Abstract
Background: Rapid wound healing is needed after tooth extraction treatment so that prosthodontics treatment can be done immediately. However, systemic diseases, such as diabetes mellitus, can inhibit the wound healing process. The state of hyperglycemia in people with diabetes mellitus can interfere with the function of macrophages and neutrophils. This condition can cause an imbalance in the cytokines IL-1β, TNF-α and IL-10 that are produced by macrophages and thus will affect the wound healing process. Spirulina and chitosan are two natural substances that have been proven to have anti-inflammatory properties. This study was aimed to determine whether the combination of 12% spirulina and 20% chitosan can accelerate wound healing through its intervention in cytokines IL-1β, TNF-α and IL-10.Method: The samples used were 36 Wistar rats suffering from diabetes mellitus and divided into control groups induced by CMC Na base gel and treatment groups induced by the combination of 12% spirulina and 20% chitosan in the socket. These 2 groups were further divided into groups terminated on one day, three days and seven days post-extraction.Results: The amount of IL-1β and TNF-α in the treatment groups is lower than that of the control group. Meanwhile, the treatment group of IL-10 showed an increase in IL-10 levels. Conclusion: The combination of 12% spirulina and 20% chitosan can accelerate wound healing. They are decreasing the amount of pro-inflammatory cytokines IL-1β and TNF-α as well as increasing the number of anti-inflammatory cytokines IL-10.
Highlights
The International Diabetes Federation (IDF) states that as many as 8.8% of the world's population of around 425 million people suffer from Diabetes Mellitus (DM) in 2017
Based on the mentioned above, this study aims to determine the effect of the combination of 12% spirulina and 20% chitosan on cytokines IL-1β, TNF-α, and IL-10 in the faster-wound healing process
The previous study by Wu et al describes that under DM conditions, there is an accumulation of advanced glycation end products (AGEs) and the amount of receptor for AGEs (RAGEs)
Summary
The International Diabetes Federation (IDF) states that as many as 8.8% of the world's population of around 425 million people suffer from Diabetes Mellitus (DM) in 2017. An imbalance between M1 (classically activated macrophages) and M2 (alternatively activated macrophage) polarization in diabetics causes an increase in expression of pro-inflammatory cytokines such as IL-1β & TNF-α by M1 It can decrease the anti-inflammatory cytokines such as IL-10 by M2.4 Excessive production of pro-inflammatory cytokines and reduced the production of anti-inflammatory cytokines will result in a longer-lasting inflammatory process that can lead to uncontrolled tissue damage.[5] In this era, a bone graft is an excellent material to accelerate bone regeneration. The state of hyperglycemia in people with diabetes mellitus can interfere with the function of macrophages and neutrophils This condition can cause an imbalance in the cytokines IL-1β, TNF-α and IL-10 that are produced by macrophages and will affect the wound healing process. This study was aimed to determine whether the combination of 12% spirulina and 20% chitosan can accelerate wound healing through its intervention in cytokines IL-1β, TNF-α and IL-10
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