Erdinç ERSEN, Erdal CİLA, CANDAN ÖZOĞUL, Arzu Gül TAŞÇI, SERKAN SİPAHİOĞLU, HALİL CAN GEMALMAZ, AKİF MUHTAR ÖZTÜRK, Yunus DOĞRAMACI

Düşük molekül ağırlıklı heparinin sıçan tendon iyileşmesi üzerine etkisi

Amaç: Düşük molekül ağırlıklı heparinin (DMAH) tendon iyileşmesi üzerindeki etkileri araştırıldı. Çalışma planı: Çalışmada, ağırlığı yaklaşık 300 gram olan 45 adet erişkin Wistar tipi sıçan eşit sayıda üç gruba ayrıldı. Tüm gruplarda Aşil tendonu kesildi ve primer tamir uygulandı. Grup I ve II’deki deneklere (grup I’ e yüksek doz, 6 mgr/kg, 170 IU AXa; grup II’ye düşük doz, 3 mgr/kg, 85 IU AXa) dört hafta süreyle, günlük, subkutan, tek doz olarak DMAH (nadroparin kalsiyum) uygulandı. Grup III’deki deneklere DMAH uygulanmadı, kontrol grubu olarak değerlendirildi. Histolojik olarak, elektron ve ışık mikroskobunda, iyileşen tendonlardaki fibriler kollajen sentezi, mitokondri dejenerasyonu ve ekstraselüler matriksteki kollajenin fibriler veya homojen yapıda olup olmadığı değerlendirildi. Biyomekanik olarak da en büyük yüklenme kuvvetleri ve bu sıradaki uzama miktarları belirlendi. Sonuçlar: Histolojik olarak, kontrol grubu ile karşılaştırıldığında, DMAH verilen iki grupta, grup I’de daha fazla olmak üzere, fibroblast sayısında, ekstraselüler matrikste fibriler kollajen oluşumunda, fibroblastların sitoplazmik içeriklerindeki granüllü endoplazmik retikulum sayısında artış, dejenerasyon göstergesi olarak da mitokondri vakuolizasyonunda azalma görüldü. Biyomekanik çalışmada, grup I’de ölçülen en büyük yüklenme ve uzama değerleri (31 N ve 25 mm) grup II (24.6 N ve 19.6 mm) ve grup III’e (23.1 N ve 17.3 mm) göre anlamlı farklılık gösterdi (p0.05). Çıkarımlar: Günlük olarak tek doz şeklinde DMAH uygulaması, fibroblast sayısı ile fibriler kollajen sentezini artırıp, mitokondri dejenerasyonunu azaltarak tendon iyileşmesini olumlu etkilemektedir.

Anahtar Kelimeler:

Histoloji, Heparin, düşük molekül ağırlıklı, Modeller, hayvan, Sıçan, Wistar, Aşil tendon, Yara iyileşmesi, İlaç uygulama programı

The effect of low-molecular-weight heparin on rat tendon healing

Objectives: We investigated the effect of low-molecularweight heparin (LMWH) on the healing of tendons. Methods: Forty-five adult Wistar rats weighing 300 g were randomized into three groups equal in number. All the rats underwent full-thickness surgical incision of the Achilles tendon followed by primary repair. After the operation, two groups received daily subcutaneous LMWH injections (nadroparin calcium) for four weeks at high or low doses (group I, 6 mg/kg, 170 IU AXa; group II, 3 mg/kg, 85 IU AXa). Group III remained untreated as the control group. Histologically, the specimens were examined under light and electron microscopy with regard to the amount of fibrillar collagen synthesis, mitochondrial degeneration, and the composition of the extracellular matrix collagen. Biomechanically, maximum load to failure and correspondent elongation of the tendons were measured. Results: Compared to the control group, histologically, both LMWH-treated groups exhibited increased number of fibroblasts, increased fibrillar collagen formation in the extracellular matrix, and higher counts of granular endoplasmic reticula in cytoplasmic contents of fibroblasts as well as decreased mitochondrial vacuolization and degeneration. Biomechanical assessments showed that tendons in group I had significantly higher maximum load to failure and elongation values than group II and III (31 N vs. 24.6 N and 23.1 N; 25 mm vs. 19.6 mm and 17.3 mm, respectively; p<0.05). Group II and III did not differ significantly in this respect (p>0.05). Conclusion: Daily administration of single dose LMWH improves tendon healing through increasing the number of fibroblasts and fibrillar collagen synthesis and decreasing mitochondrial degeneration.

Keywords:

Histology, Heparin, Low-Molecular-Weight, Models, Animal, Rats, Wistar, Achilles Tendon, Wound Healing, Drug Administration Schedule,

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