Turmocin Plus Suppresses Vascular Endothelial Growth Factor (VEGF) and Macrophage Infiltration in the Management of Perineal Wounds, Anal Fistula, Acute Anal Fissures and Haemorrhoids

Abstract

Anorectal problems such as anal fistula, Crohn’s disease, haemorrhoids, and fissures are prevalent across the general population. Severe discomfort, inflammation, swelling, itching, and bleeding during defecation are common symptoms of anorectal disorders. Depending on the severity of the condition, several medical therapies or surgical procedures may be used to treat these diseases. Surgical treatments like fistulectomy and sphincterotomy or haemorrhoidectomy are highly intrusive and have a risk of recurrence. Furthermore, surgical procedures cause pain, inflammation, and perineal sores. These will lead to severe socio-economic ramifications in the patient’s life. Therefore, treatment options that aid in the reduction of inflammation, pain, and perineal wounds are critical for anorectal disease management. Herbal formulations that comprise turmeric (Curcuma longa) extract have anti-inflammatory, pain-relieving, and wound-healing properties. The purpose of the current study was to elucidate the effect of Turmocin Plus on the infiltration of inflammatory cells and the expression of pro-angiogenic factors in anorectal and lower gastrointestinal disorders. MTT (3-[4,5-dimethylthiazol-2-yl]-2,5 diphenyl tetrazolium bromide) and wound migration assays were performed to determine the results of Turmocin Plus on the viability and migration of inflammatory cells. The effect of Turmocin Plus on pro-angiogenic factors was determined using Western blot analysis and immunofluorescence. Further, we validate our in vitro findings in human fistula specimens using IHC. The investigation showed that Turmocin Plus inhibits immunological (RAW 264.7) cell migration while maintaining their viability. Inflammation and increased levels of Vascular Endothelial Growth Factor (VEGF) were observed in Inflammatory Bowel Disease (IBD), fistula, fissures, and higher-grade haemorrhoids. However, Turmocin Plus suppresses the VEGF expression in macrophages (RAW 264.7) cells. Furthermore, compared to untreated human fistula tissues, decreased expression of VEGF was observed in Turmocin Plus treated patient samples, validating the in vitro findings. Our study suggests that Turmocin Plus is a potent therapeutic formulation in treating fistula, perineal wounds, and Crohn’s disease.