The efficacy of topical human amniotic membrane-mesenchymal stem cell-conditioned medium (hAMMSC-CM) and a mixture of topical hAMMSC-CM + vitamin C and hAMMSC-CM + vitamin E on chronic plantar ulcers in leprosy: A randomized control trial

Background: Healing of chronic plantar ulcers in leprosy (CPUL) typically takes a long time due to impaired neurological function, thereby reducing the levels of growth factors and cytokines. Cytokines can be found in metabolite products from amniotic membrane stem cells. Chronic ulcers are frequently characterized by high levels of reactive oxygen species. Vitamin E (α-tocopherol) is widely used in skin lesions, owing to its antioxidant and antiinflammatory properties. Vitamin C also has antioxidant,antiinflammatory, and collagen synthesis properties useful in wound healing. Herein, we compared the effects of topical human amniotic membrane-mesenchymal stem cellconditioned medium (hAMMSC-CM) alone and with vitamins C and E on healing of CPUL. Methods: In this randomized controlled trial, topical agents were applied every 3 days for up to 8 weeks. Ulcer size, side effects, and possible complications were monitored weekly. Results: Healing percentage increased each week in all groups. Mean difference in ulcer size was the highest in the hAMMSC-CM+vitamin E group, implying better progress of wound healing. There were no side effects or complications. Conclusion: hAMMSC-CM+vitamin E is the best for healing of CPUL. Accepted ManuscriptKeywords: hAMMSC-CM, vitamin E, vitamin C, chronic plantar ulcers in lepros

Effective healing of leprosy chronic plantar ulcers by application of human amniotic membrane stem cell secretome gel

Background: Chronic plantar ulcers are common problems for leprosy patients with numb feet due to their prolonged healing time. Chronic plantar ulcers affect the quality of life of patients and can lead to more serious complications, such as disability and deformity, if not handled appropriately. Wound-care products in the market, however, give unsatisfactory results. One factor in the delayed healing of chronic plantar ulcers due to leprosy is the lack of growth factors and cytokines in the wound due to reduced blood supply. We speculated that application of human amniotic membrane stem cell (hAMSC) secretome, which contains growth factors and cytokines, could improve wound healing. Aim: To evaluate the effect of topical application of a hAMSC secretome gel on wound healing of chronic plantar ulcers due to leprosy. Materials and Methods: We recruited 11 patients after leprosy treatment with chronic plantar ulcers due to leprosy. hAMSC secretome gel was applied topically to ulcers every 3 days for up to 2 months. Ulcer size and possible side effects or complications from gel application were evaluated weekly. Results: The ulcers of 8 of 11 patients (72.7%) completely healed, the ulcers of 2 patients (18.2%) partially healed, and the ulcers of 1 patient (9.1%) persisted. No ulcers became worse. Conclusion: hAMSC secretome was found to be an efficacious and well-tolerated alternative therapy for chronic plantar ulcers due to leprosy

The potential effect of fatty acids from Pliek U on epidermal fatty acid binding protein: chromatography and bioinformatic studies

The fatty acid analysis in Pliek U and its bioinformatic studies had been carried out and reported. Herein, fatty acids were analyzed by gas chromatography-mass spectrometry (GC-MS), meanwhile their potential effect, based on its interaction on epidermal fatty acid binding protein (E-FABP), was studied by bioinformatics approach with reverse docking technique using palmitic acid as a control compound. For the stated purpose, two Pliek U extracts were prepared, namely ethanolic Pliek U extract (EPUE), and ethanolic of residue hexane of Pliek U extract (ERHPUE). The GC-MS results showed that lauric, myristic, palmitic, and oleic acids were predominant, followed by stearic, capric, linoleic, and caprylic acids. Reverse docking results showed that linoleic acid had the lowest binding affinity (-5.9 kcal/mol) and was strongly bound to E-FABP on the same side of amino acid GLN A98, ARG A81, TYR A22, and LYS A61. These findings indicated that linoleic acid has a potential utility as a drug candidate for atopic dermatitis treatment

Towards Prevention and Eradication of Leprosy : Current Status and Research Needed in Community Health & Immune Dysregulation

Leprosy, a disease caused by , mainly affects dermis and peripheral nerve but is feared for its complications, and disabilities. Despite major reduction in leprosy cases after use of multi-drug therapy, blocking the transmission of leprosy is an arduous task due to factors that are possibly involved, these include agent (microbial characteristics), host and environmental factors. These factors including the immune dysregulations may increase the vulnerability towards leprosy, especially in women and children. This review article is aimed at understanding the current knowledge about such factors related to leprosy; and to identify the necessary steps and research needed to eradicate leprosy. A systematic literature search on PubMed, OVID, EMBASE, the Cochrane Library, Scopus,Web of Science, and Science Direct was done with the keywords "leprosy", "immune dysregulation in leprosy", and "risk factors of leprosy" to select published literature for this analysis. Several factors are identified as probable contributors to immune dysregulation/ incapability related to leprosy. These include host factors, health services and environmental factors. Important host related factors and interventions relate to stigma, vaccination, chemoprophylaxis, nutritional status, antenatal care, proper breast feeding. Environmental health factors relate to residential aspects including type of floor, humidity, intensity of sunlight, ventilation, clean water facilities, which may be contributing to persistent transmission. Health services play a role in ending leprosy transmission, both promotive, and rehabilitative treatment. In developing countries like Indonesia, health services suffer huge adverse impact from stigma..Some studies have showed the importance of an immunoprophylaxis strategy with Bacillus CalmetteñGuÈrin (BCG) vaccination, vaccination and single dose rifampicin chemoprophylaxis, as preventive measures for blocking the leprosy transmission. PEP carboxylase (PPC) is likely to be essential for the intracellular survival of and since it is absent in humans, it can be a potential target for treatment of leprosy. Studies show that vitamin D receptor (VDR) and vitamin D and role of food in leprosy needs in depth investigation. Pregnant women with poor nutritional status are prone to anaemia and malnutrition; these may be immune dysregulation and may be linked to leprosy infection. Further research is needed to better understand specific roles of said contributors towards immune dysregulation(s), thereby increasing the vulnerability of some person towards leprosy

Protective effects of acehnese traditionally fermented coconut oil (Pliek U Oil) and its residue (Pliek U) in ointment against UV light exposure: studies on male Wistar rat skin (Rattus novergicus)

A protective effect of Acehnese traditionally fermented coconut oil (Pliek U oil) and its residue (Pliek U) have been studied against UVB radiation. The research was performed by preparing the active ingredient in ointment formulation and protective test in male Wistar rat skin (Rattus novergicus). Four different extraction methods were done to produce four active ingredients, that are Pliek U oil (PUO), ethanolic Pliek U oil extract (EPUOE), ethanolic Pliek U extract (EPUE), and ethanolic hexane residue Pliek U extract (EHRPUE). The protective effect was determined based on the erythema index (EI), melanin index (MI), and level of protein oxidation parameters. The protective level from each active ingredient was studied by PCA analysis. The result showed that the active ingredient could inhibit the redness and protein oxidation in skin tissue. PCA results show that concentration (20 v. 40%) does not affect the protection level of the active ingredients of Pliek U oil, but it does affect the one of Pliek U. Therefore, these active ingredients are potential for sunscreen application