Gel Treatment Group Research Articles

Sodium pentaborate pentahydrate and pluronic containing hydrogel increases cutaneous wound healing in vitro and in vivo.

After a disruption of skin integrity, the body produces an immediate response followed by a functional and comparable regeneration period, referred to as wound healing. Although normal wounds do not need much attention during the healing period, chronic (non-healing) wounds are the major challenge of current dermatological applications. Therefore, developing new, safe, and effective wound healing drugs has always been an attractive area of international research. In the current study, sodium pentaborate pentahydrate (NaB), pluronics (Plu; F68 and F127), and their combinations were investigated for their wound healing activities, using in vitro and in vivo approaches. The results revealed that NaB significantly increased migration capacity and superoxide dismutase activity in primary human fibroblasts. Combinations of optimized concentrations for pluronic block co-polymers further increased cell migration, and the messenger RNA (mRNA) expression levels of important growth factor and cytokines (vascular endothelial growth factor (VEGF), transforming growth factor beta (TGF-β), and tumor necrosis factor alpha (TNF-α)). NaB containing hydrogel co-formulated with pluronics was also investigated for their wound healing activities using a full thickness wound model in rats. Macroscopic and histopathological analysis confirmed that wounds in combination gel-treated groups healed faster than those of control groups. NaB/Plu gel application was found to increase wound contraction and collagen deposition in the wound area. Therefore, our results suggest that NaB, and its pluronics combination, could be used in dermatological clinics and be a future solution for chronic wounds. However, further studies should be conducted to explore its exact action of mechanism and effects of this formulation on chronic wounds.

A Randomized Trial of the Effectiveness of Topical “ABH Gel” (Ativan®, Benadryl®, Haldol®) vs. Placebo in Cancer Patients With Nausea

ContextThe topical gel known as “ABH gel,” comprising lorazepam (Ativan®), diphenhydramine (Benadryl®), and haloperidol (Haldol®), is frequently used to treat nausea because of its perceived efficacy, relatively low cost, and ease of use in the home setting. There are limited scientific data on this medication, however. Recent pilot studies showed no absorption of the active ingredients of the gel, prompting further prospective studies into the cause of the perceived efficacy in the clinical setting. ObjectivesTo determine any difference in the effectiveness of ABH gel compared with placebo in cancer patients with nausea. MethodsA randomized, double-blind, placebo-controlled, crossover, noninferiority clinical trial was developed to test the hypothesis that there is no difference in the effectiveness of ABH gel compared with placebo in cancer patients with nausea. The primary outcome was the difference in nausea score (on a 0–10 scale) at baseline and at 60 minutes in each treatment group. The difference in the ABH gel-treated group compared with placebo was evaluated for noninferiority. Secondary outcomes included the number of vomiting episodes and side effects over time. ResultsThe mean change in nausea score from baseline to 60 minutes after treatment in the ABH gel group was 1.7 ± 2.05 and 0.9 ± 2.45 for the placebo group (P = 0.42). The placebo group was found to be noninferior to the ABH gel group in reducing the nausea score. ABH gel also did not decrease vomiting events better than placebo (P = 0.34). Only one patient reported any side effects from the treatments in either arm of the study. ConclusionABH gel in its current formulation should not be used in cancer patients experiencing nausea.

English

Polygonatum odoratum is an important herbal medicine that is used in folk medicine for the treatment of various elements and its components are reported to have various biological effects. This study was conducted to evaluate the effects of topical application of ethanol leaf extract of this plant on the rate of wound healing closure and histology of healed wound. Four groups of male Sprague Dawley rats, all were experimentally wound in the posterior neck area. The animal groups were topically treated respectively with 0.4 ml of each vehicle (gum acacia), Intrasite gel, 100 and 200 mg/ml of ethanol leaf extract. Macroscopically, wound dressed with leaf extracts and Intrasite gel-treated group significantly healed earlier than those treated with vehicle, and the rate of wound healing was significantly accelerated by topical application of 200 mg/kg leaf extract. Histological analysis of healed wounds dresses with leaf extracts showed comparatively less scar width at wound closure and healed wound contained less inflammatory cells and more collagen with angiogenesis as compared to wounds dressed with vehicle. In conclusion, wounds dressed with leaf extracts significantly enhanced the acceleration of wound healing enclosure in rats.   Key words: Polygonatum odoratum leaf, ethanol extract, wound healing, histology.

Endoscopic application of EGF-chitosan hydrogel for precipitated healing of GI peptic ulcers and mucosectomy-induced ulcers

The gastrointestinal (GI) endoscopy has become a standard diagnostic tool for GI ulcers and cancer. In this study we studied endoscopic application of epidermal growth factor-containing chitosan hydrogel (EGF-CS gel) for treatment of GI ulcer. We hypothesized that directional ulcer-coating using EGF-CS gel via endoscope would precipitate ulcer-healing. EGF-CS gel was directly introduced to the ulcer-region after ulceration in acetic acid-induced gastric ulcer (AAU) and mucosal resection-induced gastric ulcer (MRU) rabbit and pig models. The ulcer dimensions and mucosal thicknesses were estimated and compared with those in the control group. Healing efficacy was more closely evaluated by microscopic observation of the ulcer after histological assays. In the AAU model, the normalized ulcer size of the gel-treated group was 2.3times smaller than that in the non-treated control group on day 3 after ulceration (P<0.01). In the MRU model, the normalized ulcer size of the gel-treated group was 5.4times smaller compared to that in the non-treated control group on day 1 after ulceration (P<0.05). Histological analysis supported the ability of EGF-CS gel to heal ulcers. The present study suggests that EGF-CS gel is a promising candidate for treating gastric bleeding and ulcers.

경피전달을 위한 커큐민 젤의 창상치유효과

The aim of this study was to investigate the effect of trasdermal delivery of the curcumin gel on healing of the rats' dorsum wounds. Carbopol 934 and propylene glycol were used to prepare gels containing 1% curcumin. Curcumin gel was evaluated for various properties such as antioxidant, cell viability, anti-inflammatory, in vivo wound healing. The free radical scavenging activity using 1,1-diphenyl-2-picryl hydrazyl (DPPH) was 50% at 12.5 ppm concentration. Inhibition of nitric oxide (NO) production in lipopolysaccharide (LPS)-stimulated RAW 264.7 cells by curcumin gel. In the curcumin gel-treated group, the re-epithelialization in wounds was significantly increased compared to the control group throughout the experimental period. These results suggested that curcumin may be helpful for the promotion of wound healing.

Topical pluronic F-127 gel application enhances cutaneous wound healing in rats

Pluronic F-127 gel is used as vehicle for various topical applications. In the present study, effects of topical application of pluronic F-127 gel were evaluated in cutaneous wound healing in Wistar rats. Normal saline solution and pluronic F-127 gel (25%) were applied topically on open excision wounds for 14 days. Photography, determination of percentage wound contraction, and collection of granulation tissue were done on days 3, 7, 11 and 14 post-wounding. Topical application of gel (once daily) significantly increased the wound closure on days 11 and 14. The gel application increased the expressions of vascular endothelial growth factor (VEGF) and transforming growth factor-beta1 (TGF-β1) on days 3 and 7. Histopathologically, more leukocyte infiltration followed by well formed granulation tissue with marked fibroblast proliferation was evident in the gel-treated group, as compared to the saline-treated control group. Immunohistochemistry of CD31 on day 7 revealed significant higher microvessel density in gel-treated wounds. Picrosirius staining demonstrated higher collagen fraction in gel-treated wounds. Thus, from the results, it could be concluded that pluronic F-127 gel has a mild inflammatory nature and enhanced the healing by stimulating expression of VEGF and TGF-β1.

Clinical assessment of a CMC/PEO gel to inhibit postoperative epidural adhesion formation after lumbar discectomy: a randomized, control study

To evaluate effectiveness of carboxymethylcellulose/polyethylene oxide (CMC/PEO) gel in improving clinical outcomes after the first-time lumbar discectomy. Ninety-three patients with herniated lumbar disc at L4-L5 or L5-S1 were enrolled and randomized into two groups: CMC/PEO gel treatment group and control group. All the patients underwent laminotomy and discectomy by posterior approach. The preoperative and postoperative Oswestry Disability Index (ODI) and Visual Analogue Scale (VAS) scores for lower-back pain and leg pain were analyzed and compared between two groups at 30- and 60-day time points. No patient presented with any clinically measurable adverse event during surgery. There were no significant differences between the treated group and the control group on the preoperative ODI and VAS scores. In general, the ODI and VAS scores decreased in both groups at all the time points. At the 30-day time point, the VAS scores for back pain and leg pain and the ODI scores in treatment group were lower by 9.9% (P=0.0302), 27.0% (P=0.0002) and 16.3% (P=0.0007) than those in control group. And at the 60-day time point, the ODI and VAS scores further decreased in both groups. The VAS scores for leg pain in treatment group were lower by 4.5% than that in the control group (P=0.0149). However, no significant difference was detected between two groups on the ODI and VAS scores for back pain. The results demonstrated that CMC/PEO gel is effective in reducing posterior dural adhesions in the spine with no apparent safety issues. It can improve patients' postoperative clinical outcome.

New compound gel on enhancing healing of skin uclers in rats

Objective To investigate the effect of new compound gel of insulin plus recombinant human epidermal growth factor (rhEGF) on the healing of skin ulcers in rats.Methods The steam burn method was used to prepare 40 skin ulcers about 1.2 cm in diameter on the back of rats.These skin ulcers were randomly divided into 4 groups:new compound gel treatment group (group A),compound solution treatment group (group B),blank gel treatment group (group C).The effect on ulcer healing was assessed by the rate of ulcer healing and histopathological changes of each group.Results After treatment for 7 days,the rate of ulcer healing in group A,group B and group C was (50.23 ± 5.67) ％,(28.70 ±7.89)％,and (12.62±5.62)％ respectively.After treatment for 11 days,the rate of ulcer healing in group A,group B and group C was (74.13±8.78)％,(57.14±6.52)％,and (45.70±5.28)％ respectively.After treatment for 15 days,the rate of ulcer healing in group A,group B,and group C was (92.99 ±5.60)％,(82.61 ±5.89)％,and (68.67 ±6.03)％ respectively.At any time point after treatment,the rate of ulcer healing in group A was higher than other groups (P ＜ 0.05).Conclusion New compound gel of insulin plus rhEGF can promote the healing of skin ulcers in rats. Key words: Insulin; Recombinant human epidermal growth factor; Compound gel; Ulcer healing

Effect of Er,Cr:YSGG Laser and Professional Fluoride Application on Enamel Demineralization and on Fluoride Retention

This study evaluated the effect of Er,Cr:YSGG laser irradiation and professional fluoride application on enamel demineralization and on fluoride formation and retention. In a blind in vitro study, 264 human enamel slabs were distributed into 8 groups: G1 – untreated; G2 – treated with acidulated phosphate fluoride gel (APF gel, 1.23% F) for 4 min; G3, G4 and G5 – irradiated with Er,Cr:YSGG at 2.8, 5.6 and 8.5 J/cm², respectively; G6, G7 and G8 – preirradiated with Er,Cr:YSGG at 2.8, 5.6 and 8.5 J/cm², respectively, and subjected to APF gel application. Twenty slabs of each group were submitted to a pH-cycling regimen, and enamel demineralization was evaluated in 10 slabs of each group. In the other 10 slabs, CaF₂-like material was determined. To evaluate F formed, 10 additional slabs of each group, not subjected to the pH cycling, were submitted to analysis of CaF₂-like material and fluorapatite, while the other 3 slabs of each group were evaluated by scanning electron microscopy. The F content was also measured in all pH-cycling solutions. Laser at 8.5 J/cm² and APF treatment reduced enamel demineralization compared to the control (p < 0.05), but the combination of these treatments was not more efficient than their isolated effect. A higher concentration of retained CaF₂-like material was found in laser groups followed by APF in comparison with the APF gel treatment group. The findings suggest that laser treatment at 8.5 J/cm² was able to decrease hardness loss, even though no additive effect with APF was observed. In addition, laser treatment increased the formation and retention of CaF₂ on dental enamel.

Oxiplex Reduces Leg Pain, Back Pain, and Associated Symptoms After Lumbar Discectomy

Prospective, randomized, blinded clinical trial. To evaluate effectiveness of Oxiplex gel for reduction of pain and associated symptoms after lumbar discectomy. Oxiplex gel (carboxymethylcellulose, polyethylene oxide, and calcium) is used during discectomy to coat the surgical site for reduction of pain and symptoms after lumbar discectomy. Patients undergoing single-level lumbar discectomy performed by laminectomy or laminotomy and randomized to receive either surgery plus Oxiplex gel (treatment group) or surgery alone (control group) were assessed 6 months after surgery using (1) a quality of life questionnaire (Lumbar Spine Outcomes Questionnaire [LSOQ]) and (2) clinical evaluations. There were no statistically significant differences in baseline demographics, surgical procedures, LSOQ scores, and clinical evaluations between treatment (N = 177) and control (N = 175) groups. More gel-treated patients were satisfied with outcome of their surgical treatment than control patients (P = 0.05). The gel-treated group showed greater reductions in pain and symptoms from baseline compared with surgery-only controls. Additional benefits of gel were consistently shown in reduction of leg and back pain at 6 months in the patient population having substantial back pain at baseline (greater than or equal to the median LSOQ pain score of 63). In that population, there was a statistically significant reduction of leg pain and back pain (P < 0.01) in the treatment group compared with controls. Fewer patients in the treatment group had abnormal musculoskeletal physical examinations at 6 months compared with controls. There were no cases of cerebrospinal fluid leaks and no differences in laboratory values or vital signs. Patients in the treatment group had less hypoesthesia, paraesthesia, sensory loss, and fewer reoperations during the 6-month follow-up than controls (1 vs. 6). These data demonstrate improvements in clinical outcomes resulting from the use of Oxiplex gel in discectomy procedures for treatment of lumbar disc herniation.

Randomized Double-Masked Controlled Trial Comparing Pain Scores With and Without the Use of Supplementary 2% Lidocaine Gel in LASIK

To compare pain scores with and without supplementary topical 2% lidocaine gel in patients undergoing simultaneous bilateral laser-assisted in situ keratomileusis (LASIK) under topical anesthesia using 0.5% proparacaine eye drops. Randomized double-masked placebo-controlled trial. Fifty-one Chinese subjects (102 eyes, with 51 eyes in each arm) were included. One eye was randomly allocated to have supplementary 2% lidocaine gel while the other eye received carbomer gel as control, in addition to topical 0.5% proparacaine. The pain scores for each eye during microkeratome flap creation, during laser ablation, and at 15, 30, and 45 minutes after LASIK were assessed. An overall pain score of the LASIK procedure was also obtained. Primary outcome measures were pain scores during and after LASIK. Secondary outcomes included need for additional topical anesthesia, patient cooperation score, and duration and complications of surgery. In the 2% lidocaine gel-treated group, the pain scores were significantly lower during microkeratome flap creation and laser ablation, and postoperatively at 30 and 45 minutes (P<.05 for all). Patients in the lidocaine gel group required less additional topical anesthesia (P=.0004) and were more cooperative (P=.019) as compared to the carbomer gel group. No surgical or postoperative complications were observed. The use of supplementary 2% lidocaine gel in LASIK is effective in lowering the pain experienced during and up to 45 minutes after LASIK.

Endothelial Denudation Combined With Embolization in the Prevention of Endoleaks After Endovascular Aneurysm Repair:An Animal Study

To test whether combining embolization with endothelial denudation could reduce endoleak persistence and recurrence after endovascular aneurysm repair (EVAR) in an animal model. Type I endoleaks with collateral outflow were created in bilateral iliac aneurysms in 12 dogs. In 6 animals (group 1), endoleaks were treated by thrombin injection, with or without mechanical denudation of the endothelium. In the other 6 animals (group 2), simultaneous occlusion and endothelial denudation was induced in one side by treatment with a gel containing ethanol, ethylcellulose, and lipiodol, whereas the other side was treated with saline control. Follow-up ultrasonography and angiography were performed before necropsy and histology at 3 months. Denudation combined with thrombin injection led to higher aneurysm shrinkage than thrombin alone, as shown by the mean relative aneurysm diameter (89% vs. 124% at baseline, p<0.01) and length (61% vs. 82% at baseline, p<0.01). Denudation did not significantly reduce endoleak occurrence (4/6 vs. 6/6); however, endoleaks in denuded aneurysms were significantly smaller and located in areas inaccessible to denudation. Six of the 10 endoleaks seen at 3 months occurred despite complete initial occlusion (recurrent endoleaks). In the gel-treated group, embolized aneurysms did not shrink significantly, and stent-graft thrombosis developed in 3/6 embolized aneurysms; however, the 3 other aneurysms showed no endoleaks, while all 6 saline-treated controls exhibited persistent endoleaks. This study demonstrates the role of recanalization in endoleak recurrence and indicates that combining embolization and endothelial denudation could be a promising strategy to prevent endoleak persistence or recurrence after EVAR. However, the sclerosing gel tested in this study is not appropriate since it is prone to migration with resultant stent-graft thrombosis.

Histological study of wound healing potential by ethanol leaf extract of Strobilanthes crispus in rats

This study was conducted to evaluate the effects of topical application of ethanol extract ofStrobilanthes crispus leaf on the rate of wound healing closure and histology of healed wound. Four groups of male Sprague Dawley rats, all were experimentally wound in the posterior neck area. An area of uniform wound 2 cm in diameter using circular stamp, was excised from the nape of the dorsal neck of all rats with the aid of round seal. The animal groups were topically treated respectively with 0.2 ml of each vehicle (gum acacia), intrasite gel, 100 and 200 mg/ml of ethanol extract. Macroscopically, wound dressed with leaf extract and intrasite gel-treated group significantly healed earlier than those treated with vehicle. Histological analysis of healed wounds dresses with leaf extract showed comparatively less scar width at wound closure and healed wound contained less inflammatory cells and more collagen with angiogenesis compared to wounds dressed with vehicle. In conclusion, wounds dressed with leaf extract significantly enhanced the acceleration of wound healing enclosure in rats, and this was ascertain by histological study. Key words: Strobilanthes crispus leaf, ethanol extract, wound healing, histology.

Influence of low‐level laser associated with osteogenic proteins recombinant human BMP‐2 and Hevea brasiliensis on bone repair in Wistar rats

This study analyzed the newly formed bone tissue after application of recombinant human BMP-2 (rhBMP-2) and P-1 (extracted from Hevea brasiliensis) proteins, 2 weeks after the creation of a critical bone defect in male Wistar rats treated or not with a low-intensity laser (GaAlAs 780 nm, 60 mW of power, and energy density dose of 30 J/cm(2)). The animals were divided into two major groups: (1) bone defect plus low-intensity laser treatment and (2) bone defect without laser irradiation. The following subgroups were also analyzed: (a) 5 μg of pure rhBMP-2; (b) 5 μg of pure P-1 fraction; (c) 5 μg of rhBMP-2/monoolein gel; (d) 5 μg of P-1 fraction/monoolein gel; (e) pure monoolein gel. Comparisons of the groups receiving laser treatment with those that did not receive laser irradiation show differences in the areas of new bone tissue. The group treated with 5 μg of rhBMP-2 and laser irradiation was not significantly different (P >0.05) than the nonirradiated group that received the same treatment. The irradiated, rhBMP-2/monoolein gel treatment group showed a lower area of bone formation than the nonirradiated, rhBMP-2/gel monoolein treatment group (P < 0.001). The area of new bone tissue in the other nonirradiated and irradiated groups was not significantly different (P > 0.05). Furthermore, the group that received the 5 μg of rhBMP-2 application showed the greatest bone formation. We conclude that the laser treatment did not interfere with the area of new bone tissue growth and that the greatest stimulus for bone formation involved application of the rhBMP-2 protein.

Potential Activity of Aqueous Extract of Culinary-Medicinal Lion's Mane Mushroom, Hericium erinaceus (Bull.: Fr.) Pers. (Aphyllophoromycetideae) in Accelerating Wound Healing in Rats

This study was conducted to evaluate the effects of topical application of aqueous extract of Hericium erinaceus fruiting bodies (HEFB) on the rate of wound healing enclosure and histology of the healed wound. Five groups of male Sprague-Dawley rats were experimentally wounded in the posterior neck area. A uniform wound area of 2.00 cm in diameter, using a circular stamp, was excised from the nape of the dorsal neck of all rats with the aid of a round seal. The animal groups were topically treated, respectively, with 0.2 mL each of sterilized distilled water (sdH2O); Intrasite gel; and 20, 30, and 40 mg/mL HEFB. Macroscopically, those rats whose wounds were dressed with HEFB and those in the Intrasite gel-treated group healed earlier than those treated with sdH2O. Histological analysis of healed wounds dressed with HEFB showed less scar width at wound enclosure and the healed wound contained fewer macrophages and more collagen with angiogenesis, compared to wounds dressed with sdH2O. In conclusion, wounds dressed with HEFB significantly enhanced the acceleration of wound healing enclosure in rats.

Results of a randomized, placebo-controlled safety and efficacy study of topical diclofenac 3% gel in organ transplant patients with multiple actinic keratoses

Increasing incidence rates of cutaneous malignancies, paralleling rising survival times of grafts and patients in organ transplant recipients, represents an escalating challenge for dermatologists worldwide. Especially, invasive squamous cell carcinomas (SCC) in immuno-compromised patients are characterized by significantly increased morbidity and mortality and characteristically outnumber basal cell carcinoma in this population. Effective management of actinic keratoses (AK) could help to prevent the further development of invasive SCC. Diclofenac in hyaluronic acid has previously shown to be an effective and well tolerated option for the treatment of AK in immuno-competent patients. However, its safety and efficacy in organ-transplant patients has not been evaluated in a controlled study so far. 32 organ transplant patients (kidney (+/- pancreas), liver, heart) screened at our specialized transplant dermatology outpatient clinic were found eligible and were randomized to either active treatment (24) or vehicle (8). Patients who had stable status of the transplanted graft in the 12 months prior to entering the study and >/= 3 AK lesions in a contiguous 50 cm2 area on the face, forehead, hands or balding scalp were eligible for inclusion in the study. Treatment of AK with 3% diclofenac in 2.5% hyaluronic acid or placebo twice daily was conducted over a total of 16 weeks, followed by a final evaluation 4 weeks after last application of the study drug. Biopsies were taken from the treated areas at the final visit to verify clinical clearance. Patients were assessed for safety variables that included adverse events, local skin reactions, laboratory results, dosage of immunosuppressive medication and indication of graft rejection. A 24 months follow up was conducted after the end of treatment. 87% (n = 28/32) of the patients completed the 16 week treatment phase and presented for final evaluation 4 weeks after end of treatment. In the diclofenac 3% gel treatment group, a complete clearance of AK lesions was achieved in 41% (9/22) compared to 0% (0/6) in the vehicle group. Side effects in most of the patients included a mild erythema and a mild to moderate swelling of the areas treated. No graft rejections or trends for a deterioration of graft function were detected. No meaningful trends were observed in laboratory results. In 55% of the previously cleared patients, new AK developed in the study area after an average of 9.3 months. None of these patients developed invasive SCC in the study area within 24 months of follow-up. This study demonstrated a greater lesion clearance rate of AKs in OTRs treated with diclofenac 3% gel than with vehicle. Despite recurrent AK in 55% of the previously cleared patients, the 24 month results showed no invasive SCC in this group. This study suggests that diclofenac 3% gel is not only an efficient and well tolerated treatment for multiple AKs in OTRs but also may prevent invasive SCC in these high-risk patients.

Hematologic Safety of Dapsone Gel, 5%, for Topical Treatment of Acne Vulgaris

To evaluate the risk of hemolysis in subjects with glucose-6-phosphate dehydrogenase (G6PD) deficiency who were treated for acne vulgaris with either dapsone gel, 5% (dapsone gel), or vehicle gel. Double-blind, randomized, vehicle-controlled, crossover study. Referral centers and private practice. Sixty-four subjects 12 years or older with G6PD deficiency and acne vulgaris. Intervention Subjects were equally randomized to 1 of 2 sequences of 12-week treatment periods (vehicle followed by dapsone gel or dapsone gel followed by vehicle). The washout period was 2 weeks. Treatments were applied twice daily to the face and to other acne-affected areas of the neck, upper chest, upper back, and shoulders as required. Results of clinical chemical analysis and hematology values; plasma dapsone and N-acetyl dapsone concentrations; spontaneous reports of adverse events. A 0.32-g/dL decrease in hemoglobin concentration occurred from baseline to 2 weeks during dapsone gel treatment. This was not accompanied by changes in other laboratory parameters, including reticulocytes, haptoglobin, bilirubin, and lactate dehydrogenase levels, and was not apparent at 12 weeks as treatment continued. The number of subjects with a 1-g/dL drop in hemoglobin concentration was similar between treatment groups at both week 2 and week 12. The largest drops in hemoglobin concentration were 1.7 g/dL in the vehicle gel treatment group and 1.5 g/dL in the dapsone gel treatment group. No clinical signs or symptoms of hemolytic anemia were noted. After treatment with dapsone gel, 5%, no clinical or laboratory evidence of drug-induced hemolytic anemia was noted in G6PD-deficient subjects with acne vulgaris. Trial Registration clinicaltrials.gov Identifier: NCT00243542.

The ability of onion extract gel to improve the cosmetic appearance of postsurgical scars

Superior wound healing with excellent cosmesis is critical in superficial dermal wounds created when cosmetically unacceptable lesions are removed from the body. Dermatologists frequently remove seborrheic keratoses, nevi, and angiomas from the body with a superficial shave excision. The excision is designed to minimize dermal scarring while removing the unsightly skin growth. This study was undertaken to evaluate the ability of an onion extract gel to improve the appearance of scars following excision. Sixty subjects with symmetrical seborrheic keratoses at least 8 mm in diameter on the right and left upper chest were enrolled. The lesions were removed with a scalpel shave, following local anesthesia with 2% lidocaine plus epinephrine. The surgical sites were allowed to heal for 2 to 3 weeks, at which time the subjects returned to the research center for randomization to either the onion gel treatment group or the no-treatment group. Forty-seven subjects in the active treatment group were further randomized as to the site of study product application. Thirteen control subjects applied nothing to either side. Subjects returned to the study center at weeks 2, 4, 6, and 10 for photography, subject evaluations, and investigator assessments. The study showed that the onion extract gel significantly improved scar softness, redness, texture, and global appearance at the excision site at study weeks 4, 6, and 10 as assessed by the blinded investigator.

Toll‐Like Receptors and Cytokines as Surrogate Biomarkers for EvaluatingVaginal Immune Response following Microbicide Administration

Topical microbicides are intended for frequent use by women in reproductive age. Hence, it is essential to evaluate their impact on mucosal immune function in the vagina. In the present study, we evaluated nisin, a naturally occurring antimicrobial peptide (AMP), for its efficacy as an intravaginal microbicide. Its effect on the vaginal immune function was determined by localizing Toll-like receptors (TLRs-3, 9) and cytokines (IL-4, 6 , 10 and TNF-α) in the rabbit cervicovaginal epithelium following intravaginal administration of high dose of nisin gel for 14 consecutive days. The results revealed no alteration in the expression of TLRs and cytokines at both protein and mRNA levels. However, in SDS gel-treated group, the levels were significantly upregulated with the induction of NF-κB signalling cascade. Thus, TLRs and cytokines appear as sensitive indicators for screening immunotoxic potential of candidate microbicides.

The effect of multifunctional polymer-based gels on wound healing in full thickness bacteria-contaminated mouse skin wound models

We determined whether a two-part space-conforming polyethylene glycol/dopa polymer-based gel promoted healing of contaminated wounds in mice. This silver-catalysed gel was previously developed to be broadly microbiocidal in vitro while being biocompatible with human wound cell functioning. Full-thickness wounds were created on the backs of mice. The wounds were inoculated with 10 4 CFU of each of four common skin wound contaminants, Staphylococcus aureus, Pseudomonas aeruginosa, Acinetobacter baumanii and Clostridium perfringens. The wounds were then treated with our multifunctional polymer-based gel, the commercially available NewSkin product, or left to heal untreated. The untreated wounds were overtly infected, and presented detectable bacterial loads over the entire 21-day healing period, while the gel and NewSkin groups presented significantly smaller rises in bacterial levels and were cleared of detectable colonies by the third week, with the gel group clearing the bacteria earlier. While all three groups healed their wounds, the polymer-based gel-treated group demonstrated significantly earlier re-epithelialization and dermal maturation ( P<0.05). This was reflected in a quick regain of tensile strength. This accelerated dermal maturation and regain in strength was noted in mice treated with the polymer-based gel when compared to wound treated with the commercially available Aquacel-Ag dressing ( P<0.05). What distinguishes the polymer-based gel from these other products is that it is incorporated within the healing wound. These preclinical studies show that the anti-microbial polymer gel not only supports but also accelerates healing of bacterially contaminated wounds.