Gelatin has been frequently used in tissue engineering scaffold due to its favorable biological properties in wound healing enhancement. Genipin, a natural compound derived from Gardenia plants, was shown to be effective in improving physicochemical characteristics of the gelatin scaffold. This systematic review reported the utility of genipin as a crosslinker in gelatin scaffold fabrication. Two electronic databases, namely Scopus and MEDLINE via Ebcoshost were searched for publication between January 1999 and December 2018, using the keywords ‘gelatin’ and ‘genipin’. Articles published in English, reporting the utility of genipin in the fabrication of gelatin sponge were included. The keywords search yielded 830 articles, in which 14 articles were selected and examined in this review. The result of the search provided input in terms of the optimum concentration, crosslinking temperature, and fabrication method of genipin to be used. From the literature, it was found that 0.5% is the optimum genipin concentration and 25˚C is the optimum crosslinking temperature. The result also revealed a gap in the knowledge regarding genipin crosslinker and justifies the need to create awareness of the utility of genipin as a gelatin scaffold crosslinker. The current review provides an extensive overview on the current knowledge on genipin crosslinking and be a guide to an optimal fabrication of the genipin-crosslinked gelatin scaffold.
The pathophysiology of systemic inflammatory response syndrome (SIRS) had been described to involve various strong oxidative reactions affecting the status and progress of the patients. Antioxidant therapy had been suggested in many studies involving SIRS management. The objective of this study was to compare the role of vitamin E Tocotrienol and vitamin E Tocopherol combined with vitamin C as antioxidant therapy in the management of critically ill patients diagnosed with SIRS, admitted to the intensive care unit and high dependency wards of Universiti Kebangsaan Malaysia Medical Centre (UKMMC). It was a single blind randomized clinical trial with a total of 72 patients in which 44.4% Malays, 34.7% Chinese, 19.4% Indians and 1.4% others with 59.7% males and 40.3% females were recruited. Patients in TRI E group received Tocotrienol with Vitamin C while TOCO group received Tocopherol with Vitamin C and a control group did not receive any antioxidant. The clinical parameters (heart rate, respiratory rate, systolic blood pressure) showed improvements with significant difference at the end of study (post-intervention) as compared to admission (pre-intervention).Whereas, the sepsis (temperature, PCT, CRP and WBC) and oxidative stress (8-OHdG/Creatinine) parameters showed improvements with significant difference at the end of study (post-intervention) as compared to admission (pre-intervention). The TRI E group showed obvious improvement in clinical, sepsis and oxidative stress parameters, as compared to TOCO and control groups. This study showed that Vitamin E Tocotrienol and Vitamin E Tocopherol in combination with Vitamin C demonstrated significant improvement in the clinical and laboratory parameters during the management of SIRS. Therefore, Vitamin E in combination with Vitamin C had therapeutic benefits in the treatment of critically ill patients with SIRS.