclerotic plaque stability.

Curcumin is effective in managing oral inflammation: An in vitro study

BACKGROUND

Oral inflammation is among the most prevalent oral pathologies with systemic health implications, necessitating safe and effective treatments. Given curcumin's documented anti-inflammatory and antioxidant properties, this study focuses on the potential of a curcumin-based oral gel in safely managing oral inflammatory conditions.

METHODS

This in vitro study utilized four human cell lines: oral keratinocytes (HOKs), immortalized oral keratinocytes (OKF6), periodontal ligament fibroblasts (HPdLF), and dysplastic oral keratinocytes (DOKs). The cells were treated with Lipopolysaccharides (LPS) and curcumin-based oral gel to simulate inflammatory conditions. A panel of cellular assays were performed along with antimicrobial efficacy tests targeting Candida albicans, Streptococcus mutans, and Porphyromonas gingivalis.

RESULTS

LPS significantly reduced proliferation and wound healing capacities of HOKs, OKF6, and HPdLF, but not DOKs. Treatment with curcumin-based oral gel mitigated inflammatory responses in HOKs and HPdLF by enhancing proliferation, colony formation, and wound healing, along with reducing apoptosis. However, its impact on OKF6 and DOKs was limited in some assays. Curcumin treatment did not affect the invasive capabilities of any cell line but did modulate cell adhesion in a cell line-specific manner. The curcumin-based oral gel showed significant antimicrobial efficacy against C. albicans and S. mutans, but was ineffective against P. gingivalis.

CONCLUSION

This study demonstrates the potential of the curcumin-based oral gel as a safe and effective alternative to conventional antimicrobial treatments for managing cases of oral inflammation. This was achieved by modulating cellular responses under simulated inflammatory conditions. Future clinical-based studies are recommended to exploit curcumin's therapeutic benefits in oral healthcare.

Pluronic F127 composite hydrogel for the repair of contraction suppressed full-thickness skin wounds in a rabbit model

Hydrogels are commonly used as carriers for cell delivery due to their similarities to the extracellular matrix. A contraction-suppressed full-thickness wound model was used to evaluate the therapeutic potential of Pluronic F127 (PF127) hydrogel loaded with adipose-derived stromal vascular fraction (AdSVF), mesenchymal stem cells (AdMSC), and conditioned media (AdMSC-CM) for the repair of wounds in a rabbit model. The experimental study was conducted on forty-eight healthy adult New Zealand white rabbits randomly divided into eight groups with six animals each and treated with AdSVF, AdMSC, and AdMSC-CM as an injectable or topical preparation. The healing potential of different adipose-derived cell-based and cell-free therapeutics was evaluated based on percentage wound healing, period of epithelialization, epidermal thickness, scar evaluation, histopathology analysis, histochemical evaluation, immunohistochemistry (collagen type I), and hydroxyproline assay by comparing with the positive and negative control. Collagen density analysis using different staining methods, immunohistochemistry, and hydroxyproline assay consistently showed that delivering AdMSC and AdMSC-CM in PF127 hydrogel enhanced epithelialization, collagen production, and organization, contributing to improved tissue strength and quality. Even though allogeneic AdSVF was found to promote wound healing in rabbits, it has a lower potential than AdMSC and AdMSC-CM. The wound healing potential of AdMSC and AdMSC-CM was enhanced when loaded in PF127 hydrogel and applied topically. Even though wounds treated with AdMSC outperformed AdMSC-CM, a significant difference in the healing quality was not observed in most instances, indicating almost similar therapeutic potential. The findings indicate that the wound healing potential of AdMSC and AdMSC-CM was enhanced when loaded in PF127 hydrogel and applied topically. These treatments promoted collagen production, tissue organization, and epidermal regeneration, ultimately improving overall healing outcomes.

Polymeric scaffold integrated with nanovesicle-entrapped curcuminoids for enhanced therapeutic efficacy

Aim: Polymeric scaffolds were developed fortified with nanovesicle-encapsulated individual curcumin (CUR) and tetrahydrocurcumin (THC) for improved therapeutic efficacy due to their low stability and efficacy in native form. Method: Nanovesicle-encapsulated individual CUR and THC were fabricated using thin-film hydration techniques and characterized. Results & conclusion: CUR/THC in native and vesicle-encapsulated form demonstrated diminished LPS-instigate nitric oxide (NO) levels in macrophage cells in a concentration-dependent demeanor. However, vesicle-encapsulated CUR/THC inhibited NO production at lower concentrations, compared with the native CUR/THC form. Furthermore, the scaffold fortified with vesicle-encapsulated CUR/THC demonstrated improved physical properties with excellent antioxidant, biocompatibility, and human keratinocyte cell proliferation ability. The results recommended that nanovesicle-encapsulated THC can be retained as a potential substitute for CUR with improved therapeutic efficacy.

Challenges and Prospects of Development of Herbal Biomaterial Based Ethical Wound Care Products-A Scoping Review

Total wound care is an unmet therapeutic need considering the morbidity and mortality associated with the rising prevalence of nonhealing/chronic wounds. Current wound management fails to address all aspects/types of wounds despite the availability of scores of traditional and modern, investigational products. Traditional medicine drugs of wound healing repute validated to target multiple biological pathways and key events in the mammalian wound healing cascade, reportedly affecting wound healing phases. Advances in the development of biocomposite matrices and their analytical characterization warrant a relook at consolidating time-tested wound healing properties of herbal bioactives for prospective development as ethical wound care products. Aside from the bottlenecks of their multiconstituent profiling and clinical trial data generation, regulatory hurdles also cloister any systematic attempts at their re-engineering into clinical deliverables. In the context of national policy changes to bring in totally indigenous solutions, countries with a huge knowledge/material resource on wound healing bioactives need to essentially facilitate the same.

Progress in the Use of Hydrogels for Antioxidant Delivery in Skin Wounds

The skin is the largest organ of the body, and it acts as a protective barrier against external factors. Chronic wounds affect millions of people worldwide and are associated with significant morbidity and reduced quality of life. One of the main factors involved in delayed wound healing is oxidative injury, which is triggered by the overproduction of reactive oxygen species. Oxidative stress has been implicated in the pathogenesis of chronic wounds, where it is known to impair wound healing by causing damage to cellular components, delaying the inflammatory phase of healing, and inhibiting the formation of new blood vessels. Thereby, the treatment of chronic wounds requires a multidisciplinary approach that addresses the underlying causes of the wound, provides optimal wound care, and promotes wound healing. Among the promising approaches to taking care of chronic wounds, antioxidants are gaining interest since they offer multiple benefits related to skin health. Therefore, in this review, we will highlight the latest advances in the use of natural polymers with antioxidants to generate tissue regeneration microenvironments for skin wound healing.

Potential of Curcumin in the Management of Skin Diseases

Curcumin is a polyphenolic molecule derived from the rhizoma of Curcuma longa L. This compound has been used for centuries due to its anti-inflammatory, antioxidant, and antimicrobial properties. These make it ideal for preventing and treating skin inflammation, premature skin ageing, psoriasis, and acne. Additionally, it exhibits antiviral, antimutagenic, and antifungal effects. Curcumin provides protection against skin damage caused by prolonged exposure to UVB radiation. It reduces wound healing times and improves collagen deposition. Moreover, it increases fibroblast and vascular density in wounds. This review summarizes the available information on the therapeutic effect of curcumin in treating skin diseases. The results suggest that curcumin may be an inexpensive, well-tolerated, and effective agent for treating skin diseases. However, larger clinical trials are needed to confirm these observations due to limitations in its in vivo use, such as low bioavailability after oral administration and metabolism.

Biological study of skin wound treated with Alginate/Carboxymethyl cellulose/chorion membrane, diopside nanoparticles, and Botox A

A hydrogel-based wound dressing with desirable properties is necessary for achieving functional skin integrity post-injury. This study focuses on preparing a hydrogel using Alginate/Carboxymethyl cellulose (Alg/CMC) as a base material. To evaluate its regenerative effects on full-thickness wounds, diopside nanoparticles and Botulinum toxin A (BTX-A) were incorporated into the hydrogel along with chorion membrane. The diopside nanoparticles (DNPs) act as a proangiogenic factor, promoting proliferation and regulating inflammation, while the chorion membrane facilitates these processes. Additionally, BTX-A prevents scar formation and aids in wound closure. The nanoparticles and hydrogel were characterized using various techniques, and their cytocompatibility was assessed. In vivo studies and quantitative polymerase chain reaction analysis showed that wound area reduction was significant after two weeks of treatment with the Alg/CMC/ChNPs/DNPs/BTX-A hydrogel. Overall, this scaffold demonstrated potential for promoting tissue regeneration and new epithelization formation, making it a promising candidate for enhancing skin restoration in wound treatments.

Chitosan tamarind-based nanoparticles as a promising approach for topical application of curcumin intended for burn healing: in vitro and in vivo study

One of the most prevalent worldwide problems that affect all ages and genders is skin burn. The goal of our study was to assess the ability of curcumin nanoparticles to cure a rat burn model. Three formulations were selected after several tests were performed including investigation of encapsulation efficiency, particle size and zeta potential measurements. In vitro release was achieved on the three selected formulations. The effectiveness of the chosen formulation for healing was evaluated. The induced burn wound was smeared, starting just after excision, once daily with curcumin nanoparticles for 18 days. Our findings revealed that curcumin nanoparticles improved the burn healing potential by augmenting the skin regeneration indices as evidenced by enhancing the new production of hyaluronic acid and collagen type I. Additionally, curcumin nanoparticles could increase levels of vascular endothelial growth factor and alpha smooth muscle activity while drastically reducing the skin's tumour necrosis factor content, revealing a significant potential for burn healing process that is also reflected in the histopathological and immunohistochemical studies. Finally, our results demonstrated that curcumin nanoparticles revealed a significant potential for burn healing than curcumin alone due to its potent antimicrobial, antioxidant and anti-inflammatory properties.

Plant Extracts as Skin Care and Therapeutic Agents

Natural ingredients have been used for centuries for skin treatment and care. Interest in the health effects of plants has recently increased due to their safety and applicability in the formulation of pharmaceuticals and cosmetics. Long-known plant materials as well as newly discovered ones are increasingly being used in natural products of plant origin. This review highlights the beneficial effects of plants and plant constituents on the skin, including moisturizing (e.g., Cannabis sativa, Hydrangea serrata, Pradosia mutisii and Carthamus tinctorius), anti-aging (e.g., Aegopodium podagraria, Euphorbia characias, Premna odorata and Warburgia salutaris), antimicrobial (e.g., Betula pendula and Epilobium angustifolium), antioxidant (e.g., Kadsura coccinea, Rosmarinus officinalis, Rubus idaeus and Spatholobus suberectus), anti-inflammatory (e.g., Antidesma thwaitesianum, Helianthus annuus, Oenanthe javanica, Penthorum chinense, Ranunculus bulumei and Zanthoxylum bungeanum), regenerative (e.g., Aloe vera, Angelica polymorpha, Digitaria ciliaris, Glycyrrihza glabra and Marantodes pumilum), wound healing (e.g., Agrimonia eupatoria, Astragalus floccosus, Bursera morelensis, Jatropha neopauciflora and Sapindus mukorossi), photoprotective (e.g., Astragalus gombiformis, Calea fruticose, Euphorbia characias and Posoqueria latifolia) and anti-tyrosinase activity (e.g., Aerva lanata, Bruguiera gymnorhiza, Dodonaea viscosa, Lonicera japonica and Schisandra chinensis), as well as their role as excipients in cosmetics (coloring (e.g., Beta vulgaris, Centaurea cyanus, Hibiscus sabdariffa and Rubia tinctiorum), protective and aromatic agents (e.g., Hyssopus officinalis, Melaleuca alternifolia, Pelargonium graveolens and Verbena officinalis)).

Protein-polysaccharide-based delivery systems for enhancing the bioavailability of curcumin: A review

In recent years, a wide attention has been paid to curcumin in medicine due to its excellent physiological activities, including anti-inflammatory, antioxidant, antibacterial, and nerve damage repair. However, the low solubility, poor stability, and rapid metabolism of curcumin make its bioavailability low, which affects its development and application. As a unique biopolymer structure, protein-polysaccharide (PRO-POL)-based delivery system has the advantages of low toxicity, biocompatibility, biodegradability, and delayed release. Many scholars have investigated PRO-POL -based delivery systems to improve the bioavailability of curcumin. In this paper, we focus on the interactions between different proteins (e.g. casein, whey protein, soybean protein isolate, pea protein, zein, etc.) and polysaccharides (chitosan, sodium alginate, hyaluronic acid, pectin, etc.) and their effects on complexes diameter, surface charge, encapsulation drive, and release characteristics. The mechanism of the PRO-POL-based delivery system to enhance the bioavailability of curcumin is highlighted. In addition, the application of PRO-POL complexes loaded with curcumin is summarized, aiming to provide a reference for the construction and application of PRO-POL delivery systems.

Curcumin promotes skin wound healing by activating Nrf2 signaling pathways and inducing apoptosis in mice

Background/aim

Curcumin may have potential as a therapy for wound healing, but the underlying mechanism remains unclear. It is not known whether curcumin can promote wound healing by activating Nrf2 signaling pathway and inducing apoptosis. This study determined the role of Nrf2 signaling pathway and apoptosis in curcumin-promoting skin wound healing.

Materials and methods

The full-thickness skin defect model of mice was made and randomly divided into a control group and a curcumin group. The mice in the curcumin group and in the control group received respectively a daily topical treatment of Vaseline cream with or without 5 mg curcumin. The wound healing of mice was observed daily. The mice in two groups were killed respectively on postinjury days 3, 7, and 14, and the wound tissues were collected, with 5 mice in each group. Pathological change and formation of collagen fibers were observed by HE and Masson staining respectively. The expression of caspase-3 was observed by immunohistochemistry. Western blot was used to examine the protein levels of Nrf2 and HO-1, and ELISA assay and colorimetry assay were used to check the contents of ROS, MDA, SOD, and GSH.

Results

The wound healing rates of curcumin group were higher than those of control group (p < 0.05), and the pathological changes were also significantly better than those in the control group (p < 0.05). Collagen fiber synthesis in curcumin group was higher than that in control group (p < 0.05). Moreover, the expression of caspase-3 in curcumin group was higher than that in control group on 7th day post wound (p < 0.05). Furthermore, the levels of ROS and MDA in curcumin were lower than those in control group (p < 0.05), and the level of Nrf2, HO-1, SOD and GSH were higher than those in control group (p < 0.05).

Conclusion

Curcumin improves skin wound healing by activating the Nrf2 signaling pathway and inducing apoptosis in mice.

Evaluation of curcumin-loaded chitosan nanoparticles for wound healing activity

Background and purpose

Wound healing is a biological process that can be difficult to manage clinically. In skin wound healing, the interaction of many cells, growth factors, and cytokines reveals an outstanding biological function mechanism. Wound healing that occurs naturally restores tissue integrity, however, it is usually restricted to wound repair. Curcumin synthesised in a chitosan matrix can be used to heal skin sores.

Experimental approach

The ionotropic gelation procedure required crosslinking chitosan with a tripolyphosphate (TPP) crosslinker to generate curcumin nanoparticles encapsulated in chitosan.

Key results

The nanoparticles were between 200 and 400 nm in size, with a strong positive surface charge and good entrapment efficacy, according to SEM and TEM investigations. Curcumin and chitosan compatibility was investigated using FTIR spectroscopy. All batches showed consistent drug release, with the F5 batch having the highest curcumin release, at 75% after 16 hours. On L929 cells, scratch assays were utilised to assess wound healing. Wound closure with widths of 59 and 65 mm with curcumin and 45 and 78 mm with curcumin-loaded chitosan nanoparticles was seen after 24 and 48 hours of examination.

Conclusions

According to the findings, prepared curcumin chitosan nanoparticles are beneficial in healing skin damage.

Nanocurcumin and viable Lactobacillus plantarum based sponge dressing for skin wound healing

Curcumin loaded solid lipid nanoparticles (CSLNs) and probiotic (Lactobacillus plantarum UBLP-40; L. plantarum) were currently co-incorporated into a wound dressing. The combination with manifold anti-inflammatory, anti-infective, analgesic, and antioxidant properties of both curcumin and L. plantarum will better manage complex healing process. Recent reports indicate that polyphenolics like curcumin improve probiotic effects. Curcumin was nanoencapsulated (CSLNs) to improve its bioprofile and achieve controlled release on the wound bed. Bacteriotherapy (probiotic) is established to promote wound healing via antimicrobial activity, inhibition of pathogenic toxins, immunomodulation, and anti-inflammatory actions. Combination of CSLNs with probiotic enhanced (560%) its antimicrobial effects against planktonic cells and biofilms of skin pathogen, Staphylococcus aureus 9144. The sterile dressing was devised with selected polymers, and optimized for polymer concentration, and dressing characteristics using a central composite design. It exhibited a swelling ratio of 412 ± 36%, in vitro degradation time of 3 h, optimal water vapor transmission rate of 1516.81 ± 155.25 g/m2/day, high tensile strength, low-blood clotting index, case II transport, and controlled release of curcumin. XRD indicated strong interaction between employed polymers. FESEM revealed a porous sponge like meshwork embedded with L. plantarum and CSLNs. It degraded and released L. plantarum, which germinated in the wound bed. The sponge was stable under refrigerated conditions for up to six months. No translocation of probiotic from wound to the internal organs confirmed safety. The dressing exhibited faster wound closure and lowered bioburden in the wound area in mice. This was coupled with a decrease in TNF-α, MMP-9, and LPO levels; and an increase in VEGF, TGF-β, and antioxidant enzymes such as catalase and GSH, establishing multiple healing pathways. Results were compared with CSLNs and probiotic-alone dressings. The dressing was as effective as the silver nanoparticle-based marketed hydrogel dressing; however, the cost and risk of developing resistance would be much lower currently.

Exploring the contribution of pro-inflammatory cytokines to impaired wound healing in diabetes

Background

Impaired wound healing is the most common and significant complication of Diabetes. While most other complications of Diabetes have better treatment options, diabetic wounds remain a burden as they can cause pain and suffering in patients. Wound closure and repair are orchestrated by a sequence of events aided by the release of pro-inflammatory cytokines, which are dysregulated in cases of Diabetes, making the wound environment unfavorable for healing and delaying the wound healing processes. This concise review provides an overview of the dysregulation of pro-inflammatory cytokines and offers insights into better therapeutic outcomes.

Purpose of review

Although many therapeutic approaches have been lined up nowadays to treat Diabetes, there are no proper treatment modalities proposed yet in treating diabetic wounds due to the lack of understanding about the role of inflammatory mediators, especially Pro-inflammatory mediators- Cytokines, in the process of Wound healing which we mainly focus on this review.

Recent findings

Although complications of Diabetes mellitus are most reported after years of diagnosis, the most severe critical complication is impaired Wound Healing among Diabetes patients. Even though Trauma, Peripheral Artery Disease, and Peripheral Neuropathy are the leading triggering factors for the development of ulcerations, the most significant issue contributing to the development of complicated cutaneous wounds is wound healing impairment. It may even end up with amputation. Newer therapeutic approaches such as incorporating the additives in the present dressing materials, which include antimicrobial molecules and immunomodulatory cytokines is of better therapeutic value.

Summary

The adoption of these technologies and the establishment of novel therapeutic interventions is difficult since there is a gap in terms of a complete understanding of the pathophysiological mechanisms at the cellular and molecular level and the lack of data in terms of the assessment of safety and bioavailability differences in the individuals' patients. The target-specific pro-inflammatory cytokines-based therapies, either by upregulation or downregulation of them, will be helpful in the wound healing process and thereby enhances the Quality of life in patients, which is the goal of drug therapy.

Therapeutic Applications of Garlic and Turmeric for the Diabetic Wound Healing in Mice

Diabetes is involved in delayed wound healing that can be cured by natural products such as garlic, turmeric, and fibroin extracts. Alloxan monohydrate is used for inducing diabetes in mice. The percent wound contraction of garlic (150 mg/ml), turmeric (100 mg/ml), and fibroin (50 mg/ml), individually and in combinations garlic (150 mg/ml) + fibroin (50 mg/ml), turmeric (100 mg/ml) + fibroin (50 mg/ml), garlic (150 mg/ml) + turmeric (100 mg/ml), and garlic (150 mg/ml) + turmeric (100 mg/ml) + fibroin (50 mg/ml) was checked by evaluating the healing time, % wound contraction and histological analysis. The serum level of MMPs (MMP 2, MMP7, MMP 9), pro-inflammatory cytokines (TNF-α, IL-6, IL-8), and TIMPs were evaluated. With the combination of three extracts (Ga+Tu+Fi) garlic (150 mg/ml), turmeric (100 mg/ml) and fibroin (50 mg/ml), wounds healed in 12 days and had 97.3 ± 2.2% wound contraction. While the positive control (polyfax) and diabetic control (saline) wounds healed in 17- and 19-days with wound contraction of 96.7 ± 1.4% and 96.3 ± 1.1%, respectively. Histological analysis showed that the combination of Ga+Tu+Fi exhibited an increase in the growth of collagen fibers, fibroblasts number, and keratinocytes, and lessened inflammation of blood vessels. The combination of Ga+Tu+Fi significantly alleviated the serum concentration of TNF-α (14.2 ± 0.7 pg/ml), IL-6 (10.0 ± 1.0 pg/ml), IL-8 (16.0 ± 1.5 pg/ml), MMP2 (228.0 ± 18.1 pg/ml), MMP7 (271.0 ± 9.9 pg/ml), and MMP9 (141.0 ± 5.3 pg/ml) to diabetic control. The level of TIMPs (193.0 ± 9.1 pg/ml) was increased significantly with respect to diabetic control. We conclude that the combination of these biomaterials possessed high regenerative and healing capabilities and can be an effective remedy in the healing of chronic wounds in diabetic patients.

Catechin, epicatechin, curcumin, garlic, pomegranate peel and neem extracts of Indian origin showed enhanced anti-inflammatory potential in human primary acute and chronic wound derived fibroblasts by decreasing TGF-β and TNF-α expression

BACKGROUND

Although chronic wounds are devastating and can cause burden at multiple levels, chronic wound research is still far behind. Chronic wound treatment is often less efficient due to delay in diagnosis and treatment, non-specific treatment mainly due to lack of knowledge of wound healing or healing resistance genes. It's known that chronic wounds do not progress towards healing, because it gets stalled in inflammatory phase of wound healing.

OBJECTIVE

We aimed to use phytoextracts possessing excellent anti-inflammatory properties to regulate the unbalanced levels of cytokines responsible for increased inflammation.

METHODS

Evaluation of anti-inflammatory activity of selected phytoextracts namely, Camellia sinensis (L.) Kuntze, Acacia catechu (L.f) Willd., Curcuma longa (L.), Allium sativum (L.), Punica granatum (L.) and Azadirachta indica A. hereafter, called as catechin, epicatechin, curcumin, garlic, pomegranate and neem extracts, respectively in Acute wound fibroblasts (AWFs) and Chronic wound fibroblasts (CWFs) using flow cytometry.

RESULTS

The phytoextracts exhibited no cytotoxicity below 100 μg/ml on normal Human Dermal fibroblasts (HDFs), while garlic extract showed highest cell viability followed by catechin, epicatechin, curcumin, pomegranate peel and neem based on IC₅₀ value. Garlic, catechin and epicatechin extracts showed highest anti-inflammatory activities for both TGF-β and TNF-α in both AWFs and CWFs treated cells. After treatment of AWFs with catechin, epicatechin and garlic extracts, TGF-β and TNF-α expression was significantly reduced compared to untreated AWFs and reached to almost normal HDFs level. Also, after treatment of CWFs with catechin, epicatechin and garlic extracts, TGF-β and TNF-α expression was significantly reduced compared to untreated CWFs and was lesser than untreated AWFs.

CONCLUSION

The present findings reveal the potential of catechin, epicatechin and garlic extracts for the treatment of acute and chronic wounds with excellent anti-inflammatory properties.

A bio-polymeric scaffold incorporated with p-Coumaric acid enhances diabetic wound healing by modulating MMP-9 and TGF-β3 expression

Diabetic wounds lead to severe health complications as the tissue regeneration process fails predominantly due to prolonged inflammation, reactive oxygen species generation, and imbalance in collagen turnover. Modern wound dressings that can aid in wound management thus improving the public healthcare system, is the present need. This study aims to fabricate an effective wound dressing using plant polyphenol to treat chronic wounds as polyphenols possess excellent wound-healing ability. The collagen scaffold enriched with the polyphenol, p-Coumaric acid, was fabricated by freeze-drying method (Col-OxP3-Ca) and examined for its wound-healing ability by in vitro and in vivo analyses. Col-OxP3-Ca scaffold exhibited 85% antioxidant activity, biocompatibility in fibroblast cells, enhanced cell proliferation and migration rate. The diabetic excision wound treated with Col-OxP3-Ca scaffold healed within 21 days and a well-developed epidermis, blood vessels, hair follicle formation, fewer inflammatory cells and collagen deposition was observed in histological analysis. The immunohistochemical results depicted the enhanced expression of TGF-β3 and lessened expression of the MMP-9 in Col-OxP3-Ca scaffold treatment group. p-Coumaric acid shortened the inflammatory stage, enhanced angiogenesis, tissue regeneration and balanced collagen turnover during healing. From this, we can accomplish that the Col-OxP3-Ca wound dressing could be an outstanding alternative to treat chronic wounds.

Yuhong ointment ameliorates inflammatory responses and wound healing in scalded mice

ETHNOPHARMACOLOGICAL RELEVANCE

Yuhong ointment (YHO) is famous for its efficacy in clearing away heat and dampness, reducing swelling and relieving pain, and it has been used for more than 600 years. Scalding damages the skin's defense function, resulting in a large number of necrotic tissues and cells on the wound surface, which favors bacterial growth and inflammation. If the inflammation reaction is not controlled on time, it may lead to reduced immunity and cause complications such as infection. Yuhong ointment can promote wound healing in scalded mice, but its potential pharmacological mechanism is still unclear.

AIM OF THE STUDY

This study focused on identifying the active ingredients of YHO and on investigating the performance of YHO in terms of anti-inflammatory activity and scald wound healing activity.

MATERIALS AND METHODS

High-performance liquid chromatography (HPLC) and high-performance liquid chromatography-mass spectrometry (HPLC-MS) were performed to identify the active ingredients of YHO. The performance of transdermal delivery of YHO was studied via HPLC for analyzing the ingredients of the exposed skin liquid of mice. Enzyme-linked immunosorbent assay (ELISA) analysis, immunohistochemistry, and real-time fluorescence quantitative PCR (qRT-PCR) were used to investigate the anti-inflammatory and scald wound healing activity of YHO.

RESULTS

A total of 41 components of YHO were identified via HPLC and HPLC-MS for the first time. In the transdermal delivery experiment, the cumulative amounts of chlorogenic acid, sesamol, ferulic acid, and L-shikonin were calculated to be 342.28, 567.89, 384.54, and 528.67 μg/cm², respectively. Pharmacological activity experiments indicated that these four kinds of drugs exhibited different degrees of therapeutic effects on scald. Specifically, YHO high-dose (YHO-H) group showed better therapeutic ability (P < 0.01) than FN and MB group. Furthermore, the immune function of the YHO group was enhanced due to the continuous increment of the levels of Hydroxyproline (HYP), Immunoglobulin G (IgG), and vascular endothelial growth factor (VEGF) and simultaneous decrement of the levels of TNF-α, TNF-β, IL-10, and IL-6 in the skin wound. Histological results showed that the thickening of skin tissue was alleviated after treatment with YHO. Moreover, the expression of substance P (SP), calcitonin gene related peptide (CGRP) and transient receptor potential vanilloid-1 (TRPV1) was inhibited, and the expression of VEGF was promoted by YHO (P < 0.01). The qRT-PCR test results indicated that the YHO group exhibited better inhibitory effect on interleukin 6 (IL-6), interleukin 10 (IL-10), transforming growth factor-beta (TGF-β), and Smad-3 mRNA expression levels than the other groups.

CONCLUSIONS

In this work, the active ingredients of YHO were identified via HPLC and HPLC-MS analysis. Importantly, YHO showed great advantages in transdermal delivery and scald wound healing, which can be attributed to the both anti-inflammatory and tissue regeneration mechanisms. Therefore, this work not only identified the active ingredients of YHO but also revealed the potential pharmacological mechanism of YHO for the healing of scald.

Why traditional herbal medicine promotes wound healing: Research from immune response, wound microbiome to controlled delivery

Impaired wound healing in chronic wounds has been a significant challenge for clinicians and researchers for decades. Traditional herbal medicine (THM) has a long history of promoting wound healing, making them culturally accepted and trusted by a great number of people in the world. However, for a long time, the understanding of herbal medicine has been limited and incomplete, particularly in the allopathic medicine-dominated research system. The therapeutic effects of individual components isolated from THM are found less pronounced compared to synthetic chemical medicine, and the clinical efficacy is always inferior to herbs. In the present article, we review and discuss underlying mechanisms of the skin microbiome involved in the wound healing process; THM in regulating immune responses and commensal microbiome. We additionally propose few pioneer ideas and studies in the development of therapeutic strategies for controlled delivery of herbal medicine. This review aims to promote wound care with a focus on wound microbiome, immune response, and topical drug delivery systems. Finally, future development trends, challenges, and research directions are discussed.

An injectable elastic hydrogel crosslinked with curcumin-gelatin nanoparticles as a multifunctional dressing for the rapid repair of bacterially infected wounds

Injectable self-healing hydrogel dressings with excellent elasticity and multifunctional repair effects have been in high demand in wound healing applications, while maintaining stable elasticity in injectable multifunctional hydrogel dressings is still a challenge. Based on carboxymethyl chitosan (CMCS), curcumin-gelatin nanoparticles (CG NPs), and sodium alginate oxide (OSA), we developed a double-crosslinking injectable elastic self-healing hydrogel without any chemical cross-linking agent as a multifunctional wound healing dressing. CG NPs were more stable than pure curcumin (Cur) nanoparticles and could regulate the cross-linking of injectable hydrogels for high elasticity and rapid self-healing. We found that the CG NPs endowed the injectable hydrogel with good anti-inflammatory, antibacterial, and reactive oxygen scavenging activities and could significantly shorten the wound healing time in infected full-thickness skin defect rats by promoting the polarization of M2-type macrophages, reducing oxidative damage, accelerating collagen deposition, enhancing granulation formation, and elevating angiogenesis. Taken together, the tunable elastic injectable hydrogel dressing exhibited a long-term service life with sustained repair function and can be taken as an optimal candidate for bacteria-infected wound healing.

Formulation optimization of sterilized xanthones-loaded nanoemulgels and evaluation of their wound healing activities

Xanthones (XTs) are bioactive compounds found in mangosteen trees (Garcinia mangostana Linn.). They are used as an active ingredient in various health products. However, there is a lack of data of their application in wound healing. In particular, the topical products of XTs for wound healing; they should be sterilized to minimize the risks of wound infection from contaminated microorganisms. This study thus aimed to optimize the formulation of sterilized XTs-loaded nanoemulgel (XTs-NE-G) and to investigate their wound healing activities. The XTs-NE-Gs were prepared by mixing various gels containing sodium alginate (Alg) and Pluronic F127 (F127) into a XTs-nanoemulsion (NE) concentrate according to the face-centered central composite design. The results showed that the optimized XTs-NE-G was A5-F3 containing 5% w/w Alg and 3% w/w F127. It enhanced the proliferation-, migration rates of skin fibroblasts (HFF-1 cells) with an optimal viscosity. After blending the XTs-NE concentrate and the gel that was previously sterilized by a membrane filtration and an autoclaving technique, respectively, the sterilized A5-F3 was obtained. The sterilized A5-F3 still had effective bioactivities towards the HFF-1 cells. It promoted re-epithelialization, collagen deposition and inflammation suppression in the mice' wounds. It could thus be accepted for further investigation in clinical studies.

The Epidermal Keratinocyte as a Therapeutic Target for Management of Diabetic Wounds

Diabetes mellitus (DM) is an important cause of chronic wounds and non-traumatic amputation. The prevalence and number of cases of diabetic mellitus are increasing worldwide. Keratinocytes, the outermost layer of the epidermis, play an important role in wound healing. A high glucose environment may disrupt the physiologic functions of keratinocytes, resulting in prolonged inflammation, impaired proliferation, and the migration of keratinocytes and impaired angiogenesis. This review provides an overview of keratinocyte dysfunctions in a high glucose environment. Effective and safe therapeutic approaches for promoting diabetic wound healing can be developed if molecular mechanisms responsible for keratinocyte dysfunction in high glucose environments are elucidated.

Kampo herbal ointments for skin wound healing

The management of skin wound healing problems is a public health issue in which traditional herbal medicines could play a determining role. Kampo medicine, with three traditionally used ointments, provides interesting solutions for these dermatological issues. These ointments named Shiunkō, Chuōkō, and Shinsen taitsukō all have in common a lipophilic base of sesame oil and beeswax from which herbal crude drugs are extracted according to several possible manufacturing protocols. This review article brings together existing data on metabolites involved in the complex wound healing process. Among them are representatives of the botanical genera Angelica, Lithospermum, Curcuma, Phellodendron, Paeonia, Rheum, Rehmannia, Scrophularia, or Cinnamomum. Kampo provides numerous metabolites of interest, whose content in crude drugs is very sensitive to different biotic and abiotic factors and to the different extraction protocols used for these ointments. If Kampo medicine is known for its singular standardization, ointments are not well known, and research on these lipophilic formulas has not been developed due to the analytical difficulties encountered in biological and metabolomic analysis. Further research considering the complexities of these unique herbal ointments could contribute to a rationalization of Kampo's therapeutic uses for wound healing.

Production and Anti-Inflammatory Performance of PVA Hydrogels Loaded with Curcumin Encapsulated in Octenyl Succinic Anhydride Modified Schizophyllan as Wound Dressings

Amphiphilic polysaccharides can be used as wall materials and applied to encapsulate hydrophobic active chemicals; moreover, there is significant demand for novel medical high-molecular-weight materials with various functions. In order to prepare amphiphilic schizophyllan (SPG), octenyl succinic anhydride (OSA) was chosen to synthesize OSA-modified schizophyllan (OSSPG) using an esterified reaction. The modification of OSSPG was demonstrated through FT-IR and thermal analysis. Moreover, it was found that OSSPG has a better capacity for loading curcumin, and the loading amount was 20 μg/mg, which was 2.6 times higher than that of SPG. In addition, a hydrogel made up of PVA, borax, and C-OSSPG (OSSPG loaded with curcumin) was prepared by means of the one-pot method, based on the biological effects of curcumin and the immune-activating properties of SPG. The mechanical properties and biological activity of the hydrogel were investigated. The experimental results show that the dynamic cross-linking of PVA and borax provided the C-OSSPG/BP hydrogel dressing with exceptional self-healing properties, and it was discovered that the C-OSSPG content increased the hydrogel's swelling and moisturizing properties. In fibroblast cell tests, the cells treated with hydrogel had survival rates of 80% or above. Furthermore, a hydrogel containing C-OSSPG could effectively promote cell migration. Due to the excellent anti-inflammatory properties of curcumin, the hydrogel also significantly reduces the generation of inflammatory factors, such as TNF-α and IL-6, and thus has a potential application as a wound dressing medicinal material.

The Therapeutic Wound Healing Bioactivities of Various Medicinal Plants

The skin serves as the body's first line of defense, guarding against mechanical, chemical, and thermal damage to the interior organs. It includes a highly developed immune response that serves as a barrier against pathogenic infections. Wound healing is a dynamic process underpinned by numerous cellular activities, including homeostasis, inflammation, proliferation, and remodeling, that require proper harmonious integration to effectively repair the damaged tissue. Following cutaneous damage, microorganisms can quickly enter the tissues beneath the skin, which can result in chronic wounds and fatal infections. Natural phytomedicines that possess considerable pharmacological properties have been widely and effectively employed forwound treatment and infection prevention. Since ancient times, phytotherapy has been able to efficiently treat cutaneous wounds, reduce the onset of infections, and minimize the usage of antibiotics that cause critical antibiotic resistance. There are a remarkable number of wound-healing botanicals that have been widely used in the Northern Hemisphere, including Achiella millefolium, Aloe vera, Althaea officinalis, Calendula officinalis, Matricaria chamomilla, Curcuma longa, Eucalyptus, Jojoba, plantain, pine, green tea, pomegranate, and Inula. This review addresses the most often used medicinal plants from the Northern Hemisphere that facilitate the treatment of wounds, and also suggests viable natural alternatives that can be used in the field of wound care.

Dermocosmetic evaluation of a nutricosmetic formulation based on Curcuma

Endogenous and exogenous factors can alter the skin layer and appearance, determining skin aging. The extracts and isolated molecules from food matrixes can be used to formulate "healthy" antiaging cosmetics. Two different cosmetic approaches can be used to achieve the antiaging effect. It is possible to use topical products based on food extract (cosmeceutical approach) or take a food supplement and apply a topical cosmetic product based on food extract on the surface to be treated (nutricosmetic approach). This work evaluated in vivo the antiaging potential of a nutricosmetic formulation (cream + food supplement) and a cosmeceutical cream based on Curcuma. The choice of the commercial Curcuma extract to be used for experimental purposes was based on the curcuminoid content determined by an HPLC test. Curcuminoids are the bioactive compounds responsible for Curcuma's antioxidant and antiinflammatory properties. Their levels in Curcuma extracts vary according to the storage condition, variety, and pedoclimatic cultivation conditions. The Tewameter® TM300 was used to evaluate the Trans Epidermal Water Loss (TEWL), the Corneometer® CM 825 to determine the moisturizing effect, the Cutometer® to estimate the skin firmness and elasticity, the Dermascan to assess the collagen index, and the Visioface® 1000D to evaluate the wrinkles. The nutricosmetic product showed potential as moisturizing, anti-age, and anti-wrinkle action better than the cosmeceutical product alone.

Polyethylenimine-grafted mesoporous silica nanocarriers markedly enhance the bactericidal effect of curcumin against Staphylococcus aureus biofilm

The recalcitrant nature of biofilms makes biofilm-associated infections difficult to treat in modern medicine. Biofilms have a high vulnerability to antibiotics and a limited repertoire of antibiotics could act on matured biofilms. This issue has resulted in a gradual paradigm shift in drug discovery and therapy, with anti-biofilm compounds being sought alongside new drug carriers. A potential solution to biofilm-associated infections is to employ antibiofilm treatments, which can attack biofilms from many fronts. Nanocarriers are promising in this regard because they can be entrapped within biofilm matrix, target biofilm matrix, and provide local drug delivery to inhibit biofilm formation. In this study, curcumin as an herbal extract was loaded onto hyperbranched polyethylenimine-grafted mesoporous silica nanoparticles (F-MSN-PEI/Cur) and antibiofilm investigations were performed. The F-MSN-PEI/Cur design has the potential to repurpose curcumin as an antibiofilm agent by increasing its solubility and lowering the required doses for the destruction of matured biofilms as well as suppressing biofilm development. Using imaging and spectroscopic techniques, we assessed the interaction of F-MSN-PEI/Cur with Staphylococcus aureus bacterial cells and determined the impact of F-MSN-PEI/Cur on eradicating matured biofilms and suppressing biofilm development. The F-MSN-PEI/Cur design is highly cytocompatible, as observed by the cytotoxicity screening investigations on L929 mouse fibroblast cell line. Our findings show that F-MSN-PEI/Cur design reduces the bacterial cell viability, inhibits biofilm formation, and induces biofilm eradication, which is attributed to F-MSN-PEI/Cur design having the potential to repurpose the antibiofilm activity of curcumin-herbal extract.

Decreased expression of miR-204-3p in peripheral blood and wound margin tissue associated with the onset and poor wound healing of diabetic foot ulcers

To investigate the relationship between small non-coding RNA-204-3p (miR-204-3p) and the onset and wound healing of diabetic foot ulcers (DFU) and the underlying molecular mechanism, sixty four newly diagnosed patients with T2DM without DFU (T2DM group), 82 T2DM patients with DFU (DFU group), and 60 controls with normal glucose tolerance (NC group) were included. Quantitative real-time PCR (qRT-PCR) method was used to determine miR-204-3p expression levels in peripheral blood and wound margin tissue of subjects, and to analyse the relationship between the expression of miR-204-3p and wound healing. In vitro experiments were also performed to understand the effect of miR-204-3p on high glucose induced injury of HaCaT cells (human keratinocytes). The results showed that miR-204-3p expression level of peripheral blood in the T2DM group was marked lower than that in the NC group [2.38 (1.31-5.04) vs 3.27 (1.51-6.98)] (P < .05). Similarly, the miR-204-3p expression level of peripheral blood in the DFU group was significantly lower than the T2DM group [1.15 (0.78-2.89) vs 2.38 (1.31-5.04)] (P < .01). The expression level of miR-204-3p in peripheral blood and wound margin tissues of DFU patients was positively correlated with the healing rate of foot ulcers after 8 weeks (P < .05). Multifactorial logistic regression analysis showed that decreased expression of miR-204-3p in peripheral blood was an independent risk factor for DFU (OR = 2.95, P < .05). The results of in vitro experiments showed that miR-204-3p could improve the proliferation and migration of HKC cells and reduce the proportion of apoptosis of HKC cells by targeted regulation of zinc finger protein Kruppel like factor 6 (KLF6) in high glucose environment. Therefore, the decreased expression of miR-204-3p in peripheral blood and wound tissue of T2DM patients is closely related to the occurrence and poor wound healing of DFU. The down-regulated expression of miR-204-3p can reduce its ability to antagonise the functional damage of keratinocytes induced by high-glucose conditions. These results will provide potential targets for the treatment of DFU.

Investigation of wound healing potential of photo-active curcumin-ZnO-nanoconjugates in excisional wound model

Wound healing, being a dynamic process consisting of hemostasis, inflammation, proliferation, and remodeling, involves the complicated interplay of various growth mediators and the cells associated repair system. Current wound healing therapies usually fail to completely regain skin integrity and functionality. Traditionally, curcumin is considered a potent natural wound healing agent as it possesses antibacterial, antioxidant, and anti-inflammatory properties. It is also known that zinc oxide (ZnO) nanoparticles (NPs) have photocatalytic properties, including the generation of reactive oxygen species. ZnO nanoaprticles are also Food and Drug Administration (FDA) approved as safe substances. While ZnO oxide requires illumination with ultraviolet light to become photocatalytically active, dye-sensitized ZnO can be activated by illumination with visible light. In the present study, we explored the wound healing potential of ZnO nanoparticles sensitized with curcumin (Cu+ZnO Nps) and illuminated with visible (blue) light generated by an array of high power LEDs. We studied the antibacterial effect of our conjugates by percentage reduction in bacterial growth and biofilm formation. The wound healing potential was analyzed by percentage wound contraction, biochemical parameters, and histopathological analysis of the wounded site. Additionally, angiogenesis and wound associated cytokines was evaluated by immunohistochemistry of CD31 and gene expression analysis of IL-1β, TNF-α, and MMP-9 after 16 days of post-wound treatment, respectively. Our study suggests that the therapeutic effect of Cu+ZnO NPs with LED illumination increases its wound healing potential by producing an antibacterial and anti-inflammatory effect. Moreover, the treatment strategy of using a nano formulation in combination with LED illumination further increases its efficacy. It was concluded that the anti-inflammatory and bactericidal effects of the LED illuminated Cu+ZnO Np showed accelerated wound healing with increased wound contraction, collagen deposition, angiogenesis, and re-epithelialization.

Human primary chronic wound derived fibroblasts demonstrate differential pattern in expression of fibroblast specific markers, cell cycle arrest and reduced proliferation

INTRODUCTION

Although wound refers to simple cut in the skin, most wounds don't heal because of the various local and systemic factors that lead to its complexity and chronicity. Thus, prior understanding of the status of the wound is necessary and methods that can differentiate between the healing and non-healing wounds at a much earlier stage is crucial for a successful treatment.

METHODS

The current study aims at differentiating Acute Wound Fibroblasts (AWFs) and Chronic Wound Fibroblasts (CWFs) based on differential expression of fibroblast specific markers such as Vimentin and Alpha Smooth Muscle Actin (α-SMA) and compare its cell cycle and proliferation.

RESULTS

Immunostaining and western blotting analysis showed that, AWFs and CWFs differentially expressed vimentin and α-SMA, with AWFs and CWFs showing higher expression of vimentin and α-SMA respectively. AWFs showed higher distributions in G0/G1 (67.43% vs. 62.16%), S phase (22.61% vs. 8.51%) compared to CWFs. However, AWFs showed decreased distributions compared to CWFs in G2 + M phase (8.14% vs. 10.6%). Thus, it was observed that CWFs showed cell cycle arrest in the G1/G0 phase and inhibited DNA synthesis, which was further confirmed by reduced proliferation of CWFs. We suggest that, differential expression of the cell specific markers can be attributed to its pathophysiological status and chronicity of the wound and reduced proliferation rate of CWFs is due to lesser expression of vimentin, which is a key protein for in vitro cell proliferation.

CONCLUSIONS

Outcome of the study serve as an immunological tool to guide the chronicity of the wound, which helps to understand the wound towards design of personalized care. The findings also represent a promising opportunity to gain insight into how cell cycle arrest can impact on wound healing and clinical outcomes.

Localized delivery of curcumin by thermosensitive hydrogels for promoting wound healing

BACKGROUND

Curcumin can promote wound healing, but its drug delivery medium needs to be improved further.

OBJECTIVES

A curcumin-loaded thermosensitive hydrogel was prepared, its characterization was evaluated, and its promoting effect on wound healing was observed.

METHODS

Curcumin-loaded thermosensitive hydrogels were prepared with different percentages of poloxamer 188 and poloxamer 407. A small tube inversion assay was used to observe the sol-gel transition temperature, and a rotational rheometer was used to detect the sol viscosity, sol-gel phase transition temperature and phase transition time. The microstructure of the gel was observed by scanning electron microscopy, and Fourier infrared spectroscopy was used to evaluate whether curcumin was successfully loaded. Finally, its promoting effect on wound healing was observed in vivo and in vitro.

RESULTS

Poloxamer 407 24% and poloxamer 188 1% were selected to prepare curcumin-loaded thermosensitive hydrogels. After 60 ± 15 s at 32 °C, the sol-gel transition process was completed, with certain elastic behavior and solid-like rheological properties. Scanning electron microscopy showed that the pores of the curcumin-P407/P188 thermosensitive hydrogel were interconnected, with an average pore size ranging from 5 to 10 μm. Hydrogels showed a higher swelling ratio. Fourier transform infrared spectroscopy showed that curcumin had been incorporated into the hydrogel. Live/dead cell assays suggested that the hydrogel was not toxic to fibroblasts. Curcumin-loaded thermosensitive hydrogels can promote an increase in S-phase fibroblasts and improve wound healing.

CONCLUSIONS

Curcumin-loaded P407/P188 thermosensitive hydrogel improves wound healing. More in-depth research is needed in the future.

Mesenchymal Stem Cell-Derived Exosomes Loaded with miR-155 Inhibitor Ameliorate Diabetic Wound Healing

Diabetic wounds are one of the debilitating complications that affect up to 20% of diabetic patients. Despite the advent of extensive therapies, the recovery rate is unsatisfactory, and approximately, 25% of patients undergo amputation, thereby demanding alternative therapeutic strategies. On the basis of the individual therapeutic roles of the miR-155 inhibitor and mesenchymal stem cells (MSC)-derived exosomes, we conjectured that the combination of the miR-155 inhibitor and MSC-derived exosomes would have synergy in diabetic wound healing. Herein, miR-155-inhibitor-loaded MSC-derived exosomes showed synergistic effects in keratinocyte migration, restoration of FGF-7 levels, and anti-inflammatory action, leading to accelerated wound healing mediated by negative regulation of miR-155, using an in vitro co-culture model and in vivo mouse model of the diabetic wound. Furthermore, treatment with miR-155-inhibitor-loaded MSC-derived exosomes led to enhanced collagen deposition, angiogenesis, and re-epithelialization in diabetic wounds. This study revealed the therapeutic potential of miR-155-inhibitor-loaded MSC-derived exosomes in diabetic wound healing and opened the doors for encapsulating miRNAs along with antibiotics within the MSC-derived exosomes toward improved management of chronic, nonhealing diabetic wounds.

Decellularized extracellular matrix mediates tissue construction and regeneration

Contributing to organ formation and tissue regeneration, extracellular matrix (ECM) constituents provide tissue with three-dimensional (3D) structural integrity and cellular-function regulation. Containing the crucial traits of the cellular microenvironment, ECM substitutes mediate cell-matrix interactions to prompt stem-cell proliferation and differentiation for 3D organoid construction in vitro or tissue regeneration in vivo. However, these ECMs are often applied generically and have yet to be extensively developed for specific cell types in 3D cultures. Cultured cells also produce rich ECM, particularly stromal cells. Cellular ECM improves 3D culture development in vitro and tissue remodeling during wound healing after implantation into the host as well. Gaining better insight into ECM derived from either tissue or cells that regulate 3D tissue reconstruction or organ regeneration helps us to select, produce, and implant the most suitable ECM and thus promote 3D organoid culture and tissue remodeling for in vivo regeneration. Overall, the decellularization methodologies and tissue/cell-derived ECM as scaffolds or cellular-growth supplements used in cell propagation and differentiation for 3D tissue culture in vitro are discussed. Moreover, current preclinical applications by which ECM components modulate the wound-healing process are reviewed.

A Biomimetic Composite Bilayer Dressing Composed of Alginate and Fibroin for Enhancing Full-Thickness Wound Healing

Full-thickness skin wound dressings are critically important for acute cutaneous wound healing. In this study, we developed a bilayer sheet originating from biological macromolecules, mimicking skin hierarchy structure. This sheet was composed of a steady silk fibroin (SF)/sodium alginate (SA) composite scaffold as the bottom regenerative layer and a SA film as the protective top layer. SEM analysis revealed the thickness of the top layer was ∼25 μm and was tightly adhered to the composite scaffold layer with interconnected pores (∼150 μm). The bilayer sheets displayed suitable water uptake capacity and high stability in water. The mass retention percentage of the bilayer sheets was approximately 50% during three weeks of PBS degradation in vitro. The tensile strength of the bilayer sheets significantly increased from 13.41 ± 3.75 kPa (single scaffold) to 59.81 ± 5.98 kPa. The composite scaffolds were more conducive to the growth and proliferation of human dermal microvascular endothelial cells. The experiment results in vivo demonstrated superior and faster epithelialisation and dermal regeneration in the wound treated with bilayer sheets because the sheets accelerated wound closure, reduced the inflammatory response, and promoted protein synthesis in the extracellular matrix and blood vessel ingrowth. This article is protected by copyright. All rights reserved.

Carbopol 940 hydrogel containing curcumin-loaded micelles for skin delivery and application in inflammation treatment and wound healing

Inflammation and excessive reactive oxygen species production are main reason for slow wound healing, which needs an efficient therapy in clinic. In the paper, curcumin-enveloped methoxy poly(ethylene glycol)-poly(-valerolactone)-poly(-caprolactone) (MPEG-PVL-PCL) micelles...

Rational selection of bioactive principles for wound healing applications: Growth factors and antioxidants

Wound healing is a complex process of communication between growth factors, reactive species of oxygen, cells, signalling pathways, and cytokines in the extracellular matrix, in which growth factors are the key regulators. In humans, the main regulators of the cellular responses in wound healing are five growth factors, namely EGF, bFGF, VEGF, and TGF-β1. On the other hand, antioxidants such as astaxanthin, beta-carotene, epigallocatechin gallate, delphinidin, and curcumin have been demonstrated to stimulate cell proliferation, migration and angiogenesis, and control inflammation, to suggest a practical approach to design new strategies to treat non-healing cutaneous conditions. Based on the individual effects of growth factors and antioxidants, it may be envisioned that the use of both types of bioactives in wound healing formulations may have an additive or synergistic effect on the healing potential. This review addresses the effect of growth factors and antioxidants on wound healing-related processes. Furthermore, a prospective on their potential additive or synergistic effect on wound healing formulations, based on their individual effects, is presented. This may serve as a guide for the development of a new generation of wound healing formulations.

Effectiveness of turmeric (Curcuma Longa Linn) Gel Extract (GE) on wound healing: Pre-clinical test

OBJECTIVE

This research was basic research to identify the effect of turmeric extract tested by the in vivo method. The purpose of this study was to identify differences in the length of the wound at each concentration of gel preparations on days 3, 7, and 14, as well as differences in wound healing time at each concentration of gel preparations and, identify the most effective gel preparations for wound healing.

METHOD

This study is an experimental laboratory study with experimental animals using post-test only with control groups, the type of research used is a pre-clinical test (pre-clinical trial) on female rabbits. The sample size in this study was 12 rabbits grouped randomly. The length of each group's wounds was measured and observed on days 3, 7, and 14. Gel application was carried out twice a day in the morning and evening for 14 days. In this study, the experimental data were tested using Kruskal Wallis.

RESULTS

There were differences in wound length in each group treated with turmeric extract gel and base gel. Based on the mean wound length of each group, they experienced a reduction in wound length on days 3, 7, and 14. There were also differences in wound healing time in each group. In each group, wherein this case, the treatment group that was given 5% turmeric extract gel experienced a faster healing time <14 days than the other groups.

CONCLUSION

In general, turmeric extract gel at each concentration is effective against wound healing. Turmeric extract gel concentration is the most effective gel with a concentration of 5%, then followed by concentrations of 10% and 15%.

Toll-Like Receptors (TLRs) and their potential therapeutic applications in diabetic neuropathy

One of the most common diabetic microvascular complications is diabetic neuropathy (DN). Immune cell infiltration in the peripheral nerve system (PNS), myelin loss, Schwann cell death, and axonal damage are all hallmarks of DN, which is currently believed to be a chronic inflammatory disease. Toll-like receptors (TLRs) are found in various types of nervous system cells, including Schwann cells, microglia, oligodendrocytes, astrocytes, and neurons. Proinflammatory mediators released at the end of TLR signal transduction can trigger an inflammatory response involving the nervous system. Studies on the association between TLRs and DN began as early as 2004. Since then, several studies have been conducted to assess the involvement of TLRs in the pathogenesis of DN. The focus of this review is to give a complete summary of the researches that have been done in this context, as well as an overview of the role of TLRs and their therapeutic applications in DN.

Curcuma longa L. Effects on Akt/mTOR Pathway and NF-κB Expression During Skin Wound Healing: An Immunohistochemical Study

Skin ulcers, wounds, or burns represent a burden for health care worldwide. Our aim was to explore the effects of mucoadhesive formulation with Curcuma longa L. extract mucoadhesive formulation containing curcumin (MFC) on skin healing in Wistar rats. Fifty-four rats were randomly allocated into 3 groups: control, vehicle, and MFC. A full-thickness circular wound was induced on the back of each animal. Two daily applications of the products were performed according to the experimental group. On days 3, 10, and 21, 6 animals in each group were euthanized. Clinical analysis was based on wound area. Histologic analysis was performed in hematoxylin and eosin-stained sections, with re-epithelization and inflammation being assessed by means of semiquantitative scores. To analyze the Akt/mTOR pathway, immunohistochemistry for phospho Akt (pAkt) and phospho ribosomal protein S6 were investigated. In addition, nuclear factor kappa-light-chain-enhancer of activated B cells immunolabeling was performed. Clinical analysis revealed wounds with a smaller area on days 3 and 10 in curcumin-treated animals. Histologically, MFC had a significant impact on inflammatory events on days 3 and 10 and promoted faster re-epithelization, which was evidenced on day 10. MFC-treated wounds exhibited pAkt upregulation on day 10 and both pAkt and phospho ribosomal protein S6 downregulation on day 21. Nuclear factor kappa-light-chain-enhancer of activated B cells expression varied through the evaluation periods; however, no significant difference was observed between groups. Collectively, our results indicate that MFC is efficient in accelerating cutaneous wound repair through modulation of the inflammatory process and stimulus of re-epithelization by an Akt/mTOR-dependent mechanism.

Therapeutic Effect of Combining Anisodamine With Neostigmine on Local Scar Formation Following Roux-en-Y Choledochojejunostomy in a Novel Rat Model

Background: The present study aimed to explore the potential effect of combining anisodamine with neostigmine on local scar formation following Roux-en-Y choledochojejunostomy (RCJS) in a novel rat model.

Methods: The biliary obstruction model of Sprague Dawley (SD) rats was established in advance, and 54 rats were divided into nine groups randomly (sham operation group, anisodamine group, neostigmine group, combination group, and control group). Anisodamine (25 mg/kg) and neostigmine (50 μg/kg) were injected to the abdominal cavity separately or simultaneously for 1 week since the first day after surgery according to their allocated intervention, while the same amount of saline (0.5 ml) was injected intraperitoneally in the control group. Indexes including body weight, the diameter of the common bile duct, liver function, inflammatory indexes, and the condition of scar formation in different groups at certain time were evaluated in our study.

Results: Recovery of liver function (ALT, AST, TB, DB, and GGT) and systematic inflammation indexes (CRP, TNF-α, and IL-1β) in the combination group was prior to that in the control group (p < 0.05), while no statistical difference in the serum level of IL-10 was observed among groups. Rats in the combination group represented a wider anastomotic diameter and lower expression of α-SMA and TGF-β1 at anastomotic stoma compared to the control group (p < 0.05). Histopathological staining showed slighter proliferation of collagen and smooth muscle fibers in rats’ bile duct wall and less local scar formation at anastomotic stoma compared to the control group.

Conclusion: The combination of anisodamine and neostigmine can alleviate local and systemic inflammatory response, promote the recovery of liver function, and reduce scar formation in rats after the RCJS procedure.

Comparing the wound healing effect of a controlled release wound dressing containing curcumin/ciprofloxacin and simvastatin/ciprofloxacin in a rat model: A preclinical study

Inflammation and infection are two main factors predisposing a wound to become a chronic one. Degradable wound dressings involving the controlled release of suitable drugs at the ulcer site are one of the solutions to make wounds healing progress smoothly and rapidly. In this research, biodegradable dressings made of polyglycerol sebacate/polycaprolactone (PGS/PCL) containing curcumin/ciprofloxacin (CUR/CIP) and simvastatin/ciprofloxacin (SIM/CIP) were prepared by using the coaxial electrospinning method. Transmission electron microscopy for uniform core/shell structure, swelling ratio, and drug release pattern of the wound dressings were evaluated. At the in vivo study, histometric, histopathologic, and collagen expression study was performed. The PGS/PCL samples containing SIM/CIP showed a burst release pattern of CIP with a delay in the release of SIM; meanwhile, in the samples containing CUR/CIP, both drugs showed a burst release behavior. No cytotoxicity response was observed in the study groups. The in vivo study showed that wound closure was almost completed only in the SIM/CIP group after 14 days. After 14 days, in the wound treated with SIM/CIP dressing, the amount of collagen deposition and angiogenesis was higher than that of the others. These results clearly showed the effect of SIM/CIP on the improvement of the wound healing efficiency in the long term (14 days) and the effect of CUR/CIP on wound contraction in the short term (4 day). It seems, therefore, that the use of SIM and CUR simultaneously in a wound dressing could cause a synergistic effect in the wound repair.

Curcumin Loading on Alginate Nano-Micelle for Anti-Infection and Colonic Wound Healing

Despite the antibacterial, and anti-inflammatory properties of curcumin (C), its effect on wound healing, especially in the colorectal, is ambiguous. Moreover, due to the hydrophobic properties of C, its use is limited. Therefore, to reduce the bioavailability challenge and improve the transfer to colon area, we designed a C-alginate-based nano-micelle (C-A-NM). After fabrication of C-A-NM (55.5 nm) and physicochemical studies with the TEM, DLS and XRD, the C release rate based on gastrointestinal state was evaluated. Furthermore, the effects of C-A-NM on the survival of HCT-8 cells at 24 and 48 hours by MTT method and its antibacterial effects were also evaluated. To explain the effects of wound healing in rats, in addition to colonoscopy on the 14th-day, the repaired tissue on the 7th and 14th days were examined by Hematoxylin and Eosin method. Also, for evaluating wound healing in the colon, the protein/collagen concentration, and TGFβ1/NFκB gene expression were determined. The results of C cumulative release showed that the NM allows the drug to be loaded in the colon in a favourable manner. Also, the toxicity outputs revealed that C-A-NM at a concentration of 7.5 mg had no negative effects on cell viability. While the activity of Staphylococcus aureus, Pseudomonas aeruginosa and Escherichia coli, bacteria decreased based on the minimum inhibitory concentration value with 153, 245 and 319 (μg/mL). The use of C-A-NM not only increases protein and collagen in damaged sites, but also increases TGFβ1 expression in contrast to NFκB. Based on these results, and the results of histopathology and colonoscopy, it was found that C-A-NM accelerates the healing of damaged areas. Overall, the results show that the use of C-A-NM can significantly accelerate the healing of wounds in the gastrointestinal tract based on collagen induction and reduced bacterial activity.