Insights into the mechanisms of diabetic wounds: pathophysiology, molecular targets, and treatment strategies through conventional and alternative therapies

Diabetes mellitus is a prevalent cause of mortality worldwide and can lead to several secondary issues, including DWs, which are caused by hyperglycemia, diabetic neuropathy, anemia, and ischemia. Roughly 15% of diabetic patient's experience complications related to DWs, with 25% at risk of lower limb amputations. A conventional management protocol is currently used for treating diabetic foot syndrome, which involves therapy using various substances, such as bFGF, pDGF, VEGF, EGF, IGF-I, TGF-β, skin substitutes, cytokine stimulators, cytokine inhibitors, MMPs inhibitors, gene and stem cell therapies, ECM, and angiogenesis stimulators. The protocol also includes wound cleaning, laser therapy, antibiotics, skin substitutes, HOTC therapy, and removing dead tissue. It has been observed that treatment with numerous plants and their active constituents, including Globularia Arabica, Rhus coriaria L., Neolamarckia cadamba, Olea europaea, Salvia kronenburgii, Moringa oleifera, Syzygium aromaticum, Combretum molle, and Myrtus communis, has been found to promote wound healing, reduce inflammation, stimulate angiogenesis, and cytokines production, increase growth factors production, promote keratinocyte production, and encourage fibroblast proliferation. These therapies may also reduce the need for amputations. However, there is still limited information on how to prevent and manage DWs, and further research is needed to fully understand the role of alternative treatments in managing complications of DWs. The conventional management protocol for treating diabetic foot syndrome can be expensive and may cause adverse side effects. Alternative therapies, such as medicinal plants and green synthesis of nano-formulations, may provide efficient and affordable treatments for DWs.

Anticancer Activity of Rhizophora mucronata Leaves Extract on Sprague-Dawley Rats: In Vivo Model

Medicinal plants are now used to treat cancer due to the presence of bioactive compounds. Apart from the plants, mangroves also possess rich bioactive compounds with high medicinal activity. Based on the ethnobotanical attributes of Rhizophora mucronata, we are keen to work with its anticancer activity. The aim of the study is to assess the anticancer activity of methanolic extract of Rhizophora mucronata leaves against breast cancer. Its safety profile for anticancer investigations was therefore confirmed through an acute toxicity assessment. In accordance with OECD guiding principles, the study was approved to evaluate the toxicity, including acute and subacute effects and anticancer activities of methanolic extract of Rhizophora mucronata leaves on Sprague-Dawley rats. In acute toxicity trials, the dose of 1000 mg/kg body weight was determined to be safe and nontoxic even at high dose levels and did not result in any indicators of toxicity or death in the tested groups compared to controls for 14 days. In contrast, rats in a subacute toxicity study were given consistent doses of 100 mg/kg, 200 mg/kg, and 300 mg/kg for a total of 28 days along with a control group. Haematological, biochemical, and histological tests conducted in advance revealed that methanolic extract of Rhizophora mucronata leaves (MERML) at repeated doses of 200 mg/kg and 300 mg/kg was normal and had no significant effects on the treated groups. Rhizophora mucronata extract (250 mg/kg) was successfully used in in vivo trials to stop the growth of breast cancer cells in groups that had been given DMBA. Based on these findings, it has been concluded that methanolic extract of Rhizophora mucronata leaves (MERML) was safe at both higher and lower dosages and could be assessed for pharmacological study.

Modulatory effect of caffeic acid in alleviating diabetes and associated complications

Diabetes mellitus (DM) is one of the most common metabolic disorders characterized by elevated blood glucose levels. Prolonged uncontrolled hyperglycemia often leads to multi-organ damage including diabetic neuropathy, nephropathy, retinopathy, cardiovascular disorders, and diabetic foot ulcers. Excess production of free radicals causing oxidative stress in tissues is often considered to be the primary cause of onset and progression of DM and associated complications. Natural polyphenols can be used to induce or inhibit the expression of antioxidant enzymes such as glutathione peroxidase, heme oxygenase-1, superoxide dismutase, and catalase that are essential in maintaining redox balance, and ameliorate oxidative stress. Caffeic acid (CA) is a polyphenolderived from hydroxycinnamic acid and possesses numerous physiological properties includ-ing antioxidant, anti-inflammatory, anti-atherosclerotic, immune-stimulatory, cardioprotective, antiproliferative, and hepatoprotective activities. CA acts as a regulatory compound affecting numerous biochemical pathways and multiple targets. These include various transcription factors such as nuclear factor-B, tumor necrosis factor-α, interleukin-6, cyclooxygenase-2, and nuclear factor erythroid 2-related factor 2. Therefore, this review summarizes the pharmacological properties, molecular mechanisms, and pharmacokinetic profile of CA in mitigating the adverse effects of DM and associated complications. The bioavailability, drug delivery, and clinical trials of CA have also been discussed.

Eco-physiological response of secondary metabolites of teas: Review of quality attributes of herbal tea

Herbal tea is a rich source of secondary metabolites which are reputed to have medicinal and nutritional efficacy. These secondary metabolites are influenced by the abiotic and biotic stresses that improve the production of herbal teas in terms of biomass production, accumulation and partitioning of assimilates of compounds. In this study, various examples of herbal teas have been shown to respond differently to secondary metabolites affected by environmental factors. Thus, the meta-analysis of this study confirms that different herbal teas' response to environmental factors depends on the type of species, cultivar, and the degree of shade that the plant is exposed. It is also evident that the metabolic processes are also known to optimize the production of secondary metabolites which can thus be achieved by manipulating agronomic practices on herbal teas. The different phenolic compound in herbal teas possesses the antioxidant, antimicrobial, antiatherosclerosis, anti-inflammatory, antimutagenic, antitumor, antidiabetic and antiviral activities that are important in managing chronic diseases associated with lifestyle. It can be precluded that more studies should be conducted to establish interactive responses of biotic and abiotic environmental factors on quality attributes of herbal teas.

ELECTROSPUN SODIUM ALGINATE/POLY(ETHYLENE OXIDE) NANOFIBERS FOR WOUND HEALING APPLICATIONS: CHALLENGES AND FUTURE DIRECTIONS

Alginate is an interesting natural biopolymer to be considered for biomedical applications due to its advantages and good biological properties. These biological properties make electrospun alginate nanofibers suitable for various uses in the biomedical field, such as wound healing dressings, drug delivery systems, or both. Unfortunately, the fabrication of alginate nanofibers by electrospinning is very challenging because of the high viscosity of the solution, high surface tension and rigidity in water due to hydrogen bonding, and also their diaxial linkages. This review presents an overview of the factors affecting the electrospinning process of sodium alginate/poly(ethylene oxide) (SA/PEO), the application of SA/PEO in drug delivery systems for wound healing applications, and the degradation and swelling properties of SA/PEO. The challenges and future directions of SA/PEO in the medical field are also discussed.

Preliminary studies of Volten VR4® Kaempferia parviflora herb extracts on blood glucose levels in human type-2 diabetes mellitus and its mineral element analysis

Introduction

Volten VR4® capsules containing herb extract of Kaempferia parviflora has been claimed to reduce blood glucose in patients with diabetes.

Objectives

This preliminary study is conducted to evaluate the efficacy of Volten VR4® on healthy individuals and type-2 diabetes mellitus volunteers. The extracts of 400 mg capsules of Kaempferia parviflora (KP) were used to measure the blood glucose level of 2-hour postprandial.

Methods

The healthy group consists of 15 young adults aged 20-30 with no history of serious diseases, while the diabetic group includes 12 individuals aged 35-75 diagnosed with type-2 diabetes mellitus. Data were validated through the Willcoxon and Friedman test statistics and error distribution. The investigation was continued to trace the capsules contents of elements using inductively coupled plasma optical emission spectrometry (ICP-OES) techniques.

Results

It has been shown that KP reducing blood sugar levels has been associated with flavonoids and methoxyflavones components. The result specifically showed that consuming VR4® capsules can significantly reduce blood glucose, either at the state of fasting or postprandially. In the study the content of mineral and heavy metal elements in VR4® capsules has been evaluated.

Conclusion

Volten VR4® Kaempferia parviflora extract is safe to be consumed at a single dose of 400 mg. The study also has shown that the participants are free from adverse reactions and hypoglycaemia.