Treatment of experimentally induced diabetic wound infected with methicillin-resistant Staphylococcus aureus using Aloe vera, Apium graveolens, and Sauropus androgynus extracts in rats

Abstract

Background and Aim: One of the complications of diabetes mellitus is diabetic ulcer. Diabetic ulcer is commonly infected by infectious agents, especially methicillin-resistant Staphylococcus aureus (MRSA). This study aimed to evaluate the potential effects of alcoholic extracts of Aloe vera, Apium graveolens, and Sauropus androgynus on promoting wound healing in a diabetic wound infected with MRSA. Materials and Methods: A total of 60 male Sprague-Dawley rats (6 months old, weighing 250-300 g) were injected with 65 mg/kg body weight of streptozotocin to induce diabetes. On day 7, the backs of the rats were shaved, and two circular wounds (4 mm in diameter) were created on their back, which were infected with MRSA. The rats were divided into six groups: Group I = control, Group II = treated with cream base without extract, Group III = treated with 2% A. vera cream, Group IV = treated with 2% A. graveolens cream, Group V = treated with 2% S. androgynus cream, and Group VI = treated with 2% A. vera + 2% A. graveolens + 2% S. androgynus cream. The wounds were treated twice a day for 14 days. The data were collected on days 7 and 14. Results: The results showed that all three herbal extracts and their combination decreased wound area and percentage of the wound, increased tensile strength of skin, collagen deposition, vascular endothelial growth factor expression, and skin thickness, and depressed the C-reactive protein profile and cyclooxygenase-2 expression. Conclusion: A. vera, A. graveolens, and S. androgynus creams can be used as herbal therapies against diabetic wounds infected with MRSA, both as a single and combination treatment.

Dynamic change of blood profile in rat models with acute skin injury artificially infected with methicillin-resistant Staphylococcus aureus

“…The increase of T helper (CD4 + ) in the CW group expressed that the healing mechanism occurs faster than the CWI group. It is supported by a previous study that demonstrates that the increase of CD4 + rather than CD8 + could be used as the marker for better healing processes [17,18]. Furthermore, the representation of COX-2 in the CWI group was greater than the CW group, indicating that the oxidative stress in the group with infection was more severe than in the group without infection.…”

Aloe vera and Streptozotocin-Induced Diabetes Mellitus

“…Gharaboghaz et al ( 2020 ) reported that A. vera gel and Teucrium polium hydroethanolic extract combination curtailed the inflammatory phase and elevated cell proliferation and collagen deposition. The cream formulations of A. vera extract can be used for diabetic wounds infected with Staphylococcus aureus (Prakoso et al 2019 ).…”

“…The production of bradykinin (a mediator of inflammation) causes painful inflammation in the body, and A. vera can reduce inflammation due to an enzyme, bradykinase, which breaks down bradykinin; it can also be an effective treatment for inflammation caused by prostaglandin synthesis and leukocyte infiltration (Peng et al 1991 ). The results of various studies indicated that A. vera could reduce inflammatory responses in STZ-induced diabetic model (Davis and Maro 1989 ; Noor et al 2008 ; Inpanya et al 2012 ; Hotkar et al 2015 ; Prakoso et al 2019 ; Gharaboghaz et al 2020 ; Babu et al 2021 ). Furthermore, A. vera could diminish C -reactive protein, polymorphonuclear leukocyte infiltration, interleukin-1β, TNF-α, and interleukin-6 in STZ-induced diabetic models (Davis and Maro 1989 ; Inpanya et al 2012 ; Prakoso et al 2019 ; Gharaboghaz et al 2020 ; Babu et al 2021 ).…”

Sauropus androgynus (L.) Merr.: a multipurpose plant with multiple uses in traditional ethnic culinary and ethnomedicinal preparations

“…The wounds induced by diabetes are susceptible to S. aureus infection, but this organism is resistant to antibiotic methicillin too. Prakoso et al [ 193 ] studied the wound healing capacity of S. androgynus alcohol extract in mice with streptozotocin-induced diabetes wounds. The wound was infected with methicillin-resistant S. aureus and they recorded a reduction in the infection rate with the extract.…”