TERAPI MESENCHYMAL STEM CELL SEBAGAI MODALITAS TATALAKSANA OSTEOARTRITIS

  • Emeraldha Theodorus Program Studi Pendidikan Profesi Kedokteran, Fakultas Kedokteran, Universitas Lampung, Lampung, Indonesia
  • Debby Cinthya D Valentina Program Studi Pendidikan Profesi Kedokteran, Fakultas Kedokteran, Universitas Lampung, Lampung, Indonesia
  • Theodora Agverianti Program Studi Pendidikan Profesi Kedokteran, Fakultas Kedokteran, Universitas Lampung, Lampung, Indonesia
  • Renti Kusumaningrum Samosir Program Studi Pendidikan Profesi Kedokteran, Fakultas Kedokteran, Universitas Lampung, Lampung, Indonesia

Abstract

ABSTRAK


TERAPI MESENCHYMAL STEM CELL SEBAGAI MODALITAS TATALAKSANA OSTEOARTRITIS


Pendahuluan: Osteoartritis (OA) merupakan penyakit degeneratif dan progresif dengan adanya degradasi kartilago artikular, pembentukan osteofit, kerusakan tulang subkondral, dan inflamasi membran sinovial. Angka kejadian penyakit sendi usia di atas 15 tahun di Indonesia sebanyak 15%, dengan 60% merupakan OA pada lutut. Penelitian terbaru menyebutkan adanya potensi mesechymal stem cell (MSC) sebagai tatalaksana OA.


Pembahasan: Patogenesis OA melibatkan aktivasi sistem imun yang menyebabkan penurunan sistesis kartilago dan kerusakan kartilago. Sistem imun juga memicu aktivasi c-Jun NH 2-terminal Kinase (JNK) signalling pathway yang menyebabkan degenerasi kartilago. Penatalaksanaan OA telah berkembang menjadi terapi intra-artikular, salah satunya dengan mesenchymal stem cell (MSC). Mekanisme MSC dalam terapi OA yaitu dengan menstimulasi kolagen tipe dua untuk regenerasi kartilago, mempercepat diferensiasi kartilago, dan memiliki efek anti-inflamasi. Penggunaan MSC secara autotransplantasi dapat diambil melalui adipose tissue liposuction dan aspirasi sumsum tulang. Penggunaan MSC allotransplantasi yang terbaik berasal dari sel Wharthon’s Jelly dari human umbilical cord tissue (HUCT).


Simpulan: Potensi sel punca mesenkimal dalam proses regenerasi jaringan kartilago dan anti-inflamasi setelah paparan stres oksidatif dapat dijadikan sebagai modalitas terapi baru untuk mencegah perburukan pada pasien OA.


Kata kunci: Osteoartritis, Stem cell, Terapi

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References

1. Kim C, Keating A. Cell therapy for knee osteoarthritis: mesenchymal stromal cells. Karger. 2019 Mei;65(3): 294–8.
2. Navneet KD, Viraj KM, Rajni D, Shabbir SA, Joseph RW, Peter DW, et al. Combating osteoarthritis through stem cell therapies by rejuvenating cartilage: A review. Stem Cells International. 2018 Mar: 1-13.
3. Silverwood V, Blagojevic BM, Jinks C, Jordan JL, Protheroe J, Jordan KP. Current evidence on risk factors for knee osteoarthritis in older adults: a systematic review and meta-analysis. Osteoarthritis and Cartilage. 2015 Apr;23(4): 507–15.
4. Bombardier C, Hawker G, Mosher D. The impact of arthritis in canada, arthritis alliance of canada, toronto, ontario, canada: Today and over 30 years. Arthritis Alliance of Canada. 2011 Okt:34.
5. Disease GBD, Injury I, Prevalence C. Global, regional, and national incidence, prevalence, and years lived with disability for 354 diseases and injuries for 195 countries and territories, 1990-2017: a systematic analysis for the Global Burden of Disease Study 2017. The Lancet. 2018 Nov; 392(10159): 1789–1858
6. Ahmad IW, Rahmawati LD, wardhana TH. Demographic profile, clinical, and analysis of osteoarthritis patients in surabaya. Biomolecular and Health Science Journal. 2018 Apr; 1(1): 34-9.
7. Mora JC, Przkora R, Almeida YC. Knee osteoarthritis: pathophysiology and current treatment modalities. Journal of Pain Research. 2018 Okt; 11(1): 2189-96.
8. Patrizio M, Swarna R, Aoife G, Frank B, Murphy JM. Mesenchymal stem cell therapy for osteoarthritis: The critical role of the cell secretome. Front Bioeng Biotechnol. 2019 Jan; 7(9):1-9.
9. IRA. Rekomendasi IRA untuk diagnosis dan penatalaksanaan osteoartritis. Jakarta: Indonesian Rheumatology Association; 2014.
10. Kemenkes RI. Riset kesehatan dasar tahun 2018. Jakarta: Badan Penelitian dan Pengembangan Kesehatan Kementerian Kesehatan Republik Indonesia; 2018.
11. Mora JC, Przkora R, Cruz-Almeida Y. Knee osteoarthritis: pathophysiology and current treatment modalities. J Pain Res. 2018 Oct; 11:2189-96.
12. Ayhan E, Kesmezacar H, Akgun I. Intraarticular injection (hyaluronic acid, platelet rich plasma) for the knee osteoarthritis. World J Orthop. 2014 Jul; 5(3):351-61.
13. Ashkavand Z, Malekinejad H, Vishwanath BS. The pathophysiology of osteoarthritis. Journal of Pharmacy Research. 2013 Dec; 7(2013):132-8.
14. Palazzo C, Nguyen C, Lefevre-Colau M, Rannou F, Poiraudeau. Risk factors and burden of osteoarthritis. Ann Phys Rehabil Med. 2016 Jun; 59(3):134-8.
15. Sokolove J, Lepus CM. Role of inflammation in the pathogenesis of osteoarthritis: latest findings and interpretations. Theurapeutic Advances in Muskuloskeletal Disease. 2013 Apr; 5(2):77-88.
16. Ge HX, Zou F, Li Y, Liu A, Tu M. JNK pathway in osteoarthritis: pathological and therapeutic aspects. Journal of Receptors and Signal Transduction. 2017 Aug; 37(5):431-6.
17. Richards MM, Maxwell JS, Weng L, Angelos MG, Golzarian J. Intraarticular treatment of knee osteoarthritis: from anti-inflammatories to
products of regenerative medicine. Phys Sportsmed. 2016 Apr; 44(2):101–8.
18. Dulay GS, Cooper C, Dennison EM. Knee pain, knee injury, knee osteoarthritis & work. Best Pract Res Clin Rheumatol. 2015 Jun; 29(3):454–461
19. Kolasinski SL, Neogi T, Hochberg MC, Oatis C, Guyatt G, Block J, et al. 2019 American college of rheumatology or arthritis foundation guideline for the management of osteoarthritis of the hand, hip and knee. Arthritis Care and Research. 2020 Jan; 72(2):149-62.
20. Jevsevar DS. Treatment of osteoarthritis of the knee: evidence-based
guideline, 2nd edition. J Am Acad Orthop Surg. 2013 Sep; 21(9):571–6.
21. Mcalindon TE, Bannuru RR, Sullivan MC, Arden NK, Berenbaum F, Bierma-Zeinstra SM, et al. OARSI guidelines
for the non-surgical management of knee osteoarthritis. Osteoarthritis
Cartilage. 2014 Mar; 22(3):363–88.
22. Bannuru RR, Schmid CH, Kent DM, Vaysbrot EE, Wong JB, Mcalindon
TE. Comparative effectiveness of pharmacologic interventions for knee
osteoarthritis: a systematic review and network meta-analysis. Ann
Intern Med. 2015 Jan; 162(1):46–54.
23. Dubey NK, Mishra VK, Dubey J, Abdul SS, Wang JR, Wang PD, dkk. Combating osteoarthritis through stem cell therapies by rejuvenating cartilage: a review. Stem Cells Int. 2018 Mar;2018:1-13.
24. Djauhari T. Sel punca. Jurnal Santika Medika. 2010 Dec;6(2):91-6.
25. Zakrzewski W, Dobrzynski M, Szymonowicz M, Rybak Z. Stem cell: past, present, and future. Stem Cell Res Ther. 2019 Feb;10(68):1-22.
26. Freitag J, Bates D, Wickham J, Shah K, Huguenin L, Tenem A, dkk. Adipose-derived mesenchymal stem cell therapy in the treatment of knee osteoarthritis: a randomized controlled trial. Regen Med. 2019 Feb;14(3):213-30.
27. McGonagle D, Baboolal TG, Jones E. Native joint-resident mesenchymal stem cells for cartilage repair in osteoarthritis. Net Rev Rheumatol. 2017 Dec;13(12):719-30.
28. Whittle SL, Johnston RV, McDonalds S, Worthley D, Campbell TM, Buchbinder R. Stem cells injections for osteoarthritis of the knee [protocol]. Cochrane Database Systematic Reviews. 2019 May;5:1-17.
29. Shah K, Zhao AG, Sumer H. New approaches to treat osteoarthritis with mesenchymal stem cells. Hindawi. 2018 Sep;2018:1-9.
30. Lu L, Dai C, Zhang Z, Du H, Li S, Ye P, dkk. Treatment of knee osteoarthritis with intra-articular injection of autologous adipose-derived mesenchymal progenitor cells: a prospective, randomized, double-blind, active-controlled, phase IIb clinical trial. Stem Cell Res Ther. 2019 May; 10(143):1-10.
31. Chahal J, Aristizabal AG, Shestopaloff K, Bhatt S, Chaboureau A, Fazio A, dkk. Bone marrow mesenchymal stromal cell treatment in patients with osteoarthritis results in overall improvement in pain and symptoms and reduces synovial inflammation. STEM CELLS Translational Medicine. 2019 Apr;8(8):746-57.
32. Bianco P. Mesenchymal stem cells. Annu Rev Cell Dev Biol. 2014 Aug;30:677-704.
33. Ankrum JA, Ong JF, Karp JM. Mesenchymal stem cells: immune evasive, not immune privileged. Nature Biotechnology. 2014 Feb;32:252-60.
34. Burke J, Hunter M, Kolhe R, Isales C, Hamrick M, Fulzele S. Therapeutic potential of mesenchymal stem cell based therapy for osteoarthritis. Clin Transl Med. 2016 Aug;5(1):1-8.
Published
2022-01-31
How to Cite
THEODORUS, Emeraldha et al. TERAPI MESENCHYMAL STEM CELL SEBAGAI MODALITAS TATALAKSANA OSTEOARTRITIS. Essential: Essence of Scientific Medical Journal, [S.l.], v. 19, n. 2, p. 1-4, jan. 2022. ISSN 2655-6472. Available at: <https://ojs.unud.ac.id/index.php/essential/article/view/59091>. Date accessed: 27 june 2022. doi: https://doi.org/10.24843/ESTL.2021.v19.i02.p01.