Document Type : Original Article(s)
Authors
1
Department of Surgical Oncology, Diponegoro University, Dr. Kariadi General Hospital, Semarang, Indonesia
2
Anaesthesiology Department and Intensive Therapy, Faculty of Medicine, Diponegoro University, Semarang, Indonesia
3
Faculty of Medicine, Diponegoro University, Semarang, Indonesia
10.30476/mejc.2024.101424.2024
Abstract
Background: Radiation dermatitis is the most common side-effect of radiation therapy. The current daily therapy uses topical corticosteroids to reduce inflammation. However, long-term usage may cause some side effects. Aloe vera could act as an anti-inflammatory and antioxidant agent, and ozone exhibits an antioxidant dan bactericidal effect. The present study aimed to analyze the effect of topical administration of ozonated Aloe vera oil on inflammatory and growth factors in radiation dermatitis wounds.
Method: This was an experimental study with a "post-test only control group” design. A total number of 36 Sprague Dawley rats were divided into two control and four intervention groups. C1: no intervention, C2: hydrocortisone ointment, P1: Aloe vera oil, P2/P3/P4: ozonated aloe vera oil 300/600/1200 mg/ml. Termination and histopathological analysis of inflammatory and growth factors were performed after seven days of treatment. Statistical analysis was performed using SPSS version 22 (IBM corporation, USA). The normality test of the data was carried out using the Sapphiro Wilk test. Normally distributed data were subjected to the One-Way ANOVA test and continued with the Post Hoc LSD test after a significant difference was obtained. Data that were not normally distributed were tested using the Kruskal-Wallis test, followed by the Mann-Whitney U test. Therefore, all values obtained were considered significant at P < 0.05.
Results: Significant differences were found between the control and the treatment groups. Decreased tumor necrosis factor-alpha expression, neutrophil infiltration, endothelial damage, and increased tumor growth factor beta, platelet-derived growth factor, and fibroblast count were seen after seven days of intervention.
Conclusion: Ozonated Aloe vera oil can accelerate wound healing of radiation dermatitis.
Highlights
Yan Wisnu Prajoko (Google Scholar)
Keywords
Main Subjects
This article has been accepted for publication and undergone full peer review but has not been through the copyediting, typesetting, pagination, and proofreading process, which may lead to differences between this version and the Version of Record. Please cite this article as doi: 10.30476/mejc.2024.101424.2024
Iacovelli NA, Galaverni M, Cavallo A, Naimo S, Facchinetti N, Iotti C, et al. Prevention and treatment of radiation-induced acute dermatitis in head and neck cancer patients: a systematic review. Future Oncol. 2018;14(3):291-305. doi: 10.2217/fon-2017-0359.
Dilalla V, Chaput G, Williams T, Sultanem K. Radiotherapy side effects: integrating a survivorship clinical lens to better serve patients. Curr Oncol. 2020;27(2):107-12. doi: 10.3747/co.27.6233.
Wei J, Meng L, Hou X, Qu C, Wang B, Xin Y, et al. Radiation-induced skin reactions: mechanism and treatment. Cancer Manag Res. 2018;11:167-77. doi: 10.2147/CMAR.S188655.
Kabashima K, Honda T, Ginhoux F, Egawa G. The immunological anatomy of the skin. Nat Rev Immunol. 2019;19(1):19-30. doi: 10.1038/s41577-018-0084-5.
Wang X. Emerging roles of ozone in skin diseases. Zhong Nan Da Xue Xue Bao Yi Xue Ban. 2018;43(2):114-23. doi: 10.11817/j.issn.1672-7347.2018.02.002.
Bray FN, Simmons BJ, Wolfson AH, Nouri K. Acute and chronic cutaneous reactions to ionizing radiation therapy. Dermatol Ther (Heidelb). 2016;6(2):185-206. doi: 10.1007/s13555-016-0128-6.
Vahlepi R, Arifin MT, Nur M, Muniroh M, Susilaningsih N. Ozonated aloe vera oil improve wound healing by decreasing neutrophil count and wound diameter in Sprague dawley rats with full-thickness skin defect. Indonesia Journal of Biomedical Science (IJBS). 2020;14(2):48-54. doi: 15562/ijbs.v14i2.253.
Arora P, Shiveena B, Garg M, Kumari S, Goyal A. Curative potency of medicinal plants in management of eczema: a conservative approach. Phytomedicine Plus. 2022;2(2):100256. doi: 10.1016/j.phyplu.2022.100256.
Oryan A, Mohammadalipour A, Moshiri A, Tabandeh MR. Topical application of Aloe vera accelerated wound healing, modeling, and remodeling. Ann Plast Surg. 2016;77(1):37-46. doi: 10.1097/SAP.0000000000000713.
Tamba US, Arifin MT, Nur M, Muniroh M, Susilanigsih N. The role of ozonated Aloe vera oil in full-thickness skin defects: Macrophage count and epithelization length parameter. 2020;9:1218. doi: 10.12688/f1000research.25857.1.
Rosenthal A, Israilevich R, Moy R. Management of acute radiation dermatitis: A review of the literature and proposal for treatment algorithm. J Am Acad Dermatol. 2019;81(2):558-67. doi: 10.1016/j.jaad.2018.10.070.
Doughty DB, McNichol LL. Wound, Ostomy and Continence Nurses societyTM core curriculum: Wound management. 2nd Wolters Kluwer; 2015. p.1–496.
Huang CJ, Hou MF, Luo KH, Wei SY, Huang MY, Su SJ, et al. RTOG, CTCAE and WHO criteria for acute radiation dermatitis correlate with cutaneous blood flow measurements. 2015;24(3):230-6. doi: 10.1016/j.breast.2015.01.008.
Taqwim Hidayat A, Thohar Arifin M, Nur M, Muniroh M, Susilaningsih N. Ozonated Aloe vera oil effective increased the number of fibroblasts and collagen thickening in the healing response of full-thickness skin defects. Int J Inflam. 2021;2021:6654343. doi: 10.1155/2021/6654343.
Jacobson LK, Johnson MB, Dedhia RD, Niknam-Bienia S, Wong AK. Impaired wound healing after radiation therapy: A systematic review of pathogenesis and treatment. JPRAS Open. 2017 Sep;13(C):92-105. doi: 10.1016/j.jpra.2017.07.007.
Krzyszczyk P, Schloss R, Palmer A, Berthiaume F. The role of macrophages in acute and chronic wound healing and interventions to promote pro-wound healing phenotypes. Front Physiol. 2018;9:419. doi: 10.3389/fphys.2018.00419.
Azevedo JS de J, Juliao ELD, Dantas JB de L, Reis JVNA. Is aloe vera effective for wound healing? J Oral Diag. 2019; 04:e20190005.
Taşdemir Z, Alkan BA, Albayrak H. Effects of ozone therapy on the early healing period of deepithelialized gingival grafts: a randomized placebo-controlled clinical trial. J Periodontol. 2016;87(6):663-71. doi: 10.1902/jop.2016.150217.
Zhang J, Guan M, Xie C, Luo X, Zhang Q, Xue Y. Increased growth factors play a role in wound healing promoted by noninvasive oxygen-ozone therapy in diabetic patients with foot ulcers. Oxid Med Cell Longev. 2014;2014:273475. doi: 10.1155/2014/273475.
Hashemi SA, Madani SA, Abediankenari S. The review on properties of Aloe Vera in healing of cutaneous wounds. Biomed Res Int. 2015;2015:1-6. doi: 10.1155/2015/714216.
Liu L, Zeng L, Gao L, Zeng J, Lu J. Ozone therapy for skin diseases: Cellular and molecular mechanisms. Int Wound J. 2023;20(6):2376-85. doi: 10.1111/iwj.14060.
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