Diyabet ve Diyabetik Yaraların Tedavisinde Yeni Bir Şifacı: Stevia rebaudiana

Yıl 2023, Cilt: 8 Sayı: 2, 204 - 210, 30.06.2023

Nisanur Kunt , Şule Coşkun Cevher

https://doi.org/10.35229/jaes.1226193

Öz

Dünya’nın en yaygın hastalıklarından biri olan diyabet, yara iyileşmesinde doku hasarına karşı verilen hücresel cevapta rol alan keratinositler, fibroblastlar, endotelyal hücreler, makrofajlar ve trombositlerin ortaya çıkışında, salgıladıkları sitokinlerde, inflamatuar medyatörlerde veya büyüme faktörlerinde azalmaya yol açarak yara iyileşmesini zorlaştırmaktadır. Yaraların iyileşme süresi uzadıkça, hastaların günlük rutinlerine dönememeleri ile psikolojileri olumsuz yönde etkilenmekte ve iş gücü kaybı artmakta, ülke ekonomisi de olumsuz yönde etkilenmektedir. Son yıllarda diyabet ve diyabete bağlı yara gibi bir çok hastalığın artışına bağlı olarak kalorisiz gıdaların kullanımına ve bitkisel tedavi yöntemlerine yönelinmiştir. Bitkilerin kolay bulunması, yan etkilerinin olmaması, uygun maliyetli olmaları ve kullanımlarının kolay olması nedeniyle tıbbi ilaç kaynağı olarak kullanımları da artmaya başlamıştır. Bu ihtiyaçların karşılanabilmesi amacıyla Stevia rebaudiana bitkisinden elde edilen, kalorisiz ve şeker kamışından 300 kat daha tatlı doğal tatlandırıcı bileşenlere sahip stevia ekstraktları ya da bileşenlerini içeren tatlandırıcılar bir süredir piyasaya sürülmektedir. Şeker otu olarak da bilinen Stevia rebaudiana bitkisi dünyada yaygın olarak kullanılmasa da literatürde birçok hastalığa karşı koruyucu ve küratif ajan olarak kullanıldığını belirten yayınlara rastlamak mümkündür. Yapılan çalışmalarda, Stevia rebaudiana bitkisinin antioksidan, antidiyabetik, antitümör ve antimikrobiyal gibi çeşitli biyolojik etkilere sahip olduğu belirlenmesine rağmen diyabet ve diyabetik yara iyileşmesi üzerindeki etkisine dair bilgiler kısıtlıdır. Bu derleme, Stevia rebaudiana bitkisinin diyabet ve diyabetik yaraların tedavisi üzerindeki etkisini değerlendirmeyi amaçlamaktadır.

Anahtar Kelimeler

diabetes, diabetic wound, stevia rebaudiana

Destekleyen Kurum

GAZİ ÜNİVERSİTESİ BİLİMSEL ARAŞTIRMA PROJELERİ KOORDİNASYON BİRİMİ

Proje Numarası

FDK-2022-7732

A New Healer in the Treatment of Diabetes and Diabetic Wounds: Stevia rebaudiana

Öz

Diabetes, one of the most common diseases in the world, causes a decrease in the formation of macrophages, endothelial cells, keratinocytes, platelets, and, fibroblasts, which play a role in the cellular response to tissue damage in wound healing, and a decrease in the cytokines they secrete, inflammatory mediators, or growth factors, making wound healing difficult. As the healing period of the wounds increases, the psychology of the patients is adversely affected by the inability to return to their daily routines, the loss the of workforce increases, and the country's economy is adversely affected. In the last decades, because of the increase in many diseases such as diabetes and diabetes-related wounds, the use of calorie-free foods and herbal treatment methods has been preferred. Plants are increasingly being used as a source of pharmaceutical medications since they are simple to obtain, have no negative side effects, are affordable, and are simple to utilize. In order to meet these needs, sweeteners containing stevia extracts or components, obtained from the Stevia rebaudiana plant, that are calorie-free and 300 fold sweeter than cane sugar, have been on the market for some time. Despite the fact that Stevia rebaudiana, often known as sugar grass, is not a commonly utilized plant around the globe, it is possible to find literature that claims it is used as a preventive and curative for a variety of diseases. Although Stevia rebaudiana has various biological effects such as antioxidant, antidiabetic, antitumor, and antimicrobial, knowledge of diabetes and its effects on diabetic wound healing are limited. The purpose of this review is to evaluate how effectively Stevia rebaudiana treats diabetes and diabetic wounds.

Anahtar Kelimeler

diabetes, diabetic wound, stevia rebaudiana

Proje Numarası

FDK-2022-7732

Kaynakça

• Abbasi, N., Ghaneialvar, H., Saneei, S., Zangeneh, M.M & Zangeneh, A. (2021). Assessment of the Wound Healing Property of Aqueous Extract of Stevia Rebaudiana: an Ethnomedicinal Plant. Plant Biotechnology Persa, 3(1), 9-17.
• Alsarayreh, A.Z., Oran, S.A., Shakhanbeh, J.M., Khleifat, K.M., Al Qaisi, Y.T., Alfarrayeh, I.I. & Alkaramseh, A.M. (2022). Efficacy of methanolic extracts of some medicinal plants on wound healing in diabetic rats. Heliyon, 8(8), e10071. DOI: 10.1016/j.heliyon.2022.e10071
• Babakhanyan, M.A., Nahapetyan Kh.H., Hovhannisyan, L.E. , Simonyan, K.V., Avetisyan, L.G., Avetisyan, R.A. & Chavushyan, V.A. (2017). Wound healing potential of hydroponic stevia rebaudiana in rats. Physical Medicine and Rehabilitation Research, 2(3), 1-4. DOI: 10.15761/PMRR.1000146
• Blakytny, R. & Jude, E. (2006). The molecular biology of chronic wounds and delayed healing in diabetes. Diabetic Medicine, 23, 594-608. DOI: 10.1111/j.1464-5491.2006.01773.x
• Boonkaewwan, C., Ao, M., Toskulkao, C. & Rao, M.C. (2008). Specific immunomodulatory and secretory activities of stevioside and steviol in intestinal cells. Journal of Agricultural Food Chemistry, 56, 3777-3784. DOI: 10.1021/jf072681o
• Brodsky, S. V., Gealekman, O., Chen, J., Zhang, Fan, Togashi, N., Crabtree, M., Gross, S. S., Nasjletti, A., Goligorsky, M. S. (2004). Prevention and Reversal of Premature Endothelial Cell Senescence and Vasculopathy in ObesityInduced Diabetes by Ebselen. Circulation Research, 94, 377-384. DOI: 10.1161/01.RES.0000111802.09964.EF
• Bursać Kovačević, D., Maras, M., Barba, F.J., Granato, D., Roohinejad, S., Mallikarjunan, K., Montesano, D., Lorenzo, J.M. & Putnik, P. (2018). Innovative technologies for the recovery of phytochemicals from Stevia rebaudiana Bertoni leaves: A review. Food Chemistry, 268, 513-521. DOI: 10.1016/j.foodchem.2018.06.091
• Calabrese, V., Cornelius, C., Cuzzocrea, C., Iavicoli, I., Rizzarelli, E. & Calabrase, E.J. (2011). Hormesis, cellular stress response and vitagenes as critical determinants in aging and longevity. Molecular Aspects of Medicine, 32, 279-304. DOI: 10.1016/j.mam.2011.10.007
• Cannizzo, E.S., Clement, C.C., Sahu, R., Follo, C. & Santambrogio, L. (2011). Oxidative stress, inflammaging and immunosenescence. Journal of Proteome Research,74(11), 2313-2323. DOI: 10.1016/j.jprot.2011.06.005
• Das, K. (2013). Wound healing potential of aqueous crude extract of Stevia rebaudiana in mice. Brazilian Journal of Pharmacognosy, 23(2), 351-357. DOI: 10.1590/S0102-695X2013005000011
• Deshmukh, P.T., Fernandes, J., Akarte, A. & Emmanuel, T. (2009). Wound healing activity of Calotropis gigantea root bark in rats. Journal of Ethnopharmacology, 125, 178-181. DOI: 10.1016/j.jep.2009.06.007
• Goyal, S.K., Samsher, J.V. & Goyal R.K. (2010). Stevia (Stevia rebaudiana) a bio-sweetener: a review. International Journal of Food Sciences and Nutrition, 61(1), 1-10. DOI: 10.3109/09637480903193049
• Güleç Peker, E.G., Balabanlı, B., Özer, Ç. & Coşkun Cevher, Ş. (2021) Benfluorex, Friends or Foe? The Effects of Benfluorex on Oxidative Status in the Brain During Experimental Diabetes. Journal of Anatolian Environmental and Animal Sciences, 6(3), 357-363. DOI: 10.35229/jaes.929547
• Hussein, A.M., Eid, E.A., Jaliah, I.,Taha, M. & Lashin, L.S. (2020). Exercise and Stevia Rebaudiana (R) extracts attenuate diabetic cardiomyopathy in type 2 diabetic rats: possible underlying mechanisms. Endocrine, Metabolic & Immune Disorders - Drug Targets, 20(7), 1117-1132. DOI: 10.2174/1871530320666200420084444
• Jeppesen, P.B., Gregersen, S., Rolfsen, S.E.D., Jepsen, M., Colombo, M., Agger, A., Xiao, J., Kruhøffer, M., Ørntoft, T. & Hermansen, K. (2003). Antihyperglycemic and Blood PressureReducing Effects of Stevioside in the Diabetic Goto-Kakizaki Rat. Metabolism, 52, 372-378. DOI: 10.1053/meta.2003.50058
• Kolluru, G.K., Bir, S.C. & Kevil, CG. (2012). Endothelial dysfunction and diabetes: effects on Angiogenesis, vascular remodeling and wound healing. International Journal of - Vascular Medicine, 918267. DOI: 10.1155/2012/918267
• Ma, Q. (2014). Advances in mechanisms of anti-oxidation. Discovery Medicine, 17(93), 121-130.
• Mizushina, Y., Akihisa, T., Ukiya, M., Hamasaki, Y., Murakami-Nakai, C. Kuriyama, I., Takeuchi, T., Sugawara, F. & Yoshida, H. (2005). Structural analysis of isosteviol and related compounds as DNA polymerase and DNA topoisomerase inhibitors. Life Sciences, 77, 2127- 2140. DOI: 10.1016/j.lfs.2005.03.022
• Nafaji, F., Tahvilian, R., Farhadi, H. & Zangeneh, M.M. (2017). Effect of Stevia rebaudiana aqueous extract cream on wound healing in Sprague-Dawley male rats. Online Journal of Veterinary Research,21(11), 700-706.
• Özdemir, D., Başer, H. & Çakır, B. (2014). Tatlandırıcılar. Turkiye Klinikleri Journal of Endocrinology, 9(2).
• Patel, S., Srivastava, S., Singh, MR. & Singh, D. (2019). Mechanistic insight into diabetic wounds: Pathogenesis, molecular targets and treatment strategies to pace wound healing. Biomedicine & Pharmacotherapy, 112, 108615. DOI: 10.1016/j.biopha.2019.108615
• Pattanayak, S.P. & Sunita, P. (2008). Wound healing, anti-microbial and antioxidant potential of Dendrophthoe falcata (L.f) Ettingsh. Journal of Ethnopharmacology, 120, 241-247. DOI: 10.1016/j.jep.2008.08.019
• Ramos-Tovar, E., Casas-Grajalesa, S., HernándezAquinoa, E., Flores-Beltrána, R.E., GalindoGómezb, S., Vera-Aguilarc, E., Diaz-Ruizd, A., Montesd, S., Camachoc, J., Tsutsumib, V. & Muriela, P. (2019). Cirrhosis induced by thioacetamide is prevented by stevia. Molecular mechanisms. Journal of Functional Foods, 52, 552-564. DOI: 10.1016/j.jff.2018.11.039
• Rosso, A., Balsomo, A., Gambino, R., Dentelli, P., Falcioni, R., Casseder, M., Pegoraro, L., Pagano, G. & Brizzi, MF. (2006). p53 Mediates the accelerated onset of senescence of endothelial progenitor cells in diabetes. Journal of Biological Chemistry, 281(7), 4339-4347. DOI: 10.1074/jbc.M509293200
• Salehi, B., López, M.D., Martínez‐López, S., Victoriano, M. Sharifi‐Rad, J., Martorell, M., Rodrigues, C.F. & Martins, N. (2019). Stevia rebaudiana Bertoni bioactive effects: From in vivo to clinical trials towards future therapeutic approaches. Phytotherapy Research, 33, 2904- 2917. DOI: 10.1002/ptr.6478
• Sardar, H., Waqas, M., Naz, S., Ejaz, S., Ali, S. & Ahmad, R. (2022). Evaluation of different growing media based on agro-industrial waste materials for the morphological, biochemical and physiological characteristics of stevia. Cleaner Waste Systems, 3, 100038. DOI: 10.1016/j.clwas.2022.100038
• Schiano, C., Grimaldi, V., Franzese, M., Fiorito, C., Nigris, F.D., Donatelli, F., Soricelli, A., Salvatore, M. & Napoli, C. (2020). Nonnutritional sweeteners effects on endothelial vascular function. Toxicology in Vitro, 62, 104694. DOI: 10.1016/j.tiv.2019.104694
• Sehar, I., Kaul A., Bani S. & Pal H.C. (2008). Saxena AK. Immune up regulatory response of a noncaloric natural sweetener, stevioside. ChemicoBiological Interactions. 173, 115-121. DOI: 10.1016/j.cbi.2008.01.008
• Shukla S., Mehta A., Bajpai, V. K. & Shukla S. (2009). In vitro antioxidant activity and total phenolic content of ethanolic leaf extract of Stevia rebaudiana Bert. Food Chemistry Toxicology, 47, 2338-2343.
• Singh, K., Chauhan, M., Yadav, S. & Kumar, V. (2019). Stevia (Stevia rebaudiana): A natural healer for diabetes, heart diseases & other metabolic disorders. Vivechan International Journal of Research, 10(1).
• Singh, S., Garg, V. & Yadav, D. (2013). Antihyperglycemic and antioxidative ability of Stevia rebaudiana (Bertoni) leaves in diabetes induced mice. International Journal of Pharmacy and Pharmaceutical Sciences, 5(2), 297-302.
• Suntar, I. (2014). The medicinal value of asteraceae family plants in terms of wound healing activity. FABAD Journal of Pharmaceutical Sciences, 39, 21-31.
• Vaghela, S. & Soni, A. (2020). A comprehensıve overvıew of Stevia rebaudiana and its secondary metabolıte sweeteners. Türk Bilimsel Derlemeler Dergisi, 13(2), 126-138.
• Wang, J., Zhao, H., Wang, Y. Lau, H., Zhou, W., Chen, C. & Tan, S. (2020). A review of stevia as a potential healthcare product: Up-to-date functional characteristics, administrative standards and engineering techniques. Trends in Food Science & Technology, 103, 264-281. DOI: 10.1016/j.tifs.2020.07.023
• Yasukawa K., Kitanaka S. & Seo S. (2002). Inhibitory effect of stevioside on tumor promotion by 12-Otetradecanoylphorbol-13-acetate in two-stage carcinogenesis. Biolological and Pharmaceutical Bulletin, 25, 1488-1490. DOI: 10.1248/bpb.25.1488
• Young A. & McNaught C.E. (2011). The physiology of wound healing. Surgery, 29, 475-479. DOI: 10.1016/j.mpsur.2011.06.011
• Yuan, Q., Hu, C.P., Gong, Z.C., Bai, Y.P., Liu, S.Y., Li, Y.J. & Jiang, J.L. (2015). Accelerated onset of senescence of endothelial progenitor cells in patients with type 2 diabetes mellitus: role of dimethylarginine dimethylaminohydrolase 2 and asymmetric dimethylarginine. Biochemical and Biophysical Research Communications. 458(4), 869-876. DOI: 10.1016/j.bbrc.2015.02.050.