A diverse range of normal flora populates the human skin and numbers are relatively different between individuals and parts of the skin. Humans and normal flora have formed a symbiotic relationship over a period of time. With numerous disease processes, the interaction between the host and normal flora can be interrupted. Unlike normal wound healing, which is complex and crucial to sustaining the skin’s physical barrier, chronic wounds, especially in diabetes, are wounds that fail to heal in a timely manner. The conditions become favorable for microbes to colonize and establish infections within the skin. These include secretions of various kinds of molecules, substances or even trigger the immune system to attack other cells required for wound healing. Additionally, the healing process can be slowed down by prolonging the inflammatory phase and delaying the wound repair process, which causes further destruction to the tissue. Antibiotics and wound dressings become the targeted therapy to treat chronic wounds. Though healing rates are improved, prolonged usage of these treatments could become ineffective or microbes may become resistant to the treatments. Considering all these factors, more studies are needed to comprehensively elucidate the role of human skin normal flora at the cellular and molecular level in a chronic injury. This article will review wound healing physiology and discuss the role of normal flora in the skin and chronic wounds.

Lignosus rhinocerus (L. rhinocerus), which is known locally as Tiger Milk mushroom, is traditionally used in the treatment of asthma by indigenous communities in Malaysia. However, to date, its efficacy on asthma has not been confirmed by scientific studies and there is also sparse information available on its active constituents. In this study, the volatile constituent of L. rhinocerus hot water extract was investigated using gas chromatography mass spectrometry (GC-MS). The potential effects of L. rhinocerus extract for anti-asthmatic activity was further investigated on ovalbumin (OVA)-sensitized asthmatic Sprague Dawley rats. Sequential extraction using five solvents (petroleum ether, diethyl ether, hexane, ethyl acetate and methanol) was conducted prior to GC-MS analysis. Male Sprague Dawley rats were divided into the following four groups of five animals each: 1) normal rats, 2) sensitization plus OVA-challenged rats 3) sensitization plus OVA-challenged with L. rhinocerus treatment and 4) sensitization plus OVA-challenged with dexamethasone treatment. The levels of immunoglobulin E (IgE) in the serum and T-helper 2 cytokines, including interleukin (IL)-4, IL-5 and IL-13, in bronchoalveolar lavage fluid (BALF), as well as eosinophil infiltration in the lungs, were investigated. GC-MS analysis revealed the presence of five main groups (alkane, fatty acids, benzene, phenol and dicarboxylic acid) with a total of 18 constituents. Linoleic acid (21.35 %), octadecane (11.82 %) and 2,3-dihydroxypropyl elaidate (10.47 %) were present in high amounts. The extract significantly ameliorated the increase in total IgE in serum and IL-4, IL-5 and IL-13 levels in BALF and also effectively suppressed eosinophils numbers in BALF while attenuating eosinophil infiltrations in the lungs. L. rhinocerus hot water extract has the potential to be used as an alternative for the treatment of acute asthma.

Osteoarthritis (OA) is a chronic degenerative disorder of the joint and its prevalence and severity is increasing owing to ageing of the population. Osteoarthritis is characterized by the degradation of articular cartilage and remodeling of the underlying bone. There is little understanding of the cellular and molecular processes involved in pathophysiology of OA. Currently the treatment for OA is limited to painkillers and anti-inflammatory drugs, which only treat the symptoms. Some patients may also undergo surgical procedures to replace the damaged joints. Extracellular vesicles (EV) play an important role in intercellular communications and their concentration is elevated in the joints of OA patients, although their mechanism is unclear. Extracellular vesicles are naturally released by cells and they carry their origin cell information to be delivered to target cells. On the other hand, mesenchymal stem cells (MSCs) are highly proliferative and have a great potential in cartilage regeneration. In this review, we provide an overview of the current OA treatments and their limitations. We also discuss the role of EV in OA pathophysiology. Finally, we highlight the therapeutic potential of MSC-derived EV in OA and their challenges.

Osteoarthritis (OA) has traditionally been known as a “wear and tear” disease, which is mainly characterized by the degradation of articular cartilage and changes in the subchondral bone. Despite the fact that OA is often thought of as a degenerative disease, the catabolic products of the cartilage matrix often promote inflammation by activating immune cells. Current OA treatment focuses on symptomatic treatment, with a primary focus on pain management, which does not promote cartilage regeneration or attenuate joint inflammation. Since articular cartilage have no ability to regenerate, thus regeneration of the tissue is one of the key targets of modern treatments for OA. Cell-based therapies are among the new therapeutic strategies for OA. Mesenchymal stem cells (MSCs) have been extensively researched as potential therapeutic agents in cell-based therapy of OA due to their ability to differentiate into chondrocytes and their immunomodulatory properties that can facilitate cartilage repair and regeneration. In this review, we emphasized current knowledge and future perspectives on the use of MSCs by targeting their regeneration potential and immunomodulatory effects in the treatment of OA.

Nanoporous bioceramic recently has gained attention as a drug storage and release host in the therapeutic application. Mesoporous carbonated hydroxyapatite (MCHA) is a nanoporous bioceramic with pore sized ranged between 2-50nm. In order to use in drug delivery application, this material should demonstrate acceptable cytotoxic activity and osteoinductive response. Therefore, this study aimed to evaluate the effect of mesoporous carbonated hydroxyapatite on viability and alkaline phosphatase (ALP) activity of MC3T3-E1 osteoblasts cell line. These parameters represent cytotoxicity level and osteinductivity capability of the materials. MC3T3-E1 cells were cultured in 25mg/ml extraction of mesoporous carbonated hydroxyapatite (meso-CHA) and non-porous CHA (np-CHA) for up to 7 days for viability and 14 days for ALP test. Results indicate that meso-CHA shows better cytotoxicity properties compare to np-CHA. Intracellular ALP of cells treated with meso-CHA was higher than np-CHA