Abstract
BackgroundIn hyperglycemic conditions like diabetes, impaired wound healing occurs due to endothelial damage, dysfunction of leukocyte, decreased phagocytosis and secondary infection which may lead to amputation and debility. Ethnomedicinally, Pteris vittata L. (PV) is used for wound healing. This fern is arsenic hyper-accumulator but its therapeutic aspect is still unexplored. Hence, the present study was put forth to study its aqueous extract and ethanolic extract in diabetic wound healing.MethodsRats were divided into diabetic control, povidine iodine (PI) treated, ethanolic and aqueous extracts of PV treated groups (n = 6). Circular excision wound closure was observed for 15 days with and without treatment. After study completion, skin was divided into four sections wherein first section was homogenized for collagen, hydroxyproline and hexosamine assay. Second, third and fourth sections were used for antioxidant assay, gene expression and histopathology. Column purified fraction of ethanolic extract of PV was subjected to High Performance Liquid Chromatography, Fourier-transform infrared spectroscopy, Nuclear Magnetic Resonance and Mass spectroscopy. Data obtained were analyzed using one way analysis of variance and expressed as Mean ± SD.ResultsThe percentage difference in wound area of day 15 to day 0 showed 65% wound contraction in diabetic control rats. The percentage reduction in wound area showed by PI and extracts of PV were 79% and 85% respectively. Statistical significant increase in collagen, hydroxyproline and hexosamine was observed in the test groups as compared to disease control and PI treated rats. Similarly, statistical significant increases in antioxidant enzymes were observed in the treated groups with decrease in lipid peroxidation. Treatment of rats with PI and two extracts of PV up-regulated Matrix Metalloprotein-9, Collagenase-2 and VEGF-1 and down regulated Tumor Necrosis Factor- α and Interleukin-6. Histopathology in diabetic rats showed incomplete scab formation with haemorrhages which were absent in treated rats. Spectral data showed presence of polyphenolic compounds, fatty acids and ascorbic acid.ConclusionAlternative and complimentary management based on herbal biotherapy which can promote angiogenesis, increase collagen and lower the levels of reactive oxygen species are warranted for healing of wounds in hyperglycaemic conditions which were achieved by two extracts of PV.
Highlights
Impaired wound healing in hyperglycemic conditions is a complicated syndrome as it is a major cause of amputations
Animals treated with aqueous extract of Pteris vittata L. (PV) showed 87% reduction in the wound area while the ethanolic extract treated group showed 85% reduction in the wound area when compared with 0 day data
Conclusion it can be concluded that the lithophytic fern, PV eliminates arsenic from the contaminated environment but it can modulate the microenvironment inside endothelial and epithelial cells
Summary
Impaired wound healing in hyperglycemic conditions is a complicated syndrome as it is a major cause of amputations. It is postulated that the main etiology of this disease may be elevated blood glucose levels causing endothelial damage with consequent occlusion of capillary vessels, dysfunction of leukocyte and decreased phagocytosis resulting in impaired wound healing leading to risk of infection [2]. Major interventions used nowadays for management of wounds in diabetics include debridement, irrigation, antibiotics, tissue grafts and proteolytic enzymes [5]. Glycated collagen is more resistant to MMP-mediated degradation that disrupts matrix modeling and delay in diabetic wound healing [8]. In hyperglycemic conditions like diabetes, impaired wound healing occurs due to endothelial damage, dysfunction of leukocyte, decreased phagocytosis and secondary infection which may lead to amputation and debility. The present study was put forth to study its aqueous extract and ethanolic extract in diabetic wound healing
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