Documenti di Didattica
Documenti di Professioni
Documenti di Cultura
By Michael G/ Hiwot
August 2010
Acknowledgement
I am highly grateful for Dr Kaleab Asres for giving me this seminar work, so that I could
make an endeavor to know the different scientific aspects while studying the wound healing
activity of natural products.
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Table of Contents
List of figures:........................................................................................................................... i
Summary.................................................................................................................................. ii
1. Introduction.......................................................................................................................... 1
2. Types of wounds.................................................................................................................. 1
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6.1.1. Wound closure ......................................................................................................... 11
6.1.2. Epithelialization period............................................................................................ 12
6.1.3. Tensile strength:....................................................................................................... 12
6.1.4. Increase in granulation tissue................................................................................... 12
7.5. Alkaloids......................................................................................................................... 19
7.6. Saponins.......................................................................................................................... 20
9. Reference ........................................................................................................................... 33
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List of abbreviations:
CAF: Chloramphenicol
CAPE: Caffeic Acid Phenylether Ester
CAT: Catalase
DPPH: 2, 2’-diphenyl- picrylhydrazyl
EGCG: Epigallocatechin gallate
FBS: Fetal Bovine Serum
HMF: Hydroxymethylfurfural
MEM: Minimum Essential Medium
MIC: Minimum Inhibitory Concentration
NADH: Nicotinamide adenine dinucleotide
NADPH2: Nicotinamide adenine dinucleotide phosphate
NFkB: Nuclear Factor kappa-light-chain-enhancer of activated B cells
ROS: Reactive Oxygen Species
SOD: Superoxide Dismutase
TBA: Thiobarbituric Acid
TB4: Thymosin beta 4
TGFβ1: Transforming Growth factor β1\
List of figures:
Figure 1: Phases of cutaneous wound repair.
Figure 2: Emnbryonated chicken egg of 9 days old.
Figure 3: Tensiometer to measure tensile strength.
List of tables:
Table 1: In vitro assays for different activities associated with wound healing.
Table 2: Some food sources for flavonoids.
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Summary
A wound is a disruption of the continuity of tissues produced by external force. When
considering the manner in which the skin or tissue is broken, there are seven general kinds
of wounds: abrasions, incisions, lacerations, punctures, avulsions, amputations and
contusions. Because the skin serves as a protective barrier against the outside world, any
break in it must be rapidly and efficiently mended. Wound healing involves highly
orchestrated sequences of events, which is triggered by tissue injury and ends in either
partial or complete regeneration or more commonly by repair. Successful wound healing and
tissue regeneration depends on tightly regulated hemostasis, inflammation, matrix synthesis,
proliferation, wound contraction and tissue remodeling to restore tissue function and
integrity.
Wound healing processes are influenced by factors like infections, nutritional status, drugs
and hormones, type and sites of wound, and wasting diseases like diabetes. In folklore
medicine, medicinal plants have been used widely in facilitating wound healing.
Phytochemicals like tannins, flavonoids, polyphenols, alkaloids, terpenes and terpenoids,
and ascorbic acid are known to be responsible for wound healing properties of medicinal
plants. The high degree of successes of medicinal plants in assisting wound healing has
inspired many researches, which are aimed at validating the claims and discovering
mechanisms, which possibly explains the potentials of these herbs on wound repair
processes.
While studying the wound healing activity of medicinal plants, there are in vivo and in vitro
models. The in vivo model includes: incision wound, excision wound, dead space wound
and burn wound models. On the other hand, the in vitro model consists of antioxidant
activity testing, anti-microbial activity testing, in vitro test for fibroblast growth stimulation,
chorioallantoic membrane (CAM) model and others. The in vivo study parameters are time
of epithelialization, wound closure, tensile strength, and increase in granulation tissue. In the
case of in vitro models, the study parameters are angiogenesis, antioxidant activity, and
antimicrobial activity. In this material, the wound healing activity of forty different
medicinal plant species was reviewed.
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1. Introduction
The wound may be defined as a loss or breaking of cellular and anatomic or functional
continuity of living tissues (Nalwaya et al., 2009). Because the skin serves as a protective
barrier against the outside world, any break in it must be rapidly and efficiently mended
(Martin, 1997).
One of the surveys conducted by the WHO reports that more than 80% of the world’s
population still depends upon the traditional medicines for various diseases (Patel et al.,
2009). Some medicinal plants have been employed in folk medicine for wound care. Some
of these plants either possess pro-wound healing activities or exhibit antimicrobial and other
related properties that are beneficial in overall wound care (Esimone et al., 2009). Recently,
the traditional use of plants for wound healing has received attention by the scientific
community. Approximately one-third of all traditional medicines in use are for the treatment
of wounds and skin disorders, compared to only 1-3 % of modern drugs (Ghasemi et al.,
2010). With a view to the increase in the wide spectrum of medicinal usages, the present day
requires a new biologically active ointment which exhibit wound healing activity as local
applications (Roy et al., 2009). Wound healing studies are mainly aim to detect various
means and factor influencing healing process, so they could be either used or avoid in
clinical practice to favorably alter the healing process (Sachin et al., 2009).
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2. Types of wounds
When we consider the manner in which the skin or tissue is broken, there are seven general
kinds of wounds: abrasions, incisions, lacerations, punctures, avulsions, amputations
and contusions. Many wounds, of course, are combinations of two or more of these basic
types (http://www.tpub.com/content/medical/10669-c/css/10669-c_101.htm.).
Punctures: Wounds made by nails, needles, wire, and bullets are usually punctures. The
possibility of infection is great in all puncture wounds, especially if the penetrating object
has tetanus bacteria on it. To prevent anaerobic infections, primary closures are not
made in the case of puncture wounds (http://www.tpub.com/content/medical/10669-
c/css/10669-c_101.htm.).
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Avulsions: Injuries where a section of tissue is torn off, either partially or in total.
(http://www.medstudentlc.com/page.php?id=65). Bleeding is usually heavy. In certain
situations, the torn tissue may be surgically reattached
(http://www.tpub.com/content/medical/10669-c/css/10669-c_101.htm.).
Amputations: amputation is the removal of the limb from the body. Shock is certain to
develop in these cases. The limb can often be successfully reattached
(http://www.tpub.com/content/medical/10669-c/css/10669-c_101.htm.).
Contusions: Such injuries result from a forceful blow to the skin and soft tissue but, leaving
the outer layer of skin intact. These injuries generally require minimal care as there is no
open wound. However, an expanding hematoma can damage overlying skin and demands
evacuation (http://www.medstudentlc.com/page.php?id=65 ).
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3. Wound healing and the healing cascades
Wound healing involves sequences of events, which is triggered by tissue injury and ends in
either partial or complete regeneration or more commonly by repair (Ather et al., 2007). The
healing cascade begins immediately following injury when the platelets come in contact
with exposed collagen (Nayak, 2006). Wound healing can be classified into any of three
types: healing by first intention, healing by second intention or healing by third intention,
depending on the nature of the edges of the healed wounds (Esimone et al., 2005). Primary
wound healing or healing by first intention occurs within hours of repairing a full-thickness
surgical incision (Mercandetti and Cohen, 2007). In wounds healed by the first intention, the
edges are smoothly closed that no scar is left (Esimone et al., 2005). Wound healing by
second intention involves formation of granulation tissues, which fill up the gaps between
the wound edges and is associated with significant loss of tissue, leaving little scars
(Esimone et al., 2005). In a third type of healing, a full-thickness wound is allowed to close
and heal. It results in an inflammatory response that is more intense than with primary
wound healing (Mercandetti and Cohen, 2007). Most skin lesions are healed rapidly and
efficiently within a week or two. However, the product is neither aesthetically nor
functionally perfect (Martin, 1997). The healing process involves four types of phases
(Shetty et al., 2006).
Clot formation
The formation of a clot is the immediate response to any trauma. The clot has two functions;
it temporarily protects the uncovered tissues and it serves as a provisional matrix for cell
migration (Polimeni et al., 2006).
Inflammation
Within hours of injury, inflammatory cells populate the clot and cleanse the wound from
bacteria and necrotic. Macrophages migrate into the wound area and, in addition to wound
debridement, secrete polypeptide mediators targeting cells involved in the wound-healing
process (Polimeni et al., 2006). Growth factors and cytokines secreted by macrophages are
involved in the proliferation and migration of fibroblasts, endothelial cells, and smooth
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muscle cells into the wound area (Polimeni et al., 2006). If the inflammatory phase is
prolonged, degradation of collagen will exceed its synthesis (Sasidharan et al., 2010).
Granulation
The formation of new vasculature requires extracellular matrix and basement membrane
degradation followed by migration, mitosis, and maturation of endothelial cells (Mercandetti
and Cohen, 2007). Epithelialization of the wound is initiated within hours of injury.
Epithelial cells from the basal layer proliferate and migrate through the fibrin clot and
eventually the breach in the epithelium is sealed (Polimeni et al., 2006).
Remodeling
In this phase the wound undergoes contraction resulting in a smaller amount of apparent scar
tissue (James and Friday, 2010). Remodeling can last for years after the initial injury
occurred. Maximal tensile strength of the wound is achieved by the 12th week, and the
ultimate resultant scar has only 80% of the tensile strength of the original skin (Mercandetti
and Cohen, 2007). Whether the damaged tissues heal by regeneration or repair depends upon
two crucial factors: the availability of cell type(s) needed; and the presence or absence of
signals necessary to recruit and stimulate these cells (Polimeni et al., 2006).
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4. Existing therapy aimed for wound healing
Factors like nutritional status, concurrent therapy (such as corticosteroids) and clinical
conditions, such as anemia and diabetes affect the wound healing process. Therefore, the
objective must be the holistic management of the patient and not just the wound (David,
2008). The global advanced wound management market valued at $3.6 billion in 2008 is
forecast to grow by 4.7% annually for the next seven years to reach $5 billion by 2015. The
growth will primarily be driven by an increase in the incidence of chronic wounds such as
venous, diabetic and pressure ulcers, increased patient awareness and technology
advancement in the products. Moreover, currently available wound healing therapies are
only partially effective (Karen and Lillian, 2006). Most of the existing treatment options for
wound management are either antimicrobials like nitrofurazone ointment or anti
inflammatory agents like corticosteroids. Topical iodine in the form of Lugol’s solution
regenerates human scar tissue back to normal (David, 2008). Povidone-iodine (5% Betadine)
cream is also used for wound healing purpose (Kumar et al., 2009). As an example
neomycin-bacitracin powder (Cicatrin®), gentamycin ointment, tetracycline ointment,
nitrofurazone ointment are among the standard antibiotic used in wound healing (Esimone et
al., 2005; Annan and Dickson, 2008; Esimone et al., 2009; Nalwaya et al., 2009).
However, inflammation presents a clinical paradox. While early inflammation after
wounding triggers repair, too much may excessively destroy local tissue. To address
inflammation, anti inflammatory agents are usually given systemically, where they have
been reported to inhibit healing (Gogia, 1995). Therefore, many new cost effective therapies
with better efficacy are required (Karen and Lillian, 2006).
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5. Models to study wound healing activity of natural products
5.1. In vivo models
In vivo models of wound healing generally use small rodents such as guinea pigs or rats
(Houghton et al., 2005). Granulation, collagen maturation, and scar formation are some of
the many phases of wound healing, which run concurrently, but independent of each other
(Udupa et al., 2005). As a result, the use of a single model is inadequate as different models
provide different information, and there are three in vivo wound study models known so far.
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carefully removed and dried in an oven at 60°C to a constant weight, and the weight is
recorded. The level of increase (%) in the weight of granuloma tissue formed is calculated
relative to the control (Okoli et al., 2009). The samples are kept at -70°C for biochemical
analysis until assayed. Regenerated tissues is cut in the form of square pieces along with
normal skin on either side of the wound and preserved in 10% buffered formalin for
histological studies. Dead space wound is important to study the physical and mechanical
changes in the granuloma tissue (Paschapur et al., 2009). In dead space wound; granulation
tissue dry weight, breaking strength and hydroxyproline content are the important
parameters to be studied (Malviya et al., 2009).
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Activity Assay Positive control
Anti-inflammatory NFkB synthesis inhibition Actigenin, CAPE
(caffeic acid phenylether
ester)
Eicosanoid synthesis inhibition Indomethacin for
cycloxygenase inhibition
Fibroblast proliferation Natural Red uptake by viable 10% foetal serum
cells
Effect on keratinocytes Involucrin expression A23187
Fibroblast protein Proteomics Not used
expression
Collagen lattice Collagen lattice contraction Not used
formation
Antimicrobial activity Serial dilution to determine MIC Miconazole for fungi
and CAF for bacteria
Antioxidant properties DPPH for free radical scavenging Propyl gallate
Malondialdehyde determination Propyl gallate
using TBA
Ptorection of growing cells Catalase
challenged oxidant
Table 1: In vitro assays for different activities associated with wound healing.
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5.2.2. Chorioallantoic membrane (CAM) model:
In this model, embryonated chicken eggs (9 days old) are selected and a small window will
be made in the shell (Barua et al., 2009). Albumin is removed on the 4th day after
fertilization to drop the embryo away from the shell and to allow the CAM to develop in a
way that was accessible to treatment (Melkonian et al., 2000). Through the window, a sterile
disc treated with the extract of interest is placed inside the egg at the junction of two blood
vessels. The window is resealed and the egg will be incubated at 370c for three days. The
window will then be opened and the growth of new capillary will be observed as in figure 2
(Barua et al., 2009).
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6. Study parameters
6.1. In vivo study parameters
There are different study parameters while dealing with wound healing in vivo. It includes
wound closure, time of epithelialization, tensile strength and scar size.
The presence of myofibroblasts and the apoptosis level can be regulated by both TGFβ1 and
by the extracellular matrix and the tension in the wound bed determines the type of scar at
different body sites (Chipev and Simon, 2002). Contractions of wound is studied by tracing
the raw wound in excision wound model (Annan and Dickson, 2008), and wound
contraction (%) is calculated using the relation below (Okoli et al., 2009).
WD 0 − WDt
Wound contract ion (%) = × 100
WD0
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6.1.2. Epithelialization period
Epithelialization, which is the process of epithelial renewal after injury, involves the
proliferation and migration of epithelial cells towards the center of the wound (Atala, 2008;
Okoli et al., 2009). The epithelialization time is the time at which a complete scar formation
occur (Sachin et al., 2009).
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hydroxyproline, hydroxylysine and glycine as principal constituents, among which
hydroxyproline is considered a specific aminoacid (Azeez et al., 2007). Hence, the increased
hydroxyproline content of the granulation tissue is an indicative for an increase in collagen
turnover. Increase in breaking strength of granulation tissue indicates the enhanced collagen
maturation by increased cross-linking (Panda and Tripathy, 2009).
6.2.2. Angiogenesis
Angiogenesis is the formation of new blood vessels; it takes place during embryonic
development, wound healing and tumor growth (Hegazy et al., 2009). Angiogenesis during
wound repair serves the dual function of providing the nutrients demanded by the healing
tissues and contributing to the structural repair through the formation of granulation tissue
(Barua et al., 2009). Factors that contribute to angiogenesis include high lactate levels,
acidic pH, and, in particular, decreased oxygen tension (Monaco and Lawrence, 2003).
Angiogenesis can be studied in chorioallantoic membrane (CAM) model (Melkonian et al.,
2000; Barua et al., 2009).
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7. Phytochemicals responsible for wound healing activity
Medicinal plants that possess wound healing activity perform their action through their
phytochemicals they have in them. Not all phytochemicals have wound healing activity,
rather the following are the most responsible group of compound that assist wound healing
process in many ways.
7.1.1. Flavonoids
Flavonoids are a large group of natural products widely distributed in nature (Galicka et al.,
2007). They are present in fruits, vegetables, chocolates, herbs and beverages, such as wine,
tea or beer (table 2) (Callic et al., 2005). The chemical diversity, size, three-dimensional
shape, and physical and biochemical properties of flavonoids allow them to interact with
targets in different subcellular locations to influence biological activity in plants, animals,
and microbes (Buer et al., 2010). They have a C6-C3-C6 backbone, and apart from
modifications to this backbone, the marked structural variety of flavonoids is due to their
conjugation to sugars at different sites of the molecule (Shieber et al., 2009).
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Food Compound Subclass Amount
(mg/100g)
Cherries (sweet, raw) Pelargonidin Anthocyanidin 0.8
Chocolate (dark) Catechin Flavan-3-ols 12
Epicatechin 41.2
Tea leaves Catechin Flavan-3-ols 157
Epicatechin 293.3
Wine (red) Malvidin Anthocyanidin 4.2
Catechin Flavan-3-ol 8.9
Grapefruit (raw) Naringenin Flavanone 78.1
Celery (raw) Apigenin Flavone 6.1
Quercetin Flavonol 3.5
Cranberry (raw) Quercetin Flavonol 14
Myricetin Flavonol 4.3
Garlic (raw) Quercetin Flavonol 22.6
Orange (raw) Hesperetin Flavanone 39
Kale (raw) Kaempferol Flavonol 14.6
.
Table 2: Some food sources for flavonoids (Callic et al., 2005).
Any drug that inhibits lipid peroxidation is believed to increase the viability of collagen
fibrils by increasing the strength of collagen fibers, preventing the cell damage and by
promoting the DNA synthesis (Panda and Tripathy, 2009). Flavonoids have been
documented to possess potent antioxidant and free radical scavenging effect, which is
believed to be one of the most important components of wound healing (Shenoy et al.,
2009). Bioflavonoids are thought to benefit connective tissue by binding to elastin,
preventing its degradation by elastases (Galicka et al., 2007). They reduce lipid peroxidation
not only by preventing or slowing the onset of cell necrosis but also by improving
vascularity (Panda and Tripathy, 2009). The high mobility of the electrons in the benzenoid
nucleus of flavonoids accounts for both their antioxidant and free-radical scavenging
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properties, whereas the structural resemblance between the flavonoid aglycone and many
substances inherent to the biochemistry of normal biological cells, e.g., nucleic acid bases,
coenzymes, steroid hormones, and neurotransmitters, explains their inhibition of enzymes,
cytoplasmic/nuclear hormone receptors, and neurotransmitters, as well as gene induction
(Havsteen, 2002). Many studies have shown that antimicrobial activities of plants can also
be attributed to their flavonoid content (Owoyele et al., 2008); hence, they are helpful in
prevention of wound infection.
Most of the delay in wound healing is due to insufficient or excessive fibroblast activity.
Thus, inhibition of fibroblast growth by flavonoids such as apigenin could be beneficial for
the treatment of any skin injury. Quercetin (1), may be useful in healing after renal
transplantation (Harborne and Williams, 2000). Quercitrin (1) isolated from Hypericum
perforatum, was able to inhibit the growth of the fungus Fusarium graminearum (Kuster et
al., 2009). Flavonoids like rutin (2), naringin (3) and quercetin (1) protect DNA damage
induced by ultraviolet (Yeh et al., 2005). Strong antihistamine activity has been shown by
thymonin (4) from Mentha spicata var. crispa (Labiatae). Santin (6) may contribute to the
well known anti-inflammatory activity of the plant Tanacetum parthenium by inhibiting the
cyclo-oxygenase and the 5-lipoxygenase pathways (Harborne and Williams, 2000).
Apigenin (5)
Quercetin (1) Rutin (2)
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Santin (6)
7.1.2. Tannins
Tannins are phenolic compounds that typically act as astringents and are found in a variety
of herbal products used for wound healing. Their astringent and antimicrobial property
responsible for wound contraction and increased rate of epithelialization (Panda and
Tripathy, 2009). Medicinal plants that are known and/or used for their wound-healing or
anti-inflammatory properties tend to have high tannin contents (Araújo et al., 2008).
Research results indicated that using the oxidation of linoleic acid as a model system, 3, 4, 5
tri-O-galloylquinic acid (7) displays significantly greater antioxidant properties when
compared with ascorbic acid and the commercially used n-propyl gallate as well as gallic
acid itself. Resveratrol (8), found in red wine have been suggested to be responsible for
health benefits of wine grape through antioxidant mechanism (Yang et al., 2009).
Triphenolic stilbene like epigallocatechin gallate (9), inhibited cell death induced by ter-
butyl hydroperoxide in the presence of ferric ion (Surh, 1999).
Resveratrol (8)
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7.2. Phenolic acids
Phenolics play a beneficial role in protecting tissue from the harmful effects of reactive
oxygen species (ROS) through regulation of antioxidant enzyme response through the
phenolic-dependent peroxidases with dependency on pentose phosphate pathway but with
reduced dependency on SOD and CAT. Oregano being rich in phenolics, as an example
rosmarinic acid (10), is an effective direct quencher of free radicals (Randhir et al., 2005).
Verbascoside (14)
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7.4. Terpenes and terpenoids
Terpenoids are known to promote the wound healing process, mainly due to their astringent
and antimicrobial properties, which seem to be responsible for wound contraction and an
increased rate of epithelialization (Sasidharan et al., 2010). Triterpenes are also responsible
for promotion of rapid wound healing (Raina et al., 2008). Sesquiterpene lactones are
known to possess antioxidant activity property, which may contribute to the wound healing
process (Panda and Tripathy, 2009). Four related terpenoidal compounds from Centella
asiatica; asiatic acid (15), madecassic acid (16), asiaticoside (17) and madecassoside (18)
known to increase collagen synthesis in dose dependent fashion through modulation of gene
expression (Colen et al., 2003). Asiaticoside (19), a trisaccharide triterpene, has been
associated with the healing of wounds and duodenal ulcers of the plant Centella asiatica
(Havsteen, 2002).
7.5. Alkaloids
Alkaloids are known to promote wound healing process due to their antioxidant and
antimicrobial activities (Sachin et al., 2009). Extracts from Symphytum asperum and
Symphytum caucasicum contain allantoin (19), claimed to be a cell proliferation stimulating
agent responsible for their wound-healing propertiy (Barbakadze et al., 2009). Reportedly
the alkaloid arecoline (20) fraction of areca enhances the collagen production and hence
wound healing. But contrary to the above study, there was no increase in the hydroxyproline
content of granulation tissue in arecoline and polyphenol treatments (infact, there was a
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decrease) and insignificant change in wound breaking strength of the granulation tissue with
polyphenol treatment of the dead space wound model (Azeez et al., 2007).
Allantoin (19)
Arecoline (20)
7.6. Saponins
Saponins are known to promote wound healing process due to their antioxidant and
antimicrobial activities (Sachin et al., 2009). For example, asiaticoside (21), a saponin is
thought to be one of its active constituents Centella asiatica. A 0.2% asiaticoside solution
applied topically twice daily for seven days to punch wounds in guinea pigs resulted in 56%
increase in hydroxyproline, 57% increase in tensile strength, increased collagen content, and
better epithelialization (MacKay and Miller, 2003; MacKay and Miller, 2003). Triterpene
saponins are also reported to possess immunomodulatory properties (Havsteen, 2002).
Asiaticoside (21)
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collagen as well as elastin fibers (Sasidharan et al., 2010). For example the anti-
inflammatory property and the presence of vitamin A & proteins in Curcuma longa L.
(zingiberaceae) result in the early synthesis of collagen fibers by mimicking fibroblastic
activity (Raina et al., 2008). In addition to collagen production, ascorbic acid enhances
neutrophil function, increases angiogenesis, and functions as a powerful antioxidant.
(MacKay and Miller, 2003). There is a paucity of research to support the hypothesis that
vitamin E aids in wound healing; however, many physicians recommend that patients apply
vitamin E to surgical sites with the belief that this will improve the cosmetic outcome of the
scar (Baumann and Spencer, 1999).
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Dihidrocapsaicin (25)
Emodin (22)
Gingerol (26)
Embelin (23)
Paradol (27)
Capsaicin (24)
Lawsone (28)
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8. Plants with potential wound healing activity
Some medicinal plants have been employed in folk medicine for wound care that either
promote direct wound repair or exhibit antimicrobial and other related properties which are
beneficial in overall wound care (Odimegwu et al., 2008). Some of the plants used in wound
care have also been shown to possess a combination of these properties (Esimone et al.,
2009).
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Aloe vera (Asphodelaceae)
It has stiff grey to bright green lance-shaped leaves containing clear gel in a central
mucilaginous pulp. Recent research has shown that the pharmacologically active agent is
concentrated in both the gel and the rind of the Aloe vera leaf (Syed et al., 1996). Topical
application and oral administration of Aloe vera to rats with dermal wounds increased the
collagen content of the granulation tissue as well as the degree of cross-linkage (MacKay
and Miller, 2003). Evidence tends to support that Aloe vera might be an effective
interventions used in burn wound healing for first to second degree burns (Maenthaisong et
al., 2007). However, in some severe burns, aloe gel may actually impede healing (Raina et
al., 2008).
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Azardica indica (Meleaceae)
Neem oil contains margosic acid, glycerides of fatty acids, butyric acid and trace valeric
acid. Alcoholic extract of neem is useful in eczema, ringworm and scabies. Neem leaf
extracts and oil from seeds has proven anti-microbial effect. This keeps any wound or lesion
free from secondary infections by microorganisms. Clinical studies have also revealed that
neem inhibits inflammation as effectively as cortisone acetate; this effect further accelerates
wound healing (Raina et al., 2008).
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Centella asiatica (Mackinlayoideae)
The active principles of Centella asiatica are triterpenes and asiaticoside, which are
responsible for promotion of rapid wound healing. Aqueous extract of Centella asiatica
suspended in 5% propylene glycol promoted wound healing on topical administration in
experimentally induced open wounds in rats (Raina et al., 2008).
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tannin, saponin, alkaloid, flavonoid, steroids, reducing sugar and terpenoid (Sasidharan et
al., 2010).
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Hoslundia opposita Vahl (Lamiaceae)
Wound healing activity of Hoslundia opposita could partly be attributed to their
antibacterial and antioxidant properties as evidenced in their ability to inhibit bacteria
growth and protect human fibroblast cells against oxidant injury. As research indicate, the
increase in hydroxyproline content (indication of collagen synthesis) and tensile strength of
healing tissue after the administration of the plant extract confirmed the healing potential of
the plant (Annan and Dickson, 2008).
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Jatropha curcas L. (Euphorbiaceae)
Research performed on this plant suggest that fresh homogenized crude extract of Jatropha
curcas have beneficial influence on various phases of wound healing such as fibroplasia,
collagen synthesis and wound contraction resulting in faster healing (Shetty et al., 2006).
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ointment base. This shows that Napoleona imperialis can effectively be employed as a
cationic emulsifying ointment in wound healing (Esimone et al., 2005).
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tensile strength of the ethanol extract-treated group. On dead-space wound model the extract
showed a significant increase in dry granuloma weight, granuloma breaking strength and the
level of hydroxyproline content. Histological examination revealed that the plant has the
potential to increase collagen. Studies on the estimation of antioxidant enzyme reveal that
the extract significantly increased the levels of superoxide dismutase and catalase. In studies
using the excision wound model, animals treated with the ethanol extract of Quercus
infectoria showed a significant decrease in the epithelization period. The extract also
facilitated the rate of wound contraction (Umachigia et al., 2008).
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Trichosanthes dioica showed the presence of alkaloids, flavonoids and tannins (Shivhare et
al., 2010).
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9. Reference
Akdemir Z., Kahraman C., That I., Akkol E., Süntar I., Keles H., (2010). Bioassay-guided
isolation of anti-inflammatory, antinociceptive and wound healer glycosides from the
flowers of Verbascum mucronatum Lam.: Journal ofEthnopharmacology, xxx: 1-8.
Akond M., Khandaker L., Hossain K., Furuta Y., (2010). Total polyphenol, polyphenol
oxidase, antioxidant activity and color profiles of some wheat varieties from Bangladesh:
Research Journal of Agriculture and Biological Sciences, 6: 186-190.
Annan K., Dickson R., (2008): Evaluation of wound healing actions of Hoslundia opposita
vahl, Anthocleista nobilis g. Don. and Balanites aegyptiaca: Journal of Science and
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