Effectiveness of the Aloe Vera extract in the treatment of fistula-in-ano / Eficácia do extrato de Aloe Vera no tratamento da fístula anal

Abstract Rationale: Considering that anal fistulae are still challenging regarding their treatment due to the risk of fecal incontinence in the most complex cases and the increasing use of phytotherapeutic drugs such as Aloe Vera in medicine, even with proven healing effectiveness, there is interest in researching this drug in the treatment of anal fistulae. Objective: To evaluate the efficacy of Aloe Vera extract in the treatment of anal fistulae in rats. Method: Thirty male Wistar rats weighing 250-300 g were submitted to anal fistula and after 30 days were divided into three groups: Control Group (GCo) (n = 5), Carbopol Group (GCa) (n = 5), and Aloe Vera Group (GAV) (n = 10). In the GCo no treatment was performed, while in the others a daily infusion of 0.3 mL of solution (Carbopol only in GCa and Carbopol plus Aloe Vera extract in the GAV) was performed through the external orifice of the fistula for 30 days. Afterwards, euthanasia was performed and specimens were removed for histological study. It was evaluated the closure of the fistulous tract, the area of the remaining tract, the inflammatory infiltrate and the degree of vascular congestion. The results were submitted to statistical treatment by Kruskall-Wallis test, considering p<0.05. Results: There was no complete closure of the fistulous tract in any of the animals. The mean area of the remaining tract was 847.2 µm in the GCo, 565.6 µm in the GCa and 377.8 µm in the GAV (p<0.05). The mean of the inflammatory infiltrate score was 2.4 in the GCo, 2.4 in the GCa and 2.3 in the GAV (p<0.05), while in the evaluation of vascular congestion, we observed a mean of 1.6 in the GCo, 1.4 in GCa and 1.1 in GAV (p<0.05). Conclusion: The extract of Aloe vera was able to reduce the lumen of the fistulous tract and reduce the degree of vascular congestion; however, it did not allow the complete closure of the fistulous tract nor diminished the inflammatory process.

Resumo Racional: Considerando que o tratamento das fístulas anais tem risco de incontinência fecal e o crescente uso do Aloe Vera na medicina, há interesse em se pesquisar este fármaco. Objetivo: Avaliar a eficácia do extrato de Aloe vera no tratamento das fístulas anais em ratos. Método: Utilizou-se 30 ratos Wistar, os quais foram submetidos à criação de fístula anal e após 30 dias distribuídos em três grupos: Controle (GCo), Carbopol (GCa) e Aloe Vera (GAV). No GCo nenhum tratamento foi realizado, enquanto nos outros realizou-se infusão diária de 0,3 mL de Carbopol GCa e Carbopol mais extrato de Aloe Vera no GAV por 30 dias. Foram retirados os espécimes para estudo histológico, avaliou-se o fechamento do trajeto fistuloso, a área do trajeto remanescente, o infiltrado inflamatório e o grau de congestão vascular. Resultados: Não houve fechamento completo do trajeto fistuloso em nenhum dos animais. A média da área do trajeto remanescente foi 847,2 µm no GCo; 565,6 µm no GCa e 377,8 µm no GAV (p<0,05). A média do escore de infiltrado inflamatório foi 2,4 no GCo; 2,4 no GCa e 2,3 no GAV (p<0.05), enquanto na avaliação da congestão vascular observou-se média 1,6 no GCo; 1,4 no GCa e 1,1 no GAV (p<0,05). Conclusão: O extrato de Aloe Vera foi capaz de diminuir o lumen dos trajetos fistulosos e reduzir o grau de congestão vascular, porém, não permitiu o fechamento completo dos trajetos fistulosos nem diminuiu o processo inflamatório.

Potencial industrial del Aloe vera / Industrial potentialities of Aloe vera

El Aloe vera y los productos, como el gel, derivados de esta planta, tienen gran aplicación en la industria alimentaria, cosmética y farmacéutica; debido a la gran variedad de propiedades nutricionales y farmacológicas demostradas de esta planta, entre ellas se mencionan la inmunomoduladora, la cicatrizante, la gastroprotectora, la antimicrobiana y la antioxidante. El mercado mundial de los productos conteniendo Aloe se incrementa y se prevé un mayor crecimiento en los años siguientes; se puede asegurar la rentabilidad de los productos con este origen que se ajusten a las necesidades, exigencias y tendencias del consumidor actual. Se realizó una búsqueda automatizada de artículos científicos, utilizando las palabras clave, en las bases de datos (Proquest, Science Direct, Springer, EBSCO y otras) del Sistema de Bibliotecas e Información de la Universidad de Costa Rica. Se seleccionaron aquellos artículos más adecuados para clasificar la información que contiene este trabajo. Es importante conocer el proceso más adecuado del procesamiento del Aloe o un derivado de este, en una planta industrial que permita lograr el mejor aprovechamiento de este recurso natural y a la vez, el ofrecimiento de un producto final de calidad(AU)

Aloe vera and the products derived from this plant like gel, have wide application in the food, cosmetics and pharmaceutical industries, due to the wide variety of proven nutritional and pharmacological properties such as immunomodulatory, scarring, gastro-protective, antimicrobial and antioxidant ones. The global market for products with Aloe is growing and further development is expected for the following years; so one can assure the profitability of products from this source that meet the needs, requirements and current consumer trends. A search for scientific articles was conducted using the keywords in the databases (Proquest, Science Direct, Springer, EBSCO and others) of the System of Libraries and Information at the University of Costa Rica. The most appropriate articles were selected to classify the information contained in this paper. It is important to know the right process of the Aloe processing or derivatives thereof, in an industrial plant that would achieve the best use of this natural resource and at the same time, a quality end product(AU)