Evaluation of the Combination of Sargassum Duplicatum, Sargassum Ilicifolium, Abelmoschus Esculentus, and Garcinia Mangostana Extracts for Open Wound Healing in Diabetic Mice

Abstract

Introduction: Diabetes mellitus (DM) is a chronic disease with diverse and complex metabolic disorders. DM can be identified with hyperglycemic conditions. In 2017, Indonesia ranked sixth in the world for the highest number of diabetic patients after China, India, United States, Brazil, and Mexico. Objective: This study aims to determine the combined effect of alginate extract from Sargassum duplicatum and Sargassum ilicifolium with okra (Abelmoschus esculentus) and mangosteen (Garcinia mangostana) pericarp extracts to ameliorate the wound width process, the number of neutrophil cells, macrophages, fibroblasts, fibrocytes, and collagen density in streptozotocin-induced diabetic mice. Methods: This study used male mice (strain BALB/C, weighting 30±5 g each) which were grouped into four groups; normal control with water only; diabetic control group; combination treatment group with S. duplicatum extract, A. esculentus extract, and G. mangostana extract; and combination treatment group with S. ilicifolium extract, A. esculentus extract, and G. mangostana extract. The diabetic control group and combination treatment groups were injected with multiple low doses of streptozotocin (STZ) at 30 mg/kg BW intraperitoneally. The combination extract dose given in treatment groups was 50 mg/kg BW. Measurement of fasting blood sugar levels was done before and after the STZ injection. The mice’s skin was cut in the gluteal section as long as 1 cm, then treated topically in three different time periods namely 3, 7, and 14 days. Histological preparation and analysis were conducted on the 15th day. Results: The administration of A. esculentus extract and G. mangostana extract combined with S. duplicatum and S. ilicifolium increased wound healing indicator rate, decreased neutrophile cell count (NCC) and fibrocyte cell count (FCCC), and increased collagen synthesis as an extracellular matrix (ECM). The treatments could restore the open wound healing process of diabetic mice to their normal state. There were no significant differences in macrophage cell count (MCC) and fibroblast cell count (FBCC). The histopathology showed that the combination treatment groups also could accelerate the wound healing process in mice skin. Conclusion: In summary, this study addressed that the administration of A. esculentus extract and G. mangostana extract combined with S. duplicatum and S. silicifolium extracts could ameliorate open wound healing in diabetic mice.