Oleh admin kalbemed pada January 09, 2017 06:30

Manfaat Sel Punca pada Osteoartritis

dr.Arnold Caplan yang dijuluki dengan ” father of mesenchymal stem cells” dan temannya dr.Diego Correa menuliskan sebuah argumen dimana MSCs harus dikirim ke ”drugstore” untuk diperbaiki kerusakan dari jaringannya yang berasal dari sel mesenkim seperti kartilago, tulang, otot, dan lainnya. MSCs merupakan pericytes dan dapat diisolasi dari semua jaringan yang divaskularisasi, dan MSCs dalam jumlah yang cukup besar mengeluarkan molekul bioaktif sebagai bagian dari aktivitas imunumodulator yang terlibat dan trofik lokal mereka. MSCs berguna untuk mensuport regenerasi alami dari jaringan yang terluka. Bila luka ini terdapat pada orang dengan lanjut usia, suplai alami MSCs harus ditambahkan baik secara lokal atau secara sistemik.

Dengan alasan tersebut, maka muncul lah ide untuk penggunaan MSCs dalam pengobatan osteoartritis, para peneliti membuat hipotesa ”injury-inflammation-proliferation-remodeling-model” masih berlaku, tetapi masih jauh lebih rumit dari efek parakrin yang dapat dimunculkan dengan adanya keterlibatan MSCs. Efek parakrin yang dapat muncul diantaranya adalah angiogenesis, pencegahan apoptosis, remodeling luka, dan bahkan antibakteri. Multipotensi dari MSCs dapat sedikit lebih penting dari efek parakrin ini.

Penatalaksanaan osteoartritis dengan penggunaan stem sel ini adalah dengan metode direct intra-articular injection of MSCs, merupakan suatu metode yang paling sederhana yang dapat digunakan dalam mengobati osteoartritis. Setelah disuntikan ke dalam sendi, MSCs dapat segera terdistribusikan hingga ke seluruh celah sendi dan dapat berinteraksi dengan seluruh sel dan permukaan sel. Sinovial dan permukaan internal dari ruang sendi kecuali kartilago dan meniskus merupakan jaringan utama yang dapat berinteraksi dengan MSC.

Suatu studi pada hewan kambing yang mengalami osteoartritis buatan dengan dilakukan total medial menisektomi, kemudian dilakukan penyuntikan MSCs intraartikular. Hasil yang didapat setelah penyuntikan adalah terjadi regenerasi dari meniskus medial dan implantasi sel jaringan baru. Walaupun metode ini merupakan metode yang cukup mudah digunakan, ternyata penggunaan MSCs yang dikombinasikan dengan substrat bioaktif baik alami maupun sintetik juga memiliki potensi klinis yang cukup signifikan dan cukup penting untuk dikembangkan dengan dasar MSC dan teknologi perbaikan kartilago sehingga perbaikan tidak hanya pada lesi fokal, tetapi dapat membentuk prostesis biologis yang utuh. (AWA)



Image: Ilustrasi
Referensi:
1. Noth U, Steinert A F, Tuan R S. Technology insight: adult mesenchymal stem cells for osteoarthritis therapy. Nat Clin Pract Rheumatol. 2008;4(7):371-80.
2. Wei N. Osteoarthritis – an organ failure disesase?. [internet] May 29, 2015 [cited 26 June 2015]. Available from: http://www.medscape.com/viewarticle/845441
3. Caplan AI, Correa D. The MSC: an injury drugstore. Cell Stem Cell. 2011;9:11-5.

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