Osteoartritisli köpeklerde ıntra-artiküler otolog trombositten zengin plazma (TZP) uygulaması ile bio-fiziksel aktivatörlü otolog trombositten zengin plazma uygulamasının yangısal mediatörler ve metalloproteinaz (MMP-2 ve MMP-9) enzimlerine etkisinin araştırılması
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Dosyalar
Tarih
2018
Yazarlar
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Yayıncı
Selçuk Üniversitesi Sağlık Bilimleri Enstitüsü
Erişim Hakkı
info:eu-repo/semantics/openAccess
Özet
Bu çalışmada; köpeklerde sık görülen, multifaktöriyel patogenezisi olan OA tedavisinde trombositten zengin plazma (TZP) ve Bio-aktivatörlü TZP'nin tek ve çift eklem içi uygulamalarının klinik seyir ve eklem sıvısı analizinde yangısal mediatörler (IL-6, IL-10, TNF-α IL-1β) ve metalloproteinaz (MMP-2 ve MMP-9) enzimlerine etki sonuçlarının araştırılması amaçlanmıştır. S.Ü. Veteriner Fakültesi, Cerrahi Anabilim Dalına A. genu'daki topallık şikayeti ile getirilen ağırlıkları ortalaması 30±1, yaş ortalaması 5±1, cinsiyet dağılımı; 6 dişi, 30 erkek, ırk dağılımı; 11 Kangal, 18 Melez, 3 Akbaş, 1 Golden Retriver, 1 Boxer ve 2 Alman Çoban olmak üzere 36 adet köpek çalışmanın materyalini oluşturdu. 36 osteoartritisli köpekten eklem içi TZP, Bio-aktivatörlü TZP (BTZP) ve Kontrol (% 0.9 İzotonik) olmak üzere rastgele 3 ana grup oluşturuldu. Bu 3 ana grup kendi içinde 0. gün ve 0., 30. gün eklem içi uygulaması sayısına göre tek ve çift 2 alt gruba ayrıldı. Her gruba 0. 15. 30. 60. ve 90. günlerde eklem sıvısı analizleri, klinik muayene (Yürüyüş derecelendirme testi (HVAS-Hudson Visual Scale), Ağrı derecelendirme testi (Canine Brief Pain Inventory)), radyografik muayene, ultrasonografik muayene ve termografik muayeneleri yapıldı. Çalışmada istenilen düzeyde trombosit sayısının standardize edilmiş Genesis Autologous Cell System 2 (30ml) markalı TZP ve Bio-aktivatörlü TZP hazırlama kitlerinden yararlanıldı. 0. 15. 30. 60. ve 90. günlerde her bir hayvandan alınan sinovyal sıvı örneklerinin yangısal mediatör görevi yapan bazı sitokinler (IL-1β, IL-6, IL- 10, TNF-α) yönünden ELISA yöntemi ile metalloproteinaz (MMP-2 ve MMP-9) enzimleri ise zymografi yöntemi ile ölçümleri gerçekleştirildi. Yürüyüş ve ağrı derecelendirme testleri (HVAS-CBPI)'nde alınan kayıtlar SPSS 20.0 istatistik analiz programı ile istatistiğe tabi tutularak Mann Whitney U testi yapıldı. ELISA ve Zymografi sonuçlarına ise Tukey testi yapılarak değerlendirildi. TZP ve BTZP grubundaki olgular topallık derecelendirmesinde yürüyüş analizleri ve klinik muayenelerde pozitif yönde ilerleme göstermiştir. MMP-2 ve MMP-9 aktivitelerine zymografi yöntemi ile bakıldığında; 0. gün ile 90. gün arasında TZP ve BTZP çift uygulama grubu ile tek uygulama grubu karşılaştırılmasında istatistiksel olarak fark bulunmamasına rağmen MMP-2 ve MMP-9 0. gün ile 90. gün arasında azalan bir eğri göstererek, çift uygulamaların tek uygulamalara göre daha üstün olduğu görülmüştür. IL- 10'un değerlendirilmesinde 90. günde BTZP tek ile çift uygulama arasında istatistiksel olarak fark bulunmuştur. IL-6, TNF- α ve IL-1β seviyelerinde ise post-operatif dönemlerde düşüşler olmakla birlikte istatistiki değişimler olmamıştır. Sonuç olarak; TZP ve BTZP grubundaki olguların klinik değerlendirmelerinde olumlu sonuçlar gözlenmiştir. Fakat, alınan veriler birbirlerine olan üstünlükleri için yeterli olmamaktadır. Ayrıca, OA'nın ilerleyen döneminde oluşan osteofitik üremelere pozitif bir etkinliği radyolojik olarak görülmemiştir. TZP ve BTZP'nin hazırlığının kolay olması, uygulamasında herhangi bir komplikasyon oluşturmaması, antiinflammatuar etkinliğinden dolayı OA'nın alternatif tedavi yöntemleri arasında değerlendirilebilir. Bu tedavi uygulamasında olgu seçimleri önemlidir.
In this study; It was aimed, the results of inflammatory mediators (IL-6, IL-10, TNF-α IL-1β) and metalloproteinases (MMP-2 and MMP-9) enzymes of single and double intra-articular applications of plasma rich platelet (PRP) or Bio-activated PRP in OA treatment with multifactorial pathogenesis, which is common in dogs. The materials of the study were 36 dogs with lameness in stifle joint including 11 Kangal, 18 Crossbreed, 3 Akbas, 1 Golden Retriever, 1 Boxer and 2 German Shepherds with average of weights 30 ± 1, average age 5 ± 1, gender distribution; 6 female, 30 male, obtained to Department of Surgery, Faculty of Veternary Medicine, The University of Selcuk. In 36 dogs with osteoarthritis, 3 groups were randomly selected: intra-articular PRP, Bio-activated PRP (BPRP) and Control (0.9% isotonic). The three main groups on day 0 and 0, 30th days depending on the number of intra-articular administration of single and double were divided into 2 subgroups. Joint fluid analysis, clinical examination (HVAS-Hudson Visual Scale), pain score (CBPI-Canine Brief Pain Inventory), radiographic examination, ultrasonographic examination and thermographic examinations were repeated. Each group on days 0. 15th. 30th. 60th and 90th. Genesis Autologous Cell System 2 (30ml) PRP and Bio-activated PRP preparation kits were used to standardize platelet count at the desired level in the study. Synovial fluid samples taken from each animals to measured for metalloproteinases by zymography and some cytokines (IL-1β, IL-6, IL-10, TNF-α) by ELISA on days 0. 15. 30. 60 and 90. The Mann Whitney U test was performed by subjecting the records to the walking and pain scoring tests (CBPI and HVAS) by statistical analysis with the SPSS 20.0 statistical analysis program. Results of ELISA and zymography were evaluated by Tukey test. The cases of lameness showed positive progress with gait analysis of the clinical examination in the PRP and BPRP groups. Activation of MMP-2 and MMP-9 enzymes showed a decreasing curve from day 0 to day 90th, although there was no statistical difference in the comparison of the single then double treatment group concern with the PRP and BPRP injection, but double treatment groups was shown to be superior between day 0 and day 90th, when observed MMP-2 and MMP-9 activities by zymography method. The evaluation of IL-10 was shown statistically difference between BPRP with single and double administration at 90th days. Eventhough, IL-6, TNF-α and IL-1β levels with decreases in post-operative periods but there was not statistical. As a result; positive results were observed of the cases in the PRP and BPRP groups in the clinical evaluations. However, the received data are not sufficient for PRP or BPRP injections superiority to each other. In addition, a positive effect was not observed on osteophytic production developed in the later stages of OA by radiological evaluation. The preparation of PRP and BPRP is easy and does not cause any complication, could be considered as alternative treatment methods of OA because of its anti-inflammatory effect, but case selection is important in this treatment.
In this study; It was aimed, the results of inflammatory mediators (IL-6, IL-10, TNF-α IL-1β) and metalloproteinases (MMP-2 and MMP-9) enzymes of single and double intra-articular applications of plasma rich platelet (PRP) or Bio-activated PRP in OA treatment with multifactorial pathogenesis, which is common in dogs. The materials of the study were 36 dogs with lameness in stifle joint including 11 Kangal, 18 Crossbreed, 3 Akbas, 1 Golden Retriever, 1 Boxer and 2 German Shepherds with average of weights 30 ± 1, average age 5 ± 1, gender distribution; 6 female, 30 male, obtained to Department of Surgery, Faculty of Veternary Medicine, The University of Selcuk. In 36 dogs with osteoarthritis, 3 groups were randomly selected: intra-articular PRP, Bio-activated PRP (BPRP) and Control (0.9% isotonic). The three main groups on day 0 and 0, 30th days depending on the number of intra-articular administration of single and double were divided into 2 subgroups. Joint fluid analysis, clinical examination (HVAS-Hudson Visual Scale), pain score (CBPI-Canine Brief Pain Inventory), radiographic examination, ultrasonographic examination and thermographic examinations were repeated. Each group on days 0. 15th. 30th. 60th and 90th. Genesis Autologous Cell System 2 (30ml) PRP and Bio-activated PRP preparation kits were used to standardize platelet count at the desired level in the study. Synovial fluid samples taken from each animals to measured for metalloproteinases by zymography and some cytokines (IL-1β, IL-6, IL-10, TNF-α) by ELISA on days 0. 15. 30. 60 and 90. The Mann Whitney U test was performed by subjecting the records to the walking and pain scoring tests (CBPI and HVAS) by statistical analysis with the SPSS 20.0 statistical analysis program. Results of ELISA and zymography were evaluated by Tukey test. The cases of lameness showed positive progress with gait analysis of the clinical examination in the PRP and BPRP groups. Activation of MMP-2 and MMP-9 enzymes showed a decreasing curve from day 0 to day 90th, although there was no statistical difference in the comparison of the single then double treatment group concern with the PRP and BPRP injection, but double treatment groups was shown to be superior between day 0 and day 90th, when observed MMP-2 and MMP-9 activities by zymography method. The evaluation of IL-10 was shown statistically difference between BPRP with single and double administration at 90th days. Eventhough, IL-6, TNF-α and IL-1β levels with decreases in post-operative periods but there was not statistical. As a result; positive results were observed of the cases in the PRP and BPRP groups in the clinical evaluations. However, the received data are not sufficient for PRP or BPRP injections superiority to each other. In addition, a positive effect was not observed on osteophytic production developed in the later stages of OA by radiological evaluation. The preparation of PRP and BPRP is easy and does not cause any complication, could be considered as alternative treatment methods of OA because of its anti-inflammatory effect, but case selection is important in this treatment.
Açıklama
Anahtar Kelimeler
Köpek, Osteoartritis, Sinovyal sıvı, Metalloproteinaz, Yangısal mediatör, Dog, Osteoarthritis, Synovial fluid, Metalloproteinase, Inflammatory mediator
Kaynak
WoS Q Değeri
Scopus Q Değeri
Cilt
Sayı
Künye
Parlak, K. (2018). Osteoartritisli köpeklerde ıntra-artiküler otolog trombositten zengin plazma (TZP) uygulaması ile bio-fiziksel aktivatörlü otolog trombositten zengin plazma uygulamasının yangısal mediatörler ve metalloproteinaz (MMP-2 ve MMP-9) enzimlerine etkisinin araştırılması. Selçuk Üniversitesi, Yayımlanmış doktora tezi, Konya.
