-
Burns : Journal of the International... May 2024Anchusa azurea one of the medicinal plants that has been traditionally used for treat burn wounds. However, the traditional claim that A.azurea can hasten burn wound...
Anchusa azurea one of the medicinal plants that has been traditionally used for treat burn wounds. However, the traditional claim that A.azurea can hasten burn wound healing has not been supported by scientific studies. This experiment used a male Wistar rats model to investigate the activity of A. azurea aerial parts methanolic extract in burn wound healing. To determine their ability to help in healing burn wounds in rat models, the active components of the aerial parts of A. azurea were extracted with 80% methanol, then, 1% and 10% ointments were prepared from the extract, and applied topically. The LCMS chromatography of A. azurea plant extract showed different active ingredients, including phenolic compounds, flavonoids, fatty acids, and others. The plant extract's investigated as anti-inflammatory, antioxidant, and histological effects on the burn wound healing process. The results showed a significant (p-value < 0.025) rate of burn wound healing with 78.6% and 84.8% contraction, respectively using 1% and 10% (w/w) extract ointments after 12 days. These results were corroborated by histological observations such as collagen deposition, re-epithelialization, and repair of the remaining skin tissues without any sign of cutaneous toxicity. The plant extract showed significant (p-value < 0.025) antioxidant effect at the highest tested dose of 500 µg/mL, scavenging 89.78% of the DPPH with an IC50 of 213.6 µg/mL. These results confirmed by histological changes observations of collagen deposition, re-epithelialization, and reformation of remaining skin tissues without any signs of dermal toxicity. The plant extract exhibited significant (p-value < 0.025) level of antioxidant agents, by scavenging 89.78% of the DPPH at 500 µg/mL with IC50 of 213.6 µg/mL. Additionally, all pro-inflammatory cytokines examined, including IL-6 and IL-10, the results exhibited reduction in IL-6 level and increase IL-10 level. The aerial extract of the A. azurea plant revealed a wealth of several significant active ingredients, including phenolic compounds, flavonoids, fatty acids, and others, suggesting the potential for anti-inflammatory, burn wound-healing, and antioxidant medications. These findings can open an avenue to find new therapeutics for burn wounds healing, anti-inflammatory and antioxidant properties.
PubMed: 38760186
DOI: 10.1016/j.burns.2024.05.001 -
Frontiers in Cellular and Infection... 2024is an aromatic desert plant used in Saudi folk medicine to treat skin infections. It is widely found in Middle Eastern countries.
BACKGROUND
is an aromatic desert plant used in Saudi folk medicine to treat skin infections. It is widely found in Middle Eastern countries.
METHODS
A methanolic extract of the plant was prepared, and its phytoconstituents were determined using LC-MS. and antibacterial and antibiofilm activities of the methanolic extract were evaluated against multidrug-resistant bacteria. The cytotoxic effect was assessed using HaCaT cell lines . Diabetic mice were used to study the antibiofilm and wound healing activity using the excision wound method.
RESULTS
More than 50 phytoconstituents were found in the extract after LC-MS analysis. The extract exhibited antibacterial activity against both the tested pathogens. The extract was free of irritant effects on mice skin, and no cytotoxicity was observed on HaCaT cells with an IC value of 1381 µg/ml. The ointment formulation of the extract increased the healing of diabetic wounds. The microbial load of both pathogens in the wounded tissue was also reduced after the treatment. The extract was more effective against methicillin-resistant (MRSA) than MDR- in both and experiments. Further, skin regeneration was also observed in histological studies.
CONCLUSIONS
The results showed that methanol extract supports wound healing in infected wounds in diabetic mice through antibacterial, antibiofilm, and wound healing activities.
Topics: Animals; Biofilms; Methicillin-Resistant Staphylococcus aureus; Plant Extracts; Mice; Anti-Bacterial Agents; Wound Healing; Pseudomonas aeruginosa; Humans; Diabetes Mellitus, Experimental; Microbial Sensitivity Tests; Pseudomonas Infections; Cell Line; HaCaT Cells; Male; Wound Infection; Disease Models, Animal; Staphylococcal Infections
PubMed: 38756229
DOI: 10.3389/fcimb.2024.1386483 -
Tropical Animal Health and Production May 2024In herds of dairy goats, mastitis represents a major health and economic problem due to the multiresistance of some microorganisms. In this context, the study aimed to...
In herds of dairy goats, mastitis represents a major health and economic problem due to the multiresistance of some microorganisms. In this context, the study aimed to determine the potential of antimicrobial action and antibiofilm of the crude ethanolic extract (CEE) of Hymenaea martiana (jatobá) leaves, as well its fractions, on Staphylococcus sp isolated from bacterial cultures of goat milk. In vitro assays were performed to determine the Minimum Inhibitory Concentration (MIC) and Minimum Bactericidal Concentration (MBC), as well as tests of the effect of CEE on biofilm formation and quantification and the consolidated biofilm. The experimental infection was performed in two groups, each consisting of five goat. Experimental Group 1 (G1) consisted of five females treated with an intramammary ointment based on the CEE, at a concentration of 5%. Experimental Group 2 (G2) consisted of five females treated with a commercial intramammary ointment based on gentamicin, once a day, for six consecutive days. The diagnosis of mastitis was performed using a bacterial culture. The dichloromethane fraction of CEE was the one with the lowest concentrations of MBC, ranging from 195.3 to 781 µg / ml. Concerning to the biofilm, interference of the tested extract was observed for two isolates. In the present study, the ointment prepared from H. martiana extract (jatobá) was able to reduce bacterial infection in mammary glands experimentally infected with S. aureus. Antibacterial activity may be related to the classes of secondary metabolites found.
Topics: Animals; Goats; Female; Goat Diseases; Staphylococcal Infections; Staphylococcus aureus; Mastitis; Microbial Sensitivity Tests; Anti-Bacterial Agents; Plant Extracts; Biofilms; Milk; Plant Leaves
PubMed: 38753181
DOI: 10.1007/s11250-024-04026-7 -
Molecular Pharmaceutics Jun 2024Psoriasis, affecting 2-3% of the global population, is a chronic inflammatory skin condition without a definitive cure. Current treatments focus on managing symptoms....
Psoriasis, affecting 2-3% of the global population, is a chronic inflammatory skin condition without a definitive cure. Current treatments focus on managing symptoms. Recognizing the need for innovative drug delivery methods to enhance patient adherence, this study explores a new approach using calcipotriol monohydrate (CPM), a primary topical treatment for psoriasis. Despite its effectiveness, CPM's therapeutic potential is often limited by factors like the greasiness of topical applications, poor skin permeability, low skin retention, and lack of controlled delivery. To overcome these challenges, the study introduces CPM in the form of nanosuspensions (NSs), characterized by an average particle size of 211 ± 2 nm. These CPM NSs are then incorporated into a trilayer dissolving microneedle patch (MAP) made from poly(vinylpyrrolidone) and w poly(vinyl alcohol) as needle arrays and prefrom 3D printed polylactic acid backing layer. This MAP features rapidly dissolving tips and exhibits good mechanical properties and insertion capability with delivery efficiency compared to the conventional Daivonex ointment. The effectiveness of this novel MAP was tested on Sprague-Dawley rats with imiquimod-induced psoriasis, demonstrating efficacy comparable to the marketed ointment. This innovative trilayer dissolving MAP represents a promising new local delivery system for calcipotriol, potentially revolutionizing psoriasis treatment by enhancing drug delivery and patient compliance.
Topics: Psoriasis; Animals; Calcitriol; Rats; Rats, Sprague-Dawley; Needles; Administration, Cutaneous; Drug Delivery Systems; Skin Absorption; Skin; Particle Size; Male; Nanoparticles; Imiquimod; Suspensions; Dermatologic Agents; Transdermal Patch
PubMed: 38752564
DOI: 10.1021/acs.molpharmaceut.3c01223 -
Cureus Apr 2024Pemphigus herpetiformis (PH) is a rare autoimmune blistering disorder that typically presents in adults. However, its occurrence in paediatric patients, especially in...
Pemphigus herpetiformis (PH) is a rare autoimmune blistering disorder that typically presents in adults. However, its occurrence in paediatric patients, especially in very young children, is exceedingly rare. It presents with clinical features resembling dermatitis herpetiformis (DH) and immunologic characteristics similar to pemphigus, belonging to the group of intraepidermal autoimmune bullous diseases. We present the case of a three-year-old female with a history of annular and vesicular lesions on both forearms and legs. A skin biopsy revealed epidermal acanthosis, marked spongiosis, numerous intra-epidermal blisters, and exocytosis of eosinophils and neutrophils. A superficial perivascular lymphocytic infiltrate, accompanied by eosinophils and neutrophils, was also observed in the dermis. The diagnosis was also supported by direct and indirect immunofluorescence. The patient was treated with clobetasol ointment and dapsone, which showed significant improvement in the skin lesions. This case underscores the importance of considering PH in the differential diagnosis of vesicobullous diseases in children and the need for further research to elucidate its pathogenesis and optimal management.
PubMed: 38752034
DOI: 10.7759/cureus.58286 -
Supportive Care in Cancer : Official... May 2024Cutaneous adverse reactions to epidermal growth factor receptor inhibitors (EGFRi) are some of the most common side effects that patients experience. However, cutaneous...
INTRODUCTION
Cutaneous adverse reactions to epidermal growth factor receptor inhibitors (EGFRi) are some of the most common side effects that patients experience. However, cutaneous adverse reactions that cause dyspigmentation in patients have been rarely reported. Erythema dyschromicum perstans (EDP) is a rare pigmentary condition that causes ashy-grey hyperpigmented macules and patches, with a few cases reported from EGFRi in the literature. The disfiguration caused by this condition may negatively impact patients' quality of life. Our study aimed to describe the clinical characteristics of EDP induced by EGFRi to better recognize and manage the condition.
METHODS
We conducted a multicenter retrospective review at three academic institutions to identify patients with EDP induced by EGFRi from 2017 to 2023 and included sixteen patients in our study.
RESULTS
The median age of patients was 66 years old, with 63% female and 37% male (Table 1). The majority of our patients were Asian (88%). All patients had non-small cell lung cancer and most patients received osimertinib. Median time to EDP was 6 months. The most common areas of distribution were the head/neck region, lower extremities, and upper extremities. Various topical ointments were trialed; however, approximately less than half had improvement in their disease and most patients had persistent EDP with no resolution. All patients desired treatment except one with EDP on the tongue, and there was no cancer treatment discontinuation or interruption due to EDP. Table 1 Patient demographics and clinical characteristics of 16 patients with EDP induced by EGFRi Case no Demographics: age, race, and sex Fitzpatrick skin type Cancer type EGFR therapy Concomitant photosensitive drug(s) Time to EDP (months) Clinical features Distribution Symptoms Treatments and clinical course EDP status from most recent follow up 1 47 y/o Asian male III Stage IV NSCLC Erlotinib None Unknown Brown-blue-gray hyperpigmented patches Bilateral shins Left thigh Xerosis Pruritus Triamcinolone 0.1% ointment for 4 months, improvement of blue discoloration Tacrolimus 0.1% BID for 9 months, improvement but no resolution Ongoing 2 62 y/o Asian female IV Stage IV NSCLC Osimertinib None 4 Gray-brown hyperpigmented patches Bilateral arms Back Forehead Neck Right shin None Tacrolimus 0.1% ointment for 1 year with minor improvement Ongoing 3 69 y/o Asian female IV Stage IV NSCLC Osimertinib None 4 Gray-brown macules and patches Chest Face Forehead Bilateral legs None Tacrolimus 0.1% ointment for 10 months, no improvement Ongoing 4 79 y/o White male II Stage IV NSCLC Osimertinib None 15 Mottled grey-blue hyperpigmented patches and plaques with mild scaling Bilateral arms Back Forehead Neck None Photoprotection, no improvement Ongoing 5 69 y/o Asian female III Stage IV NSCLC Osimertinib Ibuprofen 4 Blue-grey hyperpigmented macules and patches Abdomen Bilateral arms None Tacrolimus 0.1% ointment for 7 months, no improvement Ongoing 6 65 y/o Asian male III Stage IV NSCLC Osimertinib None 20 Hyperpigmented blue gray macules and patches Helix Bilateral shins None Photoprotection, no improvement Ongoing 7 66 y/o Asian female IV Stage IV NSCLC Erlotinib TMP-SMX 6 Ashy grey-brown thin plaques Back Forehead None 2.5% hydrocortisone ointment for 8 months, resolved Resolved 8 82 y/o Asian male III Stage III NSCLC Erlotinib Simvastatin 20 Ash-grey hyperpigmented patches Dorsal feet Forehead Scalp None Photoprotection Ongoing 9 57 y/o Asian female III Stage II NSCLC Erlotinib None 1 Bue-grey discoloration Tongue None No intervention Ongoing 10 51 y/o Asian female III Stage IV NSCLC Osimertinib None 9 Blue-grey hyperpigmented macules and patches Bilateral arms Axillae Groin Neck Trunk None 2.5% hydrocortisone ointment, triamcinolone 0.1% ointment, photoprotection with mild improvement Ongoing 11 67 y/o Asian male III Stage IV NSCLC Osimertinib None 7 Gray-blue macules and patches with mild background erythema and scaling Bilateral arms Ears Face Bilateral shins None Triamcinolone 0.1% ointment, protection for 6 months with mild improvement Ongoing 12 75 y/o Asian female IV Stage III NSCLC Osimertinib TMP-SMX 3 Gray-blue hyperpigmented patches Bilateral arms Abdomen Back Face Bilateral shins Pruritus Triamcinolone 0.1% and betamethasone 0.01% with relief of pruritus, lesions unchanged Triluma cream 6 months, mild improvement Ongoing 13 42 y/o Asian male IV Stage IV NSCLC Afatinib TMP-SMX 24 Grey-brown hyperpigmented patches Back Face None Hydroquinone 4% cream for 2 years with mild improvement Ongoing 14 74 y/o White female III Stage II NSCLC Osimertinib Atorvastatin 4 Grey-brown hyperpigmented patches Bilateral legs Trunk None Photoprotection Ongoing 15 64 y/o Asian female IV Stage IV NSCLC Osimertinib None 3 Gray-brown hyperpigmentation Abdomen Bilateral arms Back Bilateral legs Pruritus Triamcinolone 0.1% cream; No change, minimal concern to patient Ongoing 16 52 y/o Asian female IV Stage IV NSCLC Osimertinib None 42 Gray hyperpigmented patches with digitate shape Abdomen Bilateral flanks None Triamcinolone 0.1% cream Ongoing NSCLC, non-small cell lung cancer, TMP-SMX, Trimethoprim/Sulfamethoxazole CONCLUSIONS: We highlight the largest case series describing EDP from EGFR inhibitors, which mostly affected Asian patients with lung malignancy and on EGFR tyrosine kinase inhibitors. Clinicians should be able to recognize this condition in their patients and assess how it is affecting their quality of life, and refer to dermatology to help with management.
Topics: Humans; Male; Female; Aged; Retrospective Studies; ErbB Receptors; Lung Neoplasms; Middle Aged; Carcinoma, Non-Small-Cell Lung; Erythema; Acrylamides; Drug Eruptions; Aged, 80 and over; Antineoplastic Agents; Protein Kinase Inhibitors; Quality of Life
PubMed: 38750379
DOI: 10.1007/s00520-024-08551-x -
International Journal of Colorectal... May 2024A high number of topical products are available for the treatment of hemorrhoidal symptoms. Sucralfate-based topical products constitute a new treatment alternative that... (Observational Study)
Observational Study
BACKGROUND AND AIMS
A high number of topical products are available for the treatment of hemorrhoidal symptoms. Sucralfate-based topical products constitute a new treatment alternative that act as a mechanical barrier to facilitate healing. The aim of this prospective, observational study was to determine patient- and physician-assessed effectiveness and tolerability of rectal ointment and suppositories containing sucralfate for the treatment of hemorrhoidal symptoms in routine clinical practice.
METHODS
Adult patients with diagnosed, mild-to-moderate, symptomatic non-bleeding hemorrhoids treated with rectal ointment or suppositories containing sucralfate were enrolled. Patients were administered treatment twice per day for at least 1 week until symptom resolution and/or for a maximum of 4 weeks. The primary endpoint was patient-assessed effectiveness on a modified Symptom Severity Score (mSSS, range 0 to 14). Physician-assessed effectiveness (9 symptoms, 0 to 5 Likert scale), hemorrhoid grade, and patient satisfaction were also determined.
RESULTS
Five investigators enrolled 60 patients; mean age was 48.4 ± 16.6 years and 72.4% were female. Pain or pressure sensitivity was reported as the most severe symptom by patients, and pressure sensitivity, discharge, soiling, and prolapse by physicians. Mean patient-assessed mSSS at baseline was 6.6 ± 1.9 and was significantly improved overall and in the ointment and suppository groups individually by -4.6 ± 2.0, -4.4 ± 1.8, and -4.8 ± 2.2, respectively (p < 0.0001). Investigator-assessed mean baseline symptom score was 18.1 ± 3.9 and improved by -7.1 ± 4.5, -6.9 ± 5.4, and -7.3 ± 3.5, respectively (p < 0.0001). Investigator-assessed symptoms of pressure sensitivity, swelling, and discharge were improved to the greatest extent. Hemorrhoid grade was improved in 38% of patients at the end of treatment. Compliance with treatment was 97.4% and patient satisfaction with application and onset of action was high (81.3% and 76.2%, respectively). Both the ointment and suppository were well tolerated.
CONCLUSIONS
The effectiveness of topical ointment or suppository containing sucralfate on patient- and investigator-assessed hemorrhoidal symptoms in real-life clinical practice was demonstrated. Patient satisfaction was high and treatments were well tolerated. Larger controlled trials are warranted to confirm the results.
Topics: Humans; Sucralfate; Hemorrhoids; Female; Suppositories; Male; Middle Aged; Ointments; Prospective Studies; Treatment Outcome; Patient Satisfaction; Adult; Aged; Administration, Rectal
PubMed: 38750150
DOI: 10.1007/s00384-024-04642-7 -
Dermatology and Therapy May 2024Atopic dermatitis (AD) is a chronic immuno-inflammatory skin disease. Crisaborole ointment, 2%, is a nonsteroidal phosphodiesterase 4 inhibitor approved for the...
INTRODUCTION
Atopic dermatitis (AD) is a chronic immuno-inflammatory skin disease. Crisaborole ointment, 2%, is a nonsteroidal phosphodiesterase 4 inhibitor approved for the treatment of mild to moderate AD. This post hoc analysis assesses the efficacy and safety of crisaborole in Chinese patients aged ≥ 2 years with mild to moderate AD.
METHODS
We evaluated the efficacy and safety of crisaborole in Chinese patients from the vehicle-controlled, phase 3 CrisADe CLEAR study. Patients were randomly assigned 2:1 to receive crisaborole or vehicle twice daily, respectively, for 28 days. The primary endpoint was percent change from baseline in Eczema Area and Severity Index (EASI) total score at day 29. Key secondary endpoints were improvement in Investigator's Static Global Assessment (ISGA), ISGA success, and change from baseline in weekly average Peak Pruritus Numerical Rating Scale (PP-NRS) score. Adverse events were documented.
RESULTS
Of 391 patients in the overall study, 237 were from China, 157 assigned to crisaborole and 80 assigned to vehicle. A greater reduction in percent change from baseline in EASI total score at day 29 was shown in the crisaborole vs. vehicle group (least squares mean [LSM]: -66.34 [95% (confidence interval) CI -71.55 to -61.12] vs. -50.18 [95% CI -58.02 to -42.34]). Response rates for achievement of ISGA improvement (43.2% [95% CI 35.4-51.1] vs. 33.4% [95% CI 22.5-44.2]) and ISGA success (31.7% [95% CI 24.3-39.0] vs. 21.5% [95% CI 12.1-30.9]) at day 29 were higher in the crisaborole vs. vehicle group. A greater reduction in change from baseline in weekly average PP-NRS score at week 4 was observed in the crisaborole vs. vehicle group (LSM: -1.98 [95% CI -2.34 to -1.62] vs. -1.08 [95% CI -1.63 to -0.53]). No new safety signals were observed.
CONCLUSION
Crisaborole was effective and well tolerated in Chinese patients aged ≥ 2 years with mild to moderate AD.
TRIAL REGISTRATION
ClinicalTrials.gov, NCT04360187.
PubMed: 38748345
DOI: 10.1007/s13555-024-01156-6 -
International Immunopharmacology Jun 2024Accelerating wound healing, as well as preventing infection and scar formation are among the most important medical challenges. This study aims to examine the...
Accelerating wound healing, as well as preventing infection and scar formation are among the most important medical challenges. This study aims to examine the antimicrobial, immunomodulatory, and anticancer properties of Morus nigra. The antimicrobial activities of ripe and unripe M. nigra fruit (MNF) extracts were tested. HPLC was employed to measure the components in the extract. Oserin ointment was made with 8 % extract. To test the ointment, 48 Wistar rats were randomly assigned into eight groups. The ointment was used daily by treating the wounds. Tissue histology and wound healing were assessed over nine days. Comparative evaluation of wound healing was conducted by analyzing TGF-β, TNF-α, and IL-1 mRNA levels. Finally, cytotoxic effects on AGS cancer and NIH-3 T3 fibroblast cells were examined. The ANOVA test and Prsim program were used for statistical analysis. Unripe MNF extract had good antimicrobial properties in standard and nosocomial strains. The most abundant compound in the extract was ascorbic acid (0.0441 mg/10 mg extract), followed by naringenin and gallic acid. In all groups treated with MNF extract ointment, a significant reduction in wound area was observed compared to other groups (p < 0.05). After six days of treatment, the microbial load was uncountable. In the microscopic studies of the wounds, a significant increase was observed in fibroblasts, angiogenesis, and in neutrophils in the first days as well as a decrease in the final days. The treatment caused a significant decline in the expression of IL-1 and TNF-α genes, as well as an increase in the expression of TGF-β (p < 0.05). This extract had no significant cytotoxic effects on human fibroblast cells (p > 0.05). In general, it can be concluded that the unripe MNF extract ointment can be a suitable option for the treatment of infectious and non-infectious skin wounds.
Topics: Animals; Wound Healing; Plant Extracts; Fruit; Ointments; Mice; Humans; Rats; Rats, Wistar; NIH 3T3 Cells; Morus; Male; Skin; Fibroblasts; Anti-Infective Agents; Cell Line, Tumor
PubMed: 38744171
DOI: 10.1016/j.intimp.2024.112230