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<front>
<journal-meta>
<journal-id journal-id-type="publisher-id">BR</journal-id>
<journal-title-group>
<journal-title>Biomedical Reports</journal-title>
</journal-title-group>
<issn pub-type="ppub">2049-9434</issn>
<issn pub-type="epub">2049-9442</issn>
<publisher>
<publisher-name>D.A. Spandidos</publisher-name>
</publisher>
</journal-meta>
<article-meta>
<article-id pub-id-type="publisher-id">BR-23-2-02009</article-id>
<article-id pub-id-type="doi">10.3892/br.2025.2009</article-id>
<article-categories>
<subj-group subj-group-type="heading">
<subject>Review</subject>
</subj-group>
</article-categories>
<title-group>
<article-title>Role of <italic>Nigella sativa</italic> L. seed (black cumin) in preventing photoaging (Review)</article-title>
</title-group>
<contrib-group>
<contrib contrib-type="author">
<name><surname>Evanti</surname><given-names>Annisa</given-names></name>
<xref rid="af1-BR-23-2-02009" ref-type="aff">1</xref>
</contrib>
<contrib contrib-type="author" corresp="yes">
<name><surname>Wargasetia</surname><given-names>Teresa Liliana</given-names></name>
<xref rid="af1-BR-23-2-02009" ref-type="aff">1</xref>
<xref rid="c1-BR-23-2-02009" ref-type="corresp"/>
</contrib>
<contrib contrib-type="author">
<name><surname>Gunadi</surname><given-names>Julia Windi</given-names></name>
<xref rid="af1-BR-23-2-02009" ref-type="aff">1</xref>
<xref rid="af2-BR-23-2-02009" ref-type="aff">2</xref>
<xref rid="af3-BR-23-2-02009" ref-type="aff">3</xref>
</contrib>
</contrib-group>
<aff id="af1-BR-23-2-02009"><label>1</label>Master Program in Skin Ageing and Aesthetic Medicine, Faculty of Medicine, Maranatha Christian University, Bandung, West Java 40164, Indonesia</aff>
<aff id="af2-BR-23-2-02009"><label>2</label>Department of Physiology, Faculty of Medicine, Maranatha Christian University, Bandung, West Java 40164, Indonesia</aff>
<aff id="af3-BR-23-2-02009"><label>3</label>Maranatha Biomedical Research Laboratory, Faculty of Medicine, Maranatha Christian University, Bandung, West Java 40164, Indonesia</aff>
<author-notes>
<corresp id="c1-BR-23-2-02009"><italic>Correspondence to:</italic> Professor Teresa Liliana Wargasetia, Master Program in Skin Ageing and Aesthetic Medicine, Faculty of Medicine, Maranatha Christian University, Jl. Prof. drg. Suria Sumantri MPH 65, Bandung, West Java 40164, Indonesia <email>teresa.lw@med.maranatha.edu</email></corresp>
</author-notes>
<pub-date pub-type="collection"><month>08</month><year>2025</year></pub-date>
<pub-date pub-type="epub"><day>04</day><month>06</month><year>2025</year></pub-date>
<volume>23</volume>
<issue>2</issue>
<elocation-id>131</elocation-id>
<history>
<date date-type="received">
<day>03</day>
<month>02</month>
<year>2025</year>
</date>
<date date-type="accepted">
<day>30</day>
<month>04</month>
<year>2025</year>
</date>
</history>
<permissions>
<copyright-statement>Copyright: &#x00A9; 2025 Evanti et al.</copyright-statement>
<copyright-year>2025</copyright-year>
<license license-type="open-access">
<license-p>This is an open access article distributed under the terms of the <ext-link ext-link-type="uri" xlink:href="https://creativecommons.org/licenses/by-nc-nd/4.0/">Creative Commons Attribution-NonCommercial-NoDerivs License</ext-link>, which permits use and distribution in any medium, provided the original work is properly cited, the use is non-commercial and no modifications or adaptations are made.</license-p></license>
</permissions>
<abstract>
<p>Photoaging is a group of clinical and pathological manifestations caused by ultraviolet (UV) radiation, characterized by deep wrinkles, rough skin textures, dyspigmentation and disturbance of skin elasticity. UV radiation can cause skin damage due to reactive oxygen species (ROS) accumulation, which activates matrix metalloproteinase and increases collagen damage. One natural ingredient that has antioxidant properties by reducing ROS production is black cumin or <italic>Nigella sativa</italic> (<italic>N. sativa</italic>) seeds; this effect is attributed to key components such as thymoquinone, flavonoids, essential fatty acids and essential minerals. The present review aimed to describe the potential ingredients of <italic>N. sativa</italic> and its mechanism against photoaging. PubMed, ScienceDirect, Springer and Google Scholar databases were searched between 2014 and March 2024. The keywords were <italic>N. sativa</italic>, black seed, thymoquinone and photoaging. The search was limited to articles in Indonesian and English. Based on the critical appraisal, the eligibility of the included articles was evaluated; nine eligible articles were selected. The authors indicated that <italic>N. sativa</italic> and its active ingredient, thymoquinone, may have a role in preventing photoaging through various potential mechanisms, including its antioxidant and anti-inflammatory properties. Some studies have compared the effects of various types (oral and topical) of <italic>N. sativa</italic> and thymoquinone with good outcomes. <italic>N. sativa</italic> and thymoquinone may prevent photoaging by neutralizing UV-induced ROS accumulation. More studies are required to determine the exact mechanism of <italic>N. sativa</italic> and thymoquinone as an alternative therapy for photoaging.</p>
</abstract>
<kwd-group>
<kwd>antioxidant</kwd>
<kwd>black cumin</kwd>
<kwd>decelerating aging</kwd>
<kwd>natural compound</kwd>
<kwd>thymoquinone</kwd>
</kwd-group>
<funding-group>
<funding-statement><bold>Funding:</bold> The present study was supported by Maranatha Christian University, Bandung, Indonesia.</funding-statement>
</funding-group>
</article-meta>
</front>
<body>
<sec>
<title>1. Introduction</title>
<p>Photoaging due to exposure to ultraviolet (UV) radiation results in the appearance of rough skin, wrinkles, xerosis, hyperpigmentation and epidermal thickening owing to the progressive loss of function and regenerative potential of the skin tissue (<xref rid="b1-BR-23-2-02009" ref-type="bibr">1</xref>). Collagen is the main supporting skin structure; its excessive degradation is directly related to wrinkle formation (<xref rid="b2-BR-23-2-02009" ref-type="bibr">2</xref>). Matrix metalloproteinase (MMP) is a matrix-degrading enzyme that degrades and modifies some components of the extracellular matrix (ECM). UV radiation can increase MMP-1 production, which in turn increases collagen degradation in human skin (<xref rid="b3-BR-23-2-02009" ref-type="bibr">3</xref>).</p>
<p>An increase in the ROS content caused by UV exposure can cause oxidative stress accumulation, which activates MMP and increases collagen damage (<xref rid="b4-BR-23-2-02009" ref-type="bibr">4</xref>). Antioxidants are chemical substances that neutralize or interfere with the action of free radicals (<xref rid="b5-BR-23-2-02009" ref-type="bibr">5</xref>); these agents are often used to prevent or slow down the oxidation of macromolecules that cause oxidative stress. One natural ingredient that has antioxidant properties by reducing ROS production is black cumin or <italic>Nigella sativa</italic> (<italic>N. sativa</italic>) seeds (<xref rid="b6-BR-23-2-02009" ref-type="bibr">6</xref>).</p>
<p><italic>N. sativa</italic> is a small shrub, 20-90 cm in height, which belongs to the <italic>Ranunculaceae</italic> family; it is known for its antioxidant, antiviral, antifungal, antiparasitic and anti-inflammatory effects (<xref rid="b7-BR-23-2-02009" ref-type="bibr">7</xref>). The effects of these agents against free radicals are related to their activities of free radical scavenging and inhibiting 5-lipooxygenase during the inflammatory phase (<xref rid="b8-BR-23-2-02009" ref-type="bibr">8</xref>). This ability is attributed to several important components, such as thymoquinone (TQ), flavonoids, essential fatty acids and various mineral components, which have been widely studied (<xref rid="b9-BR-23-2-02009" ref-type="bibr">9</xref>). <italic>N. sativa</italic> has a therapeutic effect by reducing cytotoxicity, oxidative stress, inflammatory response and cell death caused by mitochondrial dysfunction in keratinocyte cells irradiated with ultraviolet A (UVA) light (<xref rid="b10-BR-23-2-02009" ref-type="bibr">10</xref>). Another study found that <italic>N. sativa</italic> extract inhibits the formation of advanced glycation end products, collagen cross-linking, collagenase activity and elastase activity (<xref rid="b2-BR-23-2-02009" ref-type="bibr">2</xref>). An animal study with rats exposed to UVB light showed a significant increase in collagen levels after being given topical <italic>N. sativa</italic> extract (<xref rid="b11-BR-23-2-02009" ref-type="bibr">11</xref>).</p>
</sec>
<sec>
<title>2. Photoaging</title>
<p>Photoaging is a group of clinical and pathological manifestations caused by skin exposure to UV radiation (<xref rid="b12-BR-23-2-02009" ref-type="bibr">12</xref>). UVA and UVB both play a role in photoaging, although UVA rays have longer wavelengths because UVA-1 rays (340-400 nm) can be absorbed deeply into the human skin and exert effects directly through the dermal fibroblast level (<xref rid="b13-BR-23-2-02009" ref-type="bibr">13</xref>); however, UVC is fully reflected by the ozone layer (<xref rid="b14-BR-23-2-02009" ref-type="bibr">14</xref>). Photoaging involves all skin layers, with primary effects on the dermis and paracrine effects on other skin layers. This condition comprises acute and chronic cellular processes characterized by rough wrinkling, decreased skin elasticity, pigmentation, xerosis, keratosis and telangiectasis (<xref rid="b15-BR-23-2-02009" ref-type="bibr">15</xref>).</p>
<p>The clinical manifestations of normal aging and photoaging often appear simultaneously; however, there are several differences (<xref rid="b12-BR-23-2-02009" ref-type="bibr">12</xref>). Normal aging is characterized by sagging skin and an excessive expression of frown lines. Aging skin has decreased hydration and elasticity, permeability and susceptibility to irritation owing to skin barrier damage (<xref rid="b16-BR-23-2-02009" ref-type="bibr">16</xref>). The manifestations of photoaging include deep wrinkles, rough skin texture, dyspigmentation and skin elasticity disturbance (<xref rid="b17-BR-23-2-02009" ref-type="bibr">17</xref>). The distribution of photoaging is mostly limited to the face, neck and hands and rarely to the arms and lower legs. Of photoaging cases &#x007E;80&#x0025; are caused by chronic low-level UV exposure, although exposure to high levels of acute UV light can also cause skin burning, darkening and skin structure disorders (<xref rid="b18-BR-23-2-02009" ref-type="bibr">18</xref>). Microscopic examination showed an increase in the epidermal thickness, dystrophic elastin accumulation and irregular collagen in the dermal layer. Skin susceptibility to UV damage depends on the melanin content and Fitzpatrick skin types I, II and III are more susceptible to photoaging than skin types IV, V and VI (<xref rid="b19-BR-23-2-02009" ref-type="bibr">19</xref>).</p>
<p>There are three main causes of photoaging: i) Dysfunction of keratinocytes in the basal layer, which inhibits their ability to regenerate and repair the skin; ii) loss of the ability of fibroblasts to synthesize and produce collagen; iii) changes in intracellular homeostasis through certain paracrine mechanisms (<xref rid="b20-BR-23-2-02009" ref-type="bibr">20</xref>). These changes are related to UV exposure on the skin, which causes oxidative stress (<xref rid="b21-BR-23-2-02009" ref-type="bibr">21</xref>).</p>
<sec>
<title/>
<sec>
<title>Photoaging and UV exposure</title>
<p>Large amounts of UVB can reach the skin due to direct sunlight exposure during the day (<xref rid="b22-BR-23-2-02009" ref-type="bibr">22</xref>). UVA is rarely absorbed when passing through the atmosphere (<xref rid="b23-BR-23-2-02009" ref-type="bibr">23</xref>). High UVA radiation throughout the day causes greater UVA exposure on the skin than UVB exposure under normal conditions (<xref rid="b24-BR-23-2-02009" ref-type="bibr">24</xref>). UVB exposure can cause erythema, burning, skin damage and skin cancer, whereas intense UVA exposure can cause erythema and blood vessel damage (<xref rid="b25-BR-23-2-02009" ref-type="bibr">25</xref>). To produce this effect, UVA requires an amount 1,000 times greater than UVB. However, UVA can penetrate deeper than UVB, causing damage to collagen and elastic fibers in the dermal layer (<xref rid="b24-BR-23-2-02009" ref-type="bibr">24</xref>,<xref rid="b26-BR-23-2-02009" ref-type="bibr">26</xref>).</p>
<p>UV radiation as photons needs to be absorbed by chromophores, followed by various photochemical events to produce photoaging skin manifestations (<xref rid="b19-BR-23-2-02009" ref-type="bibr">19</xref>); this process involves fibroblasts, keratinocytes and neutrophils (<xref rid="b27-BR-23-2-02009" ref-type="bibr">27</xref>). Therefore, the skin is a notable part of the immune system and consists of numerous molecular mechanisms that protect the skin from UV radiation (<xref rid="b28-BR-23-2-02009" ref-type="bibr">28</xref>). The epidermal layer provides the first line of defense against hazardous external agents consisting of keratinocytes, antigen-presenting cells, Langerhans cells, T lymphocytes and melanocytes (<xref rid="b29-BR-23-2-02009" ref-type="bibr">29</xref>).</p>
<p>Keratinocytes have an immune function against UV by producing cytokines, hormones, chemokines, neuropeptides and antimicrobial peptides (<xref rid="b30-BR-23-2-02009" ref-type="bibr">30</xref>). Melanin is produced by melanocytes; it works by inhibiting and absorbing UV rays that enter the epidermis layer. As UV exposure increases, the melanin formation rate increases, causing the skin to appear darker and providing additional protection against further radiation injury (<xref rid="b22-BR-23-2-02009" ref-type="bibr">22</xref>). Furthermore, DNA damage caused by UV rays can be repaired by nucleotide repair and base excision mechanisms, apoptosis and cell cycle checkpoint system activation (<xref rid="b31-BR-23-2-02009" ref-type="bibr">31</xref>).</p>
</sec>
<sec>
<title>Photoaging and oxidative stress</title>
<p>Humans are constantly exposed to oxidants daily; oxidative stress occurs because of a disturbance in the oxidant-antioxidant balance (<xref rid="b32-BR-23-2-02009" ref-type="bibr">32</xref>,<xref rid="b33-BR-23-2-02009" ref-type="bibr">33</xref>). Excessive UV radiation can induce ROS production while downregulating peroxidase and glutathione reductase production, which depends on the amount of UV radiation absorbed (<xref rid="b34-BR-23-2-02009" ref-type="bibr">34</xref>). UV rays can not only directly damage the skin by destroying lipids, proteins and DNA cells but also indirectly through the increased oxidation of various substances, especially lipids and DNA (<xref rid="b24-BR-23-2-02009" ref-type="bibr">24</xref>).</p>
<p>The effects of UVB radiation in human keratinocyte cells are characterized by enhanced ROS production, release of nicotinamide adenine dinucleotide phosphate (NADPH) oxidase, cyclooxygenase (COX) and nuclear factor-&#x03BA;B (NF-&#x03BA;B) (<xref rid="b24-BR-23-2-02009" ref-type="bibr">24</xref>). The aging process of fibroblasts during photoaging owing to UVB exposure is associated with ROS accumulation, which escalates proteasomes inhabitation and autophagy initiation (<xref rid="b35-BR-23-2-02009" ref-type="bibr">35</xref>). Autophagy suppression is required to switch the cell pathway from senescence to the apoptotic process (<xref rid="b36-BR-23-2-02009" ref-type="bibr">36</xref>). Inactivation of the proteasome system in fibroblast cells is related to the generation of singlet oxygen, protein oxidation and transcriptional agents that regulate MMP-1 expression activation (<xref rid="b31-BR-23-2-02009" ref-type="bibr">31</xref>).</p>
</sec>
<sec>
<title>Molecular impact of ROS on photoaging</title>
<p>Human bodies produce ROS consisting of superoxide anion (O<sub>2</sub><sup>-</sup>), hydrogen peroxide (H<sub>2</sub>O<sub>2</sub>), hydroxyl radicals (OH), singlet oxygen (<sup>1</sup>O<sub>2</sub>), lipid peroxide and nitrogen oxide (<xref rid="b37-BR-23-2-02009" ref-type="bibr">37</xref>). O<sub>2</sub> molecules gain a single unpaired electron to establish O<sub>2</sub><sup>-</sup> and thus become the early stage of ROS in cells (<xref rid="b38-BR-23-2-02009" ref-type="bibr">38</xref>). O<sub>2</sub><sup>-</sup> molecules will form H<sub>2</sub>O<sub>2</sub> through antioxidant enzyme catalysis (<xref rid="b39-BR-23-2-02009" ref-type="bibr">39</xref>). O<sub>2</sub><sup>-</sup> can release iron ions under stress conditions from the iron-sulfur of proteins, participating in the Fenton reaction and converting H<sub>2</sub>O<sub>2</sub> to OH (<xref rid="b40-BR-23-2-02009" ref-type="bibr">40</xref>). Hydroxyl radicals are easily reacted with other molecules with a half-life of 10<sup>-9</sup> sec (<xref rid="b41-BR-23-2-02009" ref-type="bibr">41</xref>).</p>
<p>Normal skin aging and photoaging both involve similar signaling pathways, although they are induced differently (<xref rid="b42-BR-23-2-02009" ref-type="bibr">42</xref>,<xref rid="b43-BR-23-2-02009" ref-type="bibr">43</xref>). In photoaging, ROS can increase MMP synthesis by stimulating mitogen-activated protein kinase (MAPK) and protein-1 (AP-1) heterodimers (<xref rid="b44-BR-23-2-02009" ref-type="bibr">44</xref>). MMP-1 is capable of breaking down the integrated fibrillar collagen, whereas MMP-2, MMP-3 and MMP-9 break down the fragments and degraded forms (<xref rid="b44-BR-23-2-02009 b45-BR-23-2-02009 b46-BR-23-2-02009" ref-type="bibr">44-46</xref>). ROS and activated MAPK signaling pathways stimulate NF-&#x03BA;B and induce the expression of several proinflammatory cytokines (<xref rid="b46-BR-23-2-02009" ref-type="bibr">46</xref>,<xref rid="b47-BR-23-2-02009" ref-type="bibr">47</xref>). NF-&#x03BA;B organizes the expression of hemeoxygenase-1 and increases free iron levels in cells, thereby encouraging ROS execution through the Fenton reaction (<xref rid="b48-BR-23-2-02009" ref-type="bibr">48</xref>,<xref rid="b49-BR-23-2-02009" ref-type="bibr">49</xref>). NF-&#x03BA;B also excites MMP-8 to accelerate collagen breakdown; at the same time, AP-1 downregulates the expression of transforming growth factor-&#x03B2; (TGF-&#x03B2;) receptor type II, which disrupts the downstream Smad/TGF-&#x03B2; signal pathway, thereby reducing the transcription of the COL1A1 and COL3A1 genes encoding type I and type III collagen (<xref rid="b41-BR-23-2-02009" ref-type="bibr">41</xref>,<xref rid="b50-BR-23-2-02009 b51-BR-23-2-02009 b52-BR-23-2-02009" ref-type="bibr">50-52</xref>). Photoaging is caused not only by increased degradation of collagen by various MMPs, serine and other proteases but also by decreased collagen production by fibroblasts (<xref rid="b1-BR-23-2-02009" ref-type="bibr">1</xref>).</p>
</sec>
<sec>
<title>Photoaging and MMP activities</title>
<p>The main function of MMPs is to degrade the ECM, glycoproteins, cytokines, receptors and growth factors (<xref rid="b52-BR-23-2-02009" ref-type="bibr">52</xref>). Impaired regulation of MMP activity causes various pathologies and is divided into the following: i) Tissue damage; ii) fibrosis; and iii) matrix weakness (<xref rid="b53-BR-23-2-02009" ref-type="bibr">53</xref>). UV exposure can increase MMPs levels, which are responsible for ECM damage, including collagen, elastin, fibronectin and proteoglycans (<xref rid="b54-BR-23-2-02009" ref-type="bibr">54</xref>). This exaggerated degradation can cause clinical signs of photoaging, resulting in deep wrinkles and sagging skin through photodestruction, phototransformation and photo-oxidation of collagen and elastin fiber processes (<xref rid="b31-BR-23-2-02009" ref-type="bibr">31</xref>).</p>
<p>DNA damage following UVB exposure induces MMP-1 production by increasing MMP-1 gene expression in keratinocytes (<xref rid="b31-BR-23-2-02009" ref-type="bibr">31</xref>,<xref rid="b54-BR-23-2-02009" ref-type="bibr">54</xref>,<xref rid="b55-BR-23-2-02009" ref-type="bibr">55</xref>). Protein expression changes have a substantial role in photoaging, including the transformation of TGF-&#x03B2;, MMP-1, MMP-3 and MMP-9(<xref rid="b56-BR-23-2-02009" ref-type="bibr">56</xref>). ROS stimulates the MAPK signal pathway, which is responsible for AP-1 formation (<xref rid="b57-BR-23-2-02009" ref-type="bibr">57</xref>). AP-1 plays a crucial role in the transcription regulation of MMP-1, MMP-3 and MMP-9, which progressively damage collagen (<xref rid="b58-BR-23-2-02009" ref-type="bibr">58</xref>). In addition, AP-1 can inhibit TGF-&#x03B2;, which regulates type I procollagen production and subsequently results in decreased collagen synthesis (<xref rid="b59-BR-23-2-02009" ref-type="bibr">59</xref>). Another notable transcription factor involved in the UV response is NF-&#x03BA;B (<xref rid="b60-BR-23-2-02009" ref-type="bibr">60</xref>). It can regulate the production of MMPs, such as MMP-1 and MMP-3, by fibroblasts (<xref rid="b31-BR-23-2-02009" ref-type="bibr">31</xref>).</p>
</sec>
<sec>
<title>Photoaging and collagen levels</title>
<p>Collagen is a structural protein responsible for maintaining skin elasticity (<xref rid="b61-BR-23-2-02009" ref-type="bibr">61</xref>). Collagen produced by fibroblasts varies according to the amino acid primer sequence of the polypeptide chain (<xref rid="b62-BR-23-2-02009" ref-type="bibr">62</xref>). Type I collagen is found in 90&#x0025; of the human body (<xref rid="b63-BR-23-2-02009" ref-type="bibr">63</xref>); it is notably discovered in bones, tendons, ligaments, corneas and various interstitial connective tissues (<xref rid="b64-BR-23-2-02009" ref-type="bibr">64</xref>).</p>
<p>Type I collagen production is regulated by two genes, COL1A1 and COL1A2, which structurally consist of &#x03B1;-1 chain and &#x03B1;-2 chain (<xref rid="b62-BR-23-2-02009" ref-type="bibr">62</xref>). The COL1A1 gene is located in chromosome 17q21.33(<xref rid="b65-BR-23-2-02009" ref-type="bibr">65</xref>); its synthesis and maturation are arranged at various levels: Epigenetic and transcriptional, posttranscriptional and posttranslational (<xref rid="b66-BR-23-2-02009" ref-type="bibr">66</xref>). In photoaged skin, COL1A1 mRNA expression levels are reduced, whereas MMP-1 mRNA expression levels are increased in association with collagen metabolism (<xref rid="b67-BR-23-2-02009" ref-type="bibr">67</xref>).</p>
<p>Collagen fibers are thicker and coarser in the inner dermal layer than in the outer layer, with thinner and more tenuous collagen fibers (<xref rid="b68-BR-23-2-02009" ref-type="bibr">68</xref>). Collagen fibers in younger skin are intact, dehydrated, elastic and damage-resistant (<xref rid="b69-BR-23-2-02009" ref-type="bibr">69</xref>). Collagen levels in aging skin begin to decrease, fade, stretch and lose their elasticity (<xref rid="b70-BR-23-2-02009" ref-type="bibr">70</xref>). The destruction of collagen and damage of other structural components, including elastic and reticular fibers, underlie the characteristic changes in aging skin and photoaging (<xref rid="b64-BR-23-2-02009" ref-type="bibr">64</xref>). Significant reductions in the amount and collagen structure can weaken the flexibility of the dermal layer, causing wrinkles and xerosis (<xref rid="b71-BR-23-2-02009" ref-type="bibr">71</xref>).</p>
<p>UV radiation exposure indirectly initiates MMP activation without upregulating collagen production, causing decreased collagen levels and ECM fragmentation (<xref rid="b72-BR-23-2-02009" ref-type="bibr">72</xref>). MMP activation is influenced by photochemical reactions that change the UV energy absorbed by cellular macromolecules into ROS (<xref rid="b73-BR-23-2-02009" ref-type="bibr">73</xref>). Over time, ROS levels exceed antioxidant defense, which promotes increased collagen-degrading MMP production. ROS inhibits the activation of protein tyrosine phosphatase, causing receptor tyrosine kinase phosphorylation and activating the MAPK signaling pathway that forms AP-1(<xref rid="b74-BR-23-2-02009" ref-type="bibr">74</xref>). AP-1 is important for upregulating the transcription of MMP-1, MMP-3 and MMP-9, where excessive MMP expression can cause increased dermal ECM fragmentation (<xref rid="b56-BR-23-2-02009" ref-type="bibr">56</xref>,<xref rid="b58-BR-23-2-02009" ref-type="bibr">58</xref>).</p>
<p>Apart from collagen degradation owing to excessive MMP expression, ROS also triggers a decrease in collagen production by inhibiting the TGF-&#x03B2; signal pathway (<xref rid="b75-BR-23-2-02009" ref-type="bibr">75</xref>). ROS-induced AP-1 prevents the TGF-&#x03B2;/Smad signal pathway in fibroblasts that control collagen synthesis to prevent a decrease in collagen production (<xref rid="b76-BR-23-2-02009" ref-type="bibr">76</xref>). TGF-&#x03B2; interacts with cell surface receptors and triggers the Smad2/3 transcription factor. The phosphorylated Smad2/3 then associates with, and moves to, Smad4, thereby triggering the transcription of TGF-responsive genes (<xref rid="b71-BR-23-2-02009" ref-type="bibr">71</xref>); this leads to decreased phosphorylation and production of the Smad 2/3 transcription factor required for type I procollagen transcription (<xref rid="b75-BR-23-2-02009" ref-type="bibr">75</xref>).</p>
</sec>
</sec>
</sec>
<sec>
<title>3. <italic>N. sativa</italic> seed (black cumin)</title>
<p><italic>N. sativa</italic> is a member of the <italic>Ranunculaceae</italic> family and is known as Black Seed or Black Cumin (<xref rid="b77-BR-23-2-02009" ref-type="bibr">77</xref>). <italic>N. sativa</italic> seeds originate from Africa and Southwest Asia (<xref rid="b78-BR-23-2-02009" ref-type="bibr">78</xref>). High-quality seeds come from Egypt, where a suitable environment exists for this plant (<xref rid="b77-BR-23-2-02009" ref-type="bibr">77</xref>). <italic>N. sativa</italic> is an annual herbal plant, 20-30 cm tall, with linear leaves, 5-10 pale bluish-white flower petals and tiny black seeds similar to cumin; therefore, it is called black cumin (<xref rid="b79-BR-23-2-02009" ref-type="bibr">79</xref>). This plant has green branching stems and green leaves that turn red as they grow (<xref rid="b80-BR-23-2-02009" ref-type="bibr">80</xref>); it starts flowering between April and August and its fruit consists of 3-6 carpels, each of which contains seeds (<xref rid="b81-BR-23-2-02009" ref-type="bibr">81</xref>). The seeds are oval and 2-3.5 mm in size, composed of three to four fine-grained corners; the color turns black after being cooked and exposed to air (<xref rid="b77-BR-23-2-02009" ref-type="bibr">77</xref>,<xref rid="b79-BR-23-2-02009" ref-type="bibr">79</xref>).</p>
<p>The nutritional value of <italic>N. sativa</italic> seeds includes protein, fat, fiber and total carbohydrates (<xref rid="b82-BR-23-2-02009" ref-type="bibr">82</xref>). <italic>N. sativa</italic> seeds also contain significant amounts of iron, copper and zinc (<xref rid="b83-BR-23-2-02009" ref-type="bibr">83</xref>). <italic>N. sativa</italic> has phytoconstituents such as alkaloids, sterols, saponins and essential oils (<xref rid="b84-BR-23-2-02009" ref-type="bibr">84</xref>). Their seeds comprise primary fatty acids, linoleic acid, palmitic acid and phenolics and quinones (TQ, thymol, dithymoquinone and thymohydroquinone) (<xref rid="b85-BR-23-2-02009" ref-type="bibr">85</xref>,<xref rid="b86-BR-23-2-02009" ref-type="bibr">86</xref>). TQ (C<sub>10</sub>H<sub>12</sub>O<sub>2</sub>) has a basic quinone structure with methyl and isopropyl side chain groups added at 2 and 5 positions (<xref rid="b87-BR-23-2-02009" ref-type="bibr">87</xref>). TQ has COX and 5-lipooxygenase activities, which can inhibit eicosanoid formation during inflammatory phases and lipid membrane peroxidation (<xref rid="b88-BR-23-2-02009" ref-type="bibr">88</xref>).</p>
<p>Quercetin and kaempferol are the main flavonoid glycosides in <italic>N. sativa</italic> (<xref rid="b86-BR-23-2-02009" ref-type="bibr">86</xref>). <italic>N. sativa</italic> also contains phenolic and triterpene compounds such as saponins (<xref rid="b89-BR-23-2-02009" ref-type="bibr">89</xref>). Saponin is a group of glycosides comprising one or more hydrophilic groups combined with lipophilic triterpenes or steroid derivatives. Triterpene saponins are typical compounds found in <italic>N. sativa</italic> seeds (<xref rid="b85-BR-23-2-02009" ref-type="bibr">85</xref>).</p>
<p><italic>N. sativa</italic> extract has been accepted and recognized as safe by the Food and Drug Association in the United States (<xref rid="b90-BR-23-2-02009" ref-type="bibr">90</xref>). <italic>N. sativa</italic> is available in dietary supplements, oils, topical creams and powders (<xref rid="b91-BR-23-2-02009" ref-type="bibr">91</xref>). The acceptable and effective dose is equivalent to 1-3 g of <italic>N. sativa</italic> extract powder once daily, 40 mg/Kgbw of <italic>N. sativa</italic> extract once daily, or 1 ml of <italic>N. sativa</italic> extract cream three times daily, based on clinical trial data on humans (<xref rid="b92-BR-23-2-02009" ref-type="bibr">92</xref>). However, there is considerable variability in doses and extract preparation, including oil-based formulations, methanol extracts and advanced nanoformulations, which might affect bioavailability and clinical efficacy.</p>
<p>The <italic>in vivo</italic> TQ pharmacokinetic dose study showed a maximum concentration (Tmax) of 3.96&#x00B1;0.19 h reaching 4811.33&#x00B1;55.52 ng/ml as the maximum blood concentration (Cmax), while the elimination half-life (T1/2) was 4.4933&#x00B1;0.015 h. This indicates the suitability of TQ for extravascular administration through nanoparticle formulation, which has been shown to increase bioavailability (<xref rid="b93-BR-23-2-02009" ref-type="bibr">93</xref>). The seed extract and its constituents appear to have low levels of toxicity (<xref rid="b94-BR-23-2-02009" ref-type="bibr">94</xref>). The lethal dose 50 (LD50) of TQ is 2.4 g/kg bw in Swiss albino mice (<xref rid="b95-BR-23-2-02009" ref-type="bibr">95</xref>). Giving 6.4 g/kg bw of <italic>N. sativa</italic> extract orally every day for 6 weeks to mice caused the death of one mouse following 2 weeks of therapy, while the second and third mice died in the third and fifth weeks after being given 21 and 60 g/kg bw of <italic>N. sativa</italic> extract, respectively (<xref rid="b83-BR-23-2-02009" ref-type="bibr">83</xref>). Toxicity in mice after using fixed oil content from <italic>N. sativa</italic> extract administered intraperitoneally and intraorally showed that the LD50 was found to be 89.7-119. 7 mg/Kgbw and 647.1-1,094.8 mg/Kgbw, respectively (<xref rid="b96-BR-23-2-02009" ref-type="bibr">96</xref>). Additional studies are needed to confirm the refined dosage recommendations and evaluate <italic>N. sativa</italic>&#x0027;s long-term safety in other animals and also in clinical studies.</p>
<p>In recent decades, a number of extraction methods, such as cold pressing, supercritical fluid extraction, Soxhlet extraction, hydro distillation method, microwave-assisted extraction, ultrasonic-assisted extraction, steam distillation and accelerated solvent extraction, have been used to extract oil from black seeds under optimal conditions (<xref rid="b97-BR-23-2-02009" ref-type="bibr">97</xref>). The cold pressing method using hexane as a solvent does not involve heating or chemical treatment during oil extraction but gives low yields, whereas the Soxhlet extraction method using methanol as a solvent has low costs; however, solvent residues remain in the extracted oil. Thymoquinone in black cumin oil is encapsulated to enhance its oxidative stability. Microencapsulation was achieved through emulsification, spray drying and nanoprecipitation. These processes are more time consuming and involve hot gas flow; therefore, they are not suitable for heat-sensitive bioactives. For sensitive compounds, alternative techniques are required to overcome the drawbacks of conventional encapsulation methods. A recently developed encapsulation technology is electrospray; this process is cost-effective and simple for producing a wide range of nanoparticles. No heat is required during drying and the formation of smaller encapsulations of 1-5 &#x00B5;m is increasingly important for the encapsulation of temperature-sensitive bioactives (<xref rid="b97-BR-23-2-02009" ref-type="bibr">97</xref>). Continued investigation is required to assess the formulation-dependent differences in bioavailability to ensure consistent therapeutic outcomes, optimal absorption and effective systemic distribution.</p>
<p>No severe side effects have been reported after using the <italic>N. sativa</italic> extract, either orally or topically. Three women were reported to have acute allergic contact dermatitis after using the topical pure oil of <italic>N. sativa</italic> extract (<xref rid="b90-BR-23-2-02009" ref-type="bibr">90</xref>). Other studies have reported the side effects of gastrointestinal disorders, gastric irritation and stomach cramps (<xref rid="b98-BR-23-2-02009" ref-type="bibr">98</xref>). Gastrointestinal disturbances occurred in 9 of 49 children who orally consumed <italic>N. sativa</italic> extract at a dose of 80 mg/kg twice daily on an empty stomach (<xref rid="b99-BR-23-2-02009" ref-type="bibr">99</xref>). Further clinical research under controlled conditions is necessary to comprehensively examine the safety profile of <italic>N. sativa</italic> in dermatological applications.</p>
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<title>4. <italic>N. sativa</italic> seed (black cumin) mechanism against photoaging</title>
<p><italic>N. sativa</italic> mechanism is mainly because of its active ingredients, especially TQ (<xref rid="b91-BR-23-2-02009" ref-type="bibr">91</xref>,<xref rid="b100-BR-23-2-02009" ref-type="bibr">100</xref>). TQ has a quinone molecular structure for redox activity and the infinite capability to cover all physiological barriers so that it has easy access to subcellular compartments, which affects radical scavenging (<xref rid="b101-BR-23-2-02009" ref-type="bibr">101</xref>). TQ is known to have anti-inflammatory and antioxidant effects that can protect cells from free radicals. In addition, TQ stimulates the proliferation and migration of cells involved in tissue repair, encouraging the formation of new tissue (<xref rid="b102-BR-23-2-02009" ref-type="bibr">102</xref>). TQ reduces NF-&#x03BA;B transcription factor activity so that MMP-1 expression can be suppressed (<xref rid="b103-BR-23-2-02009" ref-type="bibr">103</xref>). Decreased expression of MMP-1 can further reduce collagen degradation. TQ also acts directly on type I collagen synthesis by preserving the physiological state of the interstitial system (<xref rid="b104-BR-23-2-02009" ref-type="bibr">104</xref>). Currently, there is no recommended dose of TQ for its role in preventing photoaging. Research by Ghorbanibirgani <italic>et al</italic> (<xref rid="b105-BR-23-2-02009" ref-type="bibr">105</xref>) using a topical extract of <italic>N. sativa</italic> twice a day for 6 months in vitiligo cases found significant improvement in patient scores. Unfortunately, this study did not clearly state the manufacture of the topical cream and its concentration. Research by Yousefi <italic>et al</italic> (<xref rid="b106-BR-23-2-02009" ref-type="bibr">106</xref>) using a topical extract of <italic>N. sativa</italic> at a dose of 2&#x0025; twice a day for 4 weeks in hand eczema cases showed equally effective results as the use of topical betamethasone. The two studies mentioned the anti-inflammatory and antioxidant effects of <italic>N. sativa</italic> and TQ as their working mechanisms.</p>
<p>Flavonoids, especially quercetin and kaempferol, play a role as strong antioxidants by interrupting free radical chain reactions and protecting against UV radiation (<xref rid="b107-BR-23-2-02009" ref-type="bibr">107</xref>). Several studies have reported that quercetin has a photoaging defense mechanism by inhibiting MMP-1 in a dose-dependent manner (<xref rid="b108-BR-23-2-02009 b109-BR-23-2-02009 b110-BR-23-2-02009 b111-BR-23-2-02009" ref-type="bibr">108-111</xref>). Quercetin shows strong antioxidant activity through <italic>in vitro</italic> chemical tests, showing an increase in quercetin activity following efficient formulation at the cellular level, as quercetin shows cell-protective action on keratinocytes and <italic>in vivo</italic> on animal skin. This antioxidant effect is also supported by the ability of quercetin to exert anti-inflammatory actions, such as the inhibition of NF-&#x03BA;B and IL-6 induction by UV irradiation. The combination of antioxidant and anti-inflammatory actions and their cross-linking mechanism highlight quercetin as a novel sunscreen. Furthermore, as quercetin has antioxidant and anti-inflammatory activities, it could be beneficial for wound healing; here, fibroblasts are the main target in contrast to keratinocytes in sunscreens. Furthermore, quercetin has a promising rejuvenating effect on keratinocytes with a supportive whitening effect (<xref rid="b112-BR-23-2-02009" ref-type="bibr">112</xref>). Kaempferol protects against UVB-induced photoaging by preventing p38 MAPK and c-Jun N-terminal kinase activation (<xref rid="b113-BR-23-2-02009" ref-type="bibr">113</xref>). These agents prevent the action and amount of MMP-1 and increase collagen levels in the dermal layer. Flavonoids can also stimulate macrophage activity, trigger the epithelialization process and escalate ECM production, growth factors, cytokines and angiogenesis by releasing keratinocyte growth factor (<xref rid="b10-BR-23-2-02009" ref-type="bibr">10</xref>).</p>
<p>Saponin is a type of glycoside from pentacyclic triterpenoids that has pharmaceutical, nutritional and cosmetic potentials with anti-inflammatory and antioxidant properties. Thus, it has the potential to protect against the detrimental effects of photoaging (<xref rid="b114-BR-23-2-02009" ref-type="bibr">114</xref>). Saponin modulates the inflammatory response, protects against ECM degradation, enhances collagen production and improves wrinkle appearance by preventing UVB-induced MAPK signaling, AP-1 and NF-&#x03BA;B activation (<xref rid="b111-BR-23-2-02009" ref-type="bibr">111</xref>,<xref rid="b115-BR-23-2-02009" ref-type="bibr">115</xref>).</p>
<p>Linoleic acid comprises &#x003E;50&#x0025; of the total fatty acids and can preserve water permeability and skin integrity (<xref rid="b116-BR-23-2-02009" ref-type="bibr">116</xref>,<xref rid="b117-BR-23-2-02009" ref-type="bibr">117</xref>). Linoleic acid, which is known for its percutaneous absorption, can increase drug absorption, whereas the oil emulsion of the substance can reduce skin irritation and improve the skin&#x0027;s moisturizing function (<xref rid="b118-BR-23-2-02009" ref-type="bibr">118</xref>). Topical application rich in linoleic and oleic acids can suppress transepidermal water loss changes, increase skin hydration, reduce skin erythema and protect against histological changes caused by UVR exposure (<xref rid="b119-BR-23-2-02009" ref-type="bibr">119</xref>).</p>
<p><italic>N. sativa</italic> seeds contain various elements, such as Cu, Zn and Fe (<xref rid="b100-BR-23-2-02009" ref-type="bibr">100</xref>). Cu is a common cofactor for a number of enzymes and in the skin acts by provoking fibroblast proliferation, increasing collagen (types I, II and V) synthesis and acting as a cofactor for superoxide dismutase (SOD) to interfere with cellular oxidative effects (<xref rid="b100-BR-23-2-02009" ref-type="bibr">100</xref>,<xref rid="b120-BR-23-2-02009" ref-type="bibr">120</xref>). Zn also inhibits the accumulation of oxidative stress markers and proinflammatory cytokines. Zn ties up to the sulfhydryl groups of oxidation-protecting biomolecules and increases the activation of glutathione (GSH), catalase and SOD and decreases the activity of enzymes that increase oxidant levels, such as inducible nitric acid synthase (iNOS) and NADPH oxidase and slows the formation of peroxidation products, lipids (<xref rid="b121-BR-23-2-02009" ref-type="bibr">121</xref>). Iron plays a role in oxygen transport and oxidation-reduction reactions as well as in various oxygenases, including procollagen-proline dioxygenase, which is associated with the skin (<xref rid="b122-BR-23-2-02009" ref-type="bibr">122</xref>). <xref rid="tI-BR-23-2-02009" ref-type="table">Table I</xref> lists the active ingredients of <italic>N. sativa</italic> seeds and their mechanism against photoaging.</p>
<p>Sunlight contains UVA and UVB, which reach the skin surface, triggering oxidative reactions that result in ROS (<xref rid="b13-BR-23-2-02009" ref-type="bibr">13</xref>). Excessive ROS accumulation in the skin activates the MAPK signaling pathway and the NF-&#x03BA;B pathway (<xref rid="b123-BR-23-2-02009" ref-type="bibr">123</xref>). The activated MAPK pathway triggers AP-1 production. ROS-induced AP-1 inhibits the TGF-&#x03B2;/Smad signaling pathway in dermal fibroblasts, which controls collagen synthesis to prevent a decrease in collagen production. TGF-&#x03B2; interacts with cell surface receptors and triggers the transcription factor Smad2/3. The phosphorylated Smad2/3 then connects and moves to Smad4, thereby triggering the transcription of genes responsive to TGF-&#x00DF;. This causes a decrease in the phosphorylation and activation of the transcription factor Smad 2/3, which is required for the transcription of type I procollagen, a precursor of type I collagen, namely the COL3A1 and COL1A1 genes (<xref rid="b1-BR-23-2-02009" ref-type="bibr">1</xref>,<xref rid="b55-BR-23-2-02009" ref-type="bibr">55</xref>,<xref rid="b57-BR-23-2-02009" ref-type="bibr">57</xref>).</p>
<p>ROS and activated MAPK signaling pathways can also activate NF-&#x03BA;B; this activation can increase the expression of proinflammatory cytokines such as IL-1&#x03B2;, IL-6, TNF-&#x03B1; and COX-2 to regulate the inflammatory response and unbalance the MMPs/tissue inhibitors of metalloproteinases (TIMPs) ratio by activating MMPs and reducing TIMPs expression, thereby decompressing the ECM (<xref rid="b6-BR-23-2-02009" ref-type="bibr">6</xref>,<xref rid="b31-BR-23-2-02009" ref-type="bibr">31</xref>,<xref rid="b41-BR-23-2-02009" ref-type="bibr">41</xref>). NF-&#x03BA;B also increases the formation of the MMP1 enzyme to accelerate collagen degradation, especially type 1 collagen (<xref rid="b31-BR-23-2-02009" ref-type="bibr">31</xref>).</p>
<p><italic>N. sativa</italic> contains an active ingredient, TQ, which is a potent antioxidant (<xref rid="b6-BR-23-2-02009" ref-type="bibr">6</xref>,<xref rid="b9-BR-23-2-02009" ref-type="bibr">9</xref>,<xref rid="b10-BR-23-2-02009" ref-type="bibr">10</xref>). The active substance TQ has a therapeutic effect by reducing oxidative stress and inflammatory responses, thereby preventing the activation of the MAPK and NF-&#x03BA;B pathways. Kaymak <italic>et al</italic> (<xref rid="b124-BR-23-2-02009" ref-type="bibr">124</xref>) reported that intraperitoneal administration of TQ 10 mg/kg bw in rats for 10 days showed a significant decrease in various inflammatory mediator levels, such as P38 MAPK and NF-kb, in the testes of rats induced by methotrexate. Activating NF-&#x03BA;B is directly associated with an increase in MMP-1(<xref rid="b125-BR-23-2-02009" ref-type="bibr">125</xref>). Chen <italic>et al</italic> (<xref rid="b103-BR-23-2-02009" ref-type="bibr">103</xref>) investigated the effect of TQ on MMP expression in an animal model of osteoarthritis. Accordingly, the downregulation of MMP-1, MMP-3 and MMP-13 expressions and the upregulation of TIMP-1 expression were reported due to the use of TQ in chondrocytes and cartilage in the animal model. The authors also showed that TQ could inhibit the NF-&#x03BA;B p65 protein level. MMP-1 can degrade fibrillar collagen in its three-helical domain, which causes the molecules to be thermally unstable so that they break down to form gelatin, which can then be degraded by other members of the MMP family (<xref rid="b126-BR-23-2-02009" ref-type="bibr">126</xref>).</p>
<p>Several photoaging therapies are often used with different working mechanisms. Topical retinoids during photoaging are mediated by their interaction with specific cellular and nucleic acid receptors. They improve photoaging by modifying cellular differentiation programs by increasing epidermal proliferation and thickening, compacting the stratum corneum and improving the deposition of glycosaminoglycans in the stratum corneum and intercellular spaces of the epidermis (<xref rid="b127-BR-23-2-02009" ref-type="bibr">127</xref>). Vitamin C is a naturally occurring antioxidant that has been shown to be effective for preventing and treating sun-damaged skin; it not only has an antioxidant, anti-inflammatory and photoprotective effect against UVA and UVB but also enhances collagen synthesis (<xref rid="b128-BR-23-2-02009" ref-type="bibr">128</xref>). The major adverse effects of topical retinoids and topical vitamin C are local skin irritation, including erythema, peeling, dryness, burning and itching, which depend on the concentration and formulation of the product (<xref rid="b129-BR-23-2-02009" ref-type="bibr">129</xref>,<xref rid="b130-BR-23-2-02009" ref-type="bibr">130</xref>). In addition, the use of retinoid agents is not recommended in pregnant women and topical vitamin C preparations are occasionally unstable, limiting their clinical use.</p>
<p>The summarized mechanism of <italic>N. sativa</italic> seed extract therapy in combating photoaging is shown in <xref rid="f1-BR-23-2-02009" ref-type="fig">Fig. 1</xref>. <italic>N. sativa</italic> plays a protective role in inhibiting photoaging manifestations by modulating oxidative stress and inflammatory pathways. UV exposure induces the production of ROS, which subsequently activate the NF-&#x03BA;B and MAPK signaling pathways, leading to increased transcription of pro-inflammatory cytokines (IL-1&#x03B2;, TNF-&#x03B1;, IL-6 and COX-2) and MMP-1, both of which contribute to inflammation and collagen degradation. However, <italic>N. sativa</italic> inhibits ROS generation, thereby downregulating NF-&#x03BA;B and AP-1 activity. These result in reduced inflammatory cytokine expression and decreased MMP-1 levels, preserving collagen density. Additionally, <italic>N. sativa</italic> enhances TIMPs and TGF-&#x03B2; receptor Smad signaling, which promotes the expression of collagen-related genes (COL1A1 and COL3A1). Collectively, these actions reduce inflammation, prevent collagen breakdown and promote skin integrity, ultimately inhibiting the visible manifestations of photoaging.</p>
<p>While multiple studies highlight the anti-photoaging effects of <italic>N. sativa</italic>, inconsistencies exist in its reported efficacy. Some studies emphasize strong antioxidant and anti-inflammatory benefits, while others suggest limited or unclear results (<xref rid="b2-BR-23-2-02009" ref-type="bibr">2</xref>,<xref rid="b10-BR-23-2-02009" ref-type="bibr">10</xref>,<xref rid="b131-BR-23-2-02009 b132-BR-23-2-02009 b133-BR-23-2-02009 b134-BR-23-2-02009" ref-type="bibr">131-134</xref>). The concentration of TQ in different extracts varies widely, which may contribute to the heterogeneity in study outcomes. Furthermore, variations in study design, including animal models compared with human clinical trials, need further standardization to ensure comparability.</p>
<p>Despite promising preliminary findings, several research gaps remain. The optimal dosage of TQ for anti-photoaging effects has not been established and most studies lack standardized extraction methods. Future research should focus on well-controlled, long-term clinical trials to assess both efficacy and safety. Additionally, the interaction of <italic>N. sativa</italic> with other dermatological treatments (such as retinoids, vitamin C, or chemical peels) warrants further investigation to determine possible synergistic or antagonistic effects. A number of studies on <italic>N. sativa</italic> and photoaging have been conducted with small sample sizes, often in preclinical settings, making it difficult to generalize findings. Additionally, industry-funded research may introduce bias in reporting only positive results and there is a lack of large-scale, double-blind, placebo-controlled clinical trials. This raises concerns about publication bias, which may interfere the perceived efficacy of <italic>N. sativa</italic> in photoaging treatment.</p>
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<title>5. <italic>N. sativa</italic> seed (black cumin) potential role against photoaging</title>
<p>The use of <italic>N. sativa</italic>, both orally and topically, has been widely studied and its use has been shown to have a potential role against photoaging. The potential antioxidant and anti-inflammatory effects are possibly caused by the active composition of <italic>N. sativa</italic>, TQ (<xref rid="b6-BR-23-2-02009" ref-type="bibr">6</xref>). There are two <italic>in vitro</italic> studies regarding antiaging and photoaging effects of TQ. Li <italic>et al</italic> (<xref rid="b2-BR-23-2-02009" ref-type="bibr">2</xref>) analyzed Thymocid<sup>&#x00AE;</sup>, a standardized TQ extract, which can inhibit the formation of advanced glycation end products, collagen cross-linking, collagenase and elastase activities <italic>in vitro</italic>. Thymocid<sup>&#x00AE;</sup> has potential as an antiaging property by maintaining its protein structure against glycation (<xref rid="b135-BR-23-2-02009" ref-type="bibr">135</xref>). In addition, Thymocid<sup>&#x00AE;</sup> can also protect the type I collagen structure from glycation-induced cross-linking; there is a possibility that its antiglycation effect may be because of the antioxidant effect of Thymocid<sup>&#x00AE;</sup> (<xref rid="b136-BR-23-2-02009" ref-type="bibr">136</xref>). Unfortunately, this study states that other phytochemical compounds besides TQ in Thymocid<sup>&#x00AE;</sup> are present, such as alipathic compounds, so there could be a bias that the effect is caused purely by the TQ compound, not the other compounds. In addition, further research on the effects of Thymocid<sup>&#x00AE;</sup> on elastase in human dermal fibroblast cells is needed to confirm its antiwrinkle effects.</p>
<p>Liang <italic>et al</italic> (<xref rid="b10-BR-23-2-02009" ref-type="bibr">10</xref>) then conducted research on TQ for its photoprotective action on human skin keratinocytes irradiated with UVA, finding that the use of pure TQ extract at doses of 6 and 12 &#x00B5;M could improve inflammation, oxidative stress, cytotoxicity and mitochondrial dysregulation caused by UVA radiation. From this research, it was concluded that TQ mechanism for skin damage caused by UVA radiation inhibits COX-2 expression by activating the NrF2/ARE pathway (<xref rid="b10-BR-23-2-02009" ref-type="bibr">10</xref>). The NrF2/ARE pathway is an important signaling pathway that reduces skin damage caused by UVB radiation (<xref rid="b137-BR-23-2-02009" ref-type="bibr">137</xref>). In addition, COX-2 is the main trigger of oxidative and inflammatory responses that are often detected in photoaging and other stress/inflammatory disorders (<xref rid="b138-BR-23-2-02009" ref-type="bibr">138</xref>). Nevertheless, this study suggested that high doses of TQ (&#x003E;16 &#x00B5;M) may exhibit cytotoxicity to keratinocytes and the most effective protective concentration of TQ should be explored in further studies.</p>
<p>Pandey <italic>et al</italic> (<xref rid="b131-BR-23-2-02009" ref-type="bibr">131</xref>) investigated the methanol extract of <italic>N. sativa</italic> given orally at a dose of 200 mg/100 g bw/day in mice to determine its protective effect against radiation exposure. Oxidative stress caused by free radicals following ionizing radiation can damage normal cells; therefore, protecting normal tissue against radiation injury is important (<xref rid="b139-BR-23-2-02009" ref-type="bibr">139</xref>). This study showed that <italic>N. sativa</italic> can prevent radiation-induced increases in lipid peroxide levels in intestinal tissue homogenates. In addition, histological examination showed the prevention of villous loss, shortening of villous height and collagen deposition owing to radiation exposure (<xref rid="b131-BR-23-2-02009" ref-type="bibr">131</xref>). In this study, it was found that the use of <italic>N. sativa</italic> extract markedly increased the antioxidant properties of the irradiated rats compared with the control group. This study also stated that repeated oral administration of <italic>N. sativa</italic> extract for 14 days resulted in a survival rate of 100&#x0025; up to 200 mg/100 g bw, so that this dose was considered the optimum dose. The antiaging effect of the oral administration of <italic>N. sativa</italic> extract was also supported by Khalaf and Mostafa (<xref rid="b140-BR-23-2-02009" ref-type="bibr">140</xref>), who administered <italic>N. sativa</italic> at a dose of 10 ml/kg bw/day to adult male rats exposed to cigarette smoke. Photoaging and tobacco smoke-induced aging are similar and include the adverse effects of oxidative stress (<xref rid="b141-BR-23-2-02009" ref-type="bibr">141</xref>). This study also found that <italic>N. sativa</italic> oil can prevent smoking-induced skin changes because of its antioxidant effects (<xref rid="b140-BR-23-2-02009" ref-type="bibr">140</xref>). In both studies, the antioxidant effect of <italic>N. sativa</italic> on organs other than the skin was due to free radicals originating from ionizing radiation and smoking. Furthermore, oral administration is not uniform, so further research is needed to assess the optimal dose of <italic>N. sativa</italic> extract.</p>
<p>Several studies have investigated the topical use of <italic>N. sativa</italic> extract and TQ as antiaging agents. &#x00C7;anakci <italic>et al</italic> (<xref rid="b132-BR-23-2-02009" ref-type="bibr">132</xref>) used cold-pressed <italic>N. sativa</italic> oil extract at 100&#x0025; concentration topically on the nasal mucosa of mice following exposure to radiotherapy radiation and found that its use could lower inflammatory cell infiltration, superficial erosion, vascular dilatation and exudates compared with the control. This study demonstrated the antioxidant and anti-inflammatory effects of <italic>N. sativa</italic> extract, even with topical use. In fact, in this study, histological images showed the protective role of <italic>N. sativa</italic> through its antioxidant, cytoprotective, anti-inflammatory and antineoplastic activities. Although this study did not review further the immunohistochemical and biochemical features, it is sufficient to confirm the role of <italic>N. sativa</italic> in preventing the detrimental effects of radiation.</p>
<p>Increased collagen density and accelerated wound repair in mice following topical application of <italic>N. sativa</italic> extract was studied by Turhan <italic>et al</italic> (<xref rid="b133-BR-23-2-02009" ref-type="bibr">133</xref>) who compared the use of <italic>N. sativa</italic> extract, nano-silver solution gold as the standard agent and a combination of the two agents applied twice daily for 15 days on 20 albino rats. The use of <italic>N. sativa</italic> extract alone resulted in improved collagen density and wound repair than that of the control group, although combined use had the best effect (<xref rid="b133-BR-23-2-02009" ref-type="bibr">133</xref>). In conclusion, <italic>N. sativa</italic> can play a synergistic role with other topical agents for wound healing. This research also suggests that <italic>N. sativa</italic> extract can be used as an agent that protects against sunburn and wounds caused by exposure to sunlight. In addition, the small sample size is a limitation of this study.</p>
<p>This wound healing enhancer effect was also supported by Han <italic>et al</italic> (<xref rid="b142-BR-23-2-02009" ref-type="bibr">142</xref>) regarding the topical use of 50&#x0025; <italic>N. sativa</italic> oil cream twice daily for 14 days on the skin of mice with skin defects. The use of <italic>N. sativa</italic> extract reduced oxidant parameters, such as malondialdehyde (MDA), glutathione (GSH) and skin catalase (CAT) and increased antioxidant-supporting enzyme parameters, such as glutathione peroxidase (GPx) and SOD levels, markedly compared with controls. It can be concluded that <italic>N. sativa</italic> extract exerts wound healing effects through its antioxidant properties. Topical application of <italic>N. sativa</italic> in the form of oil cream at a concentration of 50&#x0025; enhances the healing of open wounds in a reliable manner.</p>
<p>Algahtani <italic>et al</italic> (<xref rid="b134-BR-23-2-02009" ref-type="bibr">134</xref>) proved the effect of nanoemulsion-based hydrogel of TQ 0.5&#x0025; (w/w) on collagen fibers in mice with skin defects. Nanoemulsion-based hydrogel systems provide more efficient drug delivery to increase the biopharmaceutical attributes of drugs that are difficult to dissolve. TQ, which is difficult to dissolve in water, can be encapsulated into the lipophilic environment of nano-dimensional oil droplets and stabilized to be more optimal (<xref rid="b143-BR-23-2-02009" ref-type="bibr">143</xref>). In this study, it was found that the use of nanoemulsion-based hydrogel systems provided higher and more regular collagen density compared with the use of the standard gel form TQ and the gold standard therapy, 1&#x0025; silver sulfadiazine. All research summaries supporting the potential of <italic>N. sativa</italic> in fighting photoaging are summarized in <xref rid="tII-BR-23-2-02009" ref-type="table">Table II</xref>.</p>
<p>Various studies, both <italic>in vitro</italic> and <italic>in vivo</italic>, have shown that the use of <italic>N. sativa</italic> extract and its active substance, TQ, has a potential role against photoaging because of their antioxidant and anti-inflammatory effects (<xref rid="b10-BR-23-2-02009" ref-type="bibr">10</xref>,<xref rid="b135-BR-23-2-02009" ref-type="bibr">135</xref>,<xref rid="b139-BR-23-2-02009" ref-type="bibr">139</xref>,<xref rid="b141-BR-23-2-02009" ref-type="bibr">141</xref>). The antioxidant effect was demonstrated by improvements in parameters such as MDA, CAT and GSH levels and increased levels of the SOD enzyme (<xref rid="b135-BR-23-2-02009" ref-type="bibr">135</xref>,<xref rid="b141-BR-23-2-02009" ref-type="bibr">141</xref>). In several studies, the anti-inflammatory effect improved inflammatory parameters and histopathological features in irradiated mice (<xref rid="b2-BR-23-2-02009" ref-type="bibr">2</xref>,<xref rid="b10-BR-23-2-02009" ref-type="bibr">10</xref>,<xref rid="b139-BR-23-2-02009" ref-type="bibr">139</xref>). These two effects are thought to modulate collagenase and elastase activity, which in turn improves collagen density and skin hydration, especially in skin exposed to sunlight (<xref rid="b2-BR-23-2-02009" ref-type="bibr">2</xref>,<xref rid="b137-BR-23-2-02009" ref-type="bibr">137</xref>,<xref rid="b140-BR-23-2-02009" ref-type="bibr">140</xref>,<xref rid="b142-BR-23-2-02009" ref-type="bibr">142</xref>). A summary of the protective effects of <italic>N. sativa</italic> against photoaging is presented in <xref rid="f2-BR-23-2-02009" ref-type="fig">Fig. 2</xref>.</p>
<p>These studies have several limitations that require evaluation. First, the use of <italic>N. sativa</italic> extract has not been standardized in terms of ingredients, extraction methods, ingredient content, oral and topical preparation and concentration of active ingredients contained therein; second, research on the effects of <italic>N. sativa</italic> against UV rays and photoaging is limited; third, the outcome assessment criteria are not yet standardized; and fourth, a number of studies use relatively small sample sizes, animal studies and have a high potential for bias. Further studies are needed, especially using human samples with large sample sizes and randomized control trial methods, to clarify the role of <italic>N. sativa</italic> as a photoaging protective agent. Nevertheless, from all available sources, it can be summarized that <italic>N. sativa</italic> extract and its active components may have some potential to counteract the detrimental effects of UV radiation.</p>
</sec>
<sec>
<title>6. Conclusion</title>
<p><italic>N. sativa</italic> seeds contain a number of active ingredients and play a potential role in photoaging therapy. The mechanism underlying the accumulation of free radicals caused by UV rays is unclear. Essential active ingredients, including TQ, flavonoids, saponins, fatty acids and minerals, can participate in this effect. Their mechanism possibly not only inhibits the MAPK signaling and NF-&#x03BA;B pathways but also decreases the expression of proinflammatory cytokines in the inflammatory state. Blocking this pathway will reduce MMP1 production and collagen degradation. Several studies have shown that <italic>N. sativa</italic> seed extract and TQ have potential as antiaging agents. However, further research is needed to demonstrate its protective ability against photoaging. The use of <italic>N. sativa</italic> extract is still limited because of its preventive effects on photoaging, so further research is needed, especially in clinical trials, to determine the optimal dose or its use as a combination therapy.</p>
</sec>
</body>
<back>
<ack>
<title>Acknowledgements</title>
<p>Not applicable.</p>
</ack>
<sec sec-type="data-availability">
<title>Availability of data and materials</title>
<p>Not applicable.</p>
</sec>
<sec>
<title>Authors&#x0027; contributions</title>
<p>AE collected articles and wrote the first draft of manuscript, JWG initiated the study and revised the manuscript and TLW finalized the manuscript. Data authentication is not applicable. All authors read and approved the final manuscript.</p>
</sec>
<sec>
<title>Ethics approval and consent to participate</title>
<p>Not applicable.</p>
</sec>
<sec>
<title>Patient consent for publication</title>
<p>Not applicable.</p>
</sec>
<sec sec-type="COI-statement">
<title>Competing interests</title>
<p>The authors declare that they have no competing interests.</p>
</sec>
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</back>
<floats-group>
<fig id="f1-BR-23-2-02009" position="float">
<label>Figure 1</label>
<caption><p>Possible mechanism of <italic>N. sativa</italic> and thymoquinone against photoaging. UV, ultraviolet; ROS, reactive oxygen species; NF-&#x03BA;B, nuclear factor-kappa B; MAPK, mitogen activated protein kinase; JNK, c-Jun N-terminal kinase; ERK, extracellular signal-regulated kinase; AP-1, activator protein-1; TIMP, tissue inhibitor of metallopreoteinase; MMP-1, matrix metalloproteinase-1; IL-1&#x00DF;, interleukin 1&#x00DF;; TNF-&#x03B1;, tumor necrosis factor-&#x03B1;; IL-6, interleukin-6; COX-2, cyclooxygenase-2; TGF-&#x00DF;, tumor growth factor-&#x00DF;.</p></caption>
<graphic xlink:href="br-23-02-02009-g00.tif"/>
</fig>
<fig id="f2-BR-23-2-02009" position="float">
<label>Figure 2</label>
<caption><p>Summary of potential role of <italic>N. sativa</italic> against photoaging. MDA, malondialdehyde; GSH, glutathione; CAT, catalase; TQ, thymoquinone; UVA, ultraviolet A; HaCat, human adult cutaneous tumor cell line.</p></caption>
<graphic xlink:href="br-23-02-02009-g01.tif"/>
</fig>
<table-wrap id="tI-BR-23-2-02009" position="float">
<label>Table I</label>
<caption><p><italic>Nigella sativa</italic> contents and their possible mechanism against photoaging.</p></caption>
<table frame="hsides" rules="groups">
<thead>
<tr>
<th align="left" valign="middle">Ingredients</th>
<th align="center" valign="middle">Role against photoaging</th>
<th align="center" valign="middle">Mechanism</th>
<th align="center" valign="middle">(Refs.)</th>
</tr>
</thead>
<tbody>
<tr>
<td align="left" valign="middle">Thymoquinone</td>
<td align="left" valign="middle">Prevents oxidative injury and prevent membrane lipid peroxidation</td>
<td align="left" valign="middle">&#x2022; Inhibits the activation of NF-&#x03BA;B</td>
<td align="center" valign="middle">(<xref rid="b97-BR-23-2-02009 b98-BR-23-2-02009 b99-BR-23-2-02009" ref-type="bibr">97-99</xref>)</td>
</tr>
<tr>
<td align="left" valign="middle">&#x00A0;</td>
<td align="left" valign="middle">&#x00A0;</td>
<td align="left" valign="middle">&#x2022; Works directly on the fibrillogenesis of type I collagen</td>
<td align="center" valign="middle">&#x00A0;</td>
</tr>
<tr>
<td align="left" valign="middle">Flavonoids (quercetin and kaempferol)</td>
<td align="left" valign="middle">Interrupts free radical chain reactions and protect against UV radiation</td>
<td align="left" valign="middle">&#x2022; Inhibits MMP-1 mRNA levels</td>
<td align="center" valign="middle">(<xref rid="b101-BR-23-2-02009 b102-BR-23-2-02009 b103-BR-23-2-02009 b104-BR-23-2-02009 b105-BR-23-2-02009" ref-type="bibr">101-105</xref>)</td>
</tr>
<tr>
<td align="left" valign="middle">&#x00A0;</td>
<td align="left" valign="middle">&#x00A0;</td>
<td align="left" valign="middle">&#x2022; Inhibits ERK and p38 MAPK activation</td>
<td align="center" valign="middle">&#x00A0;</td>
</tr>
<tr>
<td align="left" valign="middle">&#x00A0;</td>
<td align="left" valign="middle">&#x00A0;</td>
<td align="left" valign="middle">&#x2022; Reduction in NF-&#x03BA;B</td>
<td align="center" valign="middle">&#x00A0;</td>
</tr>
<tr>
<td align="left" valign="middle">Saponins</td>
<td align="left" valign="middle">Modulates inflammatory response, protects against ECM degradation, enhances collagen production and improves wrinkle appearance</td>
<td align="left" valign="middle">&#x2022; Inhibits MAPK signaling, AP-1, and NF-&#x03BA;B activation</td>
<td align="center" valign="middle">(<xref rid="b35-BR-23-2-02009" ref-type="bibr">35</xref>,<xref rid="b104-BR-23-2-02009" ref-type="bibr">104</xref>)</td>
</tr>
<tr>
<td align="left" valign="middle">Linoleic and oleic acids</td>
<td align="left" valign="middle">Maintains water permeability barrier and epidermal integrity of the skin</td>
<td align="left" valign="middle">&#x2022; Suppresses UV-induced changes in TEWL, skin hydration, and erythema</td>
<td align="center" valign="middle">(<xref rid="b105-BR-23-2-02009" ref-type="bibr">105</xref>,<xref rid="b108-BR-23-2-02009" ref-type="bibr">108</xref>,<xref rid="b111-BR-23-2-02009" ref-type="bibr">111</xref>)</td>
</tr>
<tr>
<td align="left" valign="middle">Minerals (Cu, Zn and Fe)</td>
<td align="left" valign="middle">Decreases oxidative stress biomarkers and inflammatory cytokines</td>
<td align="left" valign="middle">&#x2022; Cofactor for many enzymes against oxidants</td>
<td align="center" valign="middle">(<xref rid="b96-BR-23-2-02009" ref-type="bibr">96</xref>,<xref rid="b112-BR-23-2-02009" ref-type="bibr">112</xref>,<xref rid="b114-BR-23-2-02009" ref-type="bibr">114</xref>)</td>
</tr>
</tbody>
</table>
<table-wrap-foot>
<fn><p>NF-&#x03BA;B, nuclear factor-kappa B; UV, ultraviolet; MMP-1, matrix metalloproteinase-1; ERK, extracellular signal-regulated kinase; MAPK, mitogen-activated protein kinase; ECM, extracellular matrix; AP-1, activator protein-1; TEWL, transepidermal waterloss; Cu, cuprum; Zn, zinc; Fe, iron.</p></fn>
</table-wrap-foot>
</table-wrap>
<table-wrap id="tII-BR-23-2-02009" position="float">
<label>Table II</label>
<caption><p>Studies that support the potential role of <italic>Nigella sativa</italic> against photoaging.</p></caption>
<table frame="hsides" rules="groups">
<thead>
<tr>
<th align="left" valign="middle">First author, year</th>
<th align="center" valign="middle">Subjects</th>
<th align="center" valign="middle">Methods</th>
<th align="center" valign="middle">Results</th>
<th align="center" valign="middle">(Refs.)</th>
</tr>
</thead>
<tbody>
<tr>
<td align="left" valign="middle">Li <italic>et al</italic>, 2020</td>
<td align="left" valign="middle"><italic>In vitro</italic></td>
<td align="left" valign="middle">Analysis of molecular process within glycation, collagen cross-linking, collagenase and elastase activities in murine melanoma B16F10 cells measured with collagenase activity assay kit.</td>
<td align="left" valign="middle">Thymocid<sup>&#x00AE;</sup> (50, 100 and 300 &#x00B5;g/ml) interfered with the production of advanced glycation end-products, collagen cross-linking, collagenase activity, and elastase activities (type I and III)</td>
<td align="center" valign="middle">(<xref rid="b2-BR-23-2-02009" ref-type="bibr">2</xref>)</td>
</tr>
<tr>
<td align="left" valign="middle">Liang <italic>et al</italic>, 2021</td>
<td align="left" valign="middle"><italic>In vitro</italic></td>
<td align="left" valign="middle">Analysis of oxidative stress and mitochondrial function on HaCaT cells irradiated by UVA using colorimetry, spectrophotometry, bioluminescence and dual-luciferase reporter assay. Cell viability was also evaluated using MTT and ELISA assay.</td>
<td align="left" valign="middle">TQ pure extract (6 and 12 &#x00B5;M) not only significantly improved the UVA-induced cytotoxicity, oxidative stress and inflammation but also promoted mitochondrial dysregulation in HaCaT cells.</td>
<td align="center" valign="middle">(<xref rid="b10-BR-23-2-02009" ref-type="bibr">10</xref>)</td>
</tr>
<tr>
<td align="left" valign="middle">Pandey <italic>et al</italic>, 2015</td>
<td align="left" valign="middle"><italic>In vivo</italic>, in rats</td>
<td align="left" valign="middle">Radio-protective effect of oral <italic>Nigella sativa</italic> methanolic extract (200 mg/100 g bw/day) in albino rats 2 h before Total Body Irradiation at 4, 6, 10 Gy and continued until 7 consecutive days. They evaluated for histology and antioxidant parameters</td>
<td align="left" valign="middle">Oral <italic>Nigella sativa</italic> methanolic extract (200 mg/100 g bw/day) significantly increased superoxide dismutase and catalase enzymes and inhibited lipid peroxidation activities.</td>
<td align="center" valign="middle">(<xref rid="b131-BR-23-2-02009" ref-type="bibr">131</xref>)</td>
</tr>
<tr>
<td align="left" valign="middle">Khalaf and Mostafa, 2014</td>
<td align="left" valign="middle"><italic>In vivo</italic>, in rats</td>
<td align="left" valign="middle">Twenty adult male rats were exposed to side and main stream smoke for 10 min twice daily for 4 weeks and treated orally with <italic>Nigella sativa</italic> oil 10 ml/Kgbw. Histological examination was performed.</td>
<td align="left" valign="middle">Oral <italic>Nigella sativa</italic> extract 10 ml/kg bw/day had a protective role against tobacco smoking with collagen fiber content almost the same as the nonsmoking group (negative control).</td>
<td align="center" valign="middle">(<xref rid="b140-BR-23-2-02009" ref-type="bibr">140</xref>)</td>
</tr>
<tr>
<td align="left" valign="middle">Canakci <italic>et al</italic>, 2017</td>
<td align="left" valign="middle"><italic>In vivo</italic>, in rats</td>
<td align="left" valign="middle">Radio-protective effect of topical cold pressed <italic>Nigella sativa</italic> oil (0.05 ml at 100&#x0025; concentration) given on days 1 to 3 to each nostril of female rats (n=18) after radiotherapy with a single dose of 40 Gy. Histopathological evaluation was measured.</td>
<td align="left" valign="middle">Decrease of inflammatory cell infiltration, vascular dilatation, superficial erosion, and exudates in <italic>Nigella sativa</italic> group compared with the control.</td>
<td align="center" valign="middle">(<xref rid="b132-BR-23-2-02009" ref-type="bibr">132</xref>)</td>
</tr>
<tr>
<td align="left" valign="middle">Turhan <italic>et al</italic>, 2019</td>
<td align="left" valign="middle"><italic>In vivo</italic>, in rats</td>
<td align="left" valign="middle">Collagen density and wound closure were measured with histological morphometric analysis on skin defects in 20 albino rats. The wounds were treated with 2 ml cold-pressed <italic>Nigella sativa</italic> extracts twice daily for 15 days.</td>
<td align="left" valign="middle">Higher collagen density was achieved in <italic>Nigella sativa</italic> group compared with the nano silver solution and control group. In addition, the combination of <italic>Nigella sativa</italic> and nano silver solution (1:1) had the highest collagen density among the groups.</td>
<td align="center" valign="middle">(<xref rid="b133-BR-23-2-02009" ref-type="bibr">133</xref>)</td>
</tr>
<tr>
<td align="left" valign="middle">Han <italic>et al</italic>, 2017</td>
<td align="left" valign="middle"><italic>In vivo</italic>, in rats</td>
<td align="left" valign="middle">A total of 42 female albino Wistar rats with skin defects were randomly treated with 50&#x0025; <italic>Nigella sativa</italic> oil cream, 50&#x0025; <italic>Hypericum perforatum</italic> oil cream, and placebo cream twice daily for 14 days. Histological and biochemical evaluations were performed.</td>
<td align="left" valign="middle">A significant decrease in the MDA, GSH and skin CAT levels and an increase in GPx and SOD levels were found in the <italic>Nigella sativa</italic> group when compared with the other two groups on the 14th day of treatment.</td>
<td align="center" valign="middle">(<xref rid="b142-BR-23-2-02009" ref-type="bibr">142</xref>)</td>
</tr>
<tr>
<td align="left" valign="middle">Algahtani <italic>et al</italic>, 2021</td>
<td align="left" valign="middle"><italic>In vivo</italic>, in rats</td>
<td align="left" valign="middle">Collagen fiber was measured with histopathological analysis on 16 Wistar rats with skin defects treated with 0.5&#x0025; TQ nanoemulsion-based hydrogel twice a day for 20 consecutive days.</td>
<td align="left" valign="middle">Nanoemulsion-based hydrogel of TQ 0.5&#x0025; (w/w) group had significantly more extensive and organized collagen fiber than the 1&#x0025; silver sulfadiazine group.</td>
<td align="center" valign="middle">(<xref rid="b134-BR-23-2-02009" ref-type="bibr">134</xref>)</td>
</tr>
</tbody>
</table>
<table-wrap-foot>
<fn><p>HaCat, human adult low calcium temperature; UVA, ultraviolet A; MTT, 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide; ELISA, enzyme linked immunosorbent assay; TQ, thymoquinone; Gpx, glutathione peroxidase; SOD, superoxide dismutase; MDA, malondialdehyde; GSH, glutathione; CAT, catalase.</p></fn>
</table-wrap-foot>
</table-wrap>
</floats-group>
</article>
