Aloe Gel Enhances Angiogenesis in Healing of Diabetic Wound

Djanggan Sargowo, Adeodatus Yuda Handaya, M. Aris Widodo, Diana Lyrawati, Askandar Tjokroprawiro Postgraduate Program, Brawijaya Medical School

Abstract:

Background: Diabetic micro and macroangiophaty will lead to the diabetic foot ulcers (DFU) incident that characterized by an increasing the number of circulating endothelial cells (CECs) and decreasing the number and function of endothelial progenitor cells (EPCs). This fact is correlates with ischemia and diabetic wound healing failure. Aloe vera gel is known able to stimulate VEGF expression and activity through enhancing of the NO production as result of NOS enzyme activity. It is to be a potential target to enhancing angiogenesis in wound healing. Objective: The goal of this study is exploring the major role of the active substance within Aloe vera gel on wound healing diabetic ulcers through stimulation of transduction signaling pathways that involved in angiogenesis process of diabetic ulcers healing.

Material and Methods: The experimental groups is divided into five groups consist of non-diabetic wistar rats, diabetic rats without peroral therapy aloe gel, and treatment groups (diabetic rats) with aloe gel doses 30, 60, and 120 mg/day during 14 day. All of this groups are wounded and also daily observations of wounds area was conducted. The measurement of EPC (CD 34) and CEC (CD45 and CD146) number by flowcytometry and followed with the measuring of VEGF and eNOS expression on dermal tissue by Imunohistochemistry method was observed in 0 day and 14 day after treatment. The quantitative data were analyzed by computerized software by One-way ANOVA and Linear Regression with a confidence interval 5% significance level (p <0.05) using Statistical Software Products and Solutions Servive 16 PS (SPSS 16 PS) to compare the difference and correlation between wound diameter, the number of EPC and CEC as well as the levels of VEGF and eNOS.

Results: The results showed that aloe gel oral treatment in diabetic wistar rats able to accelerate the wound healing process. It is marked by reduction of wound diameter (0.27 ± 0.02), the increasing of EPCs number (13.75 ± 1.63), elevated levels of VEGF (34,67 ± 5,03) and eNOS (42,00 ± 1,00) and also the decreasing of CECs number (0.42 ± 0.57) significantly (p <0.05). In other hand, the wound diameter and eNOS indicators showed a significantly different at doses 60 mg while the number of EPC, CEC and VEGF levels showed significantly different results in a dose 120 mg. Aloe gel peroral therapy was shows a positive trend in wound healing acceleration on the optimum dose range 60-120 mg per day.

Conclusion: Aloe gel is potential to be candidates for diabetic wound healing herbal therapies through enhancing EPC homing, decreasing the CECs number, and stimulate the increasing of VEGF and eNOS level that already proved are involved as dominant factor in the angiogenesis process. Key Word: aloe gel, diabetes, wound healing, angiogenesis

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Available from: https://www.researchgate.net/publication/290463519_Aloe_Gel_Enhances_Angiogenesis_in_Healing_of_Diabetic_Wound