Efek recombinant human growth hormon (RHGH) pada kekuatan tensile dan rasio kolagen tipe I/ III pada penyembuhan cedera parsial tendon supraspinatus kelinci

Aditya Wirakarna; I Ketut Siki Kawiyana; I Wayan Suryanto Dusak; Putu Astawa; Ketut Gede Mulyadi Ridia; I Ketut Suyasa; I Gede Eka Wiratnaya

doi:10.15562/medicina.v52i1.1033

Efek recombinant human growth hormon (RHGH) pada kekuatan tensile dan rasio kolagen tipe I/ III pada penyembuhan cedera parsial tendon supraspinatus kelinci

Aditya Wirakarna ,

I Ketut Siki Kawiyana ,

I Wayan Suryanto Dusak ,

Putu Astawa ,

Ketut Gede Mulyadi Ridia ,

I Ketut Suyasa ,

I Gede Eka Wiratnaya ,

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DOI: https://doi.org/10.15562/medicina.v52i1.1033 |
Published: 2021-04-01

Abstract

Background: The condition of partial ruptured rotator cuff tendon cause a decrease in the tensile strength of delayed of the tendon healing. Delayed healing would cause a disruption of functional on the physical activity, social and economic of patient. Administration of Recombinant Human Growth Hormone (rHGH) is expected to be able to increase the collagen type I/ III ratio that are increase the tensile strength directly. The study is aimed to determine the role of rHGH in the tendon healing process of partial rupture of the rotator cuff which are measured using the tensile strength and comparison of the collagen type I/III ratio.

Methods: The sample selection of adult rabbit based on inclusion criteria and exclusion criteria that has been determined, and divided into two groups of treatment. At control group, tendon supraspinatus rabbit is cut as much as 50% of its thickness without given rHGH and the other group, tendon supraspinatus rabbit is cut as much as 50% of its thickness and rHGH is given. The effect to the collagen type I/III ratio and tensile strength is checked through Universal Testing Machine AGS-10kNG Shimadzu Japan and through histochemistry inspection. Then do the statistics analysis to determine whether administration of rHGH provide results that much better and significant compared to the group that was not given rHGH.

Results : Administration of rHGH is able to increase the collagen type I/III ratio significantly (p=0.015, CI 95% = 0.118-1.019), and is able to increase the tensile strength significantly (p=0.023, CI 95% = 0.616-7.606).

Conclusions : Administration of Recombinant Human Growth Hormone (rhGH) can improve collagen type I/III ratio and tensile strength on partrial rotator cuff tendon ruptured significantly.

Latar Belakang: Kondisi ruptur rotator cuff parsial menyebabkan menurunnya tensile strength hingga keterlambatan penyembuhan tendon dalam proses penyembuhannya. Keterlambatan penyembuhan akan menyebabkan gangguan fungsional pada aktivitas fisik, sosial dan ekonomi pasien. Pemberian Recombinant Human Growth Hormon (rhGH) diharapkan mampu untuk meningkatkan perbandingan rasio kolagen tipe I terhadap kolagen tipe III yang secara langsung akan meningkatkan tensile strength. Penelitian ini bertujuan untuk mengetahui peranan rhGH dalam proses penyembuhan partial rupture rotator cuff yang diukur menggunakan tensile strength dan perbandingan rasio kolagen tipe I terhadap kolagen tipe III.

Metode: Dilakukan pemilihan sampel dari kelinci dewasa berdasarkan kriteria inklusi dan eksklusi yang telah ditentukan, dan dibagi menjadi 2 kelompok perlakuan. Pada kelompok kontrol, tendon supraspinatus kelinci dipotong sebanyak 50% tanpa diberikan rHGH dan pada kelompok perlakuan, tendon supraspinatus kelinci dipotong sebanyak 50% dan diberikan rhGH. Efek pelakuan terhadap ratio kolagen tipe I terhadap kolagen tipe III dan tensile strength diperiksa melalui Universal Testing Machine AGS-10kNG merk Shimadzu buatan Jepang dan pemeriksaan histokimia. Kemudian dilakukan analisis statistik untuk menentukan apakah pemberian rHGH memberikan hasil yang lebih baik dan signifikan dibandingkan kelompok yang tidak diberikan rHGH.

Hasil: Pemberian rHGH mampu meningkatkan rasio kolagen tipe I / III secara bermakna (p=0.015, IK 95%=0.118-1.019), dan mampu meningkatkan tensile strength secara bermakna (p=0.023, IK 95%=0.616-7.606).

Simpulan: Pemberian Recombinant Human Growth Hormon (rhGH) dapat meningkatan Rasio serat kolagen tipe I/tipe III pada pasca repair rupture tendon rotator cuff kelinci dan kekuatan tensile pasca repair ruptur tendon rotator cuff kelinci secara signifikan.

References

Duchman KR, Goetz JE, Uribe BU, Amendola AM, Barber JA, Malandra AE, et al. Delayed administration of recombinant human parathyroid hormone improves early biomechanical strength in a rat rotator cuff repair model. J Shoulder Elb Surg. 2016;
Camacho-Hübner C. Normal Physiology of Growth Hormone and Insulin-Like Growth Factors in Childhood. Endotext. 2000;
Hatano I, Suga T, Diao E, Peimer CA, Howard C. Adhesions from flexor tendon surgery: An animal study comparing surgical techniques. J Hand Surg Am. 2000;
Boesen AP, Dideriksen K, Couppé C, Magnusson SP, Schjerling P, Boesen M, et al. Tendon and skeletal muscle matrix gene expression and functional responses to immobilisation and rehabilitation in young males: Effect of growth hormone administration. J Physiol. 2013;
Van Der Slot-Verhoeven AJ, Van Dura EA, Attema J, Blauw B, DeGroot J, Huizinga TWJ, et al. The type of collagen cross-link determines the reversibility of experimental skin fibrosis. Biochim Biophys Acta - Mol Basis Dis. 2005;
Gerard MP, Hodgson DR, Rose RJ, Walsh WR. Effects of recombinant equine growth hormone on in vitro biomechanical properties of the superficial digital flexor tendon of Standardbred yearlings in training. Vet Surg VS Off J Am Coll Vet Surg. 2005;
Doessing S, Heinemeier KM, Holm L, Mackey AL, Schjerling P, Rennie M, et al. Growth hormone stimulates the collagen synthesis in human tendon and skeletal muscle without affecting myofibrillar protein synthesis. J Physiol. 2010;
Blackstock CD, Higashi Y, Sukhanov S, Shai SY, Stefanovic B, Tabony AM, et al. Insulin-like growth factor-1 increases synthesis of collagen type I via induction of the mRNA-binding protein LARP6 expression and binding to the 5? stem-loop of COL1a1 and COL1a2 mRNA. J Biol Chem. 2014;
Kassem M, Mosekilde L, Eriksen EF. Growth hormone stimulates proliferation of normal human bone marrow stromal osteoblast precursor cells in vitro. Growth Regul. 1994;

[1] Duchman KR, Goetz JE, Uribe BU, Amendola AM, Barber JA, Malandra AE, et al. Delayed administration of recombinant human parathyroid hormone improves early biomechanical strength in a rat rotator cuff repair model. J Shoulder Elb Surg. 2016;

[2] Camacho-Hübner C. Normal Physiology of Growth Hormone and Insulin-Like Growth Factors in Childhood. Endotext. 2000;

[3] Hatano I, Suga T, Diao E, Peimer CA, Howard C. Adhesions from flexor tendon surgery: An animal study comparing surgical techniques. J Hand Surg Am. 2000;

[4] Boesen AP, Dideriksen K, Couppé C, Magnusson SP, Schjerling P, Boesen M, et al. Tendon and skeletal muscle matrix gene expression and functional responses to immobilisation and rehabilitation in young males: Effect of growth hormone administration. J Physiol. 2013;

[5] Van Der Slot-Verhoeven AJ, Van Dura EA, Attema J, Blauw B, DeGroot J, Huizinga TWJ, et al. The type of collagen cross-link determines the reversibility of experimental skin fibrosis. Biochim Biophys Acta - Mol Basis Dis. 2005;

[6] Gerard MP, Hodgson DR, Rose RJ, Walsh WR. Effects of recombinant equine growth hormone on in vitro biomechanical properties of the superficial digital flexor tendon of Standardbred yearlings in training. Vet Surg VS Off J Am Coll Vet Surg. 2005;

[7] Doessing S, Heinemeier KM, Holm L, Mackey AL, Schjerling P, Rennie M, et al. Growth hormone stimulates the collagen synthesis in human tendon and skeletal muscle without affecting myofibrillar protein synthesis. J Physiol. 2010;

[8] Blackstock CD, Higashi Y, Sukhanov S, Shai SY, Stefanovic B, Tabony AM, et al. Insulin-like growth factor-1 increases synthesis of collagen type I via induction of the mRNA-binding protein LARP6 expression and binding to the 5? stem-loop of COL1a1 and COL1a2 mRNA. J Biol Chem. 2014;

[9] Kassem M, Mosekilde L, Eriksen EF. Growth hormone stimulates proliferation of normal human bone marrow stromal osteoblast precursor cells in vitro. Growth Regul. 1994;

Efek recombinant human growth hormon (RHGH) pada kekuatan tensile dan rasio kolagen tipe I/ III pada penyembuhan cedera parsial tendon supraspinatus kelinci

Abstract

References

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