Abstract
Aim:
The aim of this research was to determine the angiogenesis activity of Jatropha curcas latex in cream formulation on CD34 immune expression during wound healing phase in mice skin.
Materials and Methods:
Amount of 36 2-month-old male mice were used between 30 and 40 g. To surgical procedures, wound skin incision was performed 2.0 cm in length until subcutaneous on the paravertebral of each animal. The treatment was carried under locally anesthetized with procaine cream. All mice were divided into four groups, namely the base cream as control group (A), sulfadiazine 0.1% cream (B), Jatropha curcas latex cream 10% (C), and J. curcas latex cream 15% (D). All groups were treated entire surface of wound. All experiments were performed twice a day for 10 days. Experiments were terminated on days 3, 7, and 10, respectively. The wound healing was assayed in stained histological section in immunohistochemical of the wounds. The CD34 expression was investigated under a microscope.
Results:
The results showed that the cream from 10% and 15% latex J. curcas revealed moderate immune reaction to CD34 on days 3 and 7 in wound healing of mice skin.
Conclusion:
We concluded that the cream from 10% and 15% latex J. curcas has potential as angiogenesis activity in wound healing of mice skin.
Keywords: angiogenesis, CD34, Jatropha curcas latex cream, wound healing
Introduction
The wound is defined as a raw skin surface and lost its surface epithelial coverage caused by various types of injuries or diseases [1,2]. It can be damaged or disruption to the normal anatomical structure and function of skin [3]. Wounds that exhibit impaired healing, including delayed acute wounds and chronic wounds, generally have failed to progress through the normal stages of healing [4]. Neovascularization or angiogenesis is important for wound healing process. Angiogenesis plays a role in wound healing by forming new blood vessels from preexisting vessels by invading the wound clot and organizing into a microvascular network throughout the granulation tissue [5]. However, angiogenesis also plays a role in the provision of nutrients and oxygen to the wound area and increases the formation of granulation tissue with its collagen and connective tissue proteins deposition [6]. A subpopulation of hematopoietic progenitor CD34 cells could directly contribute to the neovascularization and wound repair process [7]. CD34 is a cell surface marker that is expressed by a broad range of cells including hematopoietic, stromal, epithelial, and endothelial cells [8,9].
Wound healing is influenced by many factors including the type of medication used. One is the use of traditional medicine. The use of traditional medicine is increasingly favored because of fewer side effects such as drugs from chemicals [10], the cost is relatively low, and it is easily accessible [11]. Secondary metabolites from herbal plants that are potential as microbial agents may help overcome the problem of antibiotic resistance [12]. Jatropha curcas L. (Euphorbiaceae) is multiple purpose with potential for biodiesel production and medicinal uses [13]. Some of the benefits of J. curcas are that they can adapt well to dry land, are easy to cultivate, and their utilization does not compete with food crops such as cassava, maize, coconut, and palm oil [14]. J. curcas is generally grown as a live fence for protection of agricultural fields from damage by livestock as it is not eaten by cattle [15] and to prevent erosion [16].
All parts of J. curcas have also been used in traditional medicine and for veterinary purposes [17]. The leaves and latex are used in healing of wounds, refractory ulcers, and septic gums, and styptic in cuts and bruises [18]. J. curcas contains a number of bioactive compounds that are flavonoids, saponins, tannins, and polivenol. The compounds play a role in antibacterial [19], antioxidant, anti-inflammatory, anticancer [20], antidiabetic activities [21], and wound healing [22]. However, limited information is available on the wound healing process of this plant, especially angiogenesis activity.
The aim of this research was to determine the angiogenesis activity of J. curcas latex in cream formulation on CD34 immune expression during wound healing phase in mice skin. The results will then be compared to that of treatment with sulfadiazine in standard wound therapy.
Materials and Methods
Ethical approval
This research was performed appropriately following the regulation of Animal Ethics Committee. This research was approved by the Animal Ethics Committee of Faculty of Veterinary Medicine, Syiah Kuala University, Banda Aceh, Indonesia (Approval No. 004/KEPH-C/VII/2017).
Mice
Amount of 36 heads male mice (Mus musculus) aged 2 months old and weighing 30-40 g were used in this study. All mice maintained individually in cages at the Laboratory of Pathology, Faculty of Veterinary Medicine, Syiah Kuala University. Feed and water were given ad libitum for 2 weeks.
Preparation of o/w cream formulation
The latex used in the present study acquired a break of J. curcas leaf stems which were procured from a local farm around yard areas of Banda Aceh. The latex was collected in the morning with a break of leaf stems, latex at capacity into a sterile bottle. The latex was formulated in cream following the procedure as described by Muntiaha et al. [23]. J. curcas latex cream made with a base of oil in water (O/W) because the formulation is homogeneity, spreadability, simply to use, non-sticky, soothing on the skin, and easy to clean. A cream base was added little by little with the 10% and 15% latex of J. curcas in a porcelain dish containing 100 g of cream and stirred until homogeneous at room temperature. The dosages of 10% and 15% latex of J. curcas have been proven to be effective to use for topical for topical wound healing [24].
Formation of excision wound model
The mice skin wound was done by mean of surgical procedures as explained by Salim et al. [24]. Mice were locally anesthetized by topical cream with containing lidocaine 25 mg and prilocaine 25 mg. Longitudinal wounds of about 2.0 cm were made on the paravertebral region till to subcutaneous under the aseptic condition and were observed throughout the experimental study.
Grouping of mice for experimental design
The mice were separated into four groups contained nine mice of each. group A as a negative control, the mice skin wound received base cream. group B as a positive control, the mice skin wound received standard drug containing sulfadiazine 0.1% cream. group C, the mice skin wound treated with a cream containing J. curcas latex 10%. group D the mice skin wound treated with a cream containing J. curcas latex 15%. The topical experimentally applied twice daily at 08.00 am and 18.00 pm starting from the day of wounding till to measure on 3rd, 7th, and 10th post-wounding day.
Histopathological and immunohistochemical expression of CD34
Wound skin tissue samples were collected in 10% buffered formalin for histopathological examination [25,26]. The tissues were processed by routine paraffin embedding technique, and 5 µm section was stained with immunohistochemical staining by standard methods as described by Darmawi et al. [27], using streptavidin-biotin complex. For angiogenesis immunoreaction, we used the CD34 monoclonal mouse antibody (Dako, 1:50 dilution) diluted in 1% BSA in PBS. We defined the scores of CD34 expression as negative, 0 points (Grade 0), mild 1 point (Grade 1), moderate 2 points (Grade 2), and severe 3 points (Grade 3) [28]. The intensity of staining was recorded as weak, moderate, and strong [29].
Results
The results of the present study showed that immunohistochemical of CD34-positive expression is characterized by brown color on microscopic slides. The CD34 monoclonal mouse antibody had a strong reaction with antigen on the endothelial progenitor cells and endothelial cells as shown in Figures-1-3. On day 3, the CD34 positive cells were seen in endothelial cells of each group. The minimal immunoreactivity of CD34 positive cells was observed on group A (Grade 1). Meanwhile the moderate immunoreactivity of CD34 positive cells was found in group B, C, and D (Grade 2) as seen in Figure-1. In this phase, CD34-positive immunoreaction is a sign of angiogenesis or new capillary formation and the migration of endothelial progenitor cells from the vascular.
Figure-1.

Photomicrograph of wounds skin on day 3 of treatment (streptavidin-biotin 40×). CD34-positive cells in endothelial cells each group that marked the brown color (arrow). (a) Minimal immunoreactivity CD34-positive cells on Group A (Grade 1). (b-d) Moderate immunoreactivity CD34-positive cells on Groups B, C, and D (Grade 2).
Figure-2.

Photomicrograph of wounds skin on day 7 of treatment (streptavidin-biotin 40×). CD34-positive cells in endothelial cells each group that marked the brown color (arrow). (a) Minimal immunoreactivity CD34-positive cells on Group A (Grade 1). (b-d) Moderate immunoreactivity CD34-positive cells on Groups B, C, and D (Grade 2).
Figure-3.

Photomicrograph of wounds skin on day 10 of treatment (streptavidin-biotin 40×). Immunoreactivity CD34 cells each group that marked the brown color (arrow). (a) Minimal immunoreactivity CD34-positive cells on Group A (Grade 1). (b-d) Negative immunoreactivity CD34 cells on Groups B, C, and D (Grade 0).
The results of the day 7 showed that the migration of endothelial progenitor cells and new capillaries more clearly seen. As seen in Figure-2, the minimal immunoreactivity of CD34 positive cells in endothelial cells were observed on group A (Grade 1), but on group B, C, and D we found the moderate immunoreactivity of CD34 positive cells (Grade 2). The cream from 10% and 15% latex of J. curcas and sulfadiazine 0.1% cream revealed moderate immune reaction to CD34 on days 3 and 7 in mice skin wound healing.
The results show that the number of endothelial progenitor cells in migratory and differentiated tissue decreases with the endothelial formation on day 10. As shown in Figure-3, the minimal immunoreactivity of CD34 positive cells was only found on group A (Grade 1). However, the negative immunoreactivity of CD34 cell was found on group B, C, and D (Grade 0). In this phase, CD34 is a negative immune reaction in Groups B, C, and D as a sign of the wound healing process.
Discussion
The simplest interpretation of our finding on day 3 is shown in Figure-1 and day 7 is shown in Figure-2; it was found that the angiogenesis on Groups B, C, and D (Grade 2) is better than the Group A (Grade 1). Guo et al. [7] reported a close correlation between an increase in circulating CD34+ cells in response to traumatic injury and angiogenesis in traumatic brain injury. A significant increase in the number of circulating CD34+ cells detected in traumatic brain injury. Indeed, the high levels of CD34+ were also observed in 7 days after the injury. The results found that angiogenesis involved in inflammation phase (day 3) and proliferative phase (day 7). The levels of angiogenesis in wounds often correlate with the inflammatory response, largely because inflammatory cells produce an abundance of proangiogenic mediators [7]. In confirmation of our previous study, we found that the cream from the 10% and 15% latex of J. curcas revealed moderate immune reaction to CD68 on wound healing [24]. Macrophages as inflammatory cells secrete vascular endothelial growth factor (VEGF) that induces angiogenesis [30].
Here, we described that the CD34 monoclonal mouse antibody had a strong reaction with antigen on the endothelial progenitor cells and endothelial cells. Clinical and animal studies provide evidence that stem progenitor cells are critical for neovascularization [31]. Angiogenesis is the growth of new blood vessels from existing endothelial cells of the wound’s adjacent by mature stromal cells such as fibroblasts [32]. The similar phenomenon described by Ieronimakis et al. [33] who noticed that the fraction of CD34+ cells remains steady during homeostasis and injury regeneration.
In this study, we agree with and support those of Kirby et al. [34] who explained that most hematopoietic stem cells express CD45, and subset of hematopoietic stem cells express CD34. Blood vessels are composed of epithelial tubes with epithelial cells that transport crucial fluid. During lumen formation, endothelial cells in mature blood vessels represented as the first phenotype and second phenotype, and endothelial cells polarization often starts with the delivery through exocytosis, such as CD34 [35].
The effect of J. curcas especially on wound healing has been studied using animal models. Many previous reports exist about the efficacy of J. curcas on wound healing. Jasmadi et al. [36] evaluated that the ointment from 10% latex of J. curcas has the potential to accelerate the wound healing of burns on the skin of mice. Salim et al. [37] indicated that methanol extract of J. curcas leaves was potential in accelerating wound healing in mice. Our previous study indicated that ointment from 10% latex of J. curcas has proven to accelerate the epithelial period [38,39], and remodeling period on wound healing in mice skin [40]. This causes that the ointment from 10% latex of J. curcas effective to be used for topical therapy on wound healing in mice skin. The quercetine and routine flavonoids at J. curcas can improve the wound healing process on the regulation of VEGF expression for the growth of new blood vessels (angiogenesis) [18]. Angiogenesis involved in the proliferative phase which is a principal step in epithelialization of wound healing [5].
This results study showed that on day 10, CD34 is undetected on Groups B, C, and D (Grade 0). The decrease in the number of migratory and differentiated endothelial progenitor cells was in line with endothelial cells formation [41]. DiPietro [42] stated that after an injury, levels of proangiogenic factors increase, reaching a peak slightly before maximum capillary content occurs, and then subside to nearly undetectable levels.
Conclusion
We concluded that the cream from 10% and 15% latex J. curcas has potential as angiogenesis activity in wound healing of mice skin.
Authors’ Contributions
Darmawi and MNS designed the research; UB and CDI performed immunohistochemistry; UB, Darmawi, CDI, and MNS prepared the manuscript. All authors read and approved the final manuscript.
Acknowledgments
We wish to thank the Directorate of Research and Community Service, the Directorate General of Strengthening Research and Development, Ministry of Research, Technology and Higher Education of Republic Indonesia for funding of the work grant from the Hibah Bersaing with contract number: 129/SP2H/LT/DRPM/III/2016.
Competing Interests
The authors declare that they have no competing interests.
References
- 1.Prasetyono T.O.H. General concept of wound healing, revisited. Med. J. Indones. 2009;18(3):208–216. [Google Scholar]
- 2.Agyare C, Boakye YD, Bekoe EO, Hensel A, Dapaah SO, Appiah T. Review: African medicinal plants with wound healing properties. J. Ethnopharmacol. 2016;177:85–100. doi: 10.1016/j.jep.2015.11.008. [DOI] [PubMed] [Google Scholar]
- 3.Velnar T, Bailey T, Smrkolj V. The wound healing process: An overview of cellular and molecular mechanism. J. Int. Med. Res. 2009;37:1528–1542. doi: 10.1177/147323000903700531. [DOI] [PubMed] [Google Scholar]
- 4.Guo S, DiPietro LA. Factor affecting wound healing. J. Den. Res. 2010;89(3):219–229. doi: 10.1177/0022034509359125. [DOI] [PMC free article] [PubMed] [Google Scholar]
- 5.Honnegowda TM, Kumar P, Udupa EG, Kumar S, Kumar U, Rao P. Role of angiogenesis and angiogenic factors in acute and chronic wound healing. Plast.Aesthet. Res. 2015;2:243–249. [Google Scholar]
- 6.Masir O, Manjas M, Putra AE, Agus S. Effect of fibroblast filtrate culture fluid (CFF) on wound healing: Experimental study on wistar norvegicus rats. J. Kes. Andal. 2012;1(3):112–117. [Google Scholar]
- 7.Guo X, Liu L, Zhang M, Bergeron A, Cui Z, Dong J, Zhang J. Correlation of CD34+cells with tissue angiogenesis after traumatic brain injury in a rat model. J. Neurotrauma. 2009;26(8):1337–1344. doi: 10.1089/neu.2008.0733. [DOI] [PMC free article] [PubMed] [Google Scholar]
- 8.Nielsen JS, McNagny KM. Novel function of the CD34 family. J. Cell Sci. 2008;121:3683–3692. doi: 10.1242/jcs.037507. [DOI] [PubMed] [Google Scholar]
- 9.Sidney LA, Branch MJ, Dunphy SE, Dua HS, Hopkinson A. Concise review: Evidence for CD34 as a common marker for diverse progenitors. Stem Cells. 2014;32:1380–1389. doi: 10.1002/stem.1661. [DOI] [PMC free article] [PubMed] [Google Scholar]
- 10.Ruswanti EO, Cholil Sukmana BI. The effectiveness of papaya leaf ethanol extract (Carica papaya) 100% on wound healing. Dentino. J. Kedokteran Gigi. 2014;2(2):162–166. [Google Scholar]
- 11.Yuniarti WM, Lukiswanto BS. Effects of herbal ointment containing the leaf extracts of Madeira vine (Anredera cordifolia (Ten.) Steenis) for burn wound healing process on albino rats. Vet. World. 2017;10(7):808–813. doi: 10.14202/vetworld.2017.808-813. [DOI] [PMC free article] [PubMed] [Google Scholar]
- 12.Krishnaiah D, Devi T, Bono A, Sarbatly R. Studies on phytochemical constituents of six Malaysian medicinal plants. J. Med. Plants Res. 2009;3(2):67–72. [Google Scholar]
- 13.Abdelgadir HA, Staden JV. Ethnobotany, ethnopharmacology and toxicity of Jatropha curcas L. (Euphorbiaceae): A review. South Afr. J. Bot. 2013;88:204–218. [Google Scholar]
- 14.Setyaningsih D, Panji C, Perwatasari DD. Study of antioxidant and antimicrobial activity of leaves and twigs extracts and fraction of Jatropha curcas L. and its utilization in personal hygiene products. Agritech. 2014;34(2):126–137. [Google Scholar]
- 15.Nayak BS, Patel KN. Pharmacognostic studies of the Jatropha curcas leaves. Int. J. Pharm. Tech. Res. 2010;2(1):140–143. [Google Scholar]
- 16.Kamal S, Manmohan S, Birendra S. A review on chemical and medicobiological applications of Jatropha curcas. Int. Res. J. Pharm. 2011;2(4):61–66. [Google Scholar]
- 17.Prasad DMR, Izam A, Khan MR. Jatropha curcas : Plant of medical benefits. J. Med. Plants Res. 2012;6(14):2691–2699. [Google Scholar]
- 18.Esimone C.O, Nworu CS, Jackson CL. Cutaneous wound healing activity of a herbal ointment containing the leaf extract of Jatropha curcas L. (Euphorbiaceae) Int. J. Appl. Res. Nat. Prod. 2008;1:1–4. [Google Scholar]
- 19.Sharma AK, Gangwar M, Tilak R, Nath G, Sinha ASK, Tripathi YB, Kumar D. Comparative in vitro antimicrobial and phytochemical evaluation of methanolic extract of root, stem and leaf of Jatropha curcas Linn. Phcog. J. 2012;4(30):34–40. [Google Scholar]
- 20.Oskoueian E, Abdullah N, Saad WZ, Omar AR, Ahmad S, Kuan WB, Zolkifli NA, Hendra R, Ho YW. Antioxidant, anti-inflammatory and anticancer activities of methanolic extracts from Jatropha curcas Linn. J. Med. Plants Res. 2011;5(1):49–57. [Google Scholar]
- 21.Patil RN, Patil RY, Ahirwar B, Ahirwar D. Evaluation of antidiabetic and related actions of some Indian medicinal plants in diabetic rats. Asian Pac. J. Trop. Med. 2011;4(1):20–23. doi: 10.1016/S1995-7645(11)60025-4. [DOI] [PubMed] [Google Scholar]
- 22.Sachdeva K, Garg P, Singhal M, Srivastava B. Wound healing potential of extract of Jatropha curcas L. (stem bark) in rats. Phcog. J. 2011;3(25):67–72. [Google Scholar]
- 23.Muntiaha MC, Yamlean P.V.Y, Lolo WA. Test effectivity Jatropha multifida L. to heal wound infection cause by Staphylococcus aureus in rabbit (Orytolagus cuniculus) Pharmacon. 2014;3(3):294–302. [Google Scholar]
- 24.Salim MN, Masyitha D, Harris A, Balqis U, Iskandar CD, Hambal M, Darmawi Anti inflammatory activity of Jatropha curcas Linn. latex in cream formulation on CD68 expression in mice skin wound. Vet. World. 2018;11(2):99–103. doi: 10.14202/vetworld.2018.99-103. [DOI] [PMC free article] [PubMed] [Google Scholar]
- 25.Darmawi D, Balqis U, Hambal M, Tiuria R, Frengki, Priosoeryanto BP. Mucosal mast cell response in jejunum of Ascaridia galli -infected laying hens. Media Peternak. 2013;36(2):113–119. [Google Scholar]
- 26.Balqis U, Hambal M, Rinidar Athaillah F, Ismail Azhar, Vanda H, Darmawi D. Cuticular surface damage of Ascaridia galli adult worms treated with Veitchia merrillii betel nuts extract in vitro. Vet. World. 2017;10(7):732–737. doi: 10.14202/vetworld.2017.732-737. [DOI] [PMC free article] [PubMed] [Google Scholar]
- 27.Darmawi D, Balqis U, Hambal M, Tiuria R, Priosoeryanto BP, Handharyani E. The ability of immunoglobulin yolk recognized the antigen in the tissue of Ascaridia galli. Media Peternak. 2012;35(3):190–195. [Google Scholar]
- 28.Yoshida CK, Ichimura T, Kawamura N, Nakano A, Kasai M, Sumi T, Ishiko O. A scoring system for histopathologic and immunohistochemical evaluation of uterine leiomyosarcomas. Oncol. Rep. 2009;22:725–731. doi: 10.3892/or_00000493. [DOI] [PubMed] [Google Scholar]
- 29.Goel MM, Agrawal D, Natu SM, Goel A. Hepsin immunohistochemical expression in prostate cancer in relation to Gleason's grade and serum prostate-specific antigen. Indian J Pathol.Microbiol. 2011;54(3):476–481. doi: 10.4103/0377-4929.85078. [DOI] [PubMed] [Google Scholar]
- 30.Nucera S, Biziato D, Palma MD. The interplay between macrophages and angiogenesis in development of tissue injury and regeneration. Int. J. Dev. Biol. 2011;55:495–503. doi: 10.1387/ijdb.103227sn. [DOI] [PubMed] [Google Scholar]
- 31.Thom SR, Hampton M, Troiano M, Mirza Z, Malay DS, Shannon S, Jennato NB, Donohue CM, Hoffstad O, Woltereck D, Yang M, Yu K, Bhopale VM, Kovtun S, Margolis DJ. Measurements of CD34+/CD45-dim stem cells predict healing of diabetic neuropathic wounds. Diabetes. 2016;65:486–497. doi: 10.2337/db15-0517. [DOI] [PMC free article] [PubMed] [Google Scholar]
- 32.Velazquez OC. Angiogenesis and vasculogenesis: Including the growth of blood vessels and wound healing by stimulation of bone marrow-derived progenitor cells mobilization and homing. J. Vasc. Surg. 2007;45:39A–47A. doi: 10.1016/j.jvs.2007.02.068. [DOI] [PMC free article] [PubMed] [Google Scholar]
- 33.Ieronimakis N, Balasundaram G, Rainey S, Srirangam K, Yablonka-Reuveni Z, Reyes M. Absence of CD34 on murine skeletal muscle satellite cells marks a reversible state of activation during acute injury. PLoS One. 2010;5(6):e10920. doi: 10.1371/journal.pone.0010920. [DOI] [PMC free article] [PubMed] [Google Scholar]
- 34.Kirby GTS, Mills ST, Cowin AJ, Smith LS. Stem cells for cutaneous wound healing. Biomed. Res. Int. 2015 doi: 10.1155/2015/285869. Article ID:285869, 11 Pages. [DOI] [PMC free article] [PubMed] [Google Scholar]
- 35.Ribatti D, Crivellato E. Sprouting angiogenesis, a reappraisal. Dev. Biol. 2012;372:157–165. doi: 10.1016/j.ydbio.2012.09.018. [DOI] [PubMed] [Google Scholar]
- 36.Jasmadi R, Salim MN, Harris A, Aisyah S, Armansyah T, Amiruddin A. Effectiveness of Jatropha sap ointment 10%(Jatropha curcas Linn.) and gentamicin ointment 0.1% on combustion injury II healing on mice skin. (Mus musculus).J. Med. Vet. 2016;10(2):120–122. [Google Scholar]
- 37.Salim MN, Darmawi Balqis U, Iskandar CD, Masyitha D. Wound healing effect of leaf extract of Jatropha curcas Linn in mice. Proc. Ann. Int. Con. (AIC) Syiah Kuala Univ. 2016;6:181–184. [Google Scholar]
- 38.Fauzi F, Salim MN, Nazaruddin N. Effectivity of Jatropha Sap ointment (Jatropha curcas Linn) on epithelialization phase of incision wound recovery on mice (Mus musculus) Jim. Vet. 2017;1(3):324–333. [Google Scholar]
- 39.Murti DA, Salim MN, Sabri M. The effectivity excretion of Jatropha salve (Jatropha curcas L) to epithelization phase of mice (Mus musculus) cutaneous wound healing with masson trichrome stain. Jim. Vet. 2017;1(3):465–472. [Google Scholar]
- 40.Nanda Y, Salim MN, Iskandar CD. Histopathology of mice(Mus-musculus) skin on remodeling phase of wound healing incision using Jatropha curcas ointment sap. Jim. Vet. 2017;1(4):780–787. [Google Scholar]
- 41.Sabirin IPR, Maskoen AM, Hernowo BS. Role of noni (Morinda citrofolia L.) leaf ethanolic topical application on wound healing examined from CD34 immunoexpression and collagen on wistar rats. J. Ked. Bandung. 2013;45(4):226–233. [Google Scholar]
- 42.DiPietro LA. Angiogenesis and wound repair: When enough is enough. J. Leukoc. Biol. 2016;100(5):979–984. doi: 10.1189/jlb.4MR0316-102R. [DOI] [PMC free article] [PubMed] [Google Scholar]
