Centella asiatica : alternative dry skin therapy in type 2 diabetes mellitus

https://doi.org/10.19106/JMedSci005303202108

Lili Legiawati(1*)

(1) Department of Dermatology and Venereology, Faculty of Medicine, Universitas Indonesia/Dr. Cipto Mangunkusumo National Central General Hospital, Jakarta, Indonesia
(*) Corresponding Author

Abstract


Diabetes mellitus (DM) in Indonesia has rapidly increased during recent years.
World Health Organization (WHO) predicted that in 2030, Indonesia would
be ranked fourth for the largest DM patients in the world. As the disease
progresses, uncontrolled type 2 DM (T2DM) results in dry skin as the most
prevalent skin disorder. Despite the prevalence and morbidities that lead to
infection, ulcer, gangrene that can lead to amputation when insufficiently
treated, dry skin in T2DM has limited therapeutic options. Currently, available
therapies for dry skin in T2DM have not considered factors of hyperglycemia
and hyperinsulinemia, which disturb skin homeostasis. Nonetheless, in T2DM,
there are neuropathy and biostructural changes of the skin which induce
dry skin. Alternative herbal medicine, Centella asiatica is getting well-known
nowadays because of its vast amount of benefits. Centella asiatica has been
studied for its antioxidant, antidiabetic, anti-inflammation, antiglycation, and
neuroprotective activities. Furtherly, these properties may display benefits
when introduced to T2DM dry skin therapy. The previous clinical study had
shown that topical C. asiatica improved dry skin. This clinical study was also
supported by in vitro studies. Currently, pharmacological profile studies of C. asiatica
 including dosage, toxicity, and safety have been available. This article
aimed to review the current literature on the potential of C. asiatica as an alternative to treat dry skin in T2DM.

Keywords


Centella asiatica; dry skin; therapy; type 2 diabetes mellitus; wound healing

Full Text:

PDF


References



1.World Health Organization. Global report on diabetes. World Health Organization; [cited: http://apps.who.int/iris/bitstream/10665/204871/1/9789241565257_eng.pdf
2.American Diabetes Association. Economic costs of diabetes in the U.S. in 2012. Diabetes Care 2013; 36(4):1033-46.
https://doi.org/10.2337/dc12-2625
3.Chatterjee N, Chattopadhyay C, Sengupta N, Das C, Sarma N, Pal SK. An observational study of cutaneous manifestations in diabetes mellitus in a tertiary care Hospital of Eastern India. Indian J Endocrinol Metab 2014; 18(2):217-20.
https://doi.org/10.4103/2230-8210.129115
4.Chandrika UG, Prasad Kumarab PA. Gotu kola (Centella asiatica): nutritional properties and plausible health benefits. Adv Food Nutr Res 2015; 76:125-57.
https://doi.org/10.1016/bs.afnr.2015.08.001
5.Hasanah AU. Perbandingan efektivitas dan keamanan krim pelembab yang mengandung Centella asiatica ekstrak etanol dalam nanopartikel kitosan dengan Centella asiatica ekstrak etanol dan dengan krim pelembab dasar terhadap kulit kering pada populasi geriatric. Jakarta: Faculty of Medicine, Universitas Indonesia; 2016.
6.Pavicic T, Korting HC. Xerosis and callus formation as a key to the diabetic foot syndrome: dermatologic view of the problem and its management. J Dtsch Dermatol Ges 2006; 4(11):935-41.
https://doi.org/ 10.1111/j.1610-0387.2006.06123.x
7.Sakai S, Endo Y, Ozawa N, Sugawara T, Kusaka A, Sayo T, et al. Characteristics of the epidermis and stratum corneum of hairless mice with experimentally induced diabetes mellitus. J Invest Dermatol 2003; 120(1):79-85.
https://doi.org/ 10.1046/j.1523-1747.2003.12006.x
8.Gefen A. Plantar soft tissue loading under the medial metatarsals in the standing diabetic foot. Med Eng Phys 2003; 25(6):491-9.
https://doi.org/10.1016/s1350-4533(03)00029-8
9.Seite S, Khemis A, Rougier A, Ortonne JP. Importance of treatment of skin xerosis in diabetes. J Eur Acad Dermatol Venereol 2011; 25(5):607-9.
https://doi.org/10.1111/j.1468-3083.2010.03807.x
10.Moczar M, Allard R, Ouzilou J, Robert L, Bouissou H, Julian M, et al. Structural and biochemical alterations of human diabetic dermis studied by H-lysine incorporation and microscopy. Pathol Biol 1976; 24(5):329-36.
11.Weber TM, Kausch M, Rippke F, Schoelermann AM, Filbry AW. Treatment of xerosis with a topical formulation containing glyceryl glucoside, natural moisturizing factors, and ceramide. J Clin Aesthet Dermatol 2012; 5(8):29-39.
12.Chen XF, Lin WD, Lu SL, Xie T, Ge K, Shi YQ, et al. Mechanistic study of endogenous skin lesions in diabetic rats. Exp Dermatol 2010; 19(12):1088-95.
https://doi.org/10.1111/j.1600-0625.2010.01137.x
13.de Macedo GMC, Nunes S, Barreto T. Skin disorders in diabetes mellitus: an epidemiology and physiopathology review. Diabetol Metab Syndr 2016; 8(1):63.
https://doi.org/10.1186/s13098-016-0176-y
14.Sakai S, Kikuchi K, Satoh J, Tagami H, Inoue S. Functional properties of the stratum corneum in patients with diabetes mellitus: similarities to senile xerosis. Br J Dermatol 2005; 153(2):319-23.
https://doi.org/doi: 10.1111/j.1365-2133.2005.06756.x
15.Seirafi H, Farsinejad K, Firooz A, Davoudi SM, Robati RM, Hoseini MS, et al. Biophysical characteristics of skin in diabetes: a controlled study. J Eur Acad Dermatol Venereol 2009; 23(2):146-9.
https://doi.org/10.1111/j.1468-3083.2008.02950.x
16.Thyssen JP, Linneberg A, Carlsen BC, Johansen JD, Engkilde K, Hansen T, et al. A possible association between a dysfunctional skin barrier (filaggrin null-mutation status) and diabetes: a cross-sectional study. BMJ Open 2011; 1(1):e000062.
https://doi.org/10.1136/bmjopen-2011-000062
17.Tellechea A, Kafanas A, Leal EC, Tecilazich F, Kuchibhotla S, Auster ME, et al. Increased skin inflammation and blood vessel density in human and experimental diabetes. Int J Low Extrem Wounds 2013; 12(1):4-11.
https://doi.org/10.1177/1534734612474303
18.Zakharov P, Talary MS, Kolm I, Caduff A. Full-field optical coherence tomography for the rapid estimation of epidermal thickness: study of patients with diabetes mellitus type I. Physiol Meas 2010; 31(2):193-205.
https://doi.org/ 10.1088/0967-3334/31/2/006
19.Bertheim U, Laurent AE, Hofer PA, Hallgren P, Asplund J, Hellstrom S. Loss of hyaluronan in the basement membrane zone of the skin correlates to the degree of stiff hands in diabetic patients. Acta Derm Venereol 2002; 82(5):329-34.
https://doi.org/10.1080/000155502320624041
20.Leveriza-Oh M. Diabetes and your skin. Protecting your outermost layer. Diabetes Self Manag 2006; 23(4):18-20.
21.Vinik AI, Maser RE, Mitchell BD, Freeman R. Diabetic autonomic neuropathy. Diabetes Care 2003; 26(5):1553-79.
https://doi.org/10.2337/diacare.26.5.1553
22.Sakai S, Tagami H. Dry skin in diabetes mellitus and in experimental models of diabetes. In: Farage M, Miller K, Maibach H, editors. Textbook of Aging Skin. Berlin: Springer Berline Heidelberg; 2010, 653-61.
23.Farshchian M, Farshchian M, Fereydoonnejad M, Yazdanfar A, Kimyai-Asadi A. Cutaneous manifestations of diabetes mellitus: a case series. Cutis 2010; 86(1):31-5.
24.Goyal A, Raina S, Kaushal SS, Mahajan V, Sharma NL. Pattern of cutaneous manifestations in diabetes mellitus. Indian J Dermatol 2010; 55(1):39-41.
https://doi.org/10.4103/0019-5154.60349
25.Maramaldi G, Togni S, Franceschi F, Lati E. Anti-inflammation and antiglycation activity of a novel botanical ingredient from African biodiversity (CentevitaTM). Clin Cosmet Investig Dermatol 2013; 12:1-9.
https://doi.org/10.2147/CCID.S49924
26.Haftek M, Mac-Mary S, Le Bitoux MA, Creidi P, Seite S, Rougier A, et al. Clinical, biometric and structural evaluation of the long-term effects of a topical treatment with ascorbic acid and madecassoside in photoaged human skin. Exp Dermatol 2008; 17(11):946-52.
https://doi.org/10.1111/j.1600-0625.2008.00732.x
27.Prakash V, Jaiswal N, Srivastava M. A review on medicinal properties of Centella asiatica. Asian J Pharm Clin Res 2017; 10(10):69-74.
https://doi.org/10.22159/ajpcr.2017.v10i10.20760
28.Shukla A, Rasik AM, Dhawan BN. Asiaticoside-induced elevation of antioxidant levels in healing wounds. Phytother Res 1999; 13(1):50-4.
https://doi.org/10.1002/(SICI)1099-1573(199902)13:1<50::AID-PTR368>3.0.CO;2-V
29.Shetty BS, Udupa SL, Udupa AL, Somayaji SN. Effect of Centella asiatica L (Umbelliferae) on normal and dexamethasone-suppressed wound healing in Wistar Albino rats. Int J Low Extrem Wounds 2006; 5(3):137-43.
https://doi.org/10.1177/1534734606291313
30.Paocharoen V. The efficacy and side effects of oral Centella asiatica extract for wound healing promotion in diabetic wound patients. J Med Assoc Thai 2010; 93 Suppl 7:S166-70.
31.Nowwarote N, Osathanon T, Jitjaturunt P, Manopattanasoontorn S, Pavasant P. Asiaticoside induces type I collagen synthesis and osteogenic differentiation in human periodontal ligament cells. Phytother Res 2013; 27(3):457-62.
https://doi.org/10.1002/ptr.4742
32.Suwantong O, Ruktanonchai U, Supaphol P. In vitro biological evaluation of electrospun cellulose acetate fiber mats containing asiaticoside or curcumin. J Biomed Mater Res A 2010; 94(4):1216-25.
https://doi.org/10.1002/jbm.a.32797
33.Legiawati L, Fadilah F, Bramono K, Indriatmi W. In silico study of Centella asiatica active compounds as anti-inflammatory agent by decreasing IL-1 and IL-6 activity, promoting IL-4 activity. Int J Pharm Sci Rev Res 2018; 10(9):2142-7.
34.Bylka W, Znajdek-Awizen P, Studzinska-Sroka E, Brzezinska M. Centella asiatica in cosmetology. Postepy Dermatol Alergol 2013; 30(1):46-9.
https://doi.org/10.5114/pdia.2013.33378
35.Legiawati L, Fadilah F, kusmarinah B, Siti S, Em Y. Molecular dynamic simulation of Centella asiatica compound as an inhibitor of advanced glycation end products. J App Pharm 2020; 10(08):1-7.
36.Moertolo T. Pencegahan skar atrofi dengan ekstrak Centella asiatica L Urban pada proses penyembuhan akne vulgaris [Dissertation]. Jakarta: Faculty of Medicine Universitas Indonesia; 2015.
37.Mohamed N, Abdou H. The hypoglycemic and antioxidative effects of Centella asiatica against STZ-induced diabetic disorders in rats. Int J Pharma Bio Sci 2015; 6:621-33.
38.Abdou H, Mohamed N. Centella asiatica ameliorates diabetic complications and oxidative stress in streptozotocin-induced diabetes mellitus in male rats. Int J Pharma Sci Rev Res 2016; 36:61-70.
39.Yuan Y, Zhang H, Sun F, Sun S, Zhu Z, CHai Y. Biopharmaceutical and pharmacokinetic characterization of asiatic acid in Centella asiatica as determined by a sensitive and robust HPLC-MS method. J Ethnopharmacol 2015; 163:31-8.
https://doi.org/ 10.1016/j.jep.2015.01.006
40.Anukunwithaya T, Tantisira MH, Tantisira B, Khemawoot P. Pharmacokinetics of a standardized extract of Centella asiatica ECa 233 in rats. Planta Med 2017; 83(8):710-7.
https://doi.org/10.1055/s-0042-122344
41.Wijayadi Y, Kusmarinah B, Mardliyati E, Hans-Joachim F. Effects of Centella asiatica ethanolic extract encapsulated in chitosan nanoparticles on proliferation activity of skin fibroblasts and keratinocytes, type I and III collagen synthesis and aquaporin 3 expression in vitro. J Pharm Biomed Sci 2016; 6:315-27.
https://doi.org/10.20936/jpbms/160246
42.Legiawati L, Bramono K, Indriatmi W, Yunir E, Setiati S, Jusman SWA, et al. Oral and topical centella asiatica in type 2 diabetes mellitus patients with dry skin: a three-arm prospective randomized double-blind controlled trial. Evid Based Complement Alternat Med 2020; 2020:7253560.
https://doi.org/10.1155/2020/7253560
43.Medscape. Gotu Kola. Medscape; [cited 2020 February 25]; Available from: http://reference.medscape.com/drug/brahmabuti-centella-asiatica-gotu-kola-344500
44.Examine.com. Centella asiatica. Examine.com; [cited 2020 February 25]; Available from: https://examine.com/supplements/centella-asiatica/
45.Grimaldi R, De Ponti F, D'Angelo L, Caravaggi M, Guidi G, Lecchini S, et al. Pharmacokinetics of the total triterpenic fraction of Centella asiatica after single and multiple administrations to healthy volunteers. A new assay for asiatic acid. J Ethnopharmacol 1990; 28(2):235-41.
https://doi.org/10.1016/0378-8741(90)90033-p
46.Reagan-Shaw S, Nihal M, Ahmad N. Dose translation from animal to human studies revisited. FASEB J 2008; 22(3):659-61.
https://doi.org/ 10.1096/fj.07-9574LSF
47.Chivapat S, Chavalittumrong P, Tantisira M. Acute and sub-chronic toxicity studies of a standardized extract of Centella asiatica ECa 233. Thai J Pharm Sci 2011; 35:55-64.
48.Jorge OA, Jorge AD. Hepatotoxicity associated with the ingestion of Centella asiatica. Rev Esp Enferm Dig 2005; 97(2):115-24.
https://doi.org/10.4321/s1130-01082005000200006
49.Rahman M, Hossain S, Rahaman A, Fatima N, Nahar T, Uddin B, et al. Antioxidant activity of Centella asiatica (Linn.) urban: impact of extraction solvent polarity. J Pharmacol Phytochem 2013; 1:27-32.
50.Okonogi S, Sirithynyalug J, Chen Y. Nanoencapsulation of Centella asiatica bioactive extract. In: XVIth International Conference on Bioencapsulation; Dublin: 2008. p.1-4.



DOI: https://doi.org/10.19106/JMedSci005303202108

Article Metrics

Abstract views : 3623 | views : 4738


Bookmark and Share


Copyright (c) 2021 Lili Legiawati

Creative Commons License
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.