Topical Intervention of Natural Products Applied in Patients with Pressure Injuries: A Scoping Review.

OBJECTIVE: Pressure injuries (PIs) represent a major medical and nursing problem in individuals with decreased or limited mobility. This scoping review aimed to map the controlled clinical trials with topical interventions of natural products applied to patients with PIs and to verify the existence of phytochemical similarities among these products. DATA SOURCES: This scoping review was developed according to the JBI Manual for Evidence Synthesis. Controlled trials were searched in the following electronic databases from their inceptions until February 1, 2022: Cochrane Central Register of Controlled Trials, EMBASE, PubMed, SciELO, Science Direct, and Google Scholar. STUDY SELECTION: Studies involving individuals with PIs, individuals treated with topical natural products compared to a control treatment, and outcomes with wound healing or wound reduction were included in this review. DATA EXTRACTION: The search identified 1,268 records. Only six studies were included in this scoping review. Data were independently extracted using a template instrument from the JBI. DATA SYNTHESIS: The authors summarized the characteristics of the six included articles, synthesized outcomes, and compared similar articles. Honey and Plantago major dressings were the topical interventions that significantly reduced wound size. The literature suggests that the effect on wound healing of these natural products may be related to the presence of phenolic compounds. CONCLUSIONS: The studies included in this review show that natural products can positively impact the healing of PIs. However, there are limited controlled clinical trials addressing natural products and PIs in the literature.

Sitagliptin inhibit human lymphocytes proliferation and Th1/Th17 differentiation in vitro.

Dipeptidyl peptidase-4 (DPP-4) inhibitors are a new class of anti-diabetic agents that are widely used in clinical practice to improve glycemic control in patients with type 2 diabetes. DPP-4 is also known as lymphocyte cell surface protein, CD26, and plays an important role in T-cell immunity. Recent studies suggest that DPP-4 inhibitors improve beta-cell function and attenuate autoimmunity in type 1 diabetic mouse models. To investigate the direct effect of DPP4 in immune response, human peripheral blood mononuclear cells (PBMC) from healthy volunteers were obtained by Ficoll gradient and cultivated in the absence (control) or presence of phytohemagglutinin (PHA), or stimulated with PHA and treated with sitagliptin. The immune modulation mechanisms analyzed were: cell proliferation, by MTT assay; cytokine quantification by ELISA or cytometric bead array (CBA), Th1/Th2/Th17 phenotyping by flow cytometric analysis and CD26 gene expression by real time PCR. The results showed that sitagliptin treatment inhibited the proliferation of PBMC-PHA stimulated cells in a dose dependent manner and decreased CD26 expression by these cells, suggesting that sitagliptin may interfere in CD26 expression, dimerization and cell signaling. Sitagliptin treatment not only inhibited IL-10 (p<0.05) and IFN-gamma (p=0.07) cytokines, but also completely abolish IL-6 expression by PBMCs (p<0.001). On the other hand, IL-4 were secreted in culture supernatants from sitagliptin treated cells. A statistically significant increase (p<0.05) in the ratio of TGF-beta/proliferation index after sitagliptin treatment (2627.97±1351.65), when comparing to untreated cells (646.28±376.94), was also demonstrated, indicating higher TGF-beta1 production by viable cells in cultures. Sitagliptin treatment induced a significantly (p<0.05) decrease in IL-17 and IFN-gamma intracellular expression compared with PHA alone. Also, the percentage of T CD4+IL-17+, T CD4+IFNgamma+ and T CD4+IL-4+ cells were significantly reduced (p<0.05) by sitagliptin. Our data demonstrated an immunosuppressive effect of sitagliptin on Th1, Th17 and Th2 lymphocytes differentiation that leads to the generation of regulatory TGF-beta1 secreting cells with low CD26 gene expression that may influence the state of pancreatic beta-cells and controlling DM1 patients.

Synthesis, characterization and biological evaluation of Rutin-zinc(II) flavonoid -metal complex.

Synthesis of compounds analogous to natural products from secondary metabolites, such as flavonoids, is a promising source of novel drugs. Rutin (quercetin-3-O-rutinoside) is a natural flavone, which has, in its chemical structure, different sites for coordination with transition metals and the complexation with these metals enhances its biological properties. Rutin-zinc(II), a flavonoid-metal complex, was synthesized and characterized by UV-VIS, FT-IR, elemental analysis and (1)H NMR. The antioxidant and antitumor activities, as well as the cytotoxicity and in vivo toxicity of this complex were evaluated and compared with the free rutin. Rutin-zinc(II) has not shown any cytotoxicity against normal cells (fibroblasts and HUVECs) or toxicity in BALB/c mice, but has shown antioxidant activity in vitro and cytotoxicity against leukemia (KG1, K562 and Jurkat), multiple myeloma (RPMI8226) and melanoma (B16F10 and SK-Mel-28) cell lines in vitro. In Ehrlich ascites carcinoma model, Rutin-zinc(II) modulated the mitochondrial membrane potential and the expression of genes related to cell cycle progression, angiogenesis and apoptosis.

Quercetin as a shuttle for labile iron.

The antioxidant activity of flavonoids may involve their ability to complex body iron in non-redox-active forms. In this study, it was found that the catechol flavonoids rutin and quercetin are able to suppress redox-active labile plasma iron (LPI) in both buffered solution and in iron-overloaded sera. Both flavonoids are effective in loading the metal into the iron-transport protein transferrin. Iron derivatives of quercetin and rutin are able to permeate cell membranes, however, only free quercetin is able to gain access to the cytosol and decrease intracellular labile iron pools. These results suggest that the antioxidant activity of quercetin may be dependent on its ability to shuttle labile iron from cell compartments followed by its transfer to transferrin.