The Effect of Topical Ozonated Aloe vera on VEGF Expression and Microvascular Density in Radiation Dermatitis

Yan Wisnu Prajoko; Davin Rizky Parulian Silalahi; Christina Hari Nawangsih Priharsanti; Tommy Supit

doi:10.3889/oamjms.2022.8319

Authors

Yan Wisnu Prajoko Department of Surgical Oncology, Faculty of Medicine, Universitas Diponegoro, Dr. Kariadi General Hospital, Semarang, Indonesia
Davin Rizky Parulian Silalahi Department of Surgical Oncology, Faculty of Medicine, Universitas Diponegoro, Dr. Kariadi General Hospital, Semarang, Indonesia
Christina Hari Nawangsih Priharsanti Department of Radiology, Faculty of Medicine, Universitas Diponegoro, Dr. Kariadi General Hospital, Semarang, Indonesia
Tommy Supit Department of Surgery, Faculty of Medicine, Universitas Diponegoro, Dr. Kariadi General Hospital, Semarang, Indonesia

DOI:

https://doi.org/10.3889/oamjms.2022.8319

Keywords:

Ozonated Aloe vera, Vascularization, VEGF, Microvascular density, Radiation dermatitis, Wound healing

Abstract

BACKGROUND: Radiation dermatitis is one of the most common side effects of external radiation therapy. Ozonated Aloe vera oil is a novel topical intervention with immunomodulatory properties that have been proven to improve wound healing by promoting fibroblast proliferation and collagen synthesis.

AIM: The purpose of this study was to investigate the effect of topical ozonated A. vera oil application on the vascularization aspect of wound healing in a radiation dermatitis animal model.

METHODS: Thirty-six adult male Sprague Dawley rats were randomized into six groups of equal size (n = 6/group): two control and four intervention groups: Positive control (C1) rats were not given any therapy, and comparative control (C2) rats were given topical hydrocortisone cream 2.5%. Subjects in the P1 group were given non-ozonated A. vera therapy, P2 group was given 300 mg/mL ozonated A. vera, P3 group was given 600 mg/mL ozonated A. vera, and P4 was given 1200 mg/mL ozonated A. vera therapy. Subject termination and histopathological analyses of vascular endothelial growth factor (VEGF) and microvascular density were carried out after 7 treatment days.

RESULTS: Based on Weidner microvascular density scoring system, the least microvascular density was observed in C2, P3, and P4 (2.0 ± 0.0), followed by P1 (2.1 ± 0.1), P2 (2.9 ± 1.5), and C1 (3.0 ± 0.7). Based on immunoreactive immunoreactive score (IRS) VEGF scoring system, the lowest expression of VEGF was observed in group P3 (4.1 ± 1.1), followed by P4 (4.3 ± 0.8), C2 (4.3 ± 1.3), P1 (5.1 ± 1.0), P2 (5.4 ± 0.6), and C1 (6.5 ±1.0). There was a strong positive correlation of VEGF and microvascular density.

CONCLUSION: Topical application of ozonated A. vera to the radiated skin of Sprague Dawley rats reduced VEGF expression and microvascular density. This anti-inflammatory effect may suggest its potential clinical application.

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