Proses Penyembuhan Luka Ditinjau dari Aspek Mekanisme Seluler dan Molekuler

ABSTRACTWound is the discontinue of the anatomical structure of the body tissue, the healing phase consists of 3 stages, they are the inflammatory phase, which is divided into early inflammation, and late inflammation that occurs from day 0 to day 5 after injury. The Proliferation phase, which includes three main processes, namely: Neoangiogenesis, fibroblast formation and re-epithelialization, occurs from day 3 to day 21 after injury. Maturation phase occurs from day 21 to 1 year after injury which aims to maximize the strength and structural integrity of new tissue fillings, epithelial growth and scar tissue formation. These three phases influence each other and many cells and cytokines play a role in each phase. The amount of research on the wound healing process to achieve satisfactory results with a shorter time than the nominal phase results in a theory of the process of wound healing that is increasingly detailed which will be explained from the aspects of cellular and molecular mechanisms.Keywords : wound healing, wound healing process, wound healing mechanism, cellular mechanism of wound healing, molecular mechanism of wound healingCorrespondence to  : [email protected] ABSTRAKLuka adalah terputusnya kontinuitas struktur anatomi jaringan tubuh, dimana fase penyembuhannya terdiri dari 3 tahap yaitu Fase Inflamasi yang dibagi menjadi early inflammation (Fase haemostasis), dan late inflammation yang terjadi sejak hari ke 0 sampai hari ke 5 pasca terluka. Fase Proliferasi, yang meliputi tiga proses utama yakni: Neoangiogenesis, pembentukan fibroblast dan re-epitelisasi, terjadi dari hari ke-3 sampai hari ke-21 pasca terluka. Fase Maturasi terjadi mulai hari ke-21 sampai 1 tahun pasca luka.yang bertujuan untuk memaksimalkan kekuatan dan integritas struktural jaringan baru pengisi luka, pertumbuhan epitel dan pembentukan jaringan parut. Ketiga fase ini saling mempengaruhi satu sama lain dan banyak sel dan sitokin yang berperan didalam setiap fase. Banyaknya penelitian tentang proses penyembuhan luka untuk mencapai hasil yang memuaskan dengan waktu yang lebih singkat dari fase nomal menghasilkan teori proses penyembuhan luka yang semakin detail yang akan dijelaskan dari aspek mekanisme seluler dan molekuler.Kata kunci  :penyembuhan luka, proses penyembuhan luka, mekanisme penyembuhan luka, mekanisme seluler penyembuhan luka, mekanisme molekuler penyembuhan lukaKorespondensi : [email protected]

MECHANISM OF APOPTOSIS INHIBITION TO SQUAMOUS CELL CARCINOMA OF ORAL CANCER IN CISPLATIN TREATMENT

This study was to approve the increased secretion of Hsp 70, DNA damage, and inhibitor apoptosis protein in cisplatin therapy which influence apoptosis of oral cancer cell and to know mechanism of molecular pathology. This study was an in vitro experimental laboratory using Randomized Block Design. Cell culture of oral cancer divided from cisplatin resistance cancer cell and cancer cell never induce cisplatin. Two group of cancer cell would be given cisplatin therapy. Secretion of Hsp 70, DNA damage, Inhibitor of apoptosis protein, and apoptosis index would be examined. Cisplatin resistance cancer cell group showed lower apoptosis than never induce cisplatin cancer cell. Elevated secretion of Hsp 70 in cisplatin therapy group (p= 0.000, b=0.881). Lower secretion of DNA damage protein in cisplatin resistance cancer cell and it was not going apoptosis. In path regression analysis, cisplatin was significans through IAP pathway (p=0.000, b=0.726) to apoptosis. All type of cell cultures were also significans through IAP pathway (p=0.000, b=0.496) to apoptosis. Elevated IAP secretion influenced apoptosis (b= 1.000). In conclusion, cisplatin used IAP pathway to apoptosis. All type of cell cultures also used IAP pathway to apoptosis. Cisplatin resistance cell culture had stronger effect to IAP and IAP increased inhibition to apoptosis

Penanganan Luka Bakar

Luka bakar terutama yang luas (lebih dari 20%) menyebabkan terganggunya keseirrbangan dalam tubuh, di antaranya adalah terjadinya berbagai macam perubahan metabolisme. Semakin luas luka bakar yang dialami, maka semakin besar gangguan metabolisme yang ditimbulkan, sehingga memerlukan perhatian tersendiri salah satunya adalah tunjangan nutrisi yang adekuat nutrisi. Tunjangan nutrisi pada penanganan luka bakar memegang Peranan yang sangat penting dalam menurunkan angka mortalitas mauPun morbiditas. Terutama pada luka bakar lebih dari 30% karena ketidakmampuan hrbuh untuk mengkompensasi perubahan perubahan yang terjadi, yaitu perubahan metabolisme protein, karbohidrat, lemak dan kebutuhan energi. Sudah banyak penelitian yang telah dilakukan dalam manajemen luka bakar yang bertujuan menurunkan angka kematian mauPun morbiditas pada luka bakar. Di antaranya adalah early excision dan early skin grafting yaitu membuang dengan segera jaringan yang terbakar sebelum onset inleksi dan dilanjutkan dengan penutupan dengan skin graft alatt pengganti kulit. Kemajuan dalam manajemen critical care ituga memegang Peranan penting dalam menurunkan angka morbiditas dan mgka kematian yang diakiba&m oleh luka bakar Penanganan terhadap perubahan metabotk juga merupakan hal yang penting pada penderita luka bakar dapat kehilangan berat badan sampai 30% bila tunjangm nutrisi yang diberikan tidak adekuat. Pada bab ini akan dibahas tentang nutrisi pada luka bakar, perubahan metabolisme akibat luka bakar, terutama perubahan metabolisme karbohidra! lemak dan protein, Penentuan kebutuhan nukisi pada penderita luka bakar serta teknik pemberian nutrisi pada penderita luka bakar

PHYTOCHEMISTRY SCREENING AND GAS CHROMATOGRAPHY-MASS SPECTROMETRY ANALYSIS OF BIOACTIVE COMPOUNDS PRESENT IN KARO TRADITIONAL OIL, AN INDONESIAN TRADITIONAL HERBAL MEDICINE

Objective: The purpose of this research was to observe the bioactive compounds of Karo traditional oil by phytochemistry screening and gas chromatography-mass spectrometry (GC-MS) analysis. Alkaloid, Results: Terpenoid and flavonoid compounds were found, and no polyphenol compound from phytochemistry screening and 16 constituents were identified from the GC-MS analysis, α-pinene was found as the major component (74.47%), delta-3-carene (9.62%), 1% of octane, dodecane, camphor, undecane, isodecane, sabinene, hexadecane, nonane, and <1% tridecane, cyclohexane, pentacosane, heptadecan, limonene, and camphene. Conclusion: Karo traditional oil works as a potent anti-inflammation at the inflammation phase of the wound healing process by suppressing the pro-inflammatory cytokines and promote anti-inflammatory cytokines

Effects of Albumin Infusion on Serum Levels of Albumin, Proinflammatory Cytokines (TNF-α, IL-1, and IL-6), CRP, and MMP-8; Tissue Expression of EGRF, ERK1, ERK2, TGF-β, Collagen, and MMP-8; and Wound Healing in Sprague Dawley Rats

In this study, we sought to determine the roles of albumin in wound healing, which is infused both pre- and postoperatively in malnourished patients presenting with hypoalbuminemia. For the purposes of the study, we used 25 male Sprague Dawley rats of predetermined weight and age, which were initially maintained in a standard environment and fed the same diet for 7 days prior to being segregated into one of the following five groups: A, control, normal protein feed (20% casein); B, hypoalbuminemia, 25% rat albumin infusion prior to surgery; C, hypoalbuminemia, normal protein feed (20% casein); D, hypoalbuminemia, 25% rat albumin infusion after surgery; and E, hypoalbuminemia, low-protein feed (casein 2%). The animals in all five groups were subjected to four deep incisions in their dorsal muscle fascia. On days 1, 3, 5, and 7 after surgery, ELISA was used to determine serum levels of TNF-α, IL-1, IL-6, CRP, and MMP-8, whereas immunohistochemistry was used to determine the tissue expression of EGFR, ERK1, ERK2, TGF-β, collagen, and MMP-8. Significant reductions in serum levels of TNF-α, IL-1, and CRP were detected in the groups receiving albumin infusion and the high-casein diet (P<0.05). The administration of albumin and a high-casein diet also increased the tissue expression of EGFR, ERK1, ERK2, TGF-β, and collagen and decreased that of MMP-8 relative to the hypoalbuminemia control (P<0.05). We propose that the administration of albumin promoted NF-κB signaling which, in turn, induced the transduction and transcription of factors involved in wound healing. Albumin infusion and dietary proteins play vital roles in accelerating the wound healing process, as they can contribute to correcting the hypoalbuminemic state. These findings provide insights that will contribute to our understanding of wound healing, particularly in malnourished patients

Effects of albumin infusion on serum levels of albumin, proinflammatory cytokines (TNF α, IL1, IL6), CRP, and MMP-8; tissue expression of EGRF, ERK1, ERK2, TGF-β, collagen, and MMP-8; and wound healing in Sprague–Dawley rats.

Abstract In this study, we sought to determine the roles of albumin in wound healing, which is infused both pre- and postoperatively in malnourished patients presenting with hypoalbuminemia. For the purposes of the study, we used 25 male Sprague Dawley rats of predetermined weight and age, which were initially maintained in a standard environment and fed the same diet for 7 days prior to being segregated into one of the following five groups: A, control, normal protein feed (20% casein); B, hypoalbuminemia, 25% rat albumin infusion prior to surgery; C, hypoalbuminemia, normal protein feed (20% casein); D, hypoalbuminemia, 25% rat albumin infusion after surgery; and E, hypoalbuminemia, low-protein feed (casein 2%). The animals in all five groups were subjected to four deep incisions in their dorsal muscle fascia. On days 1, 3, 5, and 7 after surgery, ELISA was used to determine serum levels of TNF-α, IL-1, IL-6, CRP, and MMP-8, whereas immunohistochemistry was used to determine the tissue expression of EGFR, ERK1, ERK2, TGF-β, collagen, and MMP-8. Significant reductions in serum levels of TNF-α, IL-1, and CRP were detected in the groups receiving albumin infusion and the high-casein diet (). The administration of albumin and a high-casein diet also increased the tissue expression of EGFR, ERK1, ERK2, TGF-β, and collagen and decreased that of MMP-8 relative to the hypoalbuminemia control (). We propose that the administration of albumin promoted NF-κB signaling which, in turn, induced the transduction and transcription of factors involved in wound healing. Albumin infusion and dietary proteins play vital roles in accelerating the wound healing process, as they can contribute to correcting the hypoalbuminemic state. These findings provide insights that will contribute to our understanding of wound healing, particularly in malnourished patients

“Role of Adipose-Derived Mesenchymal Stem Cells in Full Thickness Wound Healing .”

Abstract Background: Wound healing problems can arise in donor wounds after harvesting a full-thickness graft. Returning Mesenchymal Stem Cells (MSCs) on the wounds may accelerate wound healing. The aim of this study is to analyse the effect of MSCs in the epithelialization process and collagen density on full-thickness wound healing. Methods: The pilot study included 10 patients undergoing excision of a full-thickness skin graft on the groin. Patients were randomly divided into two groups: Mesenchymal Stem Cells (MSCs) and Non-Mesenchymal Stem Cells (Non-MSCs). The MSCs group had previously undergone fat harvesting which was processed into mesenchymal stem cells. Biopsies were taken from both groups on days 14 (proliferative phase) and 45 (maturation phase), and were compared with normal skin (NS; n=5). Epithelial layers of the epidermis were assessed with hematoxylin eosin staining. Collagen density was evaluated with MT staining, and analysed using a light microscope. Result: In the MSCs group and the Non-MSCs group, the number of epithelial layers were significantly higher compared to the NS-group on day 45 (14.7 ± 0.70 and 8.24 ± 0.76 vs 5.43 ± 0.60 respectively; p<0.001 and p<0.001). The collagen density in the MSCs group on day 14 was 33.3 ± 2.46% in the MSCs group and 45.7 ± 5.84% in the non-MSCs group, compared to 54.3 ± 3.71% in the NS-group (p<0.001 and p=0.012 resp.). These values increased on day 45 to 49.2 ± 3.28% in the MSCs group, and 73.4 ± 1.63% in the non-MSCs group. Conclusion: Mesenchymal stem cells increased the number of epithelial layers in the full-thickness wound healing process compared to normal skin. A higher increase was seen in the MSCs-group. On day 45, an increase in collagen density was observed in the MSCs group and Non-MSCs group. Adipose-derived mesenchymal stem cells can be used in the process of full-thickness wound healing. Future randomized controlled trials are needed to confirm these findings