ABSTRACT
The skin is a critical organ for the maintenance of the integrity and protection of the organism. When a wound occurs, a sequence of healing mechanisms is triggered to reconstruct the wounded area. ß-caryophyllene is a sesquiterpene in Copaifera langsdorffii oleoresin with antioxidant and anti-inflammatory potential. On the basis of previous studies with C. langsdorffii, ß-caryophyllene was selected to evaluate its wound healing potential and pharmacological mechanisms. The excision wound model was used with male Wistar rats and macroscopic, histological, immunohistochemical and biochemical analyses were performed with skin samples, comparing the ß-caryophyllene-treated group with reference drugs. The results showed macroscopic retraction of the wounds treated with ß-caryophyllene. Biochemical assays revealed the antioxidant and anti-inflammatory mechanisms of the ß-caryophyllene-treated group with increasing levels of IL-10 and GPx and decreasing levels of pro-inflammatory molecules, including TNF-α, IFN-γ, IL-1ß and IL-6. After ß-caryophyllene treatment, immunohistochemical assays showed enhanced re-epithelialization, through the increase in laminin-γ2 and desmoglein-3 immunolabeling. ß-caryophyllene also act in the remodeling mechanism, increasing the collagen content in the Masson's trichrome staining. These findings indicated the wound-healing potential of ß-caryophyllene topical formulation in rat skin wounds, mediated by antioxidant, anti-inflammatory and re-epithelialization mechanisms.
Subject(s)
Anti-Inflammatory Agents, Non-Steroidal/administration & dosage , Antioxidants/administration & dosage , Fabaceae/chemistry , Phytochemicals/administration & dosage , Phytotherapy/methods , Plant Extracts/administration & dosage , Polycyclic Sesquiterpenes/administration & dosage , Re-Epithelialization/drug effects , Skin/injuries , Wound Healing/drug effects , Wounds, Penetrating/drug therapy , Administration, Topical , Animals , Cytokines/metabolism , Male , Models, Animal , Rats , Rats, Wistar , Signal Transduction/drug effects , Treatment Outcome , Wounds, Penetrating/metabolismABSTRACT
To analyze the hemostatic, Dsurgical wounds in donor and recipient areas of free gingival grafts (FGG). Five databases (PubMed, Scopus, Science Direct, Cochrane and Web of Science) were searched up to March 2021 (PROSPERO CRD42019134497). The focus of the study (cyanoacrylate) was combined with the condition (periodontal surgery OR free gingival graft OR free soft tissue graft OR autografts), and outcome (healing OR epithelialization OR pain OR analgesia OR bleeding OR hemostasis OR hemostatic). Studies reporting cyanoacrylate isolated or associated with another substance in FGG stabilization and closure were investigated and assessed for the quality and risk of bias through the Cochrane Manual. Six studies with 323 participants were included. Evaluation of the quality and risk of bias highlighted a low risk for four articles, intermediate for one and unclear for another. The use of cyanoacrylate associated or not with the hemostatic sponge or the platelet-rich fibrin was more effective in healing (three studies), analgesia (four studies), and hemostasis in one study (p < 0.05). However, groups with the association in cyanoacrylate showed superior healing, and analgesic action to the isolated cyanoacrylate group. In addition, two studies demonstrated that cyanoacrylate use reduces surgery duration, one study showed that it reduces postoperative sensibility, and another present hemostatic effect (p < 0.05). There is scarce literature for the use of cyanoacrylate in FGG wounds indicates that it can promote a minor inflammatory response, reduce operation time, does not interfere with healing, relieves postoperative discomfort, and suggests the possibility immediate hemostasis. Its use presents an alternative to suturing in FGG surgeries. But, the limited number of cases and the relative heterogeneity of the included studies suggest caution in generalizing the indication. CLINICAL RELEVANCE: Cyanoacrylate seems to present analgesic effects and less pain when applied to wound closure and covering donor and recipient areas reducing the need for postoperative analgesic medication; and has a healing effect in the closure of the donor area on the palate. In addition, it can reduce bleeding time after surgery, and prevents late bleeding during the first postsurgical week. Scientific justification: To evaluate the hemostatic, analgesic and healing actions of cyanoacrylate compared to the suture thread and other agents when used to close surgical wounds from periodontal free gingival graft surgical wounds in both the donor and recipient areas of the graft. MAIN FINDINGS: The use of cyanoacrylate individually or in association with wound dressing agents presents analgesic effects because the patient reports less pain experienced when cyanoacrylate is applied to the wound closure and covering, thereby reducing the need for postoperative analgesic medication. In addition, a healing effect is observed in the closure of the donor area on the palate; as well as it seems to present hemostatic effects, reducing the bleeding time after surgery, and preventing late bleeding during the first postsurgical week. PRACTICAL IMPLICATIONS: Dentists may cautiously apply cyanoacrylate after periodontal surgeries for free gingival graft in both the donor and recipient areas of the graft. However, they must consider the limitations of the surgery, tension-free positioning, the patient's dyscrasia and postoperative care, constituting a set of predictors for adequate clinical decision-making. Widespread use of such material for all patients and surgical configurations may not be recommended.
Subject(s)
Analgesics/pharmacology , Cyanoacrylates/pharmacology , Gingiva/transplantation , Plastic Surgery Procedures , Re-Epithelialization/drug effects , Surgical Wound , Bandages , Bias , Hemostasis , Hemostatics/pharmacology , Humans , Palate/surgery , Platelet-Rich Fibrin , Risk , Wound HealingABSTRACT
ETHNOPHARMACOLOGICAL RELEVANCE: Sorocea guilleminina Gaudich. is a tree or shrub endemic to Brazil. Its leaves are used in Brazilian folk medicine for the healing of wounds, stomach problems, inflammation and as diuretic. The present study evaluates the activity and action mechanisms of the healing properties of the aqueous extract of S. guilleminiana leaves (AESg), in experimental models in vivo and in vitro, as well as performs a phytochemical analysis of the extract. MATERIALS AND METHODS: The AESg was prepared by infusion: Ten g of dry leaves powder in 1â¯L hot water, soaked for 15â¯min, filtered, lyophilized, and stored at -30⯰C. Phytochemical analyses were realized by colorimetry and HPLC/ESI/MS. Its' in vitro cytotoxicity was evaluated on fibroblastic N3T3 cells. The potential of the wound healing activity in vivo was evaluated using excision and incision wound rat models, by histopathology of the injured skin along with the determination of nitric oxide, cytokines (IL-1ß, IL-10, and TNF-α), and antioxidant parameters (GSH, MPO and CAT). In vitro wound healing activity was also demonstrated in scratched N3T3 cells, by measuring the proliferation/migration rate. RESULTS: The phytochemical analysis of the AESg revealed a strong presence of polar compounds, especially flavonoids (4 majoritarian), as well as terpenes and/or sterols (2 majoritarian). The AESg showed no toxicity in the N3T3 cell line (IC50â¯>â¯800⯵g/mL). Topical treatment with the AESg showed an increase (pâ¯<â¯0.05) in wound contraction with 2â¯mg/g cream on days 5 and 9 (43.56% and 6.70% increase, respectively), and with 50â¯mg/g on days 7 and 9 (10.88% and 7.91%, respectively), compared to the vehicle (non-ionic neutral cream). Topical application of AESg (2 or 50â¯mg/g non-ionic cream) in incised wounds caused an increase in the force necessary for the rupture of the wound when compared to the vehicle group. No changes in cytokines (IL-1ß, IL-10, or TNF-α) or NO accumulation was found with up to 50â¯mg/g AESg treatment. For antioxidant activity on the incision wound, an increase in GSH levels was denoted with the AESg use, at the lowest and highest dose (2 and 50â¯mg/g) by 75.86% and 61.20% respectively, when compared to the vehicle. Also, the CAT activity was accentuated by AESg at the highest dose (50â¯mg/g) by 85.87%. Finally, the AESg at all doses attenuated MPO activity significantly in the incision wound by 71.35%, 73.21%, 78.08%, respectively. In the scratch test on N3T3 cells, the treatment with AESg resulted also in an increase in fibroblast proliferation/migration rate, compared to the vehicle. CONCLUSION: AESg is not cytotoxic. The results confirm the popular use of the leaf infusion of S. guilleminiana for the treatment of cutaneous wounds, possibly by stimulating the proliferation of fibroblasts with a consequent deposition of collagen, fastening rearrangement of collagen fibers, and greater transformation into myofibroblasts, essential in the healing process. Preliminary chemical analyzes of AESg revealed the presence mainly of phenolic compounds, being salicylic acid, gallic acid, pinocembrin and isoquercitrin the majoritarian ones.
Subject(s)
Moraceae , Plant Extracts/pharmacology , Plant Leaves , Skin/drug effects , Wound Healing/drug effects , Wounds, Penetrating/drug therapy , Animals , Cell Movement/drug effects , Cell Proliferation/drug effects , Cytokines/metabolism , Disease Models, Animal , Mice , Moraceae/chemistry , NIH 3T3 Cells , Nitric Oxide/metabolism , Plant Extracts/isolation & purification , Plant Extracts/toxicity , Plant Leaves/chemistry , Rats, Wistar , Re-Epithelialization/drug effects , Skin/injuries , Skin/metabolism , Skin/pathology , Wounds, Penetrating/metabolism , Wounds, Penetrating/pathologyABSTRACT
INTRODUCTION: Chemical ocular burns are among the most frequently eye-related injuries, which require immediate and intensive evaluation and care since they may lead to potential complications such as superinfection, corneal perforation, and blindness.Vasconcellea cundinamarcensis, a species from Caricaceae family, contains highly active proteolytic enzymes in its latex that show healing activity in animal models bearing lesions of different etiologies. METHODS: We evaluate the ocular toxicity of the proteolytic fraction from V. cundinamarcensis (P1G10) by the 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide assay and Hen's Egg Test-Chorioallantoic Membrane test. The corneal healing property of P1G10 was studied by the ethanol-chemical burn in the rabbit's eyes. RESULTS: P1G10 is safe for ocular administration, except when administrated at 10µg/mL. P1G10 at 1µg/mL accelerates the corneal re-epithelization achieving complete wound closure after 72h of chemical burn. Also, P1G10 modulated the inflammatory response and controlled the arrangement of collagen fibers in the stroma, demonstrating its potential corneal healing properties. CONCLUSIONS: Our work was the first one to evaluate the ophthalmic application of P1G10. Here we demonstrated that P1G10 is suitable for ocular administration and it has a promising corneal healing activity which may emerge as a new pharmacological tool to the development of a new drug for ocular surface chemical injuries in the future.
Subject(s)
Burns, Chemical/pathology , Caricaceae/enzymology , Cornea/drug effects , Corneal Injuries/pathology , Eye Burns/pathology , Fibroblasts/drug effects , Peptide Hydrolases/pharmacology , Re-Epithelialization/drug effects , Administration, Ophthalmic , Animals , Burns, Chemical/metabolism , Cell Proliferation/drug effects , Cell Survival/drug effects , Cells, Cultured , Collagen/drug effects , Cornea/cytology , Cornea/metabolism , Cornea/pathology , Corneal Injuries/metabolism , Dose-Response Relationship, Drug , Ethanol/toxicity , Eye Burns/metabolism , Humans , In Vitro Techniques , Inflammation , Latex/chemistry , Rabbits , Solvents/toxicity , Wound Healing/drug effectsABSTRACT
A estimulação elétrica (EE) tem sido usada no tratamento de lesões crônicas apresentando resultados favoráveis no fechamento da lesão cutânea entre outras aplicações clínicas. No entanto, a literatura carece de estudos avaliando se os efeitos da EE no fechamento da lesão oral. Diante disso, torna-se relevante investigar os efeitos da EE durante o processo de reparo da lesão oral em camundongos (Swiss). Métodos: Noventa animais foram divididos em grupos: Controle (C; n=45) que receberam a aplicação da EE com o aparelho desligado e Teste (EE; n=45) que receberam a EE (100 µA; 9 kHz; 660 mVpp; 1x/dia por 3 dias). Uma lesão de espessura total foi realizada com punch de biópsia de 1,5 mm de diâmetro. Os animais foram eutanasiados no 1o, 3o e 5o dia após a confecção da lesão. As amostras foram fixadas em paraformaldeído 4%, descalcificadas em ácido fórmico 20% e emblocadas em parafina. Os parâmetros avaliados foram: fechamento clínico da lesão; distância de reparação epitelial (DRE) e conjuntiva (DRC), concentração de citocinas IL-1ß, IL-6, IL-8, IL-10, TNF-α e VEGF; porcentagem de fibras colágenas e quantificação das proteínas de sinalização Smad2. Resultados: A área de fechamento clínico foi reduzida no grupo EE no 5º dia de avaliação (p=0,01). As DRE e DRC do grupo EE apresentaram menor distância em todos os tempos avaliados (p<0,05) com reduzida concentração de IL-6, TNF-α, IL-10 e VEGF (p<0,05). Não houve diferença na porcentagem de fibras colágenas e na phospho-Smad2. Conclusão: A EE teve efeito positivo nos parâmetros clínicos e histológicos com modulação da resposta inflamatória no início do processo de reparo da lesão(AU)
Background: Since Electrical Stimulation (ES) has used for chronic wounds treatment and other clinical applications showing favorable results in wound closure, it was hypothesized whether it could bring good results in oral wound closure. The aim was to investigate the ES effects during the oral wound healing process in mice (Swiss). Methods: Ninety animals were divided in groups: Control (C; n=45) which received a fictitious ES application, i.e. the ES applicance was shutted off and ES (ES; n=45) which received ES (100 µA; 9 kHz; 660 mVpp) once time a day for 3 days consecutively. A full thickness wound was done using a 1.5 mm diameter biopsy punch in the hard palate. The animals were euthanized on 1st, 3rd and 5th day post-wounding. The samples were fixed, decalcified and embedded in paraffin. The parameters evaluated were: clinical wound closure; distance of epithelial and connective wound edges (EWD and CWD); cytokines (IL-1ß, IL-6, IL-8, IL-10), TNF-α and VEGF by multiplex, percentage of collagen fibers and Smad proteins. Results: Clinical wound closure area was reduced on day 5 in ES group (p = 0.01). Both EWD and CWD distance were shorter in all times (p < 0.05) with a reduction of inflammatory cytokines production (p < 0.05). There were no difference in collagen percentage and phospho-Smad2. Conclusion: ES had a positive effect on clinical and histomorphometric wound closure outcomes showing a modulation of inflammatory response in the beginning of wound healing(AU)
Subject(s)
Mouth Mucosa/injuries , Wound Healing/drug effects , Electric Stimulation/methods , Re-Epithelialization/drug effects , Surgical Wound/complicationsABSTRACT
Extensive burn may cause acute resistance to insulin, which accentuates hypermetabolism, impairs glucose metabolism, immune dysfunction and risks of sepsis. To minimize these effects, insulin is used as a treatment. The purpose was to analyze the collagen-elastic arrangement effects of insulin on the burned skin. Wistar rats were assigned in groups: control (C); control with insulin (C + I); scald burn injury (SBI); and SBI with insulin (SBI+ I). SBI were submitted to 45% total body surface area burn and the insulin-treated groups received insulin (5 UI/Kg/day) for 4 or 14 days (d). Insulin levels, glucose tolerance test and HOMA index were determined. The skin sections were analyzed for histophatological and morphoquantitative data. Histopathological findings showed increased reepithelization of SBI+ I and formation of a new muscle layer after 14 days. In the collagen-elastic arrangement, insulin for 4 days increased the volume fraction (Vv) of thin collagen and elastic fibers. After 14 days, independently of injury, insulin decreased the elastic fibers. Insulin was able to reverse damages in the collagen-elastic rearrangement and stimulate reepithelization after 4 days. Untreated scald-burned animals showed higher Vv of thick collagen after 4 days, while those treated had a higher Vv of thin collagen. The Vv of elastic fibers was increased in SBI+ I for 4 days. In conclusion, insulin treatment was able to stimulate reepithelization. It also reversed the damages to the collagen-elastic arrangement in the scald-burned group, improving the organization of thin collagen and increasing the Vv of elastic fibers in the injured group treated with insulin for a short time, that is, for 4 days.
Subject(s)
Burns/drug therapy , Collagen/metabolism , Elastin/metabolism , Insulin/therapeutic use , Re-Epithelialization , Animals , Area Under Curve , Body Weight , Burns/pathology , Drinking Behavior , Feeding Behavior , Glucose/metabolism , Insulin/pharmacology , Male , Rats, Wistar , Re-Epithelialization/drug effects , Skin/drug effects , Skin/pathologyABSTRACT
ABSTRACT Purpose: This study aimed to compare the effectiveness of eye drops containing a combination of sodium hyaluronate and trehalose and sodium hyaluronate for the treatment of corneal cross-linking and epithelial healing. Methods: This study included 46 eyes of 23 keratoconus patients who underwent corneal cross-linking on both eyes. Unpreserved trehalose 30 mg/mL and sodium hyaluronate 1.5 mg/mL (Thealoz Duo®; Thea, France) were applied six times a day on one eye of each patient and unpreserved sodium hyaluronate 0.15% (Eye Still®; Teka, Inc., Istanbul) was applied on the other eye. Patients were examined daily until complete re-epithelialization. Postoperative examinations to assess the measured size of epithelial defect were performed using slit-lamp biomicroscopy. Results: The study included 23 patients (13 females and 10 males) with a mean age of 20.9 ± 10.3 years. Corneal epithelial healing time after cross-linking was 2.3 ± 1.2 days for the trehalose and sodium hyaluronate group and 3.8 ± 2.9 days for the sodium hyaluronate group (p=0.03). Conclusion: The application of eye drops containing the combination of trehalose and sodium hyaluronate resulted in faster corneal re-epithelialization following corneal cross-linking than that of eye drops containing sodium hyaluronate alone.
RESUMO Objetivo: Este estudo teve como objetivo comparar a eficácia de colírios contendo uma combinação de hialurônico de sódio e hialuronato de sódio e trealose para o tratamento da cicatrização epitelial em pacientes com cross-linking corneano. Métodos: Este estudo inclui 46 olhos de 23 pacientes com ceratocone, que foram operados com cross-linking corneano em ambos os olhos. Trealose não preservada 30 mg/mL e hialuronato de sódio 1,5 mg/mL (Thealoz Duo®; Thea, França) foram aplicados seis vezes por dia em um olho de cada paciente e hialuronato de sódio não conservado, 0,15% (Eye Still®; Teka, Inc., Istambul) foi aplicada no outro olho. Os pacientes foram examinados diariamente até a completa reepitelização. Exames pós-operatórios para avaliar o tamanho medido do defeito epitelial foram realizados usando biomicroscopia com lâmpada de fenda. Resultados: O estudo incluiu 23 pacientes (13 mulheres e 10 homens) com idade média de 20,9 ± 10,3. O tempo de cicatrização epitelial da córnea após o cross-linking foi de 2,3 ± 1,2 dias para o grupo trealose e hialuronato de sódio e 3,8 ± 2,9 dias para o grupo hialurônico de sódio (p=0,03). Conclusão: A aplicação de gotas para os olhos contendo combinação de trealose e hialuronato de sódio resultou em uma re-epitelização da córnea mais rápida após o cross-linking corneano do que a de gotas contendo hialurônico de sódio apenas.
Subject(s)
Humans , Male , Female , Adult , Young Adult , Trehalose/pharmacology , Wound Healing/drug effects , Epithelium, Corneal/drug effects , Protective Agents/pharmacology , Re-Epithelialization/drug effects , Ophthalmic Solutions/pharmacology , Postoperative Care , Treatment Outcome , Epithelium, Corneal/pathology , Cross-Linking Reagents , Drug Therapy, Combination , Hyaluronic Acid/pharmacology , Keratoconus/surgeryABSTRACT
AIM: To evaluate the sex-specific effects of a hydroalcoholic extract from Eugenia punicifolia (HEEP) leaves on gastric ulcer healing. METHODS: In this rat study involving males, intact (cycling) females, and ovariectomized females, gastric ulcers were induced using acetic acid. A vehicle, lansoprazole, or HEEP was administered for 14 d after ulcer induction. Body weight was monitored throughout the treatment period. At the end of treatment, the rats were euthanized and the following in vivo and in vitro investigations were performed: macroscopic examination of the lesion area and organ weights, biochemical analysis, zymography, and evaluation of protein expression levels. Additionally, the concentration-dependent effect of HEEP was evaluated in terms of subacute toxicity and cytotoxicity. RESULTS: Compared to the vehicle, HEEP demonstrated a great healing capacity by substantially reducing the ulcerative lesion area in males (52.44%), intact females (85.22%), and ovariectomized females (65.47%), confirming that HEEP accelerates the healing of acetic acid-induced gastric lesions and suggesting that this effect is modulated by female sex hormones. The antiulcer effect of HEEP was mediated by prostaglandin E2 only in male rats. Overall, the beneficial effect of HEEP was the highest in intact females. Notably, HEEP promoted the expression of vascular endothelial growth factor (intact vs ovariectomized females) and decreased the expression of Caspase-8 and Bcl-2 (intact female vs male or ovariectomized female). Additionally, HEEP enhanced fibroblast proliferation and migration into a wounded area in vitro, confirming its healing effect. Finally, no sign of subacute toxicity or cytotoxicity of HEEP was observed. CONCLUSION: In gastric ulcers, HEEP-induced healing (modulated by female sex hormones; in males, mediated by prostaglandin) involves extracellular matrix remodeling, with gastric mucosa cell proliferation and migration.
Subject(s)
Eugenia/chemistry , Plant Extracts/pharmacology , Re-Epithelialization/drug effects , Stomach Ulcer/drug therapy , Acetic Acid/toxicity , Animals , Disease Models, Animal , Drug Evaluation, Preclinical , Female , Gastric Mucosa/drug effects , Gastric Mucosa/pathology , Humans , Male , Plant Extracts/therapeutic use , Plant Leaves/chemistry , Rats , Rats, Wistar , Sex Factors , Stomach Ulcer/chemically induced , Stomach Ulcer/pathology , Toxicity Tests, Subacute , Treatment OutcomeABSTRACT
PURPOSE: This study aimed to compare the effectiveness of eye drops containing a combination of sodium hyaluronate and trehalose and sodium hyaluronate for the treatment of corneal cross-linking and epithelial healing. METHODS: This study included 46 eyes of 23 keratoconus patients who underwent corneal cross-linking on both eyes. Unpreserved trehalose 30 mg/mL and sodium hyaluronate 1.5 mg/mL (Thealoz Duo®; Thea, France) were applied six times a day on one eye of each patient and unpreserved sodium hyaluronate 0.15% (Eye Still®; Teka, Inc., Istanbul) was applied on the other eye. Patients were examined daily until complete re-epithelialization. Postoperative examinations to assess the measured size of epithelial defect were performed using slit-lamp biomicroscopy. RESULTS: The study included 23 patients (13 females and 10 males) with a mean age of 20.9 ± 10.3 years. Corneal epithelial healing time after cross-linking was 2.3 ± 1.2 days for the trehalose and sodium hyaluronate group and 3.8 ± 2.9 days for the sodium hyaluronate group (p=0.03). CONCLUSION: The application of eye drops containing the combination of trehalose and sodium hyaluronate resulted in faster corneal re-epithelialization following corneal cross-linking than that of eye drops containing sodium hyaluronate alone.
Subject(s)
Epithelium, Corneal/drug effects , Protective Agents/pharmacology , Re-Epithelialization/drug effects , Trehalose/pharmacology , Wound Healing/drug effects , Adult , Cross-Linking Reagents , Drug Therapy, Combination , Epithelium, Corneal/pathology , Female , Humans , Hyaluronic Acid/pharmacology , Keratoconus/surgery , Male , Ophthalmic Solutions/pharmacology , Postoperative Care , Treatment Outcome , Young AdultABSTRACT
Free gingival grafting, the most predictable technique to increase the keratinized gingiva, leaves an open wound on the palate and the resulting discomfort during the healing phase is a significant concern. This study was intended to evaluate the effect of topical erythropoietin on healing of the donor site. Twelve patients lacking an attached gingiva at two sites in the mandible were included. In the test group, 1 mL of gel containing erythropoietin at a concentration of 4,000 IU mL-1 was applied to the donor site, whereas the control group was treated with 2 mL of the gel alone. On the second day after surgery, the same procedure was repeated. H2O2 was used to evaluate the amount of epithelialization. Clinical healing was compared using photographs and direct examination. The EPO group showed significantly better keratinization only on day 21. Comparison of clinical healing based on direct examination revealed significantly better healing in the test group on day 28. Furthermore, inflammation in the test group was lower than in the control group on the same day. Topical application of EPO improves palatal wound healing during the third and fourth weeks after free gingival graft procedures.
Subject(s)
Erythropoietin/administration & dosage , Free Tissue Flaps , Gingiva/transplantation , Palate/drug effects , Palate/surgery , Re-Epithelialization/drug effects , Administration, Buccal , Adult , Female , Humans , Male , Middle Aged , Re-Epithelialization/physiology , Reproducibility of Results , Statistics, Nonparametric , Time Factors , Treatment OutcomeABSTRACT
Abstract Free gingival grafting, the most predictable technique to increase the keratinized gingiva, leaves an open wound on the palate and the resulting discomfort during the healing phase is a significant concern. This study was intended to evaluate the effect of topical erythropoietin on healing of the donor site. Twelve patients lacking an attached gingiva at two sites in the mandible were included. In the test group, 1 mL of gel containing erythropoietin at a concentration of 4,000 IU mL-1 was applied to the donor site, whereas the control group was treated with 2 mL of the gel alone. On the second day after surgery, the same procedure was repeated. H2O2 was used to evaluate the amount of epithelialization. Clinical healing was compared using photographs and direct examination. The EPO group showed significantly better keratinization only on day 21. Comparison of clinical healing based on direct examination revealed significantly better healing in the test group on day 28. Furthermore, inflammation in the test group was lower than in the control group on the same day. Topical application of EPO improves palatal wound healing during the third and fourth weeks after free gingival graft procedures.
Subject(s)
Humans , Male , Female , Adult , Palate/surgery , Palate/drug effects , Erythropoietin/administration & dosage , Free Tissue Flaps , Re-Epithelialization/drug effects , Gingiva/transplantation , Time Factors , Administration, Buccal , Reproducibility of Results , Treatment Outcome , Statistics, Nonparametric , Re-Epithelialization/physiology , Middle AgedABSTRACT
ETHNOPHARMACOLOGICAL RELEVANCE: Struthanthus vulgaris (Vell.) Mart. (Loranthaceae) has been largely used in traditional folk medicine in Brazil as an anti-inflammatory agent and to treat various skin disorders, including wounds. AIMS OF THE STUDY: To investigated the influence of 5% Struthanthus vulgaris ointment during cutaneous wound healing in rats. MATERIALS AND METHODS: Twenty Wistar rats were used in each group according the daily treatment, S. vulgaris 5% ointment (SV 5%) and vehicle control groups. Four full thicknesses wounds were punched in back side skin of each animal, and five animals were sacrificed after 2, 7, 14 and 21 days after surgery for histological, immunological and biochemical analysis. RESULTS: A significant wound closured area in the S. vulgaris 5% group of about 38% and 35% as compared to 19% and 21% in the control group was observed after 2 and 5 days, respectively. Histological and biochemical analysis of the skin biopsies showed that S. vulgaris treated wounds exhibited increased granulation tissue and regulated the inflammatory response by modulating the release of pro and anti-inflammatory cytokines like IL-1α, TNF-α and IL-10, nitric oxide and, growth factors like TGF-ß. Moreover, S. vulgaris showed a marked and robust increase in the deposition and organization of collagen fibers in the wounds, and improve the quality of the scar tissue. CONCLUSIONS: Altogether these data revealed that S. vulgaris seems to prevent an over expression of inflammation and accelerates wound epithelialization and might be beneficial for treating healing disorders.
Subject(s)
Anti-Inflammatory Agents/pharmacology , Cytokines/metabolism , Inflammation Mediators/metabolism , Loranthaceae/chemistry , Plant Extracts/pharmacology , Skin/drug effects , Wound Healing/drug effects , Wounds, Penetrating/drug therapy , Administration, Cutaneous , Animals , Anti-Inflammatory Agents/administration & dosage , Anti-Inflammatory Agents/isolation & purification , Biopsy , Cicatrix/metabolism , Cicatrix/pathology , Disease Models, Animal , Fibrillar Collagens/metabolism , Granulation Tissue/drug effects , Granulation Tissue/metabolism , Granulation Tissue/pathology , Male , Ointments , Phytotherapy , Plant Extracts/administration & dosage , Plant Extracts/isolation & purification , Plant Leaves/chemistry , Plants, Medicinal , Rats, Wistar , Re-Epithelialization/drug effects , Skin/injuries , Skin/metabolism , Skin/pathology , Time Factors , Wounds, Penetrating/metabolism , Wounds, Penetrating/pathologyABSTRACT
BACKGROUND: The overproduction of reactive oxygen species (ROS) and exacerbated inflammatory response are the main events that impair healing of pressure ulcers. Therefore, olive oil may be a good alternative to improve the healing of these chronic lesions due to its anti-inflammatory and antioxidant properties. OBJECTIVE: This study investigated the effect of olive oil administration on wound healing of pressure ulcers in mice. METHODS: Male Swiss mice were daily treated with olive oil or water until euthanasia. One day after the beginning of treatment, two cycles of ischemia-reperfusion by external application of two magnetic plates were performed in skin to induced pressure ulcer formation. RESULTS: The olive oil administration accelerated ROS and nitric oxide (NO) synthesis and reduced oxidative damage in proteins and lipids when compared to water group. The inflammatory cell infiltration, gene tumor necrosis factor-α (TNF-α) expression and protein neutrophil elastase expression were reduced by olive oil administration when compared to water group. The re-epithelialization and blood vessel number were higher in the olive oil group than in the water group. The olive oil administration accelerated protein expression of TNF-α, active transforming growth factor-ß1 and vascular endothelial growth factor-A when compared to water group. The collagen deposition, myofibroblastic differentiation and wound contraction were accelerated by olive oil administration when compared to water group. CONCLUSION: Olive oil administration improves cutaneous wound healing of pressure ulcers in mice through the acceleration of the ROS and NO synthesis, which reduces oxidative damage and inflammation and promotes dermal reconstruction and wound closure.
Subject(s)
Inflammation/drug therapy , Nitric Oxide/metabolism , Olive Oil/therapeutic use , Pressure Ulcer/drug therapy , Reactive Oxygen Species/metabolism , Skin/metabolism , Wound Healing/drug effects , Administration, Cutaneous , Animals , Collagen/metabolism , Disease Models, Animal , Humans , Male , Mice , Olive Oil/administration & dosage , Re-Epithelialization/drug effects , Skin/blood supply , Skin/drug effects , Transforming Growth Factor beta1/metabolism , Tumor Necrosis Factor-alpha/metabolism , Vascular Endothelial Growth Factor A/metabolismABSTRACT
Wound healing is a complex process that involves several biological events, and a delay in this process may cause economic and social problems for the patient. The search continues for new alternative treatments to aid healing, including the use of herbal medicines. Members of the genus Caesalpinia are used in traditional medicine to treat wounds. The related species Poincianella pluviosa (DC.) L.P. Queiroz increases the cell viability of keratinocytes and fibroblasts and stimulates the proliferation of keratinocytes in vitro. The crude extract (CE) from bark of P. pluviosa was evaluated in the wound-healing process in vivo, to validate the traditional use and the in vitro activity. Standardized CE was incorporated into a gel and applied on cutaneous wounds (TCEG) and compared with the formulation without CE (Control) for 4, 7, 10, or 14 days of treatment. The effects of the CE on wound re-epithelialization; cell proliferation; permeation, using photoacoustic spectroscopy (PAS); and proteins, including vascular endothelial growth factor (VEGF), superoxide dismutase 2 (SOD-2) and cyclooxygenase 2 (COX-2) were evaluated. The TCEG stimulated the migration of keratinocytes at day 4 and proliferation on the following days, with a high concentration of cells in metaphase at 7 days. Type I collagen formed more rapidly in the TCEG. PAS showed that the CE had permeated through the skin. TCEG stimulated VEGF at day 4 and SOD-2 and COX-2 at day 7. The results suggest that the CE promoted the regulation of proteins and helped to accelerate the processes involved in healing, promoting early angiogenesis. This led to an increase in the re-epithelialized surface, with significant mitotic activity. Maturation of collagen fibers was also enhanced, which may affect the resistance of the extracellular matrix. PAS indicated a correlation between the rate of diffusion and biological events during the healing process. The CE from P. pluviosa appears promising as an aid in healing.
Subject(s)
Antioxidants/pharmacology , Fabaceae/chemistry , Plant Extracts/chemistry , Re-Epithelialization/drug effects , Skin/drug effects , Wounds, Nonpenetrating/drug therapy , Animals , Antioxidants/isolation & purification , Cell Proliferation/drug effects , Cell Survival/drug effects , Collagen Type I/biosynthesis , Collagen Type I/genetics , Cyclooxygenase 2/genetics , Cyclooxygenase 2/metabolism , Fibroblasts/drug effects , Fibroblasts/metabolism , Gene Expression/drug effects , Keratinocytes/drug effects , Keratinocytes/metabolism , Male , Neovascularization, Physiologic/drug effects , Plant Bark/chemistry , Plant Extracts/standards , Rats , Rats, Wistar , Skin/blood supply , Skin/injuries , Skin/metabolism , Superoxide Dismutase/genetics , Superoxide Dismutase/metabolism , Vascular Endothelial Growth Factor A/genetics , Vascular Endothelial Growth Factor A/metabolism , Wounds, Nonpenetrating/genetics , Wounds, Nonpenetrating/metabolism , Wounds, Nonpenetrating/pathologyABSTRACT
Aged and adult populations have differences in the structural, biological, and healing properties of skin. Comparative studies of healing under the influence of retinoids in both these populations are very important and, to the best of our knowledge, have not been performed to date. The purpose of this study was to compare the activities of topical tretinoin in aged and adult animal models of wound healing by secondary intention. Male aged rats (24 months old, n = 7) and adult rats (6 months old, n = 8) were used. The rats were assigned to the following groups according to the dates on which wound samples were excised (day 14 or 21 after model creation): treated group, control group, and naive group. Topical application of tretinoin cream was used only on the proximal wound and was applied daily for 7 days. Wound healing areas were measured using metal calipers, and morphological analysis was performed. Slides were stained with Hematoxylin and Eosin, Masson's trichrome, and periodic acid-Schiff stains. Statistical analysis adopted a 5% coefficient for rejection of the null hypothesis. Although aged animals showed skin repair, complete reepithelialization was found on day 21 in some animals of both groups (treated and control). In aged rats, the wound area was significantly smaller in treated wounds than in untreated wounds, resulting in a larger scar area compared with the adult group. When treated wounds were compared, no differences were found between the wound areas in adult and aged rats. As expected, the collagen concentration was higher in normal skin from adult rats than in normal skin from aged animals, but there was no difference when aged skin was treated with tretinoin. These results indicate that tretinoin increases collagen synthesis in aged skin and returns the healing process to a normal state of skin healing.
Subject(s)
Keratolytic Agents/pharmacology , Skin Aging/drug effects , Skin Aging/pathology , Tretinoin/pharmacology , Tretinoin/therapeutic use , Wound Healing/drug effects , Wounds and Injuries/drug therapy , Animals , Collagen/metabolism , Disease Models, Animal , Granulation Tissue/metabolism , Keratolytic Agents/therapeutic use , Male , Rats , Rats, Wistar , Re-Epithelialization/drug effects , Wounds and Injuries/pathologyABSTRACT
PURPOSES: To assess the effects of 0.5% ketorolac tromethamine without preservatives on the expression of iNOS and MMP-9 in alkali burn ulcers. METHODS: Twelve eyes of 120-day-old male rabbits were treated (TG) every 6 h with 0.5% ketorolac tromethamine and 12 other eyes were treated with saline solution (CG), immediately after the occurrence of ulcers by 1 M sodium hydroxide (NaOH). Re-epithelialization was monitored using fluorescein every 6 h. After 24 h, six corneas (n=6) of each group were collected (M1). The others (n=6) were collected after reepithelialization (M2). At both moments, the inflammatory infiltrate and the conditions of the newly formed epithelium were histologically analyzed. iNOS and MMP-9 were evaluated by immunohistochemistry. RESULTS: Mean epithelialization time in TG was 55 ± 0.84 h. In CG, it was 44 ± 1.06 h (p=0.001). At M1, corneas of TG had lower inflammatory exudation compared with (p <0.001). At M2, TG revealed discrete inflammatory exudation (p>0.05) and lower numbers of epithelial layers compared with CG. The mean iNOS in stromal cells did not differ in TG over both moments compared with CG (p>0.05) At M2, the central corneal region expressed more iNOS in both groups compared with the peripheral region. No significant differences were observed in iNOS scores of epithelial immunostaining between the groups and across M1 and M2 (p=0.69). Epithelial immunostaining scores for MMP-9 did not differ in TG compared with CG (p=0.69). The average immunostaining score of MMP-9 in stromal cells showed no differences between groups or moments. There was no correlation between immunostaining of iNOS and MMP-9 or between the amount of inflammatory cells and immunostaining of iNOS. CONCLUSIONS: Use of 0.5% keratolac tromethamine reduced inflammation and delayed reepithelialization in a cornea alkali burn model without impacting the expression of iNOS or MMP-9.
Subject(s)
Anti-Inflammatory Agents, Non-Steroidal/therapeutic use , Corneal Ulcer/drug therapy , Ketorolac Tromethamine/therapeutic use , Matrix Metalloproteinase 9/drug effects , Nitric Oxide Synthase Type II/drug effects , Ophthalmic Solutions/therapeutic use , Re-Epithelialization/drug effects , Alkalies , Animals , Anti-Inflammatory Agents, Non-Steroidal/pharmacology , Burns, Chemical/drug therapy , Cornea/drug effects , Cornea/pathology , Corneal Ulcer/chemically induced , Corneal Ulcer/pathology , Eye Burns/chemically induced , Eye Burns/drug therapy , Immunohistochemistry , Ketorolac Tromethamine/pharmacology , Male , Ophthalmic Solutions/pharmacology , Rabbits , Reproducibility of Results , Time Factors , Treatment OutcomeABSTRACT
PURPOSE: Evaluate the time of post-abrasion corneal re-epithelialization using commercially available eye drops, one of which containing 0.4% sodium hialuronate, and the other containing 1% carboxymethylcellulose, and compare them to the re-epithelialization without the drops. METHODS: 24 rabbits were used, which had the mechanical abrasion of the central 8 mm of their corneas done. These animals were divided in 3 groups. The first one received the drops containing 0.4% of sodium hialuronate, the second one received the drops containing 1% of carboxymethylcellulose and the third group did not receive any drugs. The evaluations took place every 24 hours through the analysis of digital pictures under cobalt blue light and coloring of the corneas with 2% fluorescein. The pictures were analyzed with the software Autocad 2009®. The data was analyzed through the comparison of the total re-epithelialization time among the three groups RESULTS: The time of total re-epithelialization of the group using sodium hialuronate was on average 90 hours and the group using carboxymethylcellulose 105 hours, while the group using no drugs was 108 hours. There was a better performance of those groups using the drops and this difference can be proved statistically. CONCLUSION: The drops containing 0.4% of sodium hialuronate showed a higher efficiency rate compared to the drops containing 1% of carboxymethylcellulose, which was higher than the control group. The results of the present study show that the use of lubricants in the process of re-epithelialization are extremely valid and must be used frequently in ophthalmologic clinic.
Subject(s)
Carboxymethylcellulose Sodium/therapeutic use , Corneal Injuries , Hyaluronic Acid/therapeutic use , Ophthalmic Solutions/therapeutic use , Re-Epithelialization/drug effects , Viscosupplements/therapeutic use , Animals , Cornea/cytology , Female , Male , Prospective Studies , Rabbits , Time FactorsABSTRACT
OBJETIVO: Avaliar o tempo de reepitelização corneana pós abrasão usando colírios comercialmente disponíveis, um contendo hialuronato de sódio a 0,4%, outro contendo carboximetilcelulose a 1%, e comparar com a reepitelização sem instilação de colírio. MÉTODOS: Foram utilizados 24 coelhos, nos quais foi feita a abrasão mecânica da córnea nos 8 mm centrais. Esses animais foram divididos em três grupos. O primeiro grupo recebeu um colírio disponível comercialmente contendo hialuronato de sódio 0,4%, o segundo recebeu um colírio contendo carboximetilcelulose 1% e o terceiro não recebeu nenhuma droga. A avaliação foi feita a cada 24 horas por meio da análise de fotografias digitais sob luz azul de cobalto e coramento das córneas com fluoresceína a 2%. O estudo das imagens foi feito pelo sistema de análise de imagens do Autocad 2009®. A análise dos dados foi feita comparando o tempo total de reepitelização da córnea e a cada 24 horas entre os três grupos. RESULTADOS: A velocidade de reepitelização do grupo que usou colírio contendo hialuronato de sódio foi em média 90 horas; o grupo que usou carboximetilcelulose apresentou média de 105 horas; e o grupo que não usou nenhum tipo de lubrificante apresentou média de 108 horas para total reepitelização. Houve uma melhor performance na reepitelização após 96 horas nas córneas dos coelhos que usaram os colírios lubrificantes, sendo essa diferença estatisticamente comprovada. CONCLUSÃO: O colírio contendo hialuronato de sódio 0,4% mostrou índice de eficácia maior que aquele contendo carboximetilcelulose 1%, e este maior eficácia que o controle. Os resultados encontrados neste estudo mostram que o uso de lubrificantes no processo de reepitelização são de extrema valia e devem ser usados de rotina na clínica oftalmológica.
PURPOSE: Evaluate the time of post-abrasion corneal re-epithelialization using commercially available eye drops, one of which containing 0.4% sodium hialuronate, and the other containing 1% carboxymethylcellulose, and compare them to the re-epithelialization without the drops. METHODS: 24 rabbits were used, which had the mechanical abrasion of the central 8 mm of their corneas done. These animals were divided in 3 groups. The first one received the drops containing 0.4% of sodium hialuronate, the second one received the drops containing 1% of carboxymethylcellulose and the third group did not receive any drugs. The evaluations took place every 24 hours through the analysis of digital pictures under cobalt blue light and coloring of the corneas with 2% fluorescein. The pictures were analyzed with the software Autocad 2009®. The data was analyzed through the comparison of the total re-epithelialization time among the three groups RESULTS: The time of total re-epithelialization of the group using sodium hialuronate was on average 90 hours and the group using carboxymethylcellulose 105 hours, while the group using no drugs was 108 hours. There was a better performance of those groups using the drops and this difference can be proved statistically. CONCLUSION: The drops containing 0.4% of sodium hialuronate showed a higher efficiency rate compared to the drops containing 1% of carboxymethylcellulose, which was higher than the control group. The results of the present study show that the use of lubricants in the process of re-epithelialization are extremely valid and must be used frequently in ophthalmologic clinic.