Formulation and evaluation of herbal gel of Pothos scandens Linn

ObjectiveTo formulate Pothos scandens Linn (P. scandens) leaf extract in to a gel and investigate their burn wound healing activity.MethodsEthanolic extract of dried leaves of P. scandens were subjected to priliminery phytochemical evaluation and wound healing activities studies. Different gel formulations of ethanolic extract of P. scandens (4% w/v) were prepared using polymers carbopol 934 and carbopol 940 by varying their concentration. These formulations were evaluated for physical parameters, drug content, pH, viscosity, extrudability, spreadability, primary skin irritation, pharmacological activity and stability.ResultsWound healing studies of ethanolic extract revealed that P. scandens treated animals were found to epithelise in 22 days while the solvent control and the untreated rats epithelise within 35 and 40 days respectively. The formulation with 1.5% w/w carbopol 934 was found to be more promising as it shows better physicochemical characteristics, higher pharmacological activity and stability compared to other formulations.ConclusionsP. scandens alcoholic extract shows significant improvement in burn wound contraction and hence this is a promising candidate in burn wound healing.     

Collagen-Carboxymethylcellulose Biocomposite Wound-Dressings with Antimicrobial Activity

Microbial infections associated with skin diseases are frequently investigated since they impact on the progress of pathology and healing. The present work proposes the development of freeze-dried, glutaraldehyde cross-linked, and non-cross-linked biocomposite dressings with a porous structure, which may assist the reepithelization process through the presence of collagen and carboxymethylcellulose, along with a therapeutic antimicrobial effect, due to silver nanoparticles (AgNPs) addition. Phisyco-chemical characterization revealed the porous morphology of the obtained freeze-dried composites, the presence of high crystalline silver nanoparticles with truncated triangular and polyhedral morphologies, as well as the characteristic absorption bands of collagen, silver, and carboxymethylcellulose. In vitro tests also assessed the stability, functionality, and the degradability rate of the obtained wound-dressings. Antimicrobial assay performed on Gram-negative (Escherichia coli), Gram-positive (Staphyloccocus aureus) bacteria, and yeast (Candida albicans) models demonstrated that composite wound dressings based on collagen, carboxymethylcellulose, and AgNPs are suitable for skin lesions because they prevent the risk of infection and have prospective wound healing capacity. Moreover, the cell toxicity studies proved that the obtained materials can be used in long time treatments, with no cytotoxic effects.     

Evaluation of wound healing and antimicrobial potentials of Ixora coccinea root extract

ObjectiveTo evaluate the wound healing and antimicrobial activity of root extracts of Ixora coccinea (I. coccinea).MethodsTo investigate the wound healing efficacy of root extract of I. coccinea Linn, five groups of animals were divided each containing six animals. Two wound models including incision and excision wound models were used in this study. The parameters studied were tensile strength on incision wound model and in terms of wound contraction for excision wound model were compared with standard Nitrofurazone (NFZ) ointment (0.2% w/w). Six extracts (ethanol, aqueous, petroleum ether, benzene, chloroform and ethyl acetate) of I. coccinea were screened for in vitro growth inhibiting activity against different bacterial strains viz, Staphylococcus aureus, Bacillus pumilius, Enterococcus faecalis, Escherichia coli, Salmonella typhi and Pseudomonas aeruginosa and fungi Candida albicans and Aspergillus niger were compared with the standard drugs ciprofloxacin and chloramphenicol for antibacterial and griseofulvin for antifungal screening. The serial dilution and cup (or) well plate methods were used for the antimicrobial study and MIC was determined.ResultsThe ethanolic extract showed significant (P<0.001) wound healing activity when compared to standard drug NFZ with respect to normal control group. Amongst all, ethanolic extract showed highly significant antibacterial activity against all bacterial strains used in this study when compared to standard. The aqueous extract showed moderate significant inhibition against all bacterial strains when compared to standard. All the extracts were shown negligible activity against the fungal strains used in this study.ConclusionsThe ethanolic root extract of I. coccinea showed pronounced wound healing and antibacterial activity. The probable reason to heal the wound was that the external application of the extract prevented the microbes to invade through the wound thus the protection of wound occurs against the infection of the various organisms.     

Tumor tissue derived extracellular vesicles promote diabetic wound healing

The diabetic wound nowadays remains a major public health challenge, which is characterized by overproduced reactive oxygen species (ROS). However, the current therapy for diabetic wounds is limited for reliable data in the general application. The growth of tumors has been revealed to share parallels with wound healing. Extracellular vesicles (EVs) derived from breast cancer have been reported to promote cell proliferation, migration and angiogenesis. The tumor tissue-derived EVs (tTi-EVs) of breast cancer performance a feature inheritance from original tissue and might accelerate the diabetic wound healing. We wonder whether the tumor-derived EVs are able to accelerate diabetic wound healing. In this study, tTi-EVs were extracted from breast cancer tissue via ultracentrifugation and size exclusion. Subsequently, tTi-EVs reversed the H₂O₂-induced inhibition of fibroblast proliferation and migration. Moreover, tTi-EVs significantly accelerated wound closure, collagen deposition and neovascularization, and finally promoted wound healing in diabetic mice. The tTi-EVs also reduced the level of oxidative stress in vitro and in vivo. Besides, the biosafety of tTi-EVs were preliminarily confirmed by blood tests and morphological analysis of major organs. Collectively, the present study proves that tTi-EVs can suppress oxidative stress and facilitate diabetic wound healing, which puts forward a novel function of tTi-EVs and provides potential treatment for diabetic wounds.     

Effect of Phyllanthus niruri. Linn on burn wound in rats

ObjectiveTo evaluate the effect of ethanolic extract of Phyllanthus niruri. Linn (Euphorbiaceae) on experimentally induced burn wound model in rats and to evaluate whether it reverses the wound healing in steroid suppressed rats.MethodsTwo models including burn wound model and dexamethasone suppressed burn wound model were used in the study. The formulations of ethanolic extract of Phyllanthus niruri were prepared in gum acacia at 8% and in ointment base at 10% and were administered orally (400 mg/kg) and externally respectively. The parameters studied were the wound contraction and the period of epithelialisation.ResultsIn burn wound model, oral and topical administration of Phyllanthus niruri did not show any significant effects in wound contraction and period of epithelialisation when compared to control. In dexamethasone suppressed burn wound model, wound contraction rate was increased significantly by topical (P < 0.001) and oral (P < 0.001) administrations of Phyllanthus niruri by about 47.57% and 26.16% respectively. Topical administration has shown significant (P < 0.05) enhancement of wound contraction than oral dosage form. Dexamethasone depressed epithelialisation period was reversed significantly by topical (P < 0.0001) and oral (P <0.001) administrations of Phyllanthus niruri by about 32.5% and 21.3% respectively.ConclusionsBoth topical and oral administrations of ethanolic extract of Phyllanthus niruri are found to reverse dexamethasone suppressed burn wound healing.     

Energy Utilization of Torrefied Residue from Wine Production

A significant amount of waste is generated in the food industry, which is both an environmental and an economic problem. The recycling of this waste has become an important area of research. The processing of grapes produces 20–30% of the waste in the form of grape pomace and stalks. This article assesses the fuel values of these materials before and after torrefaction. The input materials were grape pomace samples from the varieties Riesling (Vitis vinifera “Welschriesling”) and Cabernet Sauvignon (Vitis vinifera “Cabernet Sauvignon”) from the South Moravia region and stalks from the variety Welschriesling. The torrefaction process was performed using a LECO TGA 701 thermogravimetric analyzer under nitrogen atmosphere at set temperatures of 225 °C, 250 °C, and 275 °C. The residence time was 30 min. Elemental analysis, calorific value, and gross calorific value were determined for all samples. The analyses show a positive effect of torrefaction on fuel properties in the samples. Between temperatures 250 °C and 275 °C, the carbon content increased by 4.29 wt.%, and the calorific value increased with the increase in temperature reaching a value of 25.84 MJ·kg⁻¹ at a peak temperature of 275 °C in the sample grape pomace from blue grapevine.     

Bioactive compound loaded stable silver nanoparticle synthesis from microwave irradiated aqueous extracellular leaf extracts of Naringi crenulata and its wound healing activity in experimental rat model

An efficient and eco-friendly protocol for the synthesis of bioactive silver nanoparticles was developed using Naringi crenulata leaf extracts via microwave irradiation method. Silver nanoparticles were synthesized by treating N. crenulata leaf extracts with 1 mM of aqueous silver nitrate solution. An effective bioactive compound such as alkaloids, phenols, saponins and quinines present in the N. crenulata reduces the Ag⁺ into Ag⁰. The synthesized silver nanoparticles were monitored by UV–vis spectrophotometer and further characterized by X-ray diffraction (XRD), Fourier Transform Infra Red (FTIR), Energy-dispersive X-ray spectroscopy (EDX) and field emission scanning electron microscopy (FESEM). UV–vis spectroscopy showed maximum absorbance at 390 nm due to surface plasmon resonance of AgNPs. From FESEM results, an average crystal size of the synthesized nanoparticle was 72–98 nm. FT-IR results showed sharp absorption peaks and they were assigned to phosphine, alkyl halides and sulfonate groups. Silver nanoparticles synthesized were generally found to be spherical and cubic shape. Topical application of ointment prepared from silver nanoparticles of N. crenulata were formulated and evaluated in vivo using the excision wound healing model on Wistar albino rats. The measurement of the wound areas was performed on 3rd, 6th, 9th, 12th and 15th days and the percentage of wound closures was calculated accordingly. By the 15th day, the ointment base containing 5% (w/w) of silver nanoparticles showed 100% wound healing activity compared with that of the reference as well as control bases. The results strongly suggested that the batch C ointment containing silver nanaoparticles synthesized from the leaf extracts of N. crenulata was found to be very effective in wound repair and encourages harnessing the potentials of the plant biomolecules loaded silver nanoparticle in the treatment of tropical diseases including wound healing.     

Role of collagen hydrolysate in bone and joint disease

OBJECTIVES: To review the current status of collagen hydrolysate in the treatment of osteoarthritis and osteoporosis. METHODS: Review of past and current literature relative to collagen hydrolysate metabolism, and assessment of clinical investigations of therapeutic trials in osteoarthritis and osteoporosis. RESULTS: Hydrolyzed gelatin products have long been used in pharmaceuticals and foods; these products are generally recognized as safe food products by regulatory agencies. Pharmaceutical-grade collagen hydrolysate (PCH) is obtained by hydrolysis of pharmaceutical gelatin. Clinical studies suggest that the ingestion of 10 g PCH daily reduces pain in patients with osteoarthritis of the knee or hip; blood concentration of hydroxyproline is increased. Clinical use is associated with minimal adverse effects, mainly gastrointestinal, characterized by fullness or unpleasant taste. In a multicenter, randomized, doubleblind, placebo-controlled trial performed in clinics in the United States, United Kingdom, and Germany, results showed no statistically significant differences for the total study group (all sites) for differences of mean pain score for pain. There was, however, a significant treatment advantage of PCH over placebo in German sites. In addition, increased efficacy for PCH as compared to placebo was observed in the overall study population amongst patients with more severe symptomatology at study onset. Preferential accumulation of 14C-labeled gelatin hydrolysate in cartilage as compared with administration of 14C-labeled proline has been reported. This preferential uptake by cartilage suggests that PCH may have a salutary effect on cartilage metabolism. Given the important role for collagen in bone structure, the effect of PCH on bone metabolism in osteoporotic persons has been evaluated. Studies of the effects of calcitonin with and without a collagen hydrolysate-rich diet suggested that calcitonin plus PCH had a greater effect in inhibiting bone collagen breakdown than calcitonin alone, as characterized by a fall in levels of urinary pyridinoline cross-links. PCH appeared to have an additive effect relative to use of calcitonin alone. CONCLUSIONS: Collagen hydrolysate is of interest as a therapeutic agent of potential utility in the treatment of osteoarthritis and osteoporosis. Its high level of safety makes it attractive as an agent for long-term use in these chronic disorders.     

Genetic analysis of a mammalian wound-healing trait

Wound healing of mammalian tissue is an essential process in the maintenance of body integrity. The general mechanism of wound healing usually studied in adult mammals is repair, in contrast to the regeneration seen in more primitive vertebrates. We recently have discovered that MRL/MpJ mice, unlike all other strains of mice tested, undergo rapid and complete wound closure that resembles regeneration. Specifically, through-and-through surgical ear hole wounds close without scarring in <4 weeks with normal gross and microanatomic architecture, including chondrogenesis. We also demonstrated that this healing is a heritable trait in inbred mice. In this study, we present results pertaining to its genetic control in progeny segregating for this phenotype. To identify the genetic loci that control the wound closure process, a genome-wide scan was performed on (MRL/MpJ-Fas^lpr × C57BL/6)F2 and backcross populations. In the primary screens of these populations, quantitative trait loci that control the extent of wound closure were detected on chromosomes 8, 12, and 15 and at two separate locations on chromosome 13. Evidence of further genetic control of healing was found on chromosome 7. All alleles that contribute to full wound closure are derived from the MRL/MpJ-Fas^lpr parent except for the quantitative trait locus on chromosome 8, which is derived from C57BL/6.     

Adipose tissue derived mesenchymal stem cell (AD-MSC) promotes skin wound healing in diabetic rats

Aims

Stem cells are a new hope to ameliorate impaired diabetic wound healing. The purpose of this study was to evaluate the effect of adipose tissue derived mesenchymal stem cells (AD-MSCs) on wound healing in a diabetic rat model.

Methods

Twenty-six rats became diabetic by a single intraperitoneal injection of streptozotocin. Six rats served as non-diabetic (non-DM). Diabetic rats were divided into two equal groups randomly; control and treatment. Six weeks later, a full-thickness circular excisional wound was created on the dorsum of each rat. AD-MSCs were injected intra-dermally around the wounds of treatment group. PBS was applied to control and non-DM groups. The wound area was measured every other day. After wound healing completion, full thickness skin samples were taken from the wound sites for evaluation of volume density of collagen fibers, length and volume density of vessels, and numerical density of fibroblasts by stereological methods.

Results

AD-MSCs accelerated wound healing rate in diabetic rats, but did not increase length and volume density of the vessels and volume density of the collagen fibers. AD-MSCs decreased the numerical density of fibroblasts.

Conclusions

We concluded that AD-MSCs enhances diabetic wound healing rate probably by other mechanisms rather than enhancing angiogenesis or accumulating collagen fibers.     

Wound healing effect of flavonoid rich fraction and luteolin isolated from Martynia annua Linn. on streptozotocin induced diabetic rats

ObjectiveTo evaluate wound healing potential of flavonoid fractions of Martynia annua (M. annua) Linn. leaves in diabetic rats on the basis of folkloric information and preliminary study.MethodsThe flavonoid compound luteolin and apigenin were isolated from dried leaves of plant by column chromatography. The two concentrations (0.2% and 0.5% w/w) of luteolin and flavonoid fraction were selected for topically applied as ointment on diabetic wound. The Povidone Iodine Ointment USP was used as a reference. On 18th days, protein content, hydroxyproline and antioxidants (SOD, CAT and GSH) level in granuloma tissues were determined.ResultsThe results showed that, percent wound contraction were observed significantly (P<0.01) greater in MAF fraction and 0.5% w/w of luteolin treatment groups. Presence of matured collagen fibres and fibroblasts with better angiogenesis were observed in histopathological studies.ConclusionsIn conclusion, our findings suggest that flavonoid fraction (MAF) and luteolin (0.5% w/w) may have potential benefit in enhancing wound healing in diabetic condition, possibly due to free-radical scavenging activity of plant.     

Development and Characterization of Active Gelatin Films Loaded with Rapeseed Meal Extracts

The use of industrial waste as a material for the development of natural innovative and active packaging is economically and environmentally appealing. The aim of this study was to develop and characterize active gelatin films incorporating rapeseed oil industry waste. Water (RM-WE) and methanolic (RM-MWE) extracts of rapeseed meal (RM) were used as active agents in film formulations. The active films were produced by a casting technique. The physicochemical, mechanical, optical, morphological, radical scavenging, and antibacterial properties of the films were analyzed. The addition of RM-WE and RM-MWE in the concentrations range between 4 and 12% promoted an increase of Young’s modulus (YM) and radical scavenging properties of films investigated by the direct QUick, Easy, New, CHEap and Reproducible procedure using 2,2-diphenyl-1-picrylhydrazyl (QUENCHER_DPPH) and 2,2′-azino-bis(3-ethylbenzothiazoline-6-sulfonic acid) (QUENCHER_ABTS) radicals. The antibacterial properties of films were examined against five bacterial strains: E. coli, S. enterica, M. luteus, L. monocytogenes, and S. aureus. Additionally, color and opacity of the control and fortified films differed significantly. The gelatin films with RM extracts are resistant to the microbial spoilage and could be used to produce active packaging for food that is vulnerable to rancidity effects.     

Pancreatitis-Associated Protein Inhibits Human Pancreatic Stellate Cell MMP-1 and -2, TIMP-1 and -2 Secretion and RECK Expression

Background/Aims: Pancreatic stellate cells (PSCs) play a key role in fibrogenesis associated with acute and chronic pancreatitis. Pancreatitis-associated protein (PAP), an acute-phase protein, is dramatically upregulated during acute and chronic pancreatitis. Assuming a protective role of PAP, we investigated its effects on human PSCs. Methods: PSCs were obtained by outgrowth from fibrotic human pancreastissue. PAP was expressed in the yeast Pichia pastoris. PAP was added at 10 ng/ml to cultured PSCs. Cell proliferation was determined by bromodeoxyuridine incorporation. PSC migration was assessed by a wound healing assay. Collagen types I and III, fibronectin, matrix metalloproteinases (MMPs), tissue inhibitors of MMPs (TIMPs) and reversion-inducing cysteinerich protein with Kazal motifs (RECK) were demonstrated on protein and mRNA level. Results: PAP had no significant effect on PSC proliferation and migration. Cell-associated fibrillar collagen types I and III and fibronectin increased after addition of PAP to PSCs. PAP diminished the expression of MMP-1 and -2 and TIMP-1 and -2 and their concentrations in PSC supernatants. RECK was detected on the surface of PSCs and its expression was reduced after PAP application. Conclusions: Our data offer new insights into the biological functions of PAP, which may play an important role in wound healing response and cell-matrix interactions.     

From Waste to Healing Biopolymers: Biomedical Applications of Bio-Collagenic Materials Extracted from Industrial Leather Residues in Wound Healing

The biomedical properties of a porous bio-collagenic polymer extracted from leather industrial waste residues have been investigated in wound healing and tissue regeneration in induced wounds in rats. Application of the pure undiluted bio-collagen to induced wounds in rats dramatically improved its healing after 7 days in terms of collagen production and wound filling as well as in the migration and differentiation of keratinocytes. The formulation tested was found to be three times more effective than the commercial reference product Catrix^® (Heal Progress (HP): 8 ± 1.55 vs. 2.33 ± 0.52, p < 0.001; Formation of Collagen (FC): 7.5 ± 1.05 vs. 2.17 ± 0.75, p < 0.001; Regeneration of Epidermis (RE): 13.33 ± 5.11 vs. 5 ± 5.48, p < 0.05).     

Comparative analysis of angiogenic gene expression in normal and impaired wound healing in diabetic mice: effects of extracorporeal shock wave therapy

Impaired wound healing is a persistent clinical problem which has been treated with mixed results. Studies aimed at elucidating the mechanism of impaired wound healing have focused on small cohorts of genes which leave an incomplete picture of the wound healing process. We aimed to investigate impaired wound healing via a comprehensive panel of angiogenic/inflammation-related genes and wound closure kinetics with and without the application of extracorporeal shock wave therapy (ESWT), which has been demonstrated to improve wound healing. Full-thickness skin from the dorsal surface of “normal” (BALB/c) and “impaired” (db ⁺/db ⁺) mice was excised, and wound margin tissue was harvested 2, 7, and 10 days post injury. A separate, but identical wound model was established over 40 days in order to measure wound closure kinetics. Over time, the normal non-ESWT treated wounds exhibited varying patterns of elevated expression of 25–30 genes, whereas wounds with impaired healing displayed prolonged elevated expression of only a few genes (CXCL2, CXCL5, CSF3, MMP9, TGF-α). In response to ESWT, gene expression was augmented in both types of wounds, especially in the expression of PECAM-1; however, ESWT had no effect on wound closure in either model. In addition, multiple doses of ESWT exacerbated the delayed wound healing, and actually caused the wounds to initially increase in size. These data provide a more complete picture of impaired wound healing, and a way to evaluate various promising treatments.     

Efficacy of Water-Soluble Pearl Powder Components Extracted by a CO2 Supercritical Extraction System in Promoting Wound Healing

Pearl powder is a biologically active substance that is widely used in traditional medicine, skin repair and maintenance. The traditional industrial extraction processes of pearl powder are mainly based on water, acid or enzyme extraction methods, all of which have their own drawbacks. In this study, we propose a new extraction process for these active ingredients, specifically, water-soluble components of pearl powder extracted by a CO₂ supercritical extraction system (SFE), followed by the extraction efficiency evaluation. A wound-healing activity was evaluated in vitro and in vivo. This demonstrated that the supercritical extraction technique showed high efficiency as measured by the total protein percentage. The extracts exhibited cell proliferation and migration-promoting activity, in addition to improving collagen formation and healing efficiency in vivo. In brief, this study proposes a novel extraction process for pearl powder, and the extracts were also explored for wound-healing bioactivity, demonstrating the potential in wound healing.     

Matrix proteolytic activity during wound healing: modulation by acute ethanol exposure

Background: Clinical studies demonstrate that intoxicated patients exhibit an increased incidence of wound healing complications. Previous studies in a murine excisional wound model revealed that acute ethanol exposure impairs the wound healing response, causing decreased angiogenesis and a significant reduction in wound collagen content.
Methods: Using the same murine model of excisional wounding, we examined the effect of a single dose of ethanol on the overall collagen content and collagen type I and type III mRNA expression, transforming growth factor- β (TGF- β ) production, and levels of several components of the extracellular matrix proteolytic cascade.
Results: Wounds from ethanol-treated mice exhibited a significant decrease in collagen and in the production of collagen type I mRNA compared with saline controls. Exposure to ethanol also caused significant increase in wound TGF- β by day 2 after injury (1.69 ± 0.29 vs 12.34 ± 3.97 pg/ μ g protein, p <0.01). In addition, wounds from mice exposed to ethanol had significantly increased levels of active urokinase plasminogen activator at day 7, (205.10 ± 48.79 vs 642.70 ± 159.80 pg/ μ g protein, p <0.001). The level of matrix metalloproteinase-8, a collagen type I proteinase, was 2.2-fold higher in wounds of ethanol-treated mice compared with control at day 7 ( p <0.05).
Conclusions: These studies demonstrate that a single dose of ethanol decreases collagen production, increases the production of TGF- β and increases levels of matrix degrading enzymes. This alteration in protease balance may partially explain the impaired wound healing that follows acute alcohol intoxication.     

Effect of topical nitric oxide donor (0.2 % glyceryl trinitrate) on wound healing in diabetic wistar rats

Cutaneous wound healing activity of 0.2 % glyceryl trinitrate (GTN) ointment was evaluated in diabetic wistar rats. Streptozotocin (STZ)-induced diabetic rats were divided in four groups (N?=?6) and anaesthetized by ketamine 75 mg/kg and xylazine 10 mg/kg. Two groups were operated for excision wound (EW). One group served as control and another as 0.2 % GTN ointment treatment group. EW groups were studied for wound closure rate and re-epithelization. Remaining two groups were divided into control and treatment group. Rats in these two groups were inflicted with incision wound (IW) and dead space wound (DW) in the same animal. IWs were studied for wound tensile strength while DWs were studied for granulation tissue weight, hydroxyproline content and histological changes in granulation tissue. EW showed significantly higher re-epithelization in treatment group compared to control (61.10?±?2.98 vs 27.36?±?6.68; P?=?0.01) but there was no difference in wound closure rate between the groups. 0.2 % GTN did not affect tensile strength of IW, granulation tissue weight or hydroxyproline content. This suggests that topical NO does not have any effect on collagen secretion and maturation by fibroblasts in incisional wound model. In conclusion, NO donor may useful in the wounds where wound contraction has a minor role in wound closure e.g., diabetic foot ulcers.     

Healing of diabetic foot ulcers is independently associated with the use of angiotensin receptor blockers but not with those of diuretics and angiotensin conversion enzyme inhibitors

Aim. Dysregulation of the renin angiotensin system (RAS) has been proven in diabetic animal models, and studies in humans show that diuretic use is associated with lower limb amputation in diabetes. While patients with diabetes are often treated with diuretics and RAS blockers, the association between wound healing and these treatments is still unknown. We aimed to determine whether the use of diuretics and RAS blockers could influence healing of diabetic foot ulcers (DFU).Methods. Two hundred seventy-six patients referred to a specialized diabetes foot care unit for a new foot ulcer were included in this retrospective observational study.Results. Healing rate was significantly higher in patients not treated with diuretics than in those receiving diuretics (75.9 vs. 62.9%, P = 0.026) and in patients treated with angiotensin receptor blockers (ARB) than in those not treated with ARB (79.5 vs 64.4%, P = 0.012). The difference was not significant for angiotensin conversion enzyme inhibitor use. ARB use was independently and positively associated with wound healing in a multivariate adjusted model including several factors affecting wound healing (odds ratio (OR) 2.79 [1.13, 6.86] P = 0.025). Diuretic use was negatively associated with wound healing in univariate analysis (OR 0.54 [0.32, 0.91] P = 0.02) but not in multivariate adjusted analysis (OR 0.53 [0.26, 1.10] P = 0.088).Conclusions. This novel study found that ARB use is independently and positively associated with wound healing in 276 patients with DFU. On the contrary, diuretics were associated with healing rate only at univariate analysis. Further prospective studies are needed to confirm our findings.     

Evaluation of the in vivo wound healing potential of the lipid fraction from activated platelet-rich plasma

Abstract

Previous in vitro studies suggest a direct relevance for the peptide–free lipid fraction (LF) of platelet-rich plasma (PRP) in biological mechanisms related to wound healing. However, there are no scientific reports to date on the wound healing activities of this lipid component in vivo. Thus, the present study provides a scientific evaluation for the wound healing potential of the lipid portion of the activated PRP. For the wound healing activity assessment, in vivo full‐thickness excisional wounds were created on the dorsal skin of Sprague-Dawley rats. Lipid extract from pooled PRP was applied topically to the wounds on 0, 3, and 7 days after injury. Histological assessment of epidermal and dermal regeneration, granulation tissue thickness and angiogenesis by Sirius red and Masson’s trichrome staining, in addition to immunohistochemical staining for transforming growth factor beta-1 (TGF-β1), collagen type I (COL I), and collagen type III (COL III) were performed on skin biopsies at 3, 7 and 14 days. The total histological scores of the LF group were significantly higher than the 25% dimethylsulfoxide-control group. According to the immunohistochemical staining, the observed expression changes for TGF-β1, COL I and III at 3, 7, and 14 days after wounding were significantly better in the study group than the control group. Furthermore, COL I/III ratio in the lipid extract-treated group at day 14 was much higher than that of the control group. Meanwhile, analysis of the data also indicated that the LF has less positive effects on all evaluated parameters than PRP. From the present data, it could be concluded that the peptide–free LF of PRP has potent wound healing capacity in vivo for cutaneous wounds, although not as much as that of PRP. Strengthening our understanding of the wound healing potential of lipid components of PRP and platelet-derived lipid factors may provide new avenues for improving the healing process of a wound with elevated protease activity.