PMID- 32962576
OWN - NLM
STAT- MEDLINE
DCOM- 20210208
LR  - 20210208
IS  - 2687-4792 (Electronic)
IS  - 2687-4784 (Print)
IS  - 2687-4792 (Linking)
VI  - 31
IP  - 3
DP  - 2020
TI  - Tranexamic acid has positive effect in early period of tendon healing by 
      stimulating the tumor necrosis factor-alpha and matrix metalloproteinase-3 
      expression levels.
PG  - 463-469
LID - ehc.2020.74265 [pii]
LID - 10.5606/ehc.2020.74265 [doi]
AB  - OBJECTIVES: This study aims to evaluate the effect of tranexamic acid (TXA) 
      application in tendon healing by using its immunohistochemical effects on tumor 
      necrosis factor-alpha (TNF-alpha), matrix metalloproteinase-3 (MMP-3), and 
      transforming growth factor-beta (TGF-beta) expression; and to identify if TNF-alpha, 
      MMP-3, and TGF-beta can be used to monitor and evaluate tendon healing or not in 
      tenotomized rat Achilles tendons. MATERIALS AND METHODS: Twelve male 
      Wistar-Albino rats (age 6-7-month-old; weighing 300-350 g) were used in this 
      retrospective study conducted between November 2016 and May 2017. The rats were 
      divided into two groups with similar weights. The right legs of the rats were 
      determined as the study group (TXA), and the left legs as the control serum 
      physiologic (SP) group. Under anesthesia, bilateral Achilles tenotomy was 
      performed and surgically repaired. 1 mL of TXA was applied locally for the right 
      side and 1 mL of SP was locally applied for the left side. Half of the rats were 
      sacrificed at the third week (right leg-TXA3, left leg-SP3) and the other half at 
      sixth week (right leg-TXA6, left leg-SP6) and tendon samples were taken from the 
      extremities. Immunohistochemical findings of TNF-alpha, MMP-3, and TGF-beta were 
      evaluated on the basis of the frequency and intensity of staining. RESULTS: In 
      TNF-alpha and MMP-3 and TXA groups, there was a significant difference in staining 
      compared to SP groups (p<0.05). Regarding TNF-alpha expression, the total index score 
      in the TXA6 subgroup was higher than the TXA3, SP6, and SP3 subgroups (8, 7, 3, 
      and 4, respectively). Overall scores of TNF-alpha showed that TXA groups had 
      significantly higher scores when compared to SP groups (p<0.05). In addition, 
      total MMP-3 expression scores were significantly higher in TXA groups than in SP 
      groups, respectively; TXA3: 14, TXA6: 11, SP3: 10, and SP6: 9 (p<0.05). However, 
      the degree of staining with TNF-alpha was found to be significantly lower than MMP-3 
      (p<0.05). Immunohistochemical reactivity was not observed with TGF-beta. CONCLUSION: 
      Tranexamic acid has positive effect in early period of tendon healing by 
      stimulating the TNF-alpha and MMP-3 expression levels. TNF-alpha and MMP-3 can be used to 
      monitor and evaluate tendon healing.
FAU - Cirakli, Alper
AU  - Cirakli A
FAU - Gurgor, Pinar Naile
AU  - Gurgor PN
FAU - Uzun, Erdal
AU  - Uzun E
FAU - Erdem, Havva
AU  - Erdem H
FAU - Sahin, Abdullah Alper
AU  - Sahin AA
AD  - Ordu Universitesi Egitim ve Arastirma Hastanesi Ortopedi ve Travmatoloji Klinigi, 
      52200 Altinordu, Ordu, Turkiye. dr.a.alpersahin@gmail.com.
FAU - Bas, Orhan
AU  - Bas O
LA  - eng
PT  - Journal Article
PL  - Turkey
TA  - Jt Dis Relat Surg
JT  - Joint diseases and related surgery
JID - 101764223
RN  - 0 (Transforming Growth Factor beta)
RN  - 0 (Tumor Necrosis Factor-alpha)
RN  - 6T84R30KC1 (Tranexamic Acid)
RN  - EC 3.4.24.17 (Matrix Metalloproteinase 3)
SB  - IM
MH  - *Achilles Tendon/metabolism/surgery
MH  - Administration, Topical
MH  - Animals
MH  - Male
MH  - Matrix Metalloproteinase 3/*metabolism
MH  - Rats
MH  - Rats, Wistar
MH  - Retrospective Studies
MH  - *Surgical Wound/drug therapy/metabolism
MH  - Tenotomy/methods
MH  - *Tranexamic Acid/administration & dosage/pharmacokinetics
MH  - Transforming Growth Factor beta/*metabolism
MH  - Treatment Outcome
MH  - Tumor Necrosis Factor-alpha/*metabolism
MH  - *Wound Healing/drug effects/physiology
PMC - PMC7607962
COIS- Conflict of Interest: The authors declared no conflicts of interest with respect 
      to the authorship and/or publication of this article.
EDAT- 2020/09/24 06:00
MHDA- 2021/02/09 06:00
PMCR- 2020/09/11
CRDT- 2020/09/23 05:55
PHST- 2020/09/23 05:55 [entrez]
PHST- 2020/09/24 06:00 [pubmed]
PHST- 2021/02/09 06:00 [medline]
PHST- 2020/09/11 00:00 [pmc-release]
AID - ehc.2020.74265 [pii]
AID - 10.5606/ehc.2020.74265 [doi]
PST - ppublish
SO  - Jt Dis Relat Surg. 2020;31(3):463-469. doi: 10.5606/ehc.2020.74265.