Abstract BACKGROUND Diabetic foot ulcers are a common diabetic complication leading to alarming figures of amputation, disability, and early mortality. The diabetic glucooxidative environment impairs the healing response, promoting the onset of a ‘wound chronicity phenotype’. In 50% of ulcers, these non-healing wounds act as an open door for developing infections, a process facilitated by diabetic patients’ dysimmunity. Infection can elicit biofilm formation that worsens wound prognosis. How this microorganism community is able to take advantage of underlying diabetic conditions and thrive both within the wound and the diabetic host is an expanding research field. OBJECTIVES 1) Offer an overview of the major cellular and molecular derangements of the diabetic healing process versus physiological cascades in a non-diabetic host. 2) Describe the main immunopathological aspects of diabetics’ immune response and explore how these contribute to wound infection susceptibility. 3) Conceptualize infection and biofilim in diabetic foot ulcers and analyze their dynamic interactions with wound bed cells and matrices, and their systemic effects at the organism level. 4) Offer an integrative conceptual framework of wound–dysimmunity–infection–organism damage. EVIDENCE AQUISITION We retrieved 683 articles indexed in Medline/PubMed, SciELO, Bioline International and Google Scholar. 280 articles were selected for discussion under four major subheadings: 1) normal healing processes, 2) impaired healing processes in the diabetic population, 3) diabetic dysimmunity and 4) diabetic foot infection and its interaction with the host. DEVELOPMENT The diabetic healing response is heterogeneous, torpid and asynchronous, leading to wound chronicity. The accumulation of senescent cells and a protracted inflammatory profile with a pro-catabolic balance hinder the proliferative response and delay re-epithelialization. Diabetes reduces the immune system’s abilities to orchestrate an appropriate antimicrobial response and offers ideal conditions for microbiota establishment and biofilm formation. Biofilm–microbial entrenchment hinders antimicrobial therapy effectiveness, amplifies the host's pre-existing immunodepression, arrests the wound’s proliferative phase, increases localized catabolism, prolongs pathogenic inflammation and perpetuates wound chronicity. In such circumstances the infected wound may act as a proinflammatory and pro-oxidant organ superimposed onto the host, which eventually intensifies peripheral insulin resistance and disrupts homeostasis. CONCLUSIONS The number of lower-limb amputations remains high worldwide despite continued research efforts on diabetic foot ulcers. Identifying and manipulating the molecular drivers underlying diabetic wound healing failure, and dysimmunity-driven susceptibility to infection will offer more effective therapeutic tools for the diabetic population.
Essential oils (AE) are used as preservatives in the food industry, due to their physicochemical characteristics and antioxidant activity. The aim of this research was to determine yield (R), specific gravity (GE), refractive index (IR), antioxidant activity (AA) and chemical composition of AE of huacatay (Tagetes minuta), poleo (Minthostachys mollis), rosemary (Rosmarinus officinalis L.) and sachaculantro (Eryngium foetidum L.), plants collected from 52 districts of the Amazon region, Peru. For each AE, fixed-effect variance analysis was used with three replications and cluster analysis. The antioxidant activity was determined with the free radical method 2,2-diphenyl-1-picrylhydracil (DPPH) and its most abundant components were identified with headspace gas chromatography coupled to mass spectrometry. The differences in R, GE and IR were significant between districts. The AA showed no significant difference between the districts, but between the plants itself. Among the most abundant volatile components, 1-adamantanol (44.42%) was identified in huacatay, β-phellandrene (20.85%) in poleo, β-myrcene (34.59%) in rosemary and α-pinene (23.41%) in sachaculantro. It is concluded that the geographic location significantly affects the physicochemical properties of AE
Los aceites esenciales (AE) son usados como conservantes en la industria de alimentos, debido a sus características fisicoquímicas y actividad antioxidante. El objetivo de esta investigación fue determinar rendimiento (R), gravedad específica (GE), índice de refracción (IR), actividad antioxidante (AA) y composición química de AE de huacatay (Tagetes minuta), poleo (Minthostachys mollis), romero (Rosmarinus officinalis L.) y sachaculantro (Eryngium foetidum L.), plantas recolectadas de 52 distritos de la región Amazonas, Perú. Para cada AE se usó análisis de varianza de efectos fijos con tres repeticiones y análisis de clúster. La actividad antioxidante se determinó con el método del radical libre 2,2-difenil-1-picrilhidracilo (DPPH) y sus componentes más abundantes fueron identificados con cromatografía de gases acoplada a espectrometría de masas. Las diferencias en R, GE e IR fueron significativas entre distritos. La AA no mostró diferencia significativa entre los distritos, pero entre las plantas sí. Entre los componentes volátiles más abundantes se identificó 1-adamantanol (44,42%) en huacatay, β-felandreno (20,85%) en poleo, β-mirceno (34,59%) en romero y α-pineno (23,41%) en sachaculantro. Se concluye que el lugar geográfico afecta significativamente las propiedades fisicoquímicas de los AE