Application of a Purified Protein From Natural Latex and the Influence of Suture Type on Achilles Tendon Repair in Rats

Author(s)

Cury, Diego Pulzatto ^{[1, 2]} ; Schafer, Barbara Tavares ^{[1, 3]} ; Yokomizo de Almeida, Sonia Regina ^{[1, 2]} ; da Silva Righetti, Marta Maria ^{[1, 2]} ; Watanabe, Ii-sei ^{[1, 2]}

Affiliation

^[1] Univ Sao Paulo, Inst Biomed Sci, Sao Paulo - Brazil

^[2] Univ Sao Paulo, Inst Biomed Sci, Dept Anat, 2415 Prof Lineu Prestes Av, BR-05508000 Sao Paulo, SP - Brazil

^[3] Univ Sao Paulo, Sch Vet Med & Anim Sci, Dept Surg, Sao Paulo - Brazil

• Document type: Journal article
• Source: AMERICAN JOURNAL OF SPORTS MEDICINE; v. 47, n. 4, p. 901-914, MAR 2019.
• Web of Science Citations: 1

Abstract

Background: The prolonged tendon-healing process, the high costs associated with treatment, the increase in the number of injuries over the past decades, and the lack of consensus on the optimal treatment of tendon injuries are a global problem. Restoring the normal tendon anatomy and decreasing the healing time are key factors for treatment advancement. Hypothesis: Application of a purified protein from natural latex (PPNL) accelerates the healing process, increasing collagen synthesis and decreasing metalloproteinases. PPNL associated with a simpler suture technique should decrease the healing time. Study Design: Controlled laboratory study. Methods: Injury, surgery, and treatment with PPNL were conducted with male Sprague-Dawley rats. Two suture techniques were used: U-suture, a simpler and lesser traumatic technique, and Kessler-Tajima, to avoid strangulation of the microcirculation. Achilles tendons were completely sectioned, and 100 mu L of 0.1% PPNL was applied on the tendon during surgery. Tendon morphology, distribution, and quantity of collagen types I and III, as well as expression of TIMP-1, TIMP-2, MMP-2, and MMP-9 and ultrastructural aspects of cells and collagen fibrils, were assessed after 2 and 4 weeks. Results: PPNL treatment improved collagen type I synthesis and reduced MMP-2 expression. All groups showed a 6.8-times increase in tendon weight as compared with the control group after 2 weeks and a 5.2-times increase after 4 weeks. All groups showed an increase in diameter after 4 weeks, except for the ones treated with PPNL, which showed a slight reduction in diameter. The peak of concentration of collagen fibrils with a 80-nm diameter was 27.79% in the control group; all other experimental groups presented fibrils between 50 and 60 nm. However, the best results were observed with Kessler-Tajima suture associated w (AU)

• FAPESP's process: 15/24087-3 - Strategies to improve the regeneration of the calcaneal tendon
• Grantee: Ii-Sei Watanabe
• Support Opportunities: Regular Research Grants