Evaluation of the wound healing effect of Nishamalaki, an Ayurvedic formulation comprising Curcuma longa and Phyllanthus emblica in aging rats

There are very few drugs available for healing wounds in the aged population, which is more prone to chronic cutaneous wounds that are particularly hard to heal and require a long healing process. This study which deals with age-related wound healing, investigates the healing effect of Nishamalaki, a classic antidiabetic Ayurvedic formulation comprising turmeric (Curcuma longa) and Indian gooseberry (Phyllanthus emblica), on cutaneous wounds in aging rats. Rats with excision wounds of 7 mm created on their dorsal side received Nishamalaki (500 mg/kg p.o) daily, or a combination of Nishamalaki (500 mg/kg p.o) with 1% Nishamalaki gel applied on the wound or the reference standard metformin (2 μmol) applied on the wound daily till the scabs fell off. All treatments enhanced the rate of formation of granulation tissue and wound contraction. All treated rats showed lower blood glucose levels compared with their 1st-day values and significantly lower blood glucose levels when compared with the Aged Control rats. A significant restoration of the aging-depleted L-hydroxyproline, hexosamine, ascorbic acid, PDGF, AMPK, and mTOR levels, and attenuation of the aging-elevated IL-6 and TNF-α levels was elicited by all treatments. The treatments significantly restored the aging-depleted endogenous antioxidants. The Nishamalaki combination treatment of the oral extract and topical gel displayed a better wound-healing effect than the oral treatment alone. The histopathological studies on skin ulceration, hair follicles, granulation tissue, and collagen fiber formation of the wound tissues corroborated the biochemical findings. Curcumin and other antioxidant polyphenolic components of Nishamalaki may be responsible for its wound-healing effect. For the first time, the present study has investigated the action of PDGF, AMPK, and mTOR on cutaneous wounds. They seem to be acting together to promote wound healing and repair.