Abstract
Despite advances in diabetes care, impaired diabetic wound healing remains a significant clinical problem. The present study was aimed at developing a novel cream based on Ginkgo biloba extract and investigating its wound healing effect on full-thickness wounds in diabetic rats. The topical formulated oil-in-water emulsion-based cream contains Ginkgo biloba aqueous extract in an amount of about 1% to 5% as an active agent. The prepared formula was subjected to physicochemical assessment and pharmacotechnical characterization. Eighteen alloxan-induced diabetic rats completing full-thickness excisional skin wounds were randomly divided into three groups topically treated with either a normal saline (control group), the reference drug (“Cytol Centella cream®”), and cream based on the Ginkgo biloba extract. The response to treatment was assessed by macroscopic, qualitative, and quantitative histopathological analysis. The prepared formula showed good physicochemical properties. The rheological behavior of the prepared cream followed a non-Newtonian pseudoplastic pattern at different storage temperatures. The cream, which is a macroemulsion with uniform size distribution, remained stable for 6 months. Skin tolerance studies confirmed the compatibility of the cream with the skin. During the experimental trial, the cream based on the Ginkgo biloba-treated group showed significant improvements over the control and reference groups for both general wound appearance and healing dynamics. This increased rate of closure of wounds in diabetic rats was associated with increased collagen synthesis. Our findings showed that the cream could be a promising and innovative topical treatment with Ginkgo biloba extract for the management of acute diabetic wounds.
Highlights
Diabetes mellitus, commonly known as diabetes, is one of the most serious and common metabolic chronic diseases characterized by a hyperglycemic state related to insulin deficiency
Cutaneous wound healing, which is triggered by tissue injury, is an intricate and highly coordinated process that includes four phases: (i) hemostasis; (ii) inflammation which is mediated by inflammatory cell recruitment, and growth factor and cytokine secretion; (iii) proliferation characterized by the formation of the granulation tissue and reepithelialization; and (iv) remodeling, in which granulation tissue is reorganized and the mature scar is formed [3, 4]
When wound repair is defective, stimulating the synthesis of the collagen would be beneficial for promoting wound healing. These results suggest that topical application of the cream based on Ginkgo biloba extract stimulated the deposition of collagen and thereby promoted the wound healing
Summary
Commonly known as diabetes, is one of the most serious and common metabolic chronic diseases characterized by a hyperglycemic state related to insulin deficiency. Type 1 diabetes occurs due to the immunemediated destruction of the pancreatic β-cells leading to insulin deficiency. Type 2 diabetes is a polygenic disorder that involves an impairment of insulin secretion related to insulin resistance [1]. BioMed Research International complications of diabetes is impaired wound healing even in the early stage of the disease [2]. Cutaneous wound healing, which is triggered by tissue injury, is an intricate and highly coordinated process that includes four phases: (i) hemostasis; (ii) inflammation which is mediated by inflammatory cell recruitment, and growth factor and cytokine secretion; (iii) proliferation characterized by the formation of the granulation tissue and reepithelialization; and (iv) remodeling, in which granulation tissue is reorganized and the mature scar is formed [3, 4]
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