BMC Complementary Medicine and Therapies最新文献

Background: Venous leg ulcer (VLU) is among the most severe clinical manifestations of chronic venous disease (CVD) and imposes substantial burdens on both patients and society. VLU pathogenesis is closely associated with the impairment of vascular endothelial cells. In this study, tissue samples from the patients' s skins around wound at different stages of CVD were collected during operation and used to elucidate the involvement of ferroptosis in the pathogenesis of VLU. Also the potential mechanism through which Huoxue Shengji (HXSJ) decoction alleviates ferroptosis in human umbilical vein endothelial cells (HUVECs) was investigated.

Methods: During surgical procedure such as great saphenous vein high ligation and stripping surgery, matched skin tissues from the normal, hyperpigmentation (HPT), lipodermatosclerosis (LDS), and VLU regions were collected from 10 patients with VLU, and the levels of iron and glutathione peroxidase 4 (GPX4) were quantified to evaluate ferroptosis. In vitro, HUVECs were used to iron overload induction using exogenous 100 µM ferric ammonium citrate (FAC) or 100 µM hemin, or ferroptosis induction with 10 µM erastin, and treated with 10 µg/ml HXSJ decoction for 24 h. Subsequently, lipid peroxidation (LPO) damage, mitochondrial function, and key genes involved in ferroptosis were assessed.

Results: Iron deposition in the affected skin of patients with CVD gradually increased before progression to VLU and significantly decreased during the VLU stage. Moreover, GPX4 expression increased significantly in the HPT stage but was gradually suppressed with further deterioration of CVD. The in vitro results indicated that in both the iron overload and ferroptosis models, HXSJ decoction effectively upregulated the expression of nuclear factor erythroid 2-related factor 2 (Nrf2), solute carrier family 7 member 11 (SLC7A11, xCT), and GPX4, which was accompanied by the inhibition of malondialdehyde and protein carbonylation production, the alleviation of ferrous ion accumulation, and the restoration of mitochondrial function.

Conclusions: This study demonstrated that iron accumulation-mediated inactivation of GPX4 serves as a crucial mechanism in VLU formation through ferroptosis induction. Notably, the therapeutic mechanism through which HXSJ decoction alleviates ferroptosis involves Nrf2/xCT/GPX4 pathway activation and a reduction in ferrous ion accumulation. These findings may provide novel insights into VLU pathogenesis and give possible reason for developing traditional Chinese medicine therapies targeting ferroptosis and VLUs.

Background: Wound healing is a complex process requiring coordinated cellular responses. Honey and silver nanoparticles (AgNPs) are well-known for their potential to heal wounds. However, there is little evidence of their combined impact on wound healing in fibroblast cells. This study aimed to investigate the combined effects of two types of honey with AgNPs on bacterial growth inhibition and wound healing in human dermal fibroblast cells.

Method: Honey samples were characterized based on phenolic content, antioxidant capacity, and protein levels. The AgNPs were synthesized and characterized by dynamic light scattering, ultraviolet-visible, transmission electron microscopy, and X-ray powder diffraction. Antibacterial activity was assessed by checkerboard assay. The effect of honey, AgNPs, and their combination on fibroblast cell viability and wound healing was evaluated. Quantitative real-time PCR was conducted to evaluate the mRNA expression of growth factors.

Results: Our results showed that Barberry honey significantly increased fibroblast cell growth, wound healing, and expression of FGF2, TGFβ1, COL1A1, and VEGFA genes compared to commercial honey. Combination of honey with AgNPs significantly increased VEGFA gene expression compared to either agent alone. Barberry honey and AgNPs also showed strong antibacterial effects individually. However, their combination had no synergistic effect.

Conclusion: These findings suggest that Barberry honey and its combination with AgNPs could serve as effective agents for promoting the fibroblast wound healing process. However, more in vitro and in vivo research is needed to investigate further mechanisms of Barberry honey alone and in combination with AgNPs in wound healing.

Background and objective: Primary health care (PHC) systems are increasingly challenged by the rising burden of chronic diseases and the growing demand for personalized care. Persian Medicine (PM), with its constitution-based approach and rich historical foundation, holds significant potential as a complementary strategy in population health management within the PHC framework. This study aimed to explore the barriers and facilitators to integrating PM into the PHC system from the perspectives of Community Health Workers (CHWs) and Community Health Supervisors (CHSs).

Methods: A qualitative descriptive design with thematic analysis was employed. Data were collected through semi-structured interviews with 18 CHWs and CHSs in Primary Healthcare Centers (PHCs) in Tabriz, Iran. Purposive sampling with maximum variation was used to ensure diversity of perspectives. Data were analyzed using the Braun and Clarke framework with MAXQDA version 24. To ensure trustworthiness, member checking and peer debriefing were conducted by independent researchers.

Results: Five main themes emerged: (1) challenges in designing and integrating PM assessment tools into PHC; (2) structural and policy-level barriers; (3) challenges in health education and information acceptance; (4) human resource constraints and motivation; and (5) facilitating factors and participant-driven strategies. The first four themes represent barriers, while the fifth highlights strategies for successful PM integration into PHC.

Conclusion: The successful integration of PM into PHC requires a comprehensive strategy Empowering healthcare personnel, developing evidence-based protocols, improving health literacy, and fostering collaboration between PM and conventional medicine are essential steps toward achieving this goal.