Aloe Vera Delays Mortality, but Does Not Attenuate Kidney Injury in Septic Mice
Keywords:Aloe vera, medicinal plants, animal models, sepsis
Background: Intensive care units (ICUs) admissions due to sepsis represent 2 to 11%. Although there are well stablished therapeutic available, it still is the major cause of death in most ICUs and the leading cause of acute kidney injury. The objective of this work was to evaluate the role of Aloe vera extract on survival rates and kidney histopathology of mice submitted to sepsis induced by cecal ligation and puncture.
Methods and Findings: Twenty six mice were distributed into four groups: Sham - surgery simulation (N=5); Control - Cecal ligation and puncture was performed (N=7); Aloe - Surgery simulation and treatment with Aloe vera extract (N=7); and Sepsis + Aloe - Cecal ligation and puncture was performed followed by treatment with Aloe vera extract (N=7). The animals were observed until death. Kidneys were analysed by histopathology. Kruskall-Wallis test was used to compare the histopathological results. Survival analysis was assessed by Kaplan-Meier statistics and compared using log rank test. A significance level of 5% was adopted. The survival time ranged from 19 hours for the Control group up to 24 hours for the animals of Sepsis + Aloe group, corresponding to a survival time of 1.26 times greater (p<0.01). There were no difference between the Sham and Aloe groups and between Control and Sepsis + Aloe groups according to the four parameters analyzed (p>0.05).
Conclusions: Aloe vera extracts delays mortality but does not attenuate kidney injury in sepsis induced by cecal ligation and puncture in mice.
- Angus DC, Wax RS. Epidemiology of sepsis: an update. Crit Care Med. 2001; 29(Suppl7): S109-16.
- Huang CT, Tsai YJ, Tsai PR, Yu CJ, Ko WJ. Epidemiology and Outcome of Severe Sepsis and Septic Shock in Surgical Intensive Care Units in Northern Taiwan.Medicine (Baltimore). 2015 Nov;94(47):e2136. doi: 10.1097/MD.0000000000002136. PMID: 26632737.
- Stoller J, Halpin L, Weis M, Aplin B, Qu W, Georgescu C, Nazzal M. Epidemiology of severe sepsis: 2008-2012. J Crit Care. 2016 Feb;31(1):58-62. doi: 10.1016/j.jcrc.2015.09.034. PMID: 26601855.
- Sogayar AM, Machado FR, Rea-Neto A, Dornas A, Grion CM, Lobo SM, Tura BR, Silva CL, Cal RG, Beer I, Michels V, Safi J, Kayath M, Silva E. A multicentre, prospective study to evaluate costs of septic patients in Brazilian intensive care units.Pharmacoeconomics. 2008; 26(5): 425-34. doi: 10.2165/00019053-200826050-00006. PMID: 18429658.
- Westphal GA, Silva E, SalomÃ£o R, Bernardo WM, Machado FR. Guidelines for the treatment of severe sepsis and septic shock: hemodynamic resuscitation. Rev Bras TerIntensiva. 2011 Mar; 23(1): 13-23. Doi: 10.1590/S0103-507X2011000100004 . PMID: 25299549.
- Beale R, Reinhart K, Brunkhorst FM, Dobb G, Levy M, Martin G, Martin C, Ramsey G, Silva E, Vallet B, Vincent JL, Janes JM, Sarwat S, Williams MD. Promoting Global Research Excellence in Severe Sepsis (PROGRESS): lessons from an international sepsis registry.Infection. 2009 Jun; 37(3): 222-32. doi: 10.1007/s15010-008-8203-z. PMID: 19404580.
- Teles JM, Silva E, Westphal G, Filho RC, Machado FR. Surviving sepsis campaign in Brazil. Shock. 2008 Oct; 30(Suppl1 ): 47-52. doi: 10.1097/SHK.0b013e318181a128. PMID: 18704009.
- Gurib-Fakim A. Medicinal plants: traditions of yesterday and drugs of tomorrow. Mol Aspects Med. 2006 Feb;27(1):1-93. Mol Aspects Med. 2006 Feb; 27(1): 1-93. PMID: 16105678.
- Yun N, Lee C, Lee S. Protective effect of Aloe vera on polymicrobial sepsis in mice. Food ChemToxicol. 2009 Jun; 47(6): 1341-8. doi: 10.1016/j.fct.2009.03.013. PMID: 19298839.
- Choi S, Chung MH. A review on the relationship between aloe vera components and their biologic effects.Semin.Integr. Med. 2003 Mar; 1(1): 53-62.
- Hamman JH. Composition and applications of Aloe vera leaf gel. Molecules. 2008 Aug; 13(8): 1599-616. PMID: 18794775.
- Kim K, Kim H, Kwon J, Lee S, Kong H, Im SA, Lee YH, Lee YR, Oh ST, Jo TH, Park YI, Lee CK, Kim K. Hypoglycemic and hypolipidemic effects of processed Aloe vera gel in a mouse model of non-insulin-dependent diabetes mellitus. Phytomedicine. 2009 Sep;16(9):856-63. doi: 10.1016/j.phymed.2009.02.014. PMID: 19303272.
- Walley KR, Lukacs NW, Standiford TJ, Strieter RM, Kunkel SL. Balance of inflammatory cytokines related to severity and mortality of murine sepsis. Infect Immun. 1996 Nov;64(11):4733-8. PMID: 8890233.
- Zhou F, Peng ZY, Bishop JV, Cove ME, Singbartl K, Kellum JA. Effects of fluid resuscitation with 0.9% saline versus a balanced electrolyte solution on acute kidney injury in a rat model of sepsis. Crit Care Med. 2014 Apr;42(4):e270-8. doi: 10.1097/CCM.0000000000000145. PMID: 24335444.
- Ranieri VM, Thompson BT, Barie PS, Dhainaut JF, Douglas IS, Finfer S, GÃ¥rdlund B, Marshall JC, Rhodes A, Artigas A, Payen D, Tenhunen J, Al-Khalidi HR, Thompson V, Janes J, Macias WL, Vangerow B, Williams MD. Drotrecogin alfa (activated) in adults with septic shock. N Engl J Med. 2012 May; 366(22):2055-64. doi: 10.1056/NEJMoa1202290. PMID: 22616830.
- Holder AL, Huang DT. A dream deferred: the rise and fall of recombinant activated protein C. Crit Care. 2013 Mar 12;17(2):309. doi: 10.1186/cc12533. PMID: 23509922.
- VÃ¡zquez B, Avila G, Segura D, Escalante B. Antiinflammatory activity of extracts from Aloe vera gel. J Ethnopharmacol. 1996 Dec;55(1):69-75. PMID: 9121170.
- Botelho NM, Silveira EL, Lopes LN, Santos FAF, Teixeira RKC, da Silva TT. Copaiba oil effect under different pathways in mice subjected to sepsis Acta Cir Bras. 2014 Aug; 29(8): 528-31. doi: 10.1590/S0102-86502014000800008. PMID: 25140595.
- Lopes LN, Santos FAF, Oliveira LCM, Percario S, de Barros CAV, Brito MVH. Copaiba oil effect on induced fecal peritonitis in rats.Acta Cir Bras. 2015 Aug; 30(8): 568-73. doi: 10.1590/S0102-865020150080000008. PMID: 26352337.
-Wang H, Li W, Li J, Rendon-Mitchell B, Ochani M, Ashok M, Yang L, Yang H, Tracey KJ, Wang P, Sama AE. The Aqueous Extract of a Popular Herbal Nutrient Supplement, Angelica sinensis, Protects Mice against Lethal Endotoxemia and Sepsis. J Nutr. 2006 Feb; 136(2): 360-5. PMID: 16424112.
- Hsu DZ, Liu MY. Effects of sesame oil on oxidative stress after the onset of sepsis in rats. Shock. 2004 Dec; 22(6): 582-5. doi: 10.1097/01.shk.0000135254.21699.45. PMID: 15545832.
- Williams MS, Burk M, Loprinzi CL, Hill M, Schomberg PJ, Nearhood K, O'Fallon JR, Laurie JA, Shanahan TG, Moore RL, Urias RE, Kuske RR, Engel RE, Eggleston WD. Phase III double-blind evaluation of an aloe vera gel as a prophylactic agent for radiation-induced skin toxicity. Int J RadiatOncolBiol Phys. 1996 Sep 1; 36(2): 345-9. PMID: 8892458.
- Molazem Z, Mohseni F, Younesi M, Keshavarzi S. Aloe vera gel and cesarean wound healing; a randomized controlled clinical trial. Glob J Health Sci. 2014 Aug 31;7(1):203-9. doi: 10.5539/gjhs.v7n1p203. PMID: 25560349.
- Rahmani N, Khademloo M, Vosoughi K, Assadpour S. Effects of Aloe vera cream on chronic anal fissure pain, wound healing and hemorrhaging upon defection: a prospective double blind clinical trial. EurRevMedPharmacolSci. 2014;18(7):1078-84. PMID: 24763890.
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