Review Article

The Anti-Inflammatory and Antibacterial Action of Nanocrystalline Silver and Manuka Honey on the Molecular Alternation of Diabetic Foot Ulcer: A Comprehensive Literature Review

Table 2

Modes of action of nAg.

NumberAuthorNature of studyMechanism of antibacterial action

[54]Kon and Rai, 2013ReviewIncreases the surface area contacting the wound surface
[55]Morones et al., 2005In vitroHave a direct interaction on the cell surface and within the bacteria with a diameter of around 1–10 nm
[56]Pal et al., 2007In vitroThe bactericidal action of nAg with a truncated triangular shape exceeds that of nAg with a spherical or rod shape
[57]Matsumura et al., 2003In vitroInteracts with the thiol group of respiratory enzymes
[58]Gordon et al., 2010Animal studyInactivates the key enzyme by blinding the thiol group, forming free radicals, and subsequently damaging DNA
[59]Pandian et al., 2010In vitroInteracts with and condenses phosphorus-containing DNA and cytoplasm (apoptosis) and inhibits cell replication
[60]Dibrov et al., 2002In vitroBinds to the modified phospholipid bilayer and induces a massive leakage of protons
[61]Sondi and Salopek-Sondi, 2004In vitroAttaches the negatively charged cell membrane by forming “pits,” making the membrane porous and resulting in leakage of intracellular content
[62]Kim et al., 2007In vitroBacteria release cellular content after the permeability of the cell membrane increases, leading to cell death
[63]Mirzajani et al., 2011In vitroDestroyed the bonds of glycan strands composed of N-acetylglucosamine and N-acetylmuramic acid in the cell membrane of Gram +ve bacteria and causing “pits” to form
[64]McQuillan et al., 2012In vitroInteracts with the outer and inner membrane of Gram −ve bacteria, and then membrane dissolves; Ag+ releases into the cell and affects a transcriptional response
[65]Mijakovic et al., 2006In vitroPhosphorylation of the protein substrate in bacteria can influence bacterial sign transduction and cell cycle progression
[66]Shrivastava et al., 2007

NumberAuthorNature of studyMechanism of anti-inflammatory action

[67]Wright et al., 2002Animal studyReduces the activity of MMPs and stimulates the apoptosis of PMNs, leading to a decrease in the release of cytotoxic compounds such as proteases and oxygen radicals
[68]Bhol et al., 2004Animal studyEffectively decreases allergic contact dermatitis on a guinea pig model, similar to topical steroids
[69]Bhol and Schechter, 2005Animal studySuppresses the activities of TNF-α and IL-12 and induces the apoptosis of inflammatory cells
[70]Wong et al., 2009Animal studyDownregulates the production of TNF-α without having a significant toxic effect on a peritoneal adhesion model
[71]Nadworny et al., 2010Animal studyDecreases TNF-α and IL-8 and increases IL-4, EGF, KGF, and KGF-2
[72]Nadworny et al., 2010Animal studyDownregulates TNF-α and IL-8 and upregulates IL-4, IL-10, EGF, KGF, and KGF-2
[73]Bisson et al., 2013Animal studyDemonstrates a significant inflammatory effect, equivalent to that which results from using topical steroid cream
[74]Shin et al., 2007In vivoTNF-α and interferon-γ are significantly inhibited at low concentrations of nAg
[75]Mani et al., 2015In vivoTNF-α, IL-1β, and IL-6 are inhibited at concentrations ranging from 10 to 20 μg/mL