Topical ozonated virgin coconut oil improves wound healing and increases HSP90α, VEGF-A, EGF, bFGF and CD34 in diabetic ulcer mouse model of wound healing

Abstract

Background: Diabetes is a disease that affects people worldwide, including in Indonesia. The prevalence of diabetes in Indonesia is increasing from year to year. One of the most devastating complications of diabetes mellitus is diabetic ulcers, which is a limb-threatening complication. Over the past few decades, ozone generated using plasma medical technology has been investigated as an agent that helps wound healing. This study aims to evaluate the effects of topical ozonated virgin coconut oil (VCO) in a diabetic wound mouse model. Methods: This study was an experimental study with a post-test control design. An ulcer wound model was made in 50 diabetic male Wistar mice, divided into five groups, and a control group of 10 non-diabetic mice. The control groups were given conventional therapy only and the treatment groups were also given topical ozonated VCO with different flow durations (0 min, 90 min, 7 h, 14 h). Macroscopic appearance and wound contraction were observed. HSP90β, VEGF-A, EGF, bFGF and CD34 levels were measured from the immunostained slices of wound margins. Results: The reduction of wound length was proportionally related to the duration of ozone flow. Ozonated VCO with a longer duration of ozone flow healed the wound more quickly and had the shortest wound length. VCO with ozone flow for 14 hours (16837.10 µm) had the biggest reduction in wound length compared to other groups. The wounds treated with ozonated VCO showed an increase in HSP90β, VEGF-A, EGF, bFGF and CD34 levels that correlated to improved wound healing. A longer period of treatment resulted in higher levels of wound healing biomarkers compared to shorter therapeutic durations. Conclusions: Topical ozonated VCO improved the wound healing process in a diabetic ulcer mouse model by improving macroscopic wound appearance and increasing levels of wound healing biomarkers.

Hydrogel assisted synthesis of gold nanoparticles with enhanced microbicidal and in vivo wound healing potential

“…Transcription factor NANOG maintains pluripotency and promotes wound healing 32 . Increased level of transmembrane adhesion protein CD34 is typically associated with enhanced wound healing 33 . The change in the expression of NANOG, CD34, and MMP-2 genes related to wound healing was measured by quantitative real-time PCR measurements.…”

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“…(Table 2 ) Three studies were within‐subject trials of ozonated oils/water compared to control or standard treatment 19 , 20 , 21 and seven studies were between‐subjects trials of ozonated oils and/or ozonated water compared to control or standard treatments. 22 , 23 , 24 , 25 , 26 , 27 , 28 …”

“… 27 Lastly, in 60 rats with induced diabetes, wounds treated over a 14‐day period with ozonated coconut oil were significantly smaller than wounds treated with pure coconut oil or gentamycin ointment. 28 …”

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“…Fibroblast and endothelial cells are important proliferative cells, and during this phase, excessive blood supply (angiogenesis and vasculogenesis) is needed [ 24 ]. Therefore, the levels of EGF and VEGF subsequently increase [ 25 ]. After proliferation, epithelization begins where migration of keratinocytes occurs, and ultimately, the formation of granulation tissue takes place.…”