Aloe vera and wound healing
a brief review
DOI:
https://doi.org/10.1590/s2175-97902022e20837Keywords:
Wound phases, Aloe vera, Wound healing, Mechanism of action, Bioactive substancesAbstract
Aloe vera possesses a great therapeutic importance in traditional medicine. It has attracted the attention of modern medical fields due to its wide pharmacological applications. The bioactive substances in Aloe vera proved to have antioxidant, anti-inflammatory, antibacterial, and antiviral properties. Taken into our consideration the long history of clinical applications of Aloe vera in traditional medicine, especially for promoting the healing of cutaneous wounds with rare adverse effects, it provides a cheap alternative to many expensive synthetic drugs. Recent techniques in tissue engineering created novel scaffolds based on Aloe gel extracts for wound healing applications. Nonetheless, further guided researche is required to foster the development of Aloe vera based scaffolds for the benefit of worldwide populations. Here, I systemically summarize the main events following wounding and the mechanism of action of Aloe vera in promoting the healing process. I hope to provide a solid piece of information that might be helpful for designing new research studies into this topic.
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Abdel-Mohsen AM, Frankova J, Abdel-Rahman RM, Salem AA, Sahffie NM, Kubena I, et al. Chitosan-Glucan Complex Hollow Fibers Reinforced Collagen Wound Dressing Embedded with Aloe vera. II. Multifunctional Properties to Promote Cutaneous Wound Healing. Int J Pharm. 2020;582:119349.
Ahluwalia B, Magnusson MK, Isaksson S, Larsson F, Öhman L. Effects of Aloe barbadensis Mill. extract (AVH200®) on human blood T cell activity in vitro. J Ethnopharmacol. 2016;179:301-9.
Akbar S. Aloe vera (L.) Burm. f.(Asphodelaceae/ Xanthorrhoeaceae). In: Handbook of 200 Medicinal Plants. Springer; 2020. p. 187-206.
Al-Maweri SA, Ashraf S, Lingam AS, Alqutaibi A, Abdulrab S, Alaizari N, et al. Aloe vera in treatment of oral submucous fibrosis: A systematic review and meta-analysis. J Oral Pathol Med. 2019;48(2):99-107.
Al-Maweri SA, Nassani MZ, Alaizari N, Kalakonda B, Al-Shamiri HM, Alhajj MN, et al. Efficacy of aloe vera mouthwash versus chlorhexidine on plaque and gingivitis: a systematic review. Int J Dent Hyg. 2020;18(1):44-51.
Alkhouli M, Laflouf M, Alhaddad M. Efficacy of aloe-vera use for prevention of chemotherapy-induced oral mucositis in children with acute lymphoblastic leukemia: a randomized controlled clinical trial. Compr child Adolesc Nurs. 2021;44(1):49-62.
Anuradha A, Patil B, Asha VR. Evaluation of efficacy of aloe vera in the treatment of oral submucous fibrosis-a clinical study. J Oral Pathol Med . 2017;46(1):50-5.
Atiba A, Ueno H, Uzuka Y. The effect of aloe vera oral administration on cutaneous wound healing in type 2 diabetic rats. J Vet Med Sci. 2011;73(5):583-589.
Boudreau MD, Beland FA. An evaluation of the biological and toxicological properties of Aloe barbadensis (miller), Aloe vera. J Environ Sci Heal Part C. 2006;24(1):103-54.
Bowden LG, Byrne HM, Maini PK, Moulton DE. A morphoelastic model for dermal wound closure. Biomech Model Mechanobiol. 2016;15(3):663-81.
Bunyapraphatsara N, Jirakulchaiwong S, Thirawarapan S, Manonukul J. The efficacy of Aloe vera cream in the treatment of first, second and third degree burns in mice. Phytomedicine. 1996;2(3):247-51.
Cancer IA for R on. Aloe vera In: Some Drugs and Herbal Products (Volume 108). Int Agency Res Cancer, Lyon, Fr. 2015;
Chen H, Nie Q, Hu J, Huang X, Zhang K, Nie S. Glucomannans alleviated the progression of diabetic kidney disease by improving kidney metabolic disturbance. Mol Nutr Food Res. 2019;63(12):1801008.
Chiaula V, Mazurek P, Nielsen AC, Skov AL. Advanced wound care adhesives with improved moisture handling capabilities. In: 2019 Science of Adhesion Conference GRC: Adhesion and Friction in Extreme Conditions and Translation to Practical Applications. 2019.
Choi S, Chung M-H. A review on the relationship between Aloe vera components and their biologic effects. In: Seminars in integrative medicine. Elsevier. 2003. p. 53-62.
Choi S, Son B, Son Y, Park Y, Lee S, Chung M. The wound-healing effect of a glycoprotein fraction isolated from aloe vera. Br J Dermatol. 2001;145(4):535-45.
Coger V, Million N, Rehbock C, Sures B, Nachev M, Barcikowski S, et al. Tissue concentrations of zinc, iron, copper, and magnesium during the phases of full thickness wound healing in a rodent model. Biol Trace Elem Res. 2019;191(1):167-76.
Dal’Belo SE, Gaspar LR, Maia Campos PM. Moisturizing effect of cosmetic formulations containing Aloe vera extract in different concentrations assessed by skin bioengineering techniques. Ski Res Technol. 2006;12(4):241-6.
Darby IA, Laverdet B, Bonté F, Desmoulière A. Fibroblasts and myofibroblasts in wound healing. Clin Cosmet Investig Dermatol. 2014;7:301.
Delavary BM, van der Veer WM, van Egmond M, Niessen FB, Beelen RHJ. Macrophages in skin injury and repair. Immunobiology. 2011;216(7):753-62.
Ezhilarasu H, Ramalingam R, Dhand C, Lakshminarayanan R, Sadiq A, Gandhimathi C, et al. Biocompatible aloe vera and tetracycline hydrochloride loaded hybrid nanofibrous scaffolds for skin tissue engineering. Int J Mol Sci. 2019;20(20):5174.
Galea E. Moving the chronic wound along the healing trajectory. Wounds Asia. 2018;1(2):39 - 43.
Galehdari H, Negahdari S, Kesmati M, Rezaie A, Shariati G. Effect of the herbal mixture composed of Aloe Vera, Henna, Adiantum capillus-veneris, and Myrrha on wound healing in streptozotocin-induced diabetic rats. BMC Complement Altern Med. 2016;16(1):1-9.
Gao Y, Kuok KI, Jin Y, Wang R. Biomedical applications of Aloe vera. Crit Rev Food Sci Nutr. 2019;59( sup1):S244-56.
Ghorbani M, Nezhad-Mokhtari P, Ramazani S. Aloe vera-loaded nanofibrous scaffold based on Zein/Polycaprolactone/ Collagen for wound healing. Int J Biol Macromol. 2020;153:921-30.
Gil-Cifuentes L, Jiménez RA, Fontanilla MR. Evaluation of collagen type I scaffolds including gelatin-collagen microparticles and Aloe vera in a model of full-thickness skin wound. Drug Deliv Transl Res. 2019;9(1):25-36.
Goldberg SR, Diegelmann RF. Basic Science of Wound Healing. In: Critical Limb Ischemia. Springer; 2017. p. 131-6.
Gonzalez ACO, Costa TF, Andrade ZA, Medrado ARAP. Wound healing-A literature review. An Bras Dermatol. 2016;91(5):614-20.
Grosse Y, Loomis D, Lauby-Secretan B, El Ghissassi F, Bouvard V, Benbrahim-Tallaa L, et al. Carcinogenicity of some drugs and herbal products. Lancet Oncol. 2013;14(9):807.
Guo X, Mei N. Aloe vera: A review of toxicity and adverse clinical effects. J Environ Sci Heal Part C . 2016;34(2):77-96.
Gupta VK, Malhotra S. Pharmacological attribute of Aloe vera: Revalidation through experimental and clinical studies. Ayu. 2012;33(2):193.
Hamid AAA, Soliman MF. Effect of topical aloe vera on the process of healing of full-thickness skin burn: a histological and immunohistochemical study. J Histol Histopathol. 2015;2(1):3.
Hamman JH. Composition and applications of Aloe vera leaf gel. Molecules. 2008;13(8):1599-616.
Han G, Ceilley R. Chronic wound healing: a review of current management and treatments. Adv Ther. 2017;34(3):599-610.
Hanna JR, Giacopelli JA. A review of wound healing and wound dressing products. J foot ankle Surg. 1997;36(1):2-14.
Hashemi SA, Madani SA, Abediankenari S. The review on properties of Aloe vera in healing of cutaneous wounds. Biomed Res Int. 2015;2015:714216.
Hesketh M, Sahin KB, West ZE, Murray RZ. Macrophage phenotypes regulate scar formation and chronic wound healing. Int J Mol Sci. 2017;18(7):1545.
Hughes O, MacQuhae F, Rakosi A, Herskovitz I, Kirsner RS. Stress and wound healing. In: Stress and Skin Disorders. Springer. 2017. p. 185-207.
Hutter JA, Salman M, Stavinoha WB, Satsangi N, Williams RF, Streeper RT, et al. Antiinflammatory C-glucosyl chromone from Aloe barbadensis. J Nat Prod. 1996;59(5):541-3.
Ibrahim AM, Al Sadah H, Ahmad R, Ahmad N, Naqvi AA. Clinical Uses and Toxicity of Aloe vera: An Evidence-Based Comprehensive Retrospective Review (2007-2017). Pharmacogn J. 2019;11(2):424-428.
Klein AD, Penneys NS. Aloe vera. J Am Acad Dermatol. 1988;18(4):714-20.
Kumar R, Singh AK, Gupta A, Bishayee A, Pandey AK. Therapeutic potential of Aloe vera-A miracle gift of nature. Phytomedicine . 2019;60:152996.
Kuzuya H, Tamai I, Beppu H, Shimpo K, Chihara T. Determination of aloenin, barbaloin and isobarbaloin in Aloe species by micellar electrokinetic chromatography. J Chromatogr B Biomed Sci Appl. 2001;752(1):91-7.
Landén NX, Li D, Ståhle M. Transition from inflammation to proliferation: a critical step during wound healing. Cell Mol Life Sci. 2016;73(20):3861-85.
Li B, Wang JH-C. Fibroblasts and myofibroblasts in wound healing: force generation and measurement. J Tissue Viability. 2011;20(4):108-20.
Li CY, Suzuki K, Hung YL, Yang MS, Yu CP, Lin SP, et al. Aloe metabolites prevent LPS-induced sepsis and inflammatory response by inhibiting mitogen-activated protein kinase activation. Am J Chin Med. 2017;45(04):847-61.
Liu C, Cui Y, Pi F, Cheng Y, Guo Y, Qian H. Extraction, purification, structural characteristics, biological activities and pharmacological applications of acemannan, a polysaccharide from Aloe vera: a review. Molecules . 2019;24(8):1554.
Maan AA, Nazir A, Khan MKI, Ahmad T, Zia R, Murid M, et al. The therapeutic properties and applications of aloe vera: a review. J Herb Med. 2018;12:1-10.
Mahor G, Ali SA. Recent update on the medicinal properties and use of Aloe vera in the treatment of various ailments. Biosci Biotechnol Res Commun. 2016;9(2):277-92.
Mendonça FAS, Passarini Junior JR, Esquisatto MAM, Mendonça JS, Franchini CC, Santos GMT dos. Effects of the application of Aloe vera (L.) and microcurrent on the healing of wounds surgically induced in Wistar rats. Acta Cirúrgica Bras. 2009;24(2):150-5.
Minjares-Fuentes JR, Femenia A. Effect of processing on the bioactive polysaccharides and phenolic compounds from Aloe vera (Aloe barbadensis Miller). Diet Fibre Funct Food Nutraceuticals From Plant to Gut. 2017.
Minutti CM, Knipper JA, Allen JE, Zaiss DMW. Tissue-specific contribution of macrophages to wound healing. In: Seminars in cell & developmental biology. Elsevier. 2017. p. 3-11.
Mohi-Eldin MM, Allaam AA. Clinical and Pathological Assessment of Aloe Vera and Propolis for Wound Healing in Normal and Diabetic Albino Rats. Zagazig Vet J. 2017;45(4):314-25.
Na HS, Song YR, Kim S, Heo J, Chung H, Chung J. Aloin Inhibits Interleukin (IL)-1β− Stimulated IL-8 Production in KB Cells. J Periodontol. 2016;87(6):e108-15.
Nurden AT. The biology of the platelet with special reference to inflammation, wound healing and immunity. Front Biosci (Landmark Ed). 2018;23:726-51.
Oike Y, Ito Y, Maekawa H, Morisada T, Kubota Y, Akao M, et al. Angiopoietin-related growth factor (AGF) promotes angiogenesis. Blood. 2004;103(10):3760-5.
de Oliveira S, Rosowski EE, Huttenlocher A. Neutrophil migration in infection and wound repair: going forward in reverse. Nat Rev Immunol. 2016;16(6):378.
Oryan A, Mohammadalipour A, Moshiri A, Tabandeh MR. Topical application of Aloe vera accelerated wound healing, modeling, and remodeling: an experimental study. Ann Plast Surg. 2016;77(1):37-46.
Palacios S, Mejía A, Neyro JL. Treatment of the genitourinary syndrome of menopause. Climacteric. 2015;18( sup1):23-9.
Panchatcharam M, Miriyala S, Gayathri VS, Suguna L. Curcumin improves wound healing by modulating collagen and decreasing reactive oxygen species. Mol Cell Biochem. 2006;290(1-2):87-96.
Plotczyk M, Higgins CA. Skin biology. In: Biomaterials for Skin Repair and Regeneration. Elsevier. 2019. p. 3-25.
Qing C. The molecular biology in wound healing & non-healing wound. Chinese J Traumatol. 2017;20(4):189-93.
Rahman S, Carter P, Bhattarai N. Aloe vera for tissue engineering applications. J Funct Biomater. 2017;8(1):6.
Richardson M. Acute wounds: an overview of the physiological healing process. Nurs Times. 2004;100(4):50-3.
Rittié L. Cellular mechanisms of skin repair in humans and other mammals. J Cell Commun Signal. 2016;10(2):103-20.
Rodrigues M, Kosaric N, Bonham CA, Gurtner GC. Wound healing: a cellular perspective. Physiol Rev. 2019;99(1):665-706.
Rousselle P, Braye F, Dayan G. Re-epithelialization of adult skin wounds: cellular mechanisms and therapeutic strategies. Adv Drug Deliv Rev. 2019;146:344-65.
Rubio-Elizalde I, Bernáldez-Sarabia J, Moreno-Ulloa A, Vilanova C, Juárez P, Licea-Navarro A, et al. Scaffolds based on alginate-PEG methyl ether methacrylate-Moringa oleifera-Aloe vera for wound healing applications. Carbohydr Polym. 2019;206:455-67.
Sahebnasagh A, Ghasemi A, Akbari J, Alipour A, Lashkardoost H, Ala S, et al. Successful treatment of acute radiation proctitis with aloe vera: a preliminary randomized controlled clinical trial. J Altern Complement Med. 2017;23(11):858-65.
Sánchez-Machado DI, López-Cervantes J, Sendón R, Sanches-Silva A. Aloe vera: Ancient knowledge with new frontiers. Trends Food Sci Technol. 2017;61:94-102.
Sánchez M, González-Burgos E, Iglesias I, Gómez-Serranillos MP. Pharmacological update properties of Aloe vera and its major active constituents. Molecules . 2020;25(6):1324.
Sargowo D, Handaya AY, Tjokroprawiro A. The effect of aloe gel in enhancing angiogenesis in diabetic wound healing. Postgrad Program Brawijaya Med Sch Malang email djanggan@ yahoo com. 2012.
Singh B, Mohan R, Maurya A, Mishra G. Phytoconstituents and biological consequences of: A focused review Aloe vera. Asian J Pharm Pharmacol. 2018;4(1):17-22.
Singh N, Iqbal Z, Ansari TA, Khan MA, Ali N, Khan A, et al. The portent plant with a purpose: Aloe vera. J Pharmacogn Phytochem. 2019;8(3):4124-30.
Soares EJ, Siqueira RN, Leal LM, Barbosa KCO, Cipriano DF, Freitas JCC. The role played by the aging of aloe vera on its drag reduction properties in turbulent flows. J Nonnewton Fluid Mech. 2019;265:1-10.
Sorg H, Tilkorn DJ, Hager S, Hauser J, Mirastschijski U. Skin wound healing: an update on the current knowledge and concepts. Eur Surg Res. 2017;58(1-2):81-94.
Steenkamp V, Stewart MJ. Medicinal applications and toxicological activities of Aloe. Products. Pharm Biol. 2007;45(5):411-20.
Surjushe A, Vasani R, Saple DG. Aloe vera: a short review. Indian J Dermatol. 2008;53(4):163.
Takzare N, Hosseini M, Hasanzadeh G, Mortazavi H, Takzare A, Habibi P. Influence of Aloe Vera gel on dermal wound healing process in rat. Toxicol Mech Methods. 2009;19(1):73-7.
Talmadge J, Chavez J, Jacobs L, Munger C, Chinnah T, Chow JT, et al. Fractionation of Aloe vera L. inner gel, purification and molecular profiling of activity. Int Immunopharmacol. 2004;4(14):1757-73.
Tamura N, Yoshida T, Miyaji K, Sugita-Konishi Y, Hattori M. Inhibition of infectious diseases by components from Aloe vera. Biosci Biotechnol Biochem. 2009;73(4):950-3.
Taniguchi H, Matsumoto-Oda A. Wound healing in wild male baboons: Estimating healing time from wound size. PLoS One. 2018;13(10):e0205017.
Teller P, White TK. The physiology of wound healing: injury through maturation. Perioper Nurs Clin. 2011;6(2):159-70.
Teplicki E, Ma Q, Castillo DE, Zarei M, Hustad AP, Chen J, et al. The Effects of Aloe vera on Wound Healing in Cell Proliferation, Migration, and Viability. Wounds a Compend Clin Res Pract. 2018;30(9):263-8.
Thunyakitpisal P, Ruangpornvisuti V, Kengkwasing P, Chokboribal J, Sangvanich P. Acemannan increases NF-κB/ DNA binding and IL-6/-8 expression by selectively binding Toll-like receptor-5 in human gingival fibroblasts. Carbohydr Polym . 2017;161:149-57.
Tracy LE, Minasian RA, Caterson EJ. Extracellular matrix and dermal fibroblast function in the healing wound. Adv wound care. 2016;5(3):119-36.
>Tran TT, Hamid ZA, Cheong KY. A review of mechanical properties of scaffold in tissue engineering: Aloe vera composites. In: Journal of Physics: Conference Series. IOP Publishing; 2018. p. 12080.
Velnar T, Bailey T, Smrkolj V. The wound healing process: an overview of the cellular and molecular mechanisms. J Int Med Res. 2009;37(5):1528-42.
Wallace HA, Basehore BM, Zito PM. Wound Healing Phases. In: StatPearls. StatPearls Publishing, Treasure Island (FL); 2020. PMID: 29262065.
Weller C, Team V. Interactive dressings and their role in moist wound management. In: Advanced textiles for wound care. Elsevier. 2019. p. 105-34.
Whitney JD. Overview: acute and chronic wounds. Nurs Clin. 2005;40(2):191-205.
Yohannes G. Review on medicinal value of Aloe vera in veterinary practice. Biomed J Sci Tech Res. 2018;6(1):4970-4975.
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