RESUMO
Aims: This paper describes the anti-inflammatory and antinociceptive effects of the aqueous extract of Chrysobalanus icaco. Study Design: Study the anti-inflammatory and antinociceptive activity of the aqueous extract of C. icaco using in vivo models. Place and Duration of Study: Department of Antibiotics and Department of Pharmaceutical Science, Federal University of Pernambuco, Recife, Pernambuco, Brazil, between March 2010 and March 2012. Methodology: The anti-inflammatory activity was evaluated by carrageenan/dextraninduced paw edema, vascular permeability induced by acetic acid and subcutaneous air pouch models, with measurements of cell migration, nitric oxide and cytokines TNF-α and IL-6. Acetic acid-induced abdominal writhing, formalin and hot plate tests were performed to investigate the antinociceptive effects. Results: The aqueous extract of C. icaco (100, 200 and 400 mg/kg) reduced dextran/carrageenan-induced rat paw edema, the vascular permeability, cell migration, and nitric oxide concentration. However, it did not affect the levels of TNF-α and IL-6 produced in the pouch. The aqueous extract also demonstrated antinociceptive activity by acetic acid-induced abdominal writhing and formalin test, and was able to prolong the reaction time in the hot plate model in the first hour with activity similar to morphine (2.5 mg/kg, s.c.). There was no acute toxicity in mice after oral administration of the aqueous extract at doses of 2 g/kg. Conclusion: Our results indicate that the aqueous extract of C. icaco demonstrated antiinflammatory activity through the reduction of vascular permeability, inhibition of cellular migration and nitric oxide production and that the antinociceptive activity seems to be mediated by central mechanisms.
RESUMO
CONTEXT AND OBJECTIVE: Staphylococcus aureus is the most frequent agent isolated in diabetic foot infections and may be associated with changes to wound healing times. The aim of this study was to perform a systematic review of the literature, including studies that assessed the efficacy of any clinical or surgical intervention, as well as oral or topical therapy for diabetic ulcers infected with S. aureus. DESIGN AND SETTING: Systematic review with a search conducted in databases. METHODS: We conducted a systematic review with a comprehensive search in the Lilacs, SciELO, PubMed/Medline, Old Medline, Embase and Cochrane Library databases, for articles published from 1966 to 2010. The articles selected were limited to studies on diabetic patients with wounds infected with S. aureus for whom their healing was followed up, with the use of either antibiotics or experimental treatments. Animal studies and those that did not report the wound healing, as well as review articles, were excluded. RESULTS: Five studies that met the inclusion and exclusion criteria were analyzed. CONCLUSIONS: There are few studies reporting the healing of wounds infected with S. aureus in diabetic patients, although this is the most commonly found pathogen in this type of wound and it frequently consists of methicillin-resistant S. aureus (MRSA). There is insufficient evidence to support early use of broad-spectrum antibiotics against MRSA to promote healing of diabetic ulcers, since antibiotic resistance may develop from such treatment. This highlights the need for further studies on the subject.
CONTEXTO: Staphylococcus aureus é o agente mais frequentemente isolado nas infecções de pé em pacientes diabéticos e pode estar associado a mudança no tempo de cicatrização de feridas. O objetivo deste estudo foi realizar uma revisão sistemática da literatura, incluindo estudos que avaliaram a eficácia de qualquer intervenção clínica, cirúrgica, bem como terapia oral ou tópica para o tratamento de úlceras diabéticas infectadas com o S. aureus. TIPO DE ESTUDO E LOCAL: Revisão sistemática com busca realizada em bancos de dados. MÉTODOS: Realizamos uma revisão sistemática com uma busca abrangente nos bancos de dados Lilacs, SciELO, PubMed/Medline, Old Medline, Embase e no banco de dados da biblioteca Cochrane, publicados entre 1966 e 2010. Os artigos selecionados foram limitados aos estudos com feridas infectadas por S. aureus de pacientes diabéticos, que tiveram cicatrização relatada, quer pela utilização de antibióticos ou por substâncias experimentais. Foram excluídos os estudos com animais e os que não relataram a cicatrização das feridas, bem como artigos de revisão. RESULTADOS: Foram analisados cinco estudos que obedeceram aos critérios de inclusão e exclusão. CONCLUSÕES: Raros estudos relataram cicatrização de feridas infectadas com S. aureus em pacientes diabéticos, embora este seja o patógeno mais comumente encontrado neste tipo de ferida, sendo frequentemente resistente à meticilina MRSA (methicillin-resistant S. aureus). Não há evidências suficientes que suportem a utilização precoce de antibióticos de amplo espectro contra MRSA para promoção da cicatrização de úlceras diabéticas, uma vez que o desenvolvimento de resistência a antibióticos pode decorrer desse tipo de tratamento. Isso evidencia a necessidade de novos estudos sobre o assunto.