The treatment for diabetic ulcer wounds is a challenging. The Traditional Chinese medicine (TCM) exerts a significant therapeutic effect on chronic ulcer wounds. Moist exposed burn therapy/Moist exposed burn ointment (MEBT/MEBO) is a TCM surgical treatment that greatly improves the effectiveness of ulcer wound healing in clinic.
Many studies proved that MEBT/MEBO could promote ulcer wound healing in diabetic rats, but the mechanism remains unclear. Autophagy has been proved to be closely related with wound healing, so MEBO/MEBT is hypothesized to promote diabetic wound healing by regulating autophagy.
Aitian Zheng and coll. conducted this study in which Eighty healthy male Wistar rats weighing 230–260 g, were randomly assigned to control (20) and diabetic group induced by intraperitoneal injection of STZ (n¼60), which were further randomly assigned to MEBO, Kangfuxin and model groups (n¼20 each). All rats underwent full-thickness skin resection in the back. Wound healing was dynamically observed, and wound tissues were collected at five time points for pathological examination. Ulcer wounds could gradually heal over time in each group. The healing time in the control group was the shortest, and the wound almost healed on day 18. The wound healing was relatively faster and exudation and suppuration were significantly alleviated in the MEBO group compared with the model group. Granulation tissue growth was observed on the ulcer wound surface, with the infiltration of inflammatory cells, under a microscope on days 5 and 11 after the treatment. The inflammatory cell infiltration was less in the MEBO and Kangfuxin groups than in the model group. Neovascularization was noted under the microscope. Multiple previous investigations proved that MEBO could improve microcirculation, dissolving and excreting the necrotic tissue. It alleviates the wound inflammation, improving the vascular endothelial growth factor (VEGF) expression in wound surface, promoting wound tissue growth.
The present study found that the healing time in the MEBO group was the shortest, and the wound healing rate at each time point was higher in the MEBO group compared with the model group. Exudation was less, and redness and swelling in the wound margin were not obvious. Under a microscope, revascularization in the MEBO group was found to be superior to that in the model group, and the capillary network was observed on day 5 with obvious granulation tissue growth. It indicated that MEBT/MEBO could alleviate wound inflammatory response, accelerate revascularization and formation of fibroblasts, and promote wound repair and healing.
Authors: Aitian Zheng and coll
Newspaper: PHARMACEUTICAL BIOLOGY. 2020, VOL. 58, NO. 1, 124–130