Abstract: Zymography is a powerful technique to separate and identify different enzymatic activities on a standard acrylamide gel. For oxidation prone enzymes such as cysteine proteases however, the oxidizing species generated by electrolysis of the gel running buffer may result in partial or complete inactivation, thus compromising the final readout. This can be only partially remedied by subsequent treatment of the gel with reducing agents. We demonstrate the generation of reactive oxidizing species during electrophoresis and discovered that supplementation of the gel running buffer with aminimum of 5mMcysteine prevents enzyme inactivation and allows retention of proteolytic activity as measured by zymography on model substrateN-benzoyl-L-arginine p-nitroanilide, without at the same time altering the mobilities of the gel proteins.
Abstract: Lymphoedema is a debilitating condition associated with high morbidity. Swelling as a result of lymphatic insufficiency will often lead to pathological skin changes. These skin changes can worsen the degree of swelling in the patient and lead to significant discomfort. This review outlines the ways in which skin changes resultant from lymphoedema can be effectively managed. This includes: good clinical practice in the areas of initial assessment, skin cleansing and moisturisation, treatment of infection as well as wound management and debridement, plus advice on avoiding sunburn and exercising in an appropriate fashion.
Abstract: Vascular insufficiency is a major reason for the development and perpetuation of chronic wounds. It is plausible that agents that cause vasodilation may promote wound healing. The OPAL process is where ripened fruit is treated by homogenisation, heat treatment, alkalisation and filtration of the pulp. OPAL 001 uses papaw and peach fruits mixed 10: 1 by volume. This article presents four cases of non-healing ulcers that provide clinical observational support for the hypothesis that OPAL products facilitates healing by causing vasodilation of the blood vessels around the wound.
Abstract: OPAL A, derived from the pawpaw fruit, is a promising treatment for chronic skin ulcers. We report the case of a 75-year-old man with paraplegia who presented with a chronic sacral pressure ulcer and extensive hyperkeratosis on his buttocks. After two weeks of treatment with OPAL A filtrate and cream and ongoing bed rest, the ulcer showed evidence of healing and there was a marked reduction in the hyperkeratotic coverage. Five weeks later, the condition of the ulcer was further improved, but the wound was not fully closed. The hyperkeratosis had disappeared. The patient was discharged and continued OPAL A treatment at home. Follow-up examination 24 days after discharge revealed the ulcer to be in good condition, with granulation tissue present on the surface of the ulcer. Hyperkeratosis remained absent and the skin surrounding the ulcer appeared healthy. Although further studies are clearly needed, the encouraging results in this patient contribute to the chronic skin ulcers.
Abstract: OPAL A is a papaya pulp that is heated and alkalised with bicarbonate (the OPAL process) and is undergoing clinical trials for treatment of chronic wounds. The aim of this study was to investigate possible inhibitory effects of OPAL A and a non-alkalised papaya filtrate on the 5-lipoxygenase signalling pathway. Human isolated neutrophils were incubated with or without OPAL A, non-alkalised papaya or sodium bicarbonate and then exposed to the calcium ionophore, ionomycin to stimulate leukotriene B4 (LTB4) production. The production of LTB4 was inhibited in a dose-dependent manner by all three treatments. The effect of these treatments on 5-lipoxygenase activity, the enzyme involved in the production of precursors of LTB4 was investigated using a cell-free assay. 5-Lipoxygenase activity was inhibited by OPAL A and non-alkalised papaya, but not bicarbonate. Column chromatography was used to show that the active components within OPAL A were non-proteinaceous polar compounds. The inhibitory effects of OPAL A and a non-alkalised papaya filtrate on 5-lipoxygenase activity and LTB4 production suggest a possible anti-inflammatory mode of action.
Abstract: Residents at the Quadriplegic Centre located in Perth, Western Australia, were studied. The Quadriplegic Centre is a 100-bed hospital for the specialist management of people with paralysis as a consequence of spinal cord injury or diseases of the spinal cord. Clinical staff at the Quadriplegic Centre became aware of the OPAL001 filtrate and cream, derived from pawpaw (papaya) and peach, and the apparent efficacy in healing various types of ulcers. Staff initiated a trial involving patients that had suffered Stage II-IV pressure ulcers, including some of more than 5 weeks’ duration that were difficult to heal. Daily treatment consisted of application of the filtrate to the ulcer and the cream to the surrounding skin with non-adherent dressing. Treatment appeared to be effective, and persistent large and deep ulcers were healed. There was improved mobility among patients, as well as less turning and bedside care. A retrospective cost analysis shows savings arose from reduced nursing care and fewer products being used for wound care. The preliminary data presented show some evidence for OPAL001 therapy reducing costs and improving outcomes; the situation where costs decrease and health outcomes improve is both unusual and highly desirable for healthcare decision makers. A randomised clinical trial is required to show that these observations are real effects from therapy.