Evolution of radiation-induced dermatitis treatment

Radiation-induced skin damage (RID) is the most prevalent, significant side effect of radiotherapy (RT). Nearly 95% of patients experience moderate to severe skin reactions after receiving radiation therapy. However, criteria for acute radiation dermatitis (ARD) treatment remain unavailable. Topical agents with anti-inflammatory properties may protect the skin and facilitate tissue regeneration in patients with RID. Many of these topical agents function through nuclear factor kappa B pathway regulation. They either reduce the levels of inflammatory factors or elicit anti-inflammatory properties of their own, thus preventing oxidative stress and inflammatory responses and thus enabling RID prevention and management. Herein, we explore the 25 topical agents investigated for RID prevention and management thus far and evaluate their mechanisms of action. These agents include 11 natural agents, 3 miscellaneous agents, 9 topical nonsteroidal agents, and 2 topical corticosteroids.

Cold pressed Pinus halepensis Mill. seed oil for potential health applications: Analgesic, anti-inflammatory effects, and assessment of inflammatory mediators by RT-qPCR in skin wound healing

ETHNOPHARMACOLOGICAL RELEVANCE

Pinus halepensis Mill. seed (Pinaceae), commonly known as "Zgougou," is widely consumed in the Mediterranean region and has long been used to treat diseases including bronchitis, rheumatism, infection, and inflammation.

AIM OF THE STUDY

The present study was focused on the investigation of some pharmacological activities, such as analgesic, anti-inflammatory, and wound healing effects, of cold-pressed oil of Pinus halepensis Mill. seed (COPHS).

MATERIALS AND METHODS

The fixed oil of Pinus halepensis seed was extracted by a cold pressing process. The analgesic activity of COPHS was examined by acetic acid and formalin-induced contortion and pain tests. The anti-inflammatory effects were evaluated in carrageenan and formalin induced paw and ear edema models. Wound healing potential was assessed on an experimental skin wound, and the expression levels of inflammation mediators were determined by RT-qPCR in skin wound healing.

RESULTS

The results showed analgesic efficacy through significant inhibition of abdominal cramps (59.15%) and pain (75.91%). In addition, this oil exerted an anti-inflammatory effect by inhibiting ear (62.25%) and paw (70.00%) edema. The COPHS stimulated wound contraction in experimental skin wound healing with a contraction rate of 89.23% with notable reduction of TNF-α and NF-kB expression levels in the treated groups.

CONCLUSIONS

This study provided for the first time the pharmacological profile, particularly the analgesic, anti-inflammatory, and healing effects, of fixed oil extracted by cold pressing from the seed of Pinus halepensis Mill.

Preliminary evaluation of haemostatic and wound healing potential of Heliotropium europaeum

Heliotropium europaeum has been traditionally used to stop bleeding and accelerate scarring. This study provides a scientific evaluation of H. europaeum haemostatic and healing potential. To evaluate the haemostatic effect of H. europaeum, the time of bleeding of fresh wounds induced experimentally in rats was studied. Excision wounds were induced upon four groups; each one contains six rats to estimate the healing properties of wounds. Group 1 was assigned as control (not treated), group 2 was daily treated with H. europaeum leaf powder, group 3 was treated with H. europaeum every 6 days and group 4 was treated with a reference drug, an emulsion containing 10% of Mimosa tenuiflora extract. All the parameters were significantly tested (p < 0.05) with comparison to a group control. The use of H. europaeum significantly shortened the bleeding time. The rats which were daily treated with H. europaeum healed in 12 days. This time period was significantly shorter than the control groups. Wound excision was uniformly induced randomly on the dorsum of rats in 4 groups (tested support and control). The post-healing biopsies were histologically assessed, revealed a better healing quality, and continued complete tissue regeneration, abundant and well-organized network of collagen fibres, and low numbers of inflammatory cells. The experimental data revealed that H. europaeum displayed remarkable haemostatic and wound healing activities.

Concept of Unani Jali (detergents/cleansers) drugs and its scientific validation: scope for new opportunities in dermatological pharmacotherapeutics

OBJECTIVES

The use of detergent-action drugs in traditional Unani therapeutic intervention has been a long-standing Unani medicinal practice. The key aim of the article is to provide thorough information on the novel, unexplored idea of Unani Jali (detergent/cleansers) drugs for the treatment of skin ailments, as well as to identify medicinal plants that have detergent action and correlate these findings with scientific studies that may support evidence for the drug's detergent effect.

CONTENT

The ethnobotanical classical literature of Unani medicine was investigated in order to have a comprehensive insight of Unani detergents/cleansers. Scientific studies were carried from databases including PubMed, Scopus, Science Direct, and google Scholar, among others. More than fifty exclusive plant, mineral, and animal-based detergents are found specifically for skin disorders in Unani therapy. These drugs basically evacuate impurities from the body's excretory system and and have been found to have keratolytic and debris-peeling effects, as well as the ability to maintain skin tone consistency. Unani Jali drugs have also been found to have anti-inflammatory, antibacterial, analgesic, and tonic properties, suggesting its usefulness holistically.

SUMMARY AND OUTLOOK

Based on phyto constituents, prospective therapeutic response, and scientific data, this review proposes that Unani Jali drugs could be a safe and promising therapeutic option for dermatological illnesses such as vitiligo, acne, dermatitis, psoriasis, and skin sensitivity.

Investigation on wound healing effect of Mediterranean medicinal plants and some related phenolic compounds: A review

ETHNOPHARMACOLOGICAL RELEVANCE

The human skin constitutes a biological barrier against external stress and wounds can reduce the role of its physiological structure. In medical sciences, wounds are considered a major problem that requires urgent intervention. For centuries, medicinal plants have been used in the Mediterranean countries for many purposes and against wounds.

AIM OF THIS REVIEW

Provides an outlook on the Mediterranean medicinal plants used in wound healing. Furthermore, the wound healing effect of polyphenolic compounds and their chemical structures are also summarized. Moreover, we discussed the wound healing process, the structure of the skin, and the current therapies in wound healing.

MATERIALS AND METHODS

The search was performed in several databases such as ScienceDirect, PubMed, Google Scholar, Scopus, and Web of Science. The following Keywords were used individually and/or in combination: the Mediterranean, wound healing, medicinal plants, phenolic compounds, composition, flavonoid, tannin.

RESULTS

The wound healing process is distinguished by four phases, which are respectively, hemostasis, inflammation, proliferation, and remodeling. The Mediterranean medicinal plants are widely used in the treatment of wounds. The finding showed that eighty-nine species belonging to forty families were evaluated for their wound-healing effect in this area. The Asteraceae family was the most reported family with 12 species followed by Lamiaceae (11 species). Tunisia, Egypt, Morocco, and Algeria were the countries where these plants are frequently used in wound healing. In addition to medicinal plants, results showed that nineteen phenolic compounds from different classes are used in wound treatment. Tyrosol, hydroxytyrosol, curcumin, luteolin, chrysin, rutin, kaempferol, quercetin, icariin, morin, epigallocatechin gallate, taxifolin, silymarin, hesperidin, naringin, isoliquiritin, puerarin, genistein, and daidzein were the main compounds that showed wound-healing effect.

CONCLUSION

In conclusion, medicinal plants and polyphenolic compounds provide therapeutic evidence in wound healing and for the development of new drugs in this field.

Lawsonia inermis Extract-Loaded Cellulose Acetate Nanofibrous Wound Dressings Alleviate Wound Inflammation Through PI3K/AKT/NFκB Signaling Pathway: A Preclinical Investigation

In this research, we aimed to combine the principles of herbal medicine and tissue engineering to develop a bioactive wound dressing. The nanofibrous scaffolds were produced via electrospinning of cellulose acetate/Lawsonia inermis extract (LIE) solution. The developed constructs were studied regarding their interaction with fibroblast cells and their various physicochemical and biological properties. The wound healing potential of the prepared dressings was studied on a rat model skin wound. In vitro studies showed that cellulose acetate scaffolds loaded with 3% LIE had the highest cell protection capacity under oxidative stress and promoted the fibroblast cells proliferation. Therefore, this group was used for wound healing assay. In vivo study showed that LIE-loaded wound dressings had the highest epithelial thickness, collagen deposition, and angiogenesis scores. Gene expression analysis showed that wounds treated with cellulose acetate/LIE wound dressings upregulated VEGF, b-FGF, and collagen type 2 genes. While, NFK-β and TNF-a genes expressions were significantly reduced by these dressings. This study implies that local delivery of LIE via cellulose acetate scaffolds can alleviate inflammation and increase the expression of pro-healing genes.

Wound healing properties of green (using Lawsonia inermis leaf extract) and chemically synthesized ZnO nanoparticles in albino rats

Wound healing is one of the utmost medical issues in human and veterinary medicine, which explains the urgent need for developing new agents that possess wound healing activities. The present study aimed to assess the effectiveness of green and chemical zinc oxide nanoparticles (ZnO-NPs) for wound healing. ZnO-NPs (green using Lawsonia inermis leaf extract and chemical) were synthesized and characterized by X-ray powder diffraction (XRD), Fourier transform infrared (FTIR) spectroscopy, and high-resolution transmission electron microscopy (HRTEM). The gels containing the nanomaterials were prepared and inspected. Forty-five albino rats were divided into three groups, the control group was treated with normal saline 0.9%, and the other two groups were treated with gels containing green or chemical ZnO-NPs, respectively. On the 3^rd, 7^th, 14^th, and 21^st days post-treatment (PT), the wounds were clinicopathologically examined. Both nanomaterials have good crystallinity and high purity, but green ZnO-NPs have a longer nanowire length and diameter than chemical ZnO-NPs. The formed gels were highly viscous with a pH of 6.5 to 7. The treated groups with ZnO-NP gels showed clinical improvement, as decreased wound surface area (WSA) percent (WSA%), increased wound contraction percent (WC%), and reduced healing time (p < 0.05) when compared with the control group. The histological scoring showed that the epithelialization score was significantly higher at the 21^st day post-treatment in the treated groups than in the control group (p < 0.05), but the vasculature, necrosis, connective tissue formation, and collagen synthesis scores were mostly similar. The green and chemical ZnO-NP gels showed promising wound healing properties; however, the L. inermis-mediated ZnO-NPs were more effective.

Synergistic Antimicrobial Effect of Lactiplantibacillus plantarum and Lawsonia inermis Against Staphylococcus aureus

Purpose

The developed resistance of pathogenic microorganisms towards the currently used antimicrobial agents requires the fast search for newer potent antimicrobials. One of the most important ways to combat the previously mentioned disaster is the use of natural alternatives like medicinal plants. Our study aimed to estimate the anti-inflammatory property, and antibacterial effects of probiotics Lactiplantibacillus plantarum and ethanol extracts of Lawsonia inermis leaves against Staphylococcus aureus when they were used separately or collectively as synergism.

Material and Methods

Experimentally induced infected wound model in mice was created and divided into 10 groups then treated for two days by L. plantarum and L. inermis individually or in combination, followed by biochemical assays. The antibacterial, anti-inflammatory, and wound healing activity were evaluated through histopathological sections taken before and after treatment.

Results

Our results revealed that L. plantarum and L. inermis mixture could inhibit growth of S. aureus and decrease the minimal inhibitory concentration (MIC) of L. plantarum to 2 mg/mL. The mixture decreased level of both interleukin 6 (IL-6) and interferon-alpha (TNF-α) to a level near the normal uninfected group. Histopathological study showed that animals treated with both L. plantarum and L. inermis had achieved almost 90% healing.

Conclusion

These results suggest that L. plantarum and L. inermis mixture has synergistic effect on healing of infected wound.

Biological fabrication and electrostatic attractions of new layered silver/talc nanocomposite using Lawsonia inermis L. and its chitosan-capped inorganic/organic hybrid: Investigation on acceleration of Staphylococcus aureus and Pseudomonas aeruginosa infected wound healing

In the present study, new-layered inorganic/organic hybrid of silver/talc nanocomposites (Ag/Tlc-NPs) and its chitosan-capped derivative (Ag/Tlc/Csn NCs) were biochemically synthesized utilizing Lawsonia inermis L. extract. The silver nanoparticles (Ag NPs) were synthesized employing green method on the exterior surface layer of talc mineral as a solid substrate. The negatively charged surface layer of talc might function as templates and can attract the chitosan cations from a solution to yield a layered hybrid structure, whose inorganic phase is formed by Si-O-Ag bonds. Our results revealed that Ag NPs were formed on the exterior surface of talc with a diameter with size of 124-215 nm. In addition, cytotoxicity, in vitro antibacterial activity, and clinical effects of wound-healing ointments containing talc were investigated. The results implied the successful synthesis of Ag/Tlc/Csn NCs using the extract. The structures were safe up to 0.50 mg/mL. In vitro studies confirmed antioxidant and antibacterial properties of Ag/Tlc/Csn NCs. In sum, our findings showed that the ointments improve wound healing process by inducing an anti-inflammatory M2 phenotype and bFGF, CD206, collagen1A, and IL-10 production that causes fibroblast migration and wound closure through influencing M2 macrophage. Ag/Tlc/Csn is suggested to be taken into consideration as a medical combination for improving infected wound healing and as a promising agent for clinical administration.

The Role of Allium subhirsutum L. in the Attenuation of Dermal Wounds by Modulating Oxidative Stress and Inflammation in Wistar Albino Rats

In our study, Allium subhirsutum L. (AS) was investigated to assess its phenolic profile and bioactive molecules including flavonoids and organosulfur compounds. The antioxidant potential of AS and wound healing activity were addressed using skin wound healing and oxidative stress and inflammation marker estimation in rat models. Phytochemical and antiradical activities of AS extract (ASE) and oil (ASO) were studied. The rats were randomly assigned to four groups: group I served as a control and was treated with simple ointment base, group II was treated with ASE ointment, group III was treated with ASO ointment and group IV (reference group; Ref) was treated with a reference drug "Cytolcentella® cream". Phytochemical screening showed that total phenols (215 ± 3.5 mg GAE/g) and flavonoids (172.4 ± 3.1 mg QE/g) were higher in the ASO than the ASE group. The results of the antioxidant properties showed that ASO exhibited the highest DPPH free radical scavenging potential (IC50 = 0.136 ± 0.07 mg/mL), FRAP test (IC50 = 0.013 ± 0.006 mg/mL), ABTS test (IC50 = 0.52 ± 0.03 mg/mL) and total antioxidant capacity (IC50 = 0.34 ± 0.06 mg/mL). In the wound healing study, topical application of ASO performed the fastest wound-repairing process estimated by a chromatic study, percentage wound closure, fibrinogen level and oxidative damage status, as compared to ASE, the Cytolcentella reference drug and the untreated rats. The use of AS extract and oil were also associated with the attenuation of oxidative stress damage in the wound-healing treated rats. Overall, the results provided that AS, particularly ASO, has a potential medicinal value to act as effective skin wound healing agent.

Snail Soothing and Repairing Cream Improves Skin Hydration after Ablative Fractional CO2 Laser: A Split-Face Randomized Double-Blinded Placebo-Controlled Trial

BACKGROUND

Ablative fractional carbon dioxide laser (AFCO2) resurfacing causes transient skin barrier disruption characterized by decreased skin hydration and increased transepidermal water loss (TEWL). Snail Soothing and Repairing (SSR) cream, containing several glycoproteins with potential antimicrobial and antioxidant effects, may benefit skin hydration promotion after the laser treatment.

OBJECTIVE

To evaluate the efficacy and safety of SSR cream in skin hydration promotion after AFCO2 resurfacing.

METHOD

The study was a double-blinded, split-face, placebo-controlled trial in participants aged 18-50 years with atrophic acne scars on both cheeks. After AFCO2 resurfacing, participants applied the product or placebo on either cheek twice daily for 14 days. Corneometry, TEWL, colorimetry, and clinical assessments (edema, erythema, crusting, pruritus, and tightness score) were evaluated at baseline, day 7, and day 14 after AFCO2 resurfacing.

RESULTS

From 22 participants in the study, the SSR cream-treated sides showed significantly higher corneometry levels than placebo-treated sides at day 14 (p = 0.033), while TEWL and colorimetry levels were not different at any study visits. Pruritus and tightness scores of the SSR side were lower, but not significant, than the placebo. Other clinical assessments (edema, erythema, and crusting) showed similar results. No significant adverse events took place.

CONCLUSION

The SSR cream significantly improved skin hydration, highlighting skin barrier restoration after AFCO2 resurfacing, with a good safety profile.

Synthesis of biological based hennotannic acid-based salts over porous bismuth coordination polymer with phosphorous acid tags

In this paper, a novel porous polymer capable of coordinating to bismuth (PCPs-Bi) was synthesized. The Bi-PCPs was then reacted with phosphorous acid to produce a novel polymer PCPs(Bi)N(CH2PO3H2)2 which is shown to act as an efficient and recyclable catalyst. The mentioned catalyst was applied for the efficient synthesis of new mono and bis naphthoquinone-based salts of piperidine and/or piperazine via the reaction of hennotannic acid with various aldehydes, piperidine and/or piperazine, respectively. The structure of the resulting mono and bis substituted piperazine or piperidine-based naphthoquinone salts was thoroughly characterized spectroscopically. The electrochemical behavior of the products was also investigated. The presented protocol has the advantages of excellent yields (82-95%), short reaction times (4-30 min) and simple work-up.

The effect of henna and linseed herbal ointment blend on wound healing in rats with second-degree burns

The treatment of skin burns is one of the most important challenge in medical science. The aim of this study is evaluation of the efficacy of Artaderm herbal ointment containing the Henna (Lawsonia inermis) extract, Linseed (Linum usitatissimum) oil, and Honey Wax on wound healing in the rat with second-degree burn wounds. The Artaderm ointment had an effective role in controlling burn wound infections due to its antimicrobial and anti-inflammatory properties. In this study, 64 male Wistar rats were randomly divided into 8 groups (n = 8). Four groups received Artaderm, 1% Silver Sulfadiazine (SSD 1%), Cod Liver Oil and Fundermol (Alpha) ointments which used in common practices for burn injuries. Another three groups received Henna, Linseed, and Honey Wax alone and a control group that just underwent a second-degree burn injury without any treatments. A second-degree burn was formed on the back of each rat and dressed daily with one of the agents. Burn wounds were macroscopically and microscopically evaluated on the 7th, 14th, and 21st day after burn induction. Rats treated with the Artaderm ointment had significantly faster wound contraction as well as shorter healing time than the rest groups. No scar was observed in rats treated with the Artaderm ointment on the 21st day, while this level of improvement was not observed in other groups at the same time. More than 90% of wounds were healed after on the 14th day in rats treated with Artaderm (94.10 ± 0.18) and Alpha (92.05 ± 0.23) ointments. According to these findings, it can be concluded that Artaderm herbal ointment can be used as a proper alternative for healing of wounds in second-degree burns.