This is an unfold Access article distributed under the terms of the creative Commons Attribution-Noncommercial 3.0 Unported License, permitting all non-commercial use, distribution, and reproduction in any culture medium, provided the original work is by rights cited. Centella asiatica known as Gotu Kola is a medicative plant that has been used in family medicate for hundreds of years angstrom well as in scientifically oriented medicine. The active compounds include pentacyclic triterpenes, chiefly asiaticoside, madecassoside, asian and madecassic acids. Centella asiatica is effective in improving treatment of little wounds, hypertrophic wounds arsenic well as burns, psoriasis and scleroderma. The mechanism of action involves promoting fibroblast proliferation and increasing the synthesis of collagen and intracellular fibronectin message and besides improvement of the tensile potency of newly formed clamber deoxyadenosine monophosphate well as inhibiting the inflammatory phase of hypertrophic scars and keloids. Research results indicate that it can be used in the treatment of photoaging bark, cellulite and band. This review presents the results of natural process of C. asiatica in facilitating the heal of wounds, compounds responsible for activeness and mechanism of action, besides contraindications and electric potential side effects. so far studies in the practice of this plant as an ingredient in cosmetic preparations applied on photoaging skin, in cellulite and band have besides been presented. In traditional asian medicine, the herb of C. asiatica has been used for hundreds of years, specially in dermatologic conditions, to improve small wounds, scratches, burns, hypertrophic wounds healing, and as an anti-inflammatory agent, particularly in eczema. It is besides recommended as an antipyretic, diuretic drug, rheumatic, antibacterial, antiviral drug, in the treatment of vein insufficiency and for improving cognition, relieving anxiety and as an anti-cancer agent [ 1, 4, 5 ]. once, C. asiatica was besides used in epilepsy, craze, leprosy, and in minor itch and worm bites [ 5 ].

Centella asiatica ( L. ) Urban., synonym : Hydrocotyle asiatica L. ( Eng. indian Pennywort, Fr. Hydrocotyle asiatique, Ger. Asiatischer Wassernabel ), besides known by common names as : Gotu kola or Tiger Grass, belongs to the Apiaceae family. It grows in Asia, chiefly in India, Pakistan, Madagascar, equatorial Africa, central America and in the tropical region of Oceania [ 1 ]. The C. asiatica herb was already used as a “ panacea ” three thousand years ago in China, India, Africa, the Philippines, Sri Lanka and Madagascar. In the 19 thorium hundred, C. asiatica and C. asiatica extract were included in the indian Pharmacopoeia. Due to the medicative properties of the plant it was gradually incorporated into other Pharmacopoeias : british Herbal Pharmacopoeia, Chinese Pharmacopoeia, Dutch Pharmacopoeia, German Pharmacopoeia, Homöopathisches Arzneibuch, Martindale European Pharmacopoeia, Pharmacopee française, La Farmacopea Italiana X, european Pharmacopoeia VI and into polish Pharmacopoeia IX edition [ 1 – 3 ]. According to European and Polish Pharmacopoeias, Centella ( Centellae asiaticae herba ) consists of dried, fragmented forward pass parts of Centella asiatica ( L. Urban. ), contains not less than 6.0 per penny of total triterpenoid derivatives expressed as asiaticoside [ 2, 3 ]. Centellosides are chiefly ursane- and oleanane-type pentacyclic triterpenoid saponins. The most significant compounds, due to their pharmacological activity, are asiaticoside, madecassoside, asian acid and madecassic acid. other centellosides occurring in C. asiatica include triterpenic acids, for example : brahmic acid, madasiatic acid, terminolic acid, centellic acid angstrom well as their glycosides : brahminoside, madasiaticoside and centelloside [ 6 ]. Centella besides contains other components, including fickle oils ( 0.1 % ), flavonoids, tannins, phytosterols, amino acids and sugars [ 1, 8 ]. The most important constituents isolated from C. asiatica were triterpenoid saponins known as centelloids. Saponins may account for 1 % to 8 % of all C. asiatica constituents [ 6 ]. The variable quantity chiefly depends on the lineage of the establish and can be established using the HPLC-UV method acting [ 7 ]. The C. asiatica preparations used in ceremonious medicine are applied in an oral form ( tablets and drops ), topical medication ( ointments and gunpowder ), in the human body of injections ( s.c., i.m. ) and external or inner homeopathic preparations [ 1 ]. clinical trials were performed using TECA and ETCA ( Estratto Titolato di Centella asiatica ) or commercially produced extracts : Centella asiatica full triterpenic fraction ( CATTF ) and TTFCA equally well as isolated triterpenoid saponins, chiefly asiaticoside, madecassoside and asian acid [ 1, 9 ]. Pharmacological, biochemical and clinical studies were related to undefined aqueous or alcohol extracts and define extracts. Pharmacological inquiry included the pursue extracts : titrated press out of Centella asiatica ( TECA ), sum triterpenoid fraction of Centella asiatica ( TTFCA ), both containing asian acerb ( 30 % ), madecassic acerb ( 30 % ), asiaticosides ( 40 % ) and total triterpenic fraction ( TTF ) which comprises asian acerb and madecassic acid ( 60 % ) vitamin a well as asiaticosides ( 40 % ) [ 1 ]. however, information coming from licensed medicative products says that all of the above mentioned TECA, TTFCA, TTF arsenic well as CATTF and ETCA are different acronyms to designate the lapp excerpt, commercially known as Madecassol ®, Centellase ® or Blastoestimulina ®, containing 40 % of asiaticoside and a 60 % mix of asian and madecassic acids [ 1, 9 ] .

Table of Contents

Biological activity

Centella asiatica is effective in treatment of wounds, even in infect wounds, adenine well as burns and postoperative hypertrophic scars [ 10 – 13 ]. Triterpene compounds : asian acid, madecassic acid, asiaticoside and madecassoside are the principal components of C. asiatica, responsible for wound healing. The action has been demonstrated both for the extracts equally well as triterpene compounds in a big number of scientific reports involving in vitro and in vivo experiments [ 14, 15 ]. The terpenoids ( TTF ) cause a significant increase in the percentage of collagen and cell layer fibronectin. The most beneficial effects are the foreplay of scar maturation by the product of type I collagen, decrease in the incendiary reaction and myofibroblast output [ 16 ]. According to Maquart et al., wounds treated with TECA and its separate components : asian acid, madecassic acidic and asiaticoside increased sum protein, collagen, and peptic hydroxyproline message. As a result, the increase of fibroblast proliferation by foreplay of cell migration from the surrounding tissues and/or the expression or energizing of some growth factors in the wound was observed. The triterpenoid components were besides able to stimulate glycosaminoglycan, specially hyaluronic acidic synthesis [ 17 ]. The saponins from C. asiatica administered orally or subcutaneously to the rats, during 3 weeks caused the reduction of the scratch granuloma, whereas the rupture, ductile strength and the collagen content in the scar tissue increased [ 1 ]. The ethanolic excerpt of the C. asiatica facilitated the wound-healing in both normal and dexamethasone suppressed wound healing. The study was done in Wistar albino rats using incision, deletion and dead space wounds models. The infusion increased the weave breaking intensity in incision wound model, accelerated the epithelization and the rate of wind contraction. Granulation tissue and hydroxyproline subject in a dead quad wind besides increased. The extract attenuated dexamethasone healing effect in all wreathe models [ 18 ]. Madecassol® was found to have a preventive effect on burn off and postoperative hypertrophic scars [ 13 ]. Madecassoside was active in tan wound healing, through increasing antioxidative natural process and enhancing collagen deduction, and influencing angiogenesis. oral presidency of this compound at doses of 6 mg/kg, 12 mg/kg and 24 mg/kg to mice facilitated wound closure in a time-dependent manner and complete wind closing took rate on the twentieth day in the group receiving 24 mg/kg of madecassoside. The compound caused cuticular proliferation of fibroblasts and increased the level of hydroxyproline ( used as an index of collagen synthesis in burn off skin ) which resulted in enhanced epithelization. These results confirm a positive effect on fibroblast proliferation and collagen synthesis during bite wound repair [ 11 ].

Asiaticoside besides stimulated angiogenesis then that the increase in latent hostility and elasticity of blood vessels was observed [ 19 ]. Studies on rats have shown that this compound ( 0.2 % ) applied locally increases the levels of enzymatic and non-enzymatic antioxidants in the newly created tissues [ 20 ]. Asiaticoside caused an increase in hydroxyproline and besides in tensile persuasiveness, a raise in collagen content and better epithelization of punch/puncture wounds in guinea pigs or on delayed-type wounds of wop pigs with experimentally induced diabetes [ 19 ]. The mechanism of action of asiaticoside is the initiation of type I collagen synthesis in homo dermal fibroblast cells by phosphorylation of both Smad 2 and Smad 3, besides binding Smad 3 and Smad 4. Studies show that asiaticoside can induce type I collagen by energizing of tumor growth factor β ( TGF-β ) sense organ I kinase – autonomous Smad pathway [ 21 ]. The facilitation of burn wound heal, observed after 20 days of local lotion of asiaticoside at a venereal disease of 10 pg, 1 nanogram, or 100 ng/wound area on the backs of mouse, took place through determine on the degree of respective cytokines produced in the place of the burn wound. The improvement in burn weave healing might be an result of angiogenesis promotion during wind healing in the hurt area occurring as a result of the stimulation of vascular endothelial emergence factor ( VEGF ) production [ 22 ]. finally, proliferation of epithelial cells and injure contraction happen. In contraction, the wind is made smaller by the activity of myofibroblasts [ 10 – 12 ]. Centella asiatica herb water system extracts besides shows the anti-psoriatic natural process [ 23 ], exerts a beneficial effect in treating systemic scleroderma and focal scleroderma [ 24 ]. In cosmetology C. asiatica has been used as an effective anti-photoaging agent, chiefly due to enhancement of type I collagen, which sum in skin decreases with historic period. The action was confirmed in a randomized, double blind clinical trial conducted among 20 female participants ( 45-60 years old ) with photoaged skin to examine the affect of locally applied 0.1 % madecassoside in concurrence with 5 % vitamin C on their skin. Six-month treatment resulted in a meaning improvement in resoluteness, elasticity and skin hydration, which was confirmed by allow biometrological tests. It is considered that the beneficial consequence of C. asiatica on improving the stipulate of skin was due to madecassoside, a know inducer of collagen expression by activating the SMAD signaling nerve pathway. In the former analyze, the same investigators confirmed the beneficial effect of 5 % vitamin C on photoaged skin, which resulted from stimulation of collagen synthesis in fibroblasts and control of matrix metalloproteinase enzymes creditworthy for abasement of collagen, while in photoaged hide, the horizontal surface of vitamin C in tissues was significantly reduced. thus, it follows that the mix of vitamin C and madecassoside is an attractive combination of two active agent compounds characterized by unlike mechanisms of action, which exert an linear or synergetic effect “ causing the remodel of the superficial dermis ” [ 25 ]. Centella asiatica is a common ingredient of cosmetics used in cellulite and band. Cellulite, known as liposclerosis, is a non-inflammatory change within the hypodermic adipose tissue caused by an increase in the volume of fat cells or by increase part of the conjunction tissue, which causes constriction of small blood vessels. The result is a disorder of metabolism in the hypodermic adipose tissue, resulting in “ distended ” fatness cells in this tissue, particularly around hips, buttocks, abdomen, thighs and arms. Cellulite is an ailment that affects many people, most frequently women, specially corpulent and run stationary life style, but may even be encountered in children. Preparations that affect the adipose weave, connective tissue and improve microcirculation are applied in the treatment of cellulite. They can be used locally, internally and transdermally. It is recommended to include medicines of plant origin in the fight against cellulite. Methylxanthines ( caffeine, theobromine, theophylline ) have a lipophilic effect, while the extract of C. asiatica normalizes the metabolism occurring in the cells of the connection weave, shows anti-inflammatory and drain natural process and regulates microcirculation. The study confirmed the influence of triterpenes of C. asiatica on increasing the metamorphosis of lysine and proline, the amino acids building the collagen molecule. In summation, these compounds increased the synthesis of tropocollagen, and mucopolysaccharide in the connection tissues. The results obtained showed the shock of C. asiatica on improving nutrition of tissues and connection vascular stimulation [ 26 ]. The positive effects of the treatment of cellulite with the C. asiatica excerpt were confirmed by a few clinical studies that used different methodologies. These experiments, however, used non-standard criteria to evaluate the progress of the treatment and most of them lacked a control condition group. The histopathological study performed in a double-blind test, involving 35 patients evaluated the size of adipocytes in the gluteofemoral region and in the deltoid area. Twenty people participating in the experiment were administered 60 magnesium of the dry excerpt of C. asiatica orally once a day, for 90 days. other participants of the experiment group took a placebo. The results showed that in the patients taking the Gotu Kola extract, the diameter of fat cells ( or adipocytes ) decreased in both study regions of the body with a predomination of positive changes in the gluteofemoral region. In this learn, a decrease in interadipocyte fibrosis was besides observed [ 27 ].

In the experiment on a group of 60 people with cellulite, the influence of Madecassol® applied four times a day for 4 months was studied. The results clearly showed a beneficial consequence of the Gotu Kola infusion on inhibiting the progress of cellulite and a significant improvement in the skin circumstance in 85 % of the experiment participants. The preparation was well tolerated [ 1 ]. other experiments conducted on 65 patients with advance cellulite showed that oral consumption of the preparation Madecassol together with coincident decrease in diet for 3 months caused a significant decay in cellulite in 58 % of the patients, whereas in 20 % of the volunteers the effects were only satisfactory [ 28 ]. A randomize, double-blind, placebo-controlled test of the cream Trofolastin®, containing an distill of C. asiatica, α-tocopherol, hydrolyzed collagen and elastin, was carried out on 100 meaning women. half of the women, who qualified for the study, received a placebo, the other one-half were applied a test cosmetic preparation. The cream was applied daily on breasts, abdomen, buttocks and hips, starting from the third base calendar month of pregnancy. The test lasting 30 months was carried through by 80 of the women ( 39 in the placebo group and 41 in the group using the skim ). The results indicated that in the placebo group, band occurred in 56 % of the women ( 22 patients ), whereas in the group that used the cream with the press out of C. asiatica, the problem affected 14 women entirely. The study besides assessed the asperity of stria on a scale of 0-3. Among the patients using the skim the average numeral value of the argument adopted was 1.42, and 2.13 among those receiving the placebo. The test cream provided significant protective covering for the women who had had striae during puberty ( 89 % of the women ) [ 29 ] .