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Özkan E, Köze BŞ, Yavuz van Giersbergen M. Effectiveness of plant and animal-based interventions in preventing and reducing pressure injuries: A systematic review and meta-analysis. J Tissue Viability 2025; 34:100893. [PMID: 40154133 DOI: 10.1016/j.jtv.2025.100893] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2024] [Revised: 10/12/2024] [Accepted: 03/19/2025] [Indexed: 04/01/2025]
Abstract
BACKGROUND Pressure injuries (PIs) are a significant concern among the elderly and bedridden patients, often resulting from prolonged pressure on the skin. Various interventions, including plant and animal-based therapies, are used to prevent and treat PIs. However, there is a lack of comprehensive understanding of the effectiveness of these natural interventions. AIM This study aims to systematically review and conduct a meta-analysis of studies using plant and animal-based interventions to prevent and treat pressure injuries. METHODS A systematic review and meta-analysis were performed according to the PRISMA guidelines. Searches were conducted in PubMed, Web of Science, SCOPUS, and Cochrane databases using keywords related to pressure injuries and natural interventions. Studies published between 2003 and 2023 were included. The inclusion criteria were experimental, quasi-experimental, and case-control studies. Data extraction and quality assessment were performed independently by two researchers. The effect size was calculated using Hedges' g, and heterogeneity was assessed using Cochrane Q and I2 tests. RESULTS A total of 13,563 records were identified, with 20 studies meeting the inclusion criteria after screening and full-text review. The total sample size was 2541 participants. The meta-analysis revealed a significant overall effect size (g = -0.614, 95 % CI: -0.890 to -0.337) indicating moderate effectiveness of plant and animal-based interventions in preventing and reducing PIs. Aloe vera, olive oil, and fish oil showed significant effects with p-values <0.05. High heterogeneity was observed among the studies (Q = 91.007, p < 0.05; I2 = 79.123 %), leading to the use of a random effects model. CONCLUSIONS Plant and animal-based interventions are moderately effective in preventing and reducing pressure injuries. These findings support the integration of natural therapies into clinical practice for PI management. Further research is needed to standardize protocols and explore the long-term effects of these interventions.
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Affiliation(s)
- Esra Özkan
- Giresun University Faculty of Health Sciences, Department of Surgical Diseases Nursing, Giresun, Türkiye.
| | - Burçak Şahin Köze
- Ege University Faculty of Health Sciences, Department of Surgical Diseases Nursing, İzmir, Türkiye.
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Yan R, Wang Y, Li W, Sun J. Promotion of chronic wound healing by plant-derived active ingredients and research progress and potential of plant polysaccharide hydrogels. CHINESE HERBAL MEDICINES 2025; 17:70-83. [PMID: 39949811 PMCID: PMC11814255 DOI: 10.1016/j.chmed.2024.11.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2024] [Revised: 06/30/2024] [Accepted: 11/19/2024] [Indexed: 02/16/2025] Open
Abstract
Wound healing is a complex biochemical process. The use of herbal medicine in wound healing not only carries forward the wisdom of traditional medicine, with its anti-inflammatory and immune-regulating effects, but also reflects the direction of modern biopharmaceutical technology, such as its potential in developing new biomaterials like hydrogels. This article first outlines the inherent structural properties of healthy skin, along with the physiological characteristics related to chronic wounds in patients with diabetes and burns. Subsequently, the article delves into the latest advancements in clinical and experimental research on the impact of active constituents in herbal medicine on wound tissue regeneration, summarizing existing studies on the mechanisms of various herbal medicines in the healing of diabetic and burn wounds. Finally, the paper thoroughly examines the application and mechanisms of plant polysaccharide hydrogels containing active herbal compounds in chronic wound healing. The primary objective is to provide valuable resources for the clinical application and development of herbal medicine, thereby maximizing its therapeutic potential. It also represents the continuation of traditional medical wisdom, offering new possibilities for advancements in regenerative medicine and wound care.
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Affiliation(s)
- Ru Yan
- School of Pharmacy, Heilongjiang University of Chinese Medicine, Harbin 150006, China
- Key Laboratory of Basic and Application Research of Beiyao, Ministry of Education, Heilongjiang University of Chinese Medicine, Harbin 150006, China
| | - Yanhong Wang
- School of Pharmacy, Heilongjiang University of Chinese Medicine, Harbin 150006, China
- Key Laboratory of Basic and Application Research of Beiyao, Ministry of Education, Heilongjiang University of Chinese Medicine, Harbin 150006, China
| | - Weinan Li
- School of Pharmacy, Heilongjiang University of Chinese Medicine, Harbin 150006, China
- Key Laboratory of Basic and Application Research of Beiyao, Ministry of Education, Heilongjiang University of Chinese Medicine, Harbin 150006, China
| | - Jialin Sun
- Department of Medicine, Heilongjiang Minzu College, Harbin 150066, China
- Postdoctoral Research Station, Heilongjiang University of Chinese Medicine, Harbin 150006, China
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Shabib S, Soltani R, Khorvash F, Taheri A, Shahbazi Azad M. The Effect of Topical Cow's Milk on the Healing of Diabetic Foot Ulcers: A Randomized Controlled Pilot Clinical Trial. INT J LOW EXTR WOUND 2024; 23:585-592. [PMID: 35287509 DOI: 10.1177/15347346221084788] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Diabetic foot ulcer (DFU) is a very serious side effect among the diabetic patients with substantial clinical and economic consequences. The aim of this study was to investigate the efficacy of cows' milk topical ointment, as an available and cost-effective natural product, on accelerating the healing of DFU. In this randomized controlled clinical trial, patients with grade 1 or 2 DFU were randomly divided into two groups of intervention (n = 50) and control (n = 49). For patients of intervention group, cows' milk 20% topical ointment was applied on the ulcer once daily for two weeks, while a type of novel dressing was used for control group with the same frequency and duration. Both groups received usual standard wound care measures. The percentage of change in the ulcer size and the number of cases with complete wound healing (>90% reduction in the ulcer size) were recorded in the both groups. The ulcer size significantly reduced in both groups on the seventh and 14th days of intervention; however, the percentage of reduction was significantly higher in the intervention (milk) group compared to control at both time points (44.64 ± 15.98 vs. 24.95 ± 12.78, P < .001; 67.67 ± 22.15 vs. 42.87 ± 19.74, P < .001). Furthermore, although more patients in the intervention group (n = 4, 8%) showed complete healing of the ulcer compared to control (n = 0), the difference was not statistically significant (P = .117). Cow's milk 20% topical ointment improves and accelerates the healing of diabetic foot ulcers. However, more clinical studies are required to confirm these effects.
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Affiliation(s)
- Somayeh Shabib
- Department of Clinical Pharmacy and Pharmacy Practice, School of Pharmacy and Pharmaceutical Sciences, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Rasool Soltani
- Department of Clinical Pharmacy and Pharmacy Practice, School of Pharmacy and Pharmaceutical Sciences, Isfahan University of Medical Sciences, Isfahan, Iran
- Pharmaceutical Sciences Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Farzin Khorvash
- Nosocomial Infection Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Azade Taheri
- Department of Pharmaceutics, School of Pharmacy and Novel Drug Delivery System Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Mehdi Shahbazi Azad
- Nosocomial Infection Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
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Zamanifard M, Nasiri M, Yarahmadi F, Zonoori S, Razani O, Salajegheh Z, Imanipour M, Mohammadi SM, Jomehzadeh N, Asadi M. Healing of diabetic foot ulcer with topical and oral administrations of herbal products: A systematic review and meta-analysis of randomized controlled trials. Int Wound J 2024; 21:e14760. [PMID: 38356150 PMCID: PMC10867296 DOI: 10.1111/iwj.14760] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2024] [Revised: 01/27/2024] [Accepted: 01/28/2024] [Indexed: 02/16/2024] Open
Abstract
This systematic review aimed to qualitatively synthesize recent randomized controlled trials (RCTs) regarding the effect of topical application and oral intake of herbal products on the healing of diabetic foot ulcer (DFU). Also, we sought to pool the obtained findings in a meta-analysis using a random-effects model, if RCTs were relatively comparable and homogenous. A comprehensive search was performed on five electronic data sources from their inception through 23 January 2024. The RCTs, without restriction on the country of origin, were included if they compared the effect of administering standard treatments and/or placebo (i.e. control condition) to applying standard treatments and/or herbal products in topical or oral routes (i.e. experimental condition). Out of 1166 retrieved records, 28 RCTs were included. Studies used different poly and single herbal formulations. Based on the meta-analysis, administration of standard care plus daily dressing of the ulcer site with olive oil for 28 days significantly increased the total ulcer healing score (3 RCTs; weighted mean difference [WMD] = 89.30; p < 0.001), raised frequency of complete ulcer healing (2 RCTs; risk ratio [RR] = 12.44; p = 0.039) and declined ulcer degree (3 RCTs; WMD = -22.28; p = 0.002). Also, daily use of the bitter melon leaf extract in oral form for 28 days significantly increased the total ulcer healing score (2 RCTs; WMD = 0.40; p = 0.001). Additionally, based on qualitative synthesis, the adjuvant use of herbal agents seems an intriguing choice to manage DFU. Nonetheless, considering the undesirable methodological quality of most studies and the high heterogeneity in administered herbal formulations, more robust trials are required to build a solid conclusion regarding the use of herbal products for healing DFU.
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Affiliation(s)
- Mina Zamanifard
- Department of Nursing, School of Nursing and MidwiferyJahrom University of Medical SciencesJahromIran
| | - Morteza Nasiri
- Department of Anesthesiology, School of Allied Medical SciencesTehran University of Medical SciencesTehranIran
| | - Fatemeh Yarahmadi
- Department of Nursing, Broujerd School of NursingLorestan University of Medical SciencesKhorramabadIran
| | - Sahar Zonoori
- Department of Nursing, Broujerd School of NursingLorestan University of Medical SciencesKhorramabadIran
| | - Omolbanin Razani
- Department of Nursing, Doroud BranchIslamic Azad UniversityDoroudIran
| | - Zahra Salajegheh
- Department of Medical‐Surgical Nursing, School of Nursing and MidwiferyKerman University of Medical SciencesKermanIran
| | - Mohammad Imanipour
- Department of Medical‐Surgical Nursing, Faculty of NursingAja University of Medical SciencesTehranIran
| | | | - Nabi Jomehzadeh
- Department of Medical Bacteriology, School of MedicineAbadan University of Medical SciencesAbadanIran
| | - Masoomeh Asadi
- Department of Operating Room NursingAbadan University of Medical SciencesAbadanIran
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Yadav JP, Singh AK, Grishina M, Pathak P, Verma A, Kumar V, Kumar P, Patel DK. Insights into the mechanisms of diabetic wounds: pathophysiology, molecular targets, and treatment strategies through conventional and alternative therapies. Inflammopharmacology 2024; 32:149-228. [PMID: 38212535 DOI: 10.1007/s10787-023-01407-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2023] [Accepted: 11/27/2023] [Indexed: 01/13/2024]
Abstract
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.
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Affiliation(s)
- Jagat Pal Yadav
- Department of Pharmaceutical Sciences, Sam Higginbottom University of Agriculture, Technology and Sciences, Prayagraj, 211007, India.
- Pharmacology Research Laboratory, Faculty of Pharmaceutical Sciences, Rama University, Kanpur, 209217, India.
- Bioorganic and Medicinal Chemistry Research Laboratory, Department of Pharmaceutical Sciences, Sam Higginbottom University of Agriculture, Technology and Sciences, Prayagraj, 211007, India.
| | - Ankit Kumar Singh
- Department of Pharmaceutical Sciences and Natural Products, Central University of Punjab, Bathinda, 151401, India
| | - Maria Grishina
- Laboratory of Computational Modeling of Drugs, Higher Medical and Biological School, South Ural State University, Chelyabinsk, 454008, Russia
| | - Prateek Pathak
- Department of Pharmaceutical Analysis, Quality Assurance, and Pharmaceutical Chemistry, School of Pharmacy, GITAM (Deemed to Be University), Hyderabad, 502329, India
| | - Amita Verma
- Bioorganic and Medicinal Chemistry Research Laboratory, Department of Pharmaceutical Sciences, Sam Higginbottom University of Agriculture, Technology and Sciences, Prayagraj, 211007, India
| | - Vikas Kumar
- Natural Product Drug Discovery Laboratory, Department of Pharmaceutical Sciences, Sam Higginbottom University of Agriculture, Technology and Sciences, Prayagraj, 211007, India
| | - Pradeep Kumar
- Department of Pharmaceutical Sciences and Natural Products, Central University of Punjab, Bathinda, 151401, India
| | - Dinesh Kumar Patel
- Department of Pharmaceutical Sciences, Sam Higginbottom University of Agriculture, Technology and Sciences, Prayagraj, 211007, India.
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Salahi P, Nasiri M, Yazdanpanah L, Khosravi S, Amini MR. Short-term effect of dressing with Dermaheal ointment in the treatment of diabetic foot ulcer: A double-blinded randomized controlled clinical trial. Health Sci Rep 2024; 7:e1868. [PMID: 38357487 PMCID: PMC10864714 DOI: 10.1002/hsr2.1868] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2023] [Revised: 01/10/2024] [Accepted: 01/21/2024] [Indexed: 02/16/2024] Open
Abstract
Background and Aims Diabetic foot ulcers, a major cause of amputations in diabetics, could benefit from natural products as adjuncts to standard care, given the costs and adverse effects of typical therapies. This study aims to evaluate the short-term effects of dressing with Dermaheal ointment in the treatment of DFUs through a double-blinded randomized controlled clinical trial. Methods This double-blinded, placebo-controlled trial included 50 patients with Wagner's ulcer grade I or II, randomly assigned to Dermaheal and placebo groups (received standard treatment and placebo ointment). The ulcer site was dressed daily for four consecutive weeks with either Dermaheal or placebo ointment. Ulcer healing score (using DFU healing checklist), ulcer size with transparent ruler and largest dimension of ulcer, and pain severity using numerical pain rating score (were recorded at five-time points, including baseline, and on weeks 1, 2, 3, and 4). Also, ulcer healing status was investigated at the trial ended in November 2021. Results Both groups showed significant improvement in ulcer healing over 4 weeks (p time < 0.001), with more remarkable progress in the Dermaheal group (p group = 0.03). At the trial end, complete ulcer healing was also significantly higher in the Dermaheal group compared to the placebo group (56% vs. 12%, p = 0.002). Both groups exhibited a decrease in ulcer size (p time < 0.001). Considering the baseline ulcer size as a covariate, substantial changes in mean ulcer size were noted in the initial (p = 0.01), second (p = 0.001), third (p = 0.002), and fourth (p = 0.002) weeks of the intervention, showing a preference for the Dermaheal group. However, no significant between-group difference was observed in pain severity levels. Conclusion Dressing with Dermaheal as a topical treatment shows promise in improving healing and reducing the size of diabetic foot ulcers. Further research is needed to confirm these findings' long-term efficacy.
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Affiliation(s)
- Pouya Salahi
- Endocrinology and Metabolism Research Center, Endocrinology and Metabolism Clinical Sciences InstituteTehran University of Medical SciencesTehranIran
| | - Morteza Nasiri
- Department of Operating Room Nursing, School of Allied Medical SciencesTehran University of Medical SciencesTehranIran
| | - Leila Yazdanpanah
- Health Research Institute, Diabetes Research CenterAhvaz Jundishapur University of Medical SciencesAhvazIran
| | - Sepehr Khosravi
- Non‐Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences InstituteTehran University of Medical SciencesTehranIran
| | - Mohammad Reza Amini
- Diabetes Research Center, Endocrinology and Metabolism Clinical Sciences InstituteTehran University of Medical SciencesTehranIran
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Irani PS, Ranjbar H, Mehdipour-Rabori R, Torkaman M, Amirsalari S, Alazmani-Noodeh F. The Effect of Aloe vera on the Healing of Diabetic Foot Ulcer: A Randomized, Double-blind Clinical Trial. Curr Drug Discov Technol 2024; 21:56-63. [PMID: 37670716 DOI: 10.2174/1570163820666230904150945] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2023] [Revised: 06/08/2023] [Accepted: 07/25/2023] [Indexed: 09/07/2023]
Abstract
BACKGROUND Diabetic foot ulcer (DFU) is a prevalent complication of diabetes that can result in severe consequences. The cost of treating DFUs is high, and there is a lack of new therapies available in developing countries. This has created a demand for complementary and alternative treatments. The objective of this study was to assess the impact of aloe vera gel on the healing process of diabetic foot ulcers. MATERIALS AND METHODS The study was a double-blind, randomized, controlled clinical trial. The study samples were 66 patients with diabetic foot ulcers who were randomly assigned to two groups (intervention and control). All ulcers in both groups were washed with normal saline and dressed in sterile gauze. The ulcers in the intervention group were covered with a thin layer of Aloe Vera gel before the dressing. The Bates-Jensen Wound Assessment Tool (BWAT) was used on three occasions, including before the intervention period and at the end of each week. Data were analyzed using SPSS 16. RESULTS After three weeks, there was a notable contrast in the recovery pattern of the two groups. The patients who had aloe vera gel added to their dressing showed a more substantial decrease in the mean scores of their BWAT. CONCLUSION These findings are promising and suggest that Aloe vera may be a safe and effective adjunctive treatment for diabetic foot ulcers. However, further research is needed to confirm these results and to investigate the underlying mechanisms of aloe vera's therapeutic effect on diabetic foot ulcers.
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Affiliation(s)
- Parichehr Sabaghzadeh Irani
- Department of Nursing and Midwifery, Student Research Committee, Kerman University of Medical Sciences, Kerman, Iran
| | - Hadi Ranjbar
- Mental Health Research Center, Psychosocial Health Research Institute, Iran University of Medical Sciences, Tehran, Iran
| | - Roghayeh Mehdipour-Rabori
- Razi Faculty of Nursing and Midwifery, Department of Medical-surgical Nursing, Nursing Research Nursing, Kerman University of Medical Science, Kerman, Iran
| | - Mahya Torkaman
- Student Research Committee, Kerman University of Medical Sciences, Kerman, Iran
| | - Sudabeh Amirsalari
- Department of Reproductive Health Midwifery, School of Nursing & Midwifery, Tehran University of Medical Sciences, Tehran, Iran
| | - Farshid Alazmani-Noodeh
- Critical Care Nursing Department, Faculty of Nursing, Aja University of Medical Sciences, Tehran, Iran
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Narzary I, Swarnakar A, Kalita M, Middha SK, Usha T, Babu D, Mochahary B, Brahma S, Basumatary J, Goyal AK. Acknowledging the use of botanicals to treat diabetic foot ulcer during the 21 st century: A systematic review. World J Clin Cases 2023; 11:4035-4059. [PMID: 37388781 PMCID: PMC10303622 DOI: 10.12998/wjcc.v11.i17.4035] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/06/2023] [Revised: 04/24/2023] [Accepted: 05/16/2023] [Indexed: 06/12/2023] Open
Abstract
BACKGROUND Diabetic foot ulcer (DFU) is a serious health issue of diabetes mellitus that affects innumerable people worldwide. Management and treatment of this complication are challenging, especially for those whose immune system is weak. AIM To discuss the plants and their parts used to heal DFU, along with the mode of their administration in diabetic patients. METHODS The original articles on "the plants for the treatment of DFU" studied in clinical cases only were obtained from various bibliographic databases using different keywords. RESULTS The search resulted in 22 clinical cases records with 20 medicinal plants belonging to 17 families on 1553 subjects. The fruits and leaves were the most preferentially used parts for DFU treatment, regardless of whether they were being administered orally or applied topically. Of the 20 medicinal plants, 19 reported their effectiveness in increasing angiogenesis, epithelialization, and granulation, thus hastening the wound-healing process. The efficacy of these botanicals might be attributed to their major bioactive compounds, such as actinidin and ascorbic acid (in Actinidia deliciosa), 7-O-(β-D-glucopyranosyl)-galactin (in Ageratina pichinchensis), omega-3-fatty acid (in Linum usitatissimum), isoquercetin (in Melilotus officinalis), anthocyanins (in Myrtus communis), and plantamajoside (in Plantago major). CONCLUSION The validation of mechanisms of action underlying these phytocompounds contributing to the management of DFU can aid in our better understanding of creating efficient treatment options for DFU and its associated problems.
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Affiliation(s)
- Illora Narzary
- Department of Biotechnology, Bodoland University, Kokrajhar 783370, Assam, India
- Department of Zoology, Baosi Banikanta Kakati College, Barpeta 781311, Assam, India
| | - Amit Swarnakar
- Medical Unit, Bodoland University, Kokrajhar 783370, Assam, India
| | - Mrinal Kalita
- Department of Biotechnology, Bodoland University, Kokrajhar 783370, Assam, India
| | - Sushil Kumar Middha
- Department of Biotechnology, Maharani Lakshmi Ammanni College for Women, Bengaluru 560012, Karnataka, India
| | - Talambedu Usha
- Department of Biochemistry, Maharani Lakshmi Ammanni College for Women, Bengaluru 560012, Karnataka, India
| | - Dinesh Babu
- Faculty of Pharmacy and Pharmaceutical Sciences, University of Alberta, Edmonton, Alberta T6G 2E1, Canada
| | - Banjai Mochahary
- Department of Biotechnology, Bodoland University, Kokrajhar 783370, Assam, India
| | - Sudem Brahma
- Department of Biotechnology, Bodoland University, Kokrajhar 783370, Assam, India
| | - Jangila Basumatary
- Department of Biotechnology, Bodoland University, Kokrajhar 783370, Assam, India
| | - Arvind Kumar Goyal
- Department of Biotechnology, Bodoland University, Kokrajhar 783370, Assam, India
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Evidence for Natural Products as Alternative Wound-Healing Therapies. Biomolecules 2023; 13:biom13030444. [PMID: 36979379 PMCID: PMC10046143 DOI: 10.3390/biom13030444] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2022] [Revised: 02/13/2023] [Accepted: 02/15/2023] [Indexed: 03/02/2023] Open
Abstract
Chronic, non-healing wounds represent a significant area of unmet medical need and are a growing problem for healthcare systems around the world. They affect the quality of life for patients and are an economic burden, being difficult and time consuming to treat. They are an escalating problem across the developed world due to the increasing incidence of diabetes and the higher prevalence of ageing populations. Effective treatment options are currently lacking, and in some cases chronic wounds can persist for years. Some traditional medicines are believed to contain bioactive small molecules that induce the healing of chronic wounds by reducing excessive inflammation, thereby allowing re-epithelisation to occur. Furthermore, many small molecules found in plants are known to have antibacterial properties and, although they lack the therapeutic selectivity of antibiotics, they are certainly capable of acting as topical antiseptics when applied to infected wounds. As these molecules act through mechanisms of action distinct from those of clinically used antibiotics, they are often active against antibiotic resistant bacteria. Although there are numerous studies highlighting the effects of naturally occurring small molecules in wound-healing assays in vitro, only evidence from well conducted clinical trials can allow these molecules or the remedies that contain them to progress to the clinic. With this in mind, we review wound-healing natural remedies that have entered clinical trials over a twenty-year period to the present. We examine the bioactive small molecules likely to be in involved and, where possible, their mechanisms of action.
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Rayate AS, Nagoba BS, Mumbre SS, Mavani HB, Gavkare AM, Deshpande AS. Current scenario of traditional medicines in management of diabetic foot ulcers: A review. World J Diabetes 2023; 14:1-16. [PMID: 36684382 PMCID: PMC9850800 DOI: 10.4239/wjd.v14.i1.1] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/24/2022] [Revised: 11/04/2022] [Accepted: 12/06/2022] [Indexed: 01/10/2023] Open
Abstract
Diabetic foot infections and diabetic foot ulcers (DFU) cause significant suffering and are often recurring. DFU have three important pathogenic factors, namely, microangiopathy causing local tissue anoxia, neuropathy making the foot prone to injuries from trivial trauma, and local tissue hyperglycaemia favouring infection and delaying the wound healing. DFU have been the leading cause for non-traumatic amputations of part or whole of the limb. Western medicines focus mainly on euglycaemia, antimicrobials, debridement and wound cover with grafts, and off-loading techniques. Advances in euglycaemic control, foot care and footwear, systemic antimicrobial therapy, and overall health care access and delivery, have resulted in an overall decrease in amputations. However, the process of wound care after adequate debridement remains a major cost burden globally, especially in developing nations. This process revolves around two basic concerns regarding control/eradication of local infection and promotion of faster healing in a chronic DFU without recurrence. Wound modulation with various dressings and techniques are often a costly affair. Some aspects of the topical therapy with modern/Western medicines are frequently not addressed. Cost of and compliance to these therapies are important as both the wounds and their treatment are “chronic.” Naturally occurring agents/medications from traditional medicine systems have been used frequently in different cultures and nations, though without adequate clinical base/relevance. Traditional Chinese medicine involves restoring yin-yang balance, regulating the ‘chi’, and promoting local blood circulation. Traditional medicines from India have been emphasizing on ‘naturally’ available products to control wound infection and promote all the aspects of wound healing. There is one more group of chemicals which are not pharmaceutical agents but can create acidic milieu in the wound to satisfy the above-mentioned basic concerns. Various natural and plant derived products (e.g., honey, aloe vera, oils, and calendula) and maggots are also used for wound healing purposes. We believe that patients with a chronic wound are so tired physically, emotionally, and financially that they usually accept native traditional medicine which has the same cultural base, belief, and faith. Many of these products have never been tested in accordance to “evidence-based medicine.” There are usually case reports and experience-based reports about these products. Recently, there have been some trials (in vitro and in vivo) to verify the claims of usage of traditional medicines in management of DFU. Such studies show that these natural products enhance the healing process by controlling infection, stimulating granulation tissue, antimicrobial action, promoting fibroblastic activity and collagen deposition, etc. In this review, we attempt to study and analyse the available literature on results of topical traditional medicines, which are usually advocated in the management of DFU. An integrated and ‘holistic’ approach of both modern and traditional medicine may be more acceptable to the patient, cost effective, and easy to administer and monitor. This may also nevertheless lead to further improvement in quality of life and decrease in the rates of amputations for DFU.
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Affiliation(s)
- Abhijit S Rayate
- Department of Surgery, Maharashtra Institute of Medical Sciences & Research (Medical College), Latur 413531, India
| | - Basavraj S Nagoba
- Department of Microbiology, Maharashtra Institute of Medical Sciences & Research (Medical College), Latur 413531, India
| | - Sachin S Mumbre
- Department of Community Medicine, Ashwini Rural Medical College, Solapur 413006, India
| | - Hardi B Mavani
- Department of Surgery, Maharashtra Institute of Medical Sciences & Research (Medical College), Latur 413531, India
| | - Ajay M Gavkare
- Department of Physiology, Maharashtra Institute of Medical Sciences & Research (Medical College), Latur 413531, India
| | - Advait S Deshpande
- Department of Surgery, Maharashtra Institute of Medical Sciences & Research (Medical College), Latur 413531, India
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11
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Second-Degree Burns and Aloe Vera: A Meta-analysis and Systematic Review. Adv Skin Wound Care 2022; 35:1-9. [DOI: 10.1097/01.asw.0000875056.29059.78] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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12
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Usai R, Majoni S, Rwere F. Natural products for the treatment and management of diabetes mellitus in Zimbabwe-a review. Front Pharmacol 2022; 13:980819. [PMID: 36091798 PMCID: PMC9449367 DOI: 10.3389/fphar.2022.980819] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2022] [Accepted: 08/02/2022] [Indexed: 12/19/2022] Open
Abstract
Use of medicinal plants and herbs in the treatment and management of diseases, including diabetes mellitus and its complications remains an integral part of African tradition. In Zimbabwe, nearly one million people are living with diabetes mellitus. The prevalence of diabetes mellitus in Zimbabwe is increasing every year due to lifestyle changes, and has accelerated the use of traditional medicines for its treatment and management in urban areas. In addition, the high cost of modern medicine has led many people in rural parts of Zimbabwe to rely on herbal plant medicine for the treatment of diabetes mellitus and its complications. This review highlights a number of studies carried out to evaluate the antidiabetic properties of indigenous plants found in Zimbabwe with the goal of treating diabetes mellitus. Further, we discuss the mechanism of action of various plant extracts in the treatment and management of diabetes mellitus. Together, this review article can open pathways leading to discovery of new plant derived medicines and regularization of use of crude plant remedies to treat diabetes mellitus by the Zimbabwean government and others across Africa.
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Affiliation(s)
- Remigio Usai
- Department of Chemistry, Marquette University, Milwaukee, WI, United States
| | - Stephen Majoni
- Department of Chemical and Forensic Sciences, Botswana International University of Science and Technology, Palapye, Botswana
| | - Freeborn Rwere
- Department Anesthesiology, Perioperative, and Pain Medicine, School of Medicine, Stanford University, Stanford, CA, United States
- Department of Chemistry, School of Natural Sciences and Mathematics, Chinhoyi University of Technology, Chinhoyi, Zimbabwe
- *Correspondence: Freeborn Rwere,
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Awasthi A, Vishwas S, Gulati M, Corrie L, Kaur J, Khursheed R, Alam A, Alkhayl FF, Khan FR, Nagarethinam S, Kumar R, Arya K, Kumar B, Chellappan DK, Gupta G, Dua K, Singh SK. Expanding arsenal against diabetic wounds using nanomedicines and nanomaterials: Success so far and bottlenecks. J Drug Deliv Sci Technol 2022. [DOI: 10.1016/j.jddst.2022.103534] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
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Investigation of the relationship between the use of complementary alternative medicine and illness perception and illness cognition in patients with diabetic foot ulcer. J Tissue Viability 2022; 31:637-642. [DOI: 10.1016/j.jtv.2022.08.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2022] [Revised: 07/30/2022] [Accepted: 08/24/2022] [Indexed: 11/22/2022]
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Massoud D, Fouda MMA, Sarhan M, Salama SG, Khalifa HS. Topical application of Aloe gel and/or olive oil combination promotes the wound healing properties of streptozotocin-induced diabetic rats. ENVIRONMENTAL SCIENCE AND POLLUTION RESEARCH INTERNATIONAL 2022; 29:59727-59735. [PMID: 35394628 DOI: 10.1007/s11356-022-20100-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/21/2022] [Accepted: 04/01/2022] [Indexed: 06/14/2023]
Abstract
Diabetic wounds are characterized by a delayed closure rate due to the excess inflammation and the inhibition of angiogenesis. Natural products derived from Aloe vera have shown great promise due to their healing magnificent properties. Olive oil is another natural product with anti-microbial and anti-inflammatory properties that may contribute to the healing process. In the present investigation, we tried to evaluate the efficacy of topical application of Aloe gel and/or olive oil in the enhancement of diabetic wounds using histological and immunohistochemical analysis. Excisional wounds were created on the back skin of streptozotocin-induced diabetic rats. Topical treatments of Aloe gel and/or olive oil were applied separately and in a combination (AVO) daily for experimental groups. Macroscopic and microscopic observations of the excision wounds were monitored at time intervals (3, 6, 9, 14 days) post-wounding. Macroscopic observations of the AVO group exhibited almost complete healing at day 14, while other groups were still in progress. Similarly, immunohistochemical analysis of the AVO group showed a mild expression pattern of NF-κB.. While, the cell proliferation (Ki-67), and angiogenesis (CD34) markers were upregulated. Conclusively, the obtained results showed that the AVO combination effectively improved the healing process in diabetic excisional wounds with significant differences in the healing kinetics compared to wounds that received Aloe gel or olive oil separately.
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Affiliation(s)
- Diaa Massoud
- Department of Biology, College of Science, Jouf University, P.O. Box 2014, Sakaka, Al-Jouf, Saudi Arabia.
- Department of Zoology, Faculty of Science, Fayoum University, Fayoum, Egypt.
| | - Maged M A Fouda
- Department of Biology, College of Science, Jouf University, P.O. Box 2014, Sakaka, Al-Jouf, Saudi Arabia
- Department of Zoology, Faculty of Science, Al-Azhar University, Assiut, Egypt
| | - Moustafa Sarhan
- Department of Zoology, Faculty of Science, Al-Azhar University, Assiut, Egypt
| | - Shaimaa Gamal Salama
- Department of Botany and Microbiology, Faculty of Science, Damanhour University, Damanhour, Egypt
| | - Heba Saied Khalifa
- Department of Zoology, Faculty of Science, Damanhour University, Damanhour, Egypt
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16
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Keshavarzi A, Montaseri H, Akrami R, Moradi Sarvestani H, Khosravi F, Foolad S, Zardosht M, Zareie S, Saharkhiz MJ, Shahriarirad R. Therapeutic Efficacy of Great Plantain ( Plantago major L.) in the Treatment of Second-Degree Burn Wounds: A Case-Control Study. Int J Clin Pract 2022; 2022:4923277. [PMID: 35966146 PMCID: PMC9359829 DOI: 10.1155/2022/4923277] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/15/2022] [Accepted: 07/13/2022] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND Great plantain (Plantago major L. or P.major) is a medicinal plant that is available all around the world. The whole plant has several bioactive compounds including terpenoids, flavonoids, phenolic compounds, alkaloids, fatty acids, iridoid glycosides, polysaccharides, and vitamins. Scientific studies have recognized several medical benefits like wound healing, anti-inflammatory, antimicrobial, antiulcerative, and antioxidative agents. The wound-healing capacity of this plant has been investigated under in vivo and ex vivo conditions. In the current study, we aim to compare the therapeutic effect of the P.major extract with 1% sulfadiazine on the healing of second-degree burn wounds. METHOD Second-degree burn victims were included in our study. The investigation and control group, respectively, received P. major ointment 10% and silver sulfadiazine ointment 1%. The bacterial culture from the wound site was taken on days 3, 7, 10, 13, and last day of hospitalization. Patients' subjective complaints were obtained through the visual analog scale (VAS). All patients were treated and evaluated in the hospital. RESULT Among the 15 patients, 11 were male, and the mean age was 33.3 years. The average complete healing duration was 11.73 vs. 13 days in the P. major and control group, respectively (P=0.166). On the third day, infection control was similar between the two groups, and on the seventh day, all bacterial cultures were negative. Although there was a significant reduction in pain scores during the recovery time, no significant differences in pain reduction were noted between the two groups (P=0.849). CONCLUSION We showed that P.major ointment is a safe and suitable herbal compound in the treatment of second-degree burn wounds that not only has wound-healing properties but also is an analgesic and antimicrobial compound.
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Affiliation(s)
| | - Hashem Montaseri
- Department of Quality Control, Faculty of Pharmacy, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Rahimeh Akrami
- Burn and Wound Healing Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | | | - Fateme Khosravi
- MPH Department, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran
- Student Research Committee, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Sara Foolad
- College of Agricultural Sciences, Shiraz Branch, Islamic Azad University, Shiraz, Iran
| | - Mitra Zardosht
- Burn and Wound Healing Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Saeid Zareie
- Bachelor of Nursing, Nurse of Intensive Care Unit (ICU) of Amir Al-Momenin Burn Injury Hospital, Shiraz University of Medical Sciences, Shiraz, Iran
| | | | - Reza Shahriarirad
- Student Research Committee, Shiraz University of Medical Sciences, Shiraz, Iran
- Thoracic and Vascular Surgery Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
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Marmitt DJ, Shahrajabian MH, Goettert MI, Rempel C. Clinical trials with plants in diabetes mellitus therapy: a systematic review. Expert Rev Clin Pharmacol 2021; 14:735-747. [PMID: 33884948 DOI: 10.1080/17512433.2021.1917380] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
INTRODUCTION The chronic metabolic disorder diabetes mellitus is a fast-growing global problem with huge social, health, and economic consequences, having one of the highest morbidities and mortality rates. Prolonged use of many available medications can produce undesirable side effects. Thus, plants appear as an important source of bioactive resources for the discovery of new treatments for diabetes. AREAS COVERED In this sense, this systematic review focused on clinical trials involving plants of National List of Medicinal Plants of Interest to the Unified Health System (RENISUS) (or compounds) with antidiabetic properties. We analyzed indexed studies in PubMed following the reporting guidelines of PRISMA. EXPERT OPINION Of the 51 clinical trials found, Curcuma longa, Glycine max, Zingiber officinale, Punica granatum, Aloe vera, Momordica charantia are the species with the greatest amount of clinical trials and the attenuation of insulin resistance, decreased fasting blood glucose and glycosylated hemoglobin levels are some of the main mechanisms by which these plants exert hypoglycemic effects. Thus, we speculate that the Clinical Pharmacology should explore the field of plant-based compounds that will keep concentrating the attention of researchers, and therefore, we gathered studies in advanced stages that highlight the role of plants in the diabetes therapy.
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Affiliation(s)
- Diorge Jonatas Marmitt
- Programa De Pós-graduação Em Biotecnologia, Universidade Do Vale Do Taquari - Univates, Lajeado, RS, Brasil
| | | | - Márcia Inês Goettert
- Programa De Pós-graduação Em Biotecnologia, Universidade Do Vale Do Taquari - Univates, Lajeado, RS, Brasil
| | - Claudete Rempel
- Programa De Pós-graduação Em Ambiente E Desenvolvimento/Programa De Pós-graduação Em Sistemas Ambientais Sustentáveis, Universidade Do Vale Do Taquari - Univates, Lajeado, RS, Brasil
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Ghiasian M, Niroomandi Z, Dastan D, Poorolajal J, Zare F, Ataei S. Clinical and phytochemical studies of Plantago major in pressure ulcer treatment: A randomized controlled trial. Complement Ther Clin Pract 2021; 43:101325. [PMID: 33548748 DOI: 10.1016/j.ctcp.2021.101325] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2020] [Revised: 01/05/2021] [Accepted: 01/25/2021] [Indexed: 02/07/2023]
Abstract
BACKGROUND Plantago major L. is used by local people to improve various wounds and lesions such as pressure ulcer. In this study, the therapeutic effects of P. major topical formulation on the stage 1 pressure ulcer in patients have been investigated. MATERIALS AND METHODS This randomized triple blind clinical trial study was performed on 130 patients. During the 14 days of study, each of the test and control groups was checked according to check list. Also the topical formulation was standardized by HPLC based on the amount of quercetin. RESULTS The findings of this study indicated a significant difference in resolution of the damage between the test and control groups. Topical formulation was standardized by HPLC based on the quercetin (1.88 mg/100g) and no side effects associated with this topical formulation was found. CONCLUSION The results confirmed the traditional use of P. major in resolution of the damage. CLINICAL TRIAL ID: (IRCT201609209014N117).
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Affiliation(s)
- Masoud Ghiasian
- Department of Neurology, School of Medicine, Hamadan University of Medical Science, Hamadan, Iran
| | - Zahra Niroomandi
- Department of Clinical Pharmacy, School of Pharmacy, Medicinal Plants and Natural Products Research Center, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Dara Dastan
- Department of Pharmacognosy, School of Pharmacy, Medicinal Plants and Natural Products Research Center, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Jalal Poorolajal
- Department of Epidemiology, School of Public Health, Hamadan University of Medical Science, Hamadan, Iran
| | - Fateme Zare
- Department of Neurology, School of Medicine, Hamadan University of Medical Science, Hamadan, Iran
| | - Sara Ataei
- Department of Clinical Pharmacy, School of Pharmacy, Medicinal Plants and Natural Products Research Center, Hamadan University of Medical Sciences, Hamadan, Iran.
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Mieczkowski M, Mrozikiewicz-Rakowska B, Siwko T, Bujalska-Zadrozny M, de Corde-Skurska A, Wolinska R, Gasinska E, Grzela T, Foltynski P, Kowara M, Mieczkowska Z, Czupryniak L. Insulin, but Not Metformin, Supports Wound Healing Process in Rats with Streptozotocin-Induced Diabetes. Diabetes Metab Syndr Obes 2021; 14:1505-1517. [PMID: 33854349 PMCID: PMC8039538 DOI: 10.2147/dmso.s296287] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/17/2020] [Accepted: 02/23/2021] [Indexed: 12/15/2022] Open
Abstract
PURPOSE Optimal glycemic control is crucial for proper wound healing in patients with diabetes. However, it is not clear whether other antidiabetic drugs support wound healing in mechanisms different from the normalization of blood glucose control. We assessed the effect of insulin and metformin administration on the wound healing process in rats with streptozotocin-induced diabetes. METHODS The study was conducted on 200 male Wistar rats with streptozotocin-induced diabetes. In the last phase of the study, 45 rats, with the most stable glucose levels in the range of 350-500 mg/dL, were divided into three groups: group I received human non-protamine insulin subcutaneously (5 IU/kg body mass) once a day, group II received metformin intragastrically (500 mg/kg b.m.), and group III (control) was given saline subcutaneously. After 14 days of antidiabetic treatment, a 2 cm × 2 cm thin layer of skin was cut from each rat's dorsum and a 4 cm disk with a hole in its center was sewn in to stabilize the skin and standardize the healing process. The wound healing process was followed up for 9 days, with assessment every 3 days. Biopsy samples were subjected to hematoxylin and eosin staining and immunohistochemical assays. RESULTS Analysis of variance revealed significant influence of treatment type (insulin, control, or metformin) on the relative change in wound surface area. The wound healing process in rats treated with insulin was more effective than in the metformin and control groups. Wound tissue samples taken from the insulin-treated animals presented significantly lower levels of inflammatory infiltration. Immunohistochemical assessment showed the greatest density of centers of proliferation Ki-67 in insulin-treated animals. CONCLUSION These results suggest that an insulin-based treatment is more beneficial than metformin, in terms of accelerating the wound healing process in an animal model of streptozocin-induced diabetes.
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Affiliation(s)
- Mateusz Mieczkowski
- Department of Diabetology and Internal Medicine, Medical University of Warsaw, Warsaw, Poland
| | - Beata Mrozikiewicz-Rakowska
- Department of Diabetology and Internal Medicine, Medical University of Warsaw, Warsaw, Poland
- Correspondence: Beata Mrozikiewicz-Rakowska Department of Diabetology and Internal Medicine, Medical University of Warsaw, Poland ul. Banacha 1A, Warsaw, 02-097, PolandTel +48 600 311 399Fax +48225992832 Email
| | - Tomasz Siwko
- Department of Diabetology and Internal Medicine, Medical University of Warsaw, Warsaw, Poland
| | | | | | - Renata Wolinska
- Department of Pharmacodynamics, Medical University of Warsaw, Warsaw, Poland
| | - Emilia Gasinska
- Department of Pharmacodynamics, Medical University of Warsaw, Warsaw, Poland
| | - Tomasz Grzela
- Department of Histology and Embryology, Medical University of Warsaw, Warsaw, Poland
| | - Piotr Foltynski
- Nalecz Institute of Biocybernetics and Biomedical Engineering Polish Academy of Sciences, Warsaw, Poland
| | - Michal Kowara
- Department of Cardiology, Medical University of Warsaw, Warsaw, Poland
| | - Zofia Mieczkowska
- Department of Diabetology and Internal Medicine, Medical University of Warsaw, Warsaw, Poland
| | - Leszek Czupryniak
- Department of Diabetology and Internal Medicine, Medical University of Warsaw, Warsaw, Poland
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Diabetic Foot Ulcers: Current Advances in Antimicrobial Therapies and Emerging Treatments. Antibiotics (Basel) 2019; 8:antibiotics8040193. [PMID: 31652990 PMCID: PMC6963879 DOI: 10.3390/antibiotics8040193] [Citation(s) in RCA: 75] [Impact Index Per Article: 12.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2019] [Revised: 10/16/2019] [Accepted: 10/17/2019] [Indexed: 12/23/2022] Open
Abstract
Diabetic foot ulcers (DFUs) are very important diabetes-related lesions that can lead to serious physical consequences like amputations of limbs and equally severe social, psychological, and economic outcomes. It is reported that up to 25% of patients with diabetes develop a DFU in their lifetime, and more than half of them become infected. Therefore, it is essential to manage infection and ulcer recovery to prevent negatives outcomes. The available information plays a significant role in keeping both physicians and patients aware of the emerging therapies against DFUs. The purpose of this review is to compile the currently available approaches in the managing and treatment of DFUs, including molecular and regenerative medicine, antimicrobial and energy-based therapies, and the use of plant extracts, antimicrobial peptides, growth factors, ozone, devices, and nano-medicine, to offer an overview of the assessment of this condition.
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Lans C. Do recent research studies validate the medicinal plants used in British Columbia, Canada for pet diseases and wild animals taken into temporary care? JOURNAL OF ETHNOPHARMACOLOGY 2019; 236:366-392. [PMID: 30772483 DOI: 10.1016/j.jep.2019.02.030] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/07/2018] [Revised: 02/13/2019] [Accepted: 02/13/2019] [Indexed: 06/09/2023]
Abstract
ETHNOPHARMACOLOGICAL RELEVANCE There are insufficient safe and effective treatments for chronic pain in pets. In cases such as osteoarthritis there is no commercially available cure and veterinarians use NSAIDs to manage pain. Pet owners may have to plan for a lifetime of plant-based treatment for the conditions that lead to chronic pain in pets. Phytopharmacotherapies have the advantage of being less toxic, cheap or free, readily available, are more likely to be safe for long-term use and have the potential to reset the immune system to normal functioning. AIM OF THE STUDY To examine the recently published medicinal plant research that matches unpublished data on ethnoveterinary medicines (EVM) used for pets in Canada (British Columbia) to see if the EVM data can provide a lead to the development of necessary drugs. MATERIALS AND METHODS In 2003 semi-structured interviews were conducted with 60 participants who were organic farmers or holisitic medicinal/veterinary practitioners obtained using a purposive sample. A draft manual prepared from the data was then evaluated by participants at a participatory workshop that discussed the plant-based treatments. A copy of the final version of the manual was given to all research participants. In 2018, the recently published research matching the EVM data was reviewed to see if the EVM practices could serve as a lead for further research. RESULTS AND CONCLUSION Medicinal plants are used to treat a range of conditions. The injuries treated in pets in British Columbia included abscesses (resulting from an initial injury), sprains and abrasions. Dogs were also treated with medicinal plants for rheumatoid arthritis, joint pain and articular cartilage injuries. More than 40 plants were used. Anal gland problems were treated with Allium sativum L., Aloe vera L., Calendula officinalis L., Plantago major L., Ulmus fulva Michx., Urtica dioica L. and Usnea longissima Ach. Arctium lappa, Hydrangea arborescens and Lactuca muralis were used for rheumatoid arthritis and joint pain in pets. Asthma was treated with: Linum usitatissimum L., Borago officinalis L., Verbascum thapsus L., Cucurbita pepo L., Lobelia inflata L., and Zingiber officinale Roscoe. Pets with heart problems were treated with Crataegus oxyacantha L., Cedronella canariensis (L.) Willd. ex Webb & Berth, Equisetum palustre L., Cypripedium calceolus L., Pinus ponderosa Douglas ex Lawson, Humulus lupulus L., Valeriana officinalis L., Lobelia inflata L., Stachys officinalis (L.) Trev., and Viscum album L. The following plants were used for epilepsy, motion sickness and anxiety- Avena sativa L., Valeriana officinalis, Lactuca muralis (L.) Fresen., Scutellaria lateriflora L., Satureja hortensis L., and Passiflora incarnata L. Plants used for cancer treatment included Phytolacca decandra, Ganoderma lucidum, Lentinula edodes, Rumex acetosella, Arctium lappa, Ulmus fulva, Rheum palmatum, Frangula purshiana, Zingiber officinale, Glycyrrhiza glabra, Ulmus fulva, Althea officinalis, Rheum palmatum, Rumex crispus and Plantago psyllium. Trifolium pratense was used for tumours in the prostate gland. Also used were Artemisia annua, Taraxacum officinale and Rumex crispus. This review of plants used in EVM was possible because phytotherapy research of the plants described in this paper has continued because few new pharmaceutical drugs have been developed for chronic pain and because treatments like glucocorticoid therapy do not heal. Phytotherapuetic products are also being investigated to address the overuse of antibiotics. There have also been recent studies conducted on plant-based functional foods and health supplements for pets, however there are still gaps in the knowledge base for the plants Stillingia sylvatica, Verbascum thapsus, Yucca schidigera and Iris versicolor and these need further investigation.
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Affiliation(s)
- Cheryl Lans
- Institute for Ethnobotany and Zoopharmacognosy (IEZ), Rijksstraatweg 158A, 6573 DG Beek, the Netherlands.
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