Therapeutic promise of Calotropis procera (Aiton) W.T. Aiton latex for wound healing and keloid prevention: A narrative review

Background: A scar represents an alteration in skin architecture that occurs during the wound-healing process when the regenerated tissue does not fully resemble the original structure. Optimal healing requires a harmonious balance between the deposition and degradation of the extracellular matrix (ECM). Conditions such as keloids and hypertrophic scars (HTS) arise due to excessive collagen accumulation and dysregulated fibroblast activity, primarily influenced by growth factors like PDGF and TGF-β within the ECM. Disturbed maturation of granulation tissue further contributes to abnormal scar formation. Calotropis procera (Aiton) W.T. Aiton, a traditionally recognized medicinal plant in Ayurveda, possesses bioactive latex constituents with significant wound-healing potential. Its soluble latex proteins exhibit hemostatic, pro-inflammatory, and anti-inflammatory actions that support sequential phases of healing. These properties highlight the therapeutic relevance of Calatropis. procera in managing pathological scar formation within holistic and integrative wound-care approaches. Objectives: This review compiles in vitro and in vivo studies on raw and processed latex of Calotropis procera, (Ait.), emphasizing its hemostatic and anti-inflammatory effects. It focuses on gallic acid, quercetin, and kaempferol as secondary metabolites in the lyophilized non-protein fraction, proposing their repurposing as bio-rational agents for anti-scar therapeutic and cosmetic applications. Results: Research supports the latex’s hemostatic, pro-inflammatory, and anti-inflammatory activities in various animal models. Latex cysteine peptidases exhibit thrombin- and plasmin-like activities. It synergistically inhibits inflammatory cytokines such as COX-2, TNF-α, iNOS, and TGF-β, protecting against acute infections. Gallic acid modulates inflammatory mediators, while quercetin and kaempferol provide protective effects against scar formation. Conclusion: Current evidence supports the use of Calotropis procera latex as a hemostatic and anti-inflammatory agent with potential for further development as an anti-scar therapeutic and cosmetic drug. This review suggests its theoretical use in scar management warrants additional investigation.