Efek Platelet-Rich Fibrin (PRF) Terhadap Timbunan Kolagen Fibroblas Pasca Pajanan Dengan Mitomisin C
SANTI RINI, dr. Ishandono Dachlan, MSc, SpB, SpBP (K), Dr. dr. Y. Widodo Wirohadidjojo, SpKK
2014 | Tesis | SP ILMU BEDAHLatar Belakang: Luka kronis menunjukkan gambaran fibroblas tua yang memiliki kemampuan proliferasi rendah, di mana jaringan granulasi dan sintesis kolagen akan terhambat sehingga luka sulit menyembuh. Mitomisin C secara in-vitro dapat menimbulkan penghambatan proliferasi sel dan menimbulkan penuaan sel yang serupa dengan luka kronis. Platelet-rich fibrin (PRF) merupakan matriks fibrin autolog yang mengandung sejumlah besar trombosit dan sitokin lekosit. Penggunaan PRF pada perawatan luka kronis seperti ulkus diabetikum dan ulkus pada karsinoma payudara paska radioterapi menunjukkan waktu penyembuhan yang lebih cepat dibandingkan dengan perawatan standar. Tujuan Penelitian: Untuk mengetahui efek pemberian PRF terhadap deposisi kolagen pasca pemberian mitomisin C, serta mengetahui berapa kadar PRF yang dibutuhkan untuk menimbulkan efek tersebut. Metode Penelitian: Penelitian ini adalah penelitian in-vitro dengan metode eksperimental kuasi. Sel fibroblas dari kultur jaringan dermis preputium normal 6 probandus anak sehat dibuat suspensi, dan dibagi menjadi 5 kelompok perlakuan: a) medium dan FBS10% b) mitomisin C 10 mikrogram/mL, c) mitomisin C 10 mikrogram/mL dan PRF100%, d) mitomisin C 10 mikrogram/mL dan PRF50%, e) mitomisin C 10 mikrogram/mL dan PRF25%. Densitas kolagen diukur dengan Sirius Red assay. Data dianalisis dengan oneway ANOVA pada tingkat keyakinan p=0,05. Hasil Penelitian: Telah dilakukan penelitian dengan sampel 90 sumuran sel fibroblas dengan hasil rerata deposisi kolagen: a) medium dan FBS10% 0,0967 ± 0,0211, b) mitomisin C 10 mikrogram/mL 0,0611 ± 0,0126, c) mitomisin C 10 mikrogram/mL dan PRF100% 0,1566 ± 0,0354, d) mitomisin C 10 mikrogram/mL dan PRF50% 0,1334 ± 0,0423, e) mitomisin C 10 mikrogram/mL dan PRF25% 0,1106 ± 0,0291. Didapatkan peningkatan timbunan kolagen pada kelompok perlakuan PRF100%, PRF50%, dan PRF25% terhadap kelompok mitomisin C dengan p<0,05. Timbunan kolagen pada kelompok PRF100% lebih tinggi daripada PRF50%, namun tidak berbeda bermakna (p>0,05). Kesimpulan: Timbunan kolagen fibroblas pasca pemberian mitomisin C dan PRF lebih tinggi dibandingkan timbunan kolagen fibroblas pasca pemberian mitomisin C saja. Timbunan kolagen fibroblas pasca pemberian mitomisin C dan platelet-rich fibrin (PRF) 25%, 50% dan 100% meningkat secara bermakna sesuai dengan peningkatan kadar PRF yang digunakan.
Background: Chronic wound showed a histological appearance of senescent fibroblasts which had low proliferative capability, inhibited granulation and collagen synthesis, thus prevented wound healing. In in-vitro study, mitomycin C inhibited cell proliferation and caused cell senescence which was similar to those in chronic wound. Platelet-rich fibrin (PRF) was an autolog fibrin matrix containing a large quantity of platelet and leukocyte cytokines. The use of PRF in chronic wound treatment e.g diabetic ulcer and post-radiation wound in breast cancer patients showed faster healing times when compared with standard care. Purpose of Study: To understand the effect of PRF on collagen deposition in fibroblast after mitomycin C treatment, and to identify the adequate PRF concentration to produce such effect. Methods: This study was an in-vitro quasy experimental study. Suspension of fibroblast cells cultivated from foreskin dermal tissue culture of 6 healthy male children were divided into 5 treatment groups: a) medium and FBS10% b) mitomycin C 10 microgram/mL, c) mitomycin C 10 microgram/mL and PRF100%, d) mitomycin C 10 microgram/mL and PRF50%, e) mitomycin C 10 microgram/mL and PRF25%. Collagen deposition was measured with Sirius Red assay. Data analysis was done with oneway ANOVA with significant level of p=0.05. Results: We studied 90 wells of fibroblast cell, which resulted in collagen deposition as follows: a) medium and FBS10% 0.0967 ± 0.0211, b) mitomycin C 10 microgram/mL 0.0611 ± 0.0126, c) mitomycin C 10 microgram/mL and PRF100% 0.1566 ± 0.0354, d) mitomycin C 10 microgram/mL and PRF50% 0.1334 ± 0.0423, e) mitomycin C 10 microgram/mL and PRF25% 0.1106 ± 0.0291. There was an increase of collagen deposition in PRF100%, PRF50%, and PRF25% treatment groups when compared with mitomycin C group, with p<0.05. Collagen deposition in PRF100% group was higher than the one in PRF50% group, but it was not significantly different (p>0.05). Conclusion: Collagen deposition in fibroblast after mitomycin C and PRF treatment was higher than those after mitomycin C treatment only. Collagen deposition in fibroblast after mitomisin C and PRF treatment (25%, 50% and 100% respectively) increased significantly according to the increase of PRF concentration.
Kata Kunci : platelet rich-fibrin (PRF), fibroblas, timbunan kolagen, mitomisin C
