DIABETOLOGY / EXPERIMENTAL RESEARCH
 
KEYWORDS
TOPICS
ABSTRACT
Introduction:
Impairments in wound healing commonly occur among patients with diabetes. Herbal medicines have a long history of usage in wound care management. Super green (SG) is a newly discovered natural product obtained from Musa paradisiaca. This study aimed to investigate the efficacy of the topical application of SG in healing surgical wounds in diabetic rats.

Material and methods:
Wistar rats received a one-time intraperitoneal injection of streptozotocin to induce type 1 diabetes. Full-thickness excisional skin wounds were created on the backs of the rats. The relevant groups were topically treated with the indicated concentrations of SG or vehicle dressing throughout the study duration. Histological analysis was performed and the mRNA levels of proinflammatory cytokines were measured to evaluate the improvement of wound closure.

Results:
The wound area ratio of the SG (1/6000 dilution)-treated group was greatly reduced compared to that of the vehicle-treated group. The histological analysis showed fewer inflammatory cells, accelerated re-epithelialization, and increased collagen deposition in SG 1/6000-treated wounds. The gene expression levels of tumor necrosis factor-α, interleukin-1β, and interleukin-6 were decreased and the levels of type I and type III collagen were increased after SG treatment.

Conclusions:
These results show that the most therapeutically efficacious concentration of SG (1/6000 dilution) can enhance wound repair in diabetic rats. SG has the potential to be a new treatment strategy for diabetic wounds.

 
REFERENCES (46)
1.
Dunachie S, Chamnan P. The double burden of diabetes and global infection in low and middle-income countries. Trans R Soc Trop Med Hyg 2019; 113: 56-64.
 
2.
Wang N, Zhang JP, Xing XY, et al. MARCH: factors associated with weight loss in patients with newly diagnosed type 2 diabetes treated with acarbose or metformin. Arch Med Sci 2019; 15: 309-20.
 
3.
Atwa H, Gad K, Hagrasy H, et al. Is subclinical atherosclerosis associated with visceral fat and fatty liver in adolescents with type 1 diabetes? Arch Med Sci 2018; 14: 1355-60.
 
4.
Mejias SG, Ramphul K. Prevalence of peripheral arterial disease among diabetic patients in Santo Domingo, Dominican Republic and associated risk factors. Arch Med Sci Atheroscler Dis 2018; 3: e35-e40.
 
5.
Teng Y, Wang S, Wang N, et al. STOP-Bang questionnaire screening for obstructive sleep apnea among Chinese patients with type 2 diabetes mellitus. Arch Med Sci 2018; 14: 971-8.
 
6.
Spravchikov N, Sizyakov G, Gartsbein M, et al. Glucose effects on skin keratinocytes: implications for diabetes skin complications. Diabetes 2001; 50: 1627-35.
 
7.
Demidova-Rice TN, Hamblin MR, Herman IM. Acute and impaired wound healing: pathophysiology and current methods for drug delivery, part 1: normal and chronic wounds: biology, causes, and approaches to care. Adv Skin Wound Care 2012; 25: 304-14.
 
8.
Grzelak T, Wedrychowicz A, Grupinska J, et al. Neuropeptide B and neuropeptide W as new serum predictors of nutritional status and of clinical outcomes in pediatric patients with type 1 diabetes mellitus treated with the use of pens or insulin pumps. Arch Med Sci 2019; 15: 619-31.
 
9.
Zhao R, Liang H, Clarke E, et al. Inflammation in chronic wounds. Int J Mol Sci 2016; 17: 2085.
 
10.
Ramalho T, Filgueiras L, Silva-Jr IA, et al. Impaired wound healing in type 1 diabetes is dependent on 5-lipoxygenase products. Sci Rep 2018; 8: 14164.
 
11.
Javor J, Ferencik S, Bucova M, et al. Polymorphisms in the genes encoding TGF-beta1, TNF-alpha, and IL-6 show association with type 1 diabetes mellitus in the Slovak population. Arch Immunol Ther Exp 2010; 58: 385-93.
 
12.
Tong M, Tuk B, Shang P, et al. Diabetes-impaired wound healing is improved by matrix therapy with heparan sulfate glycosaminoglycan mimetic OTR4120 in rats. Diabetes 2012; 61: 2633-41.
 
13.
Ibrahim N, Wong SK, Mohamed IN, et al. Wound healing properties of selected natural products. Int J Environ Res Public Health 2018; 15: E2360.
 
14.
Kumar KPS, Bhowmik D, Duraivel S, et al. Traditional and medicinal uses of banana. J Pharmaco Phytochem 2012; 1: 51-63.
 
15.
Imam M, Akter S. Musa paradisiaca L. and Musa sapientum L: a phytochemical and pharmacological review J App Pharm Sci 2011; 1: 14-20.
 
16.
Shodehinde SA, Oboh G. Antioxidant properties of aqueous extracts of unripe Musa paradisiaca on sodium nitroprusside induced lipid peroxidation in rat pancreas in vitro. Asian Pac J Trop Biomed 2013; 3: 449-57.
 
17.
Kapadia SP, Pudakalkatti PS, Shivanaikar S. Detection of antimicrobial activity of banana peel (Musa paradisiaca L.) on Porphyromonas gingivalis and Aggregatibacter actinomycetemcomitans: an in vitro study. Contemp Clin Dent 2015; 6: 496-9.
 
18.
Kalita H, Boruah DC, Deori M, et al. Antidiabetic and antilipidemic effect of musa balbisiana root extract: a potent agent for glucose homeostasis in streptozotocin-induced diabetic rat. Front Pharmacol 2016; 7: 102.
 
19.
Amutha K, Selvakumari U. Wound healing activity of methanolic stem extract of Musa paradisiaca Linn. (Banana) in Wistar albino rats. Int Wound J 2016; 13: 763-7.
 
20.
Mohammadimanesh A, Vahidiniya AA, Doaei S, et al. The effect of different types of honey on the lipid profile of streptozotocin-induced diabetic rats. Arch Med Sci Atheroscler Dis 2019; 4: e113-8.
 
21.
Chan JK. The wonderful colors of the hematoxylin-eosin stain in diagnostic surgical pathology. Int J Surg Pathol 2014; 22: 12-32.
 
22.
Altavilla D, Saitta A, Cucinotta D, et al. Inhibition of lipid peroxidation restores impaired vascular endothelial growth factor expression and stimulates wound healing and angiogenesis in the genetically diabetic mouse. Diabetes 2001; 50: 667-74.
 
23.
Altavilla D, Galeano M, Bitto A, et al. Lipid peroxidation inhibition by raxofelast improves angiogenesis and wound healing in experimental burn wounds. Shock 2005; 24: 85-91.
 
24.
Kamber M, Papalazarou V, Rouni G, et al. Angiotensin II inhibitor facilitates epidermal wound regeneration in diabetic mice. Front Physiol 2015; 6: 170.
 
25.
Karuppiah P, Mustaffa M. Antibacterial and antioxidant activities of Musa sp. leaf extracts against multidrug resistant clinical pathogens causing nosocomial infection. Asian Pac J Trop Biomed 2013; 3: 737-42.
 
26.
Berlanga-Acosta J, Schultz GS, Lopez-Mola E, et al. Glucose toxic effects on granulation tissue productive cells: the diabetics’ impaired healing. Biomed Res Int 2013; 2013: 256043.
 
27.
Cheng KY, Lin ZH, Cheng YP, et al. Wound healing in streptozotocin-induced diabetic rats using atmospheric-pressure argon plasma jet. Sci Rep 2018; 8: 12214.
 
28.
Seitz O, Schurmann C, Hermes N, et al. Wound healing in mice with high-fat diet- or ob gene-induced diabetes-obesity syndromes: a comparative study. Exp Diabetes Res 2010; 2010: 476969.
 
29.
Baltzis D, Eleftheriadou I, Veves A. Pathogenesis and treatment of impaired wound healing in diabetes mellitus: new insights. Adv Ther 2014; 31: 817-36.
 
30.
Pastar I, Stojadinovic O, Yin NC, et al. Epithelialization in wound healing: a comprehensive review. Adv Wound Care (New Rochelle) 2014; 3: 445-64.
 
31.
Ganeshkumar M, Ponrasu T, Krithika R, et al. Topical application of Acalypha indica accelerates rat cutaneous wound healing by up-regulating the expression of type I and III collagen. J Ethnopharmacol 2012; 142: 14-22.
 
32.
Black E, Vibe-Petersen J, Jorgensen LN, et al. Decrease of collagen deposition in wound repair in type 1 diabetes independent of glycemic control. Arch Surg 2003; 138: 34-40.
 
33.
Volk SW, Wang Y, Mauldin EA, et al. Diminished type III collagen promotes myofibroblast differentiation and increases scar deposition in cutaneous wound healing. Cells Tissues Organs 2011; 194: 25-37.
 
34.
Serra MB, Barroso WA, da Silva NN, et al. From inflammation to current and alternative therapies involved in wound healing. Int J Inflam 2017; 2017: 3406215.
 
35.
Kaur R, Kaur M, Singh J. Endothelial dysfunction and platelet hyperactivity in type 2 diabetes mellitus: molecular insights and therapeutic strategies. Cardiovasc Diabetol 2018; 17: 121.
 
36.
Koh TJ, DiPietro LA. Inflammation and wound healing: the role of the macrophage. Expert Rev Mol Med 2011; 13: e23.
 
37.
Werner S, Krieg T, Smola H. Keratinocyte-fibroblast interactions in wound healing. J Invest Dermatol 2007; 127: 998-1008.
 
38.
Totomoch-Serra A, Munoz ML, Burgueno J, et al. Association of common polymorphisms in the VEGFA and SIRT1 genes with type 2 diabetes-related traits in Mexicans. Arch Med Sci 2018; 14: 1361-73.
 
39.
Krzyszczyk P, Schloss R, Palmer A, et al. The role of macrophages in acute and chronic wound healing and interventions to promote pro-wound healing phenotypes. Front Physiol 2018; 9: 419.
 
40.
Chesney J, Metz C, Stavitsky AB, et al. Regulated production of type I collagen and inflammatory cytokines by peripheral blood fibrocytes. J Immunol 1998; 160: 419-25.
 
41.
Murphy PS, Evans GR. Advances in wound healing: a review of current wound healing products. Plast Surg Int 2012; 2012: 190436.
 
42.
Olczyk P, Mencner L, Komosinska-Vassev K. Diverse roles of heparan sulfate and heparin in wound repair. Biomed Res Int 2015; 2015: 549417.
 
43.
Finley PJ, Huckfeldt RE, Walker KD, et al. Silver dressings improve diabetic wound healing without reducing bioburden. Wounds 2013; 25: 293-301.
 
44.
Agarwal PK, Singh A, Gaurav K, et al. Evaluation of wound healing activity of extracts of plantain banana (Musa sapientum var. paradisiaca) in rats. Indian J Exp Biol 2009; 47: 32-40.
 
45.
Tsuchiya H, Sato M, Miyazaki T, et al. Comparative study on the antibacterial activity of phytochemical flavanones against methicillin-resistant Staphylococcus aureus. J Ethnopharmacol 1996; 50: 27-34.
 
46.
Kumar M, Gautam MK, Singh A, et al. Healing effects of Musa sapientum var. paradisiaca in diabetic rats with co-occurring gastric ulcer: cytokines and growth factor by PCR amplification. BMC Complement Altern Med 2013; 13: 305.
 
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