Abstract Polyphenolics from Rhizophora mangle (R. mangle) have shown wound healing and anti- inflammatory effects that may be potentiated by being associated with ascorbic acid, an important substance for collagen and elastin synthesis that plays a role in tissue repair. In our study, we aimed to formulate an association of R. mangle and ascorbic acid in hydrogels and evaluate the association’s cytotoxic and immunomodulatory effects. In a pre-formulation study, three gelling polymers (i.e.xanthan gum, poloxamer and hydroxyethyl cellulose) were tested. The selected polymer (i.e. xanthan gum) was used to evaluate cytotoxic and immunomodulatory effects using flow cytometry. Xanthan gum (1.5%) had a homogeneous appearance, an orange colour, a smooth surface, intense brightness and the typical odour, as well as non-Newtonian pseudoplastic behaviour. With a pH of 5.0-5.3 and a non-cytotoxic profile, xanthan gum induced the proliferation and activation of CD4 +, CD8+ and NK T lymphocytes and the production of IL- 2, IL-4, IL-10, IL-17 and TNF-α cytokines in stimulated splenocytes. The results suggest that the association of R. mangle and ascorbic acid in 1.5% xanthan gum hydrogel may be promising in preparations for wound-healing processes. R (R anti repair study associations s preformulation pre formulation i.e.xanthan iexanthan i e cellulose tested i.e. ie (i.e cytometry 15 1 5 (1.5% appearance colour surface odour nonNewtonian non Newtonian behaviour 5.05.3 5053 5.0 5.3 0 3 5.0-5. noncytotoxic profile CD + CD8 IL 2 IL4, IL4 4, 4 IL-4 IL10, IL10 10, 10 IL-10 IL17 17 IL-1 TNFα TNF α splenocytes 1.5 woundhealing processes i.e (1.5 05 5.05. 505 50 5. 53 5.0-5 IL1 1. (1. 5.05 5.0- (1 (

Abstract Studies have shown that Caesalpinia pulcherrima extracts promote antioxidant, healing, immunomodulating and antiparasitic activities and its polysaccharides can be used as functional food. In this sense, this work had as objective the isolation and characterization of a polysaccharide-like pectin, extracted from the C. pulcherrima leaves and its possible applications as an antioxidant and immunomodulator agent. The molecule was characterized by high performance liquid chromatography, fourier transform infrared spectroscopy and nuclear magnetic resonance spectroscopy. Its antioxidant potential was evaluated through the methods of phosphomolybdenum, ABTS radical scavenging [2,2'-azino-bis (3-ethylbenzothiazoline-6-sulfonic acid], DPPH (1,1-diphenyl-2-picrylhydrazyl) and nitric oxide radical. The immunostimulating effects of pectin were tested in splenocytes to evaluate its toxic, proliferative and cell activator and immunomodulatory potential. The polysaccharide obtained has structural characteristics similar to pectins. Pectin showed high in vitro antioxidant activity for ABTS radical scavenging, moderate activity for phosphomolybdenum and low activity for DPPH and nitric oxide. In vitro immunomodulation assays showed that pectin obtained did not promote a cytotoxic effect (viability > 90%). The increase in cytosolic ROS levels indicates a possible mechanism of cell activation without causing damage. Immunophenotyping showed that pectin increased a subpopulation of CD8+ T lymphocytes and monocytes. In addition, it promoted a mostly pro-inflammatory response confirmed by the production of cytokines IL-2, -4, -6, IFN-γ and TNF-α. These results reinforce the ethnopharmacological use of C. pulcherrima leaves and expand the use of this plant for future applications as herbal medicines.

RESUMO A filariose linfática põe em risco bilhões de pessoas em todo o mundo. Apesar disso, pouco se sabe sobre o impacto da morbidade crônica da doença, como o linfedema. A terapia complexa descongestiva apresenta-se como padrão ouro para tratar linfedemas, mas ainda não existem protocolos viáveis para implementação em países em desenvolvimento. O objetivo deste ensaio clínico foi avaliar a eficácia dessa técnica, com o uso de material alternativo, e comparar seus efeitos na qualidade de vida, funcionalidade e peso corporal. Os grupos intervenção e controle foram avaliados por meio de perimetria e cálculo do volume dos membros, do questionário de qualidade de vida Whoqol-bref, do teste de funcionalidade e mobilidade de membros inferiores Timed Up and Go e avaliação do peso corporal. O grupo intervenção recebeu a terapia complexa descongestiva duas vezes por semana, durante dez semanas, utilizando-se um material alternativo para o enfaixamento, confeccionado com tecido de cambraia, o que apresenta baixo custo em relação às faixas importadas. O grupo controle recebeu palestra com informações sobre a doença e orientações de cuidados e higiene dos membros. A amostra foi composta por trinta pacientes com idade média de 50,8±10 anos, sendo 52,9% mulheres. Na análise estatística foram utilizados os testes t de Student, Multivariate analysis of variance, teste de Wilcoxon e Kolmogorov-Smirnov. A significância adotada foi de 5% (p<0,05). Houve redução significativa do volume e perimetria do linfedema no grupo intervenção, e aumentou no grupo controle. A funcionalidade não apresentou melhora significativa na avaliação pelo teste Timed Up and Go. A qualidade de vida teve melhora significativa nos domínios físico e meio ambiente no grupo intervenção. O efeito do tratamento no peso corporal também foi significativo, apresentando redução no grupo controle e intergrupos. A terapia complexa descongestiva mostrou-se eficaz na redução e no controle do linfedema e impactou de maneira positiva, aumentando os valores numéricos dos aspectos físico e meio ambiente da qualidade de vida do grupo intervenção.

ABSTRACT Lymphatic filariasis puts billions of people around the world at risk. Despite this, little is known about the impact of chronic disease morbidity, such as lymphedema. The complex decongestant therapy is a gold standard for treating lymphedemas, but there are no viable protocols for implementation in developing countries. The objective of this clinical trial was to evaluate the efficacy of this technique with the use of alternative material and compare its effects on quality of life, functionality and body weight. The intervention and control groups were evaluated using perimetry and limb volume calculation, the Whoqol-bref quality of life questionnaire, the Functional and Mobility test of the lower limbs Timed Up and Go, and body weight assessment. The intervention group received the complex decongestant therapy twice a week for ten weeks, using an alternative material for the bandaging, made with cambric tissue, which presents low cost in relation to the imported bands. The control group received a lecture with information about the disease and care and hygiene guidelines of the members. The sample consisted of thirty patients with a mean age of 50.8 ± 10 years, 52.9% of whom were women. In the statistical analysis, Student's t test, Multivariate analysis of variance, Wilcoxon test and Kolmogorov-Smirnov test were used. The significance was 5% (p<0.05). There was a significant reduction in lymphedema volume and perimetry in the intervention group, and increased in the control group. The functionality did not show significant improvement in the evaluation by the Timed Up and Go test. The quality of life had significant improvement in the physical and environmental domains in the intervention group. The effect of treatment on body weight was also significant, presenting reduction in the control group and intergroups. Complex decongestant therapy was effective in reducing and controlling lymphedema and positively impacted, increasing the numerical values of the physical and environmental aspects of the quality of life of the intervention group.

RESUMEN La filariasis linfática presenta riesgo para muchas personas en el mundo. Pero poco se sabe acerca del impacto de la morbilidad crónica de esta enfermedad, como es el linfedema. Y surge la terapia compleja descongestiva como la forma de tratarlo, pero todavía no hay protocolos que le posibilite su implementación en países en desarrollo. Este estudio clínico tiene el propósito de valorar la eficacia de esta técnica, con el empleo de material alternativo, y de comparar sus efectos en la calidad de vida, funcionalidad y peso corporal. Se evaluaron a los grupos intervención y control a través de medición y cálculo del volumen de los miembros, de cuestionario de calidad de vida Whoqol-Bref, de la prueba de funcionalidad y movilidad de los miembros inferiores Timed Up and Go y la evaluación del peso corporal. El grupo intervención hizo la terapia compleja descongestiva dos veces a la semana, durante diez semanas, y utilizó un material alternativo, el linón, para el vendaje, lo que mostró ser de bajo costo en comparación a otras vendas importadas. El grupo control vio una charla que exponía informaciones sobre la enfermedad y sobre los cuidados e higienización de los miembros. Treinta pacientes con promedio de edad de 50,8±10 años formaron la muestra, con un 52,9% de participantes mujeres. En el análisis estadístico se emplearon las pruebas t de Student, Multivariate analysis of variance, la prueba de Wilcoxon y Kolmogorov-Smirnov. El nivel de significación ha sido de 5% (p<0,05). Se observó una significativa reducción en el volumen y en la medición del linfedema en el grupo intervención, pero había aumentado en el grupo control. La funcionalidad no ha presentado mejora en la evaluación por la prueba Timed Up and Go. La calidad de vida ha presentado mejora en los dominios físico y medioambiente en el grupo intervención. El efecto del tratamiento en el peso corporal también ha sido significativo por presentar reducción en el grupo control e intergrupal. La terapia compleja descongestiva puede ser eficaz en la reducción y en el control del linfedema, además de aumentar positivamente los valores en los dominios físico y medioambiente de la calidad de vida del grupo intervención.