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Potential Syringetin-Based Nhac/PLGA As Bionano Bone Graft to Improved Osteoinductivity and Osteoconductivity

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Potential Syringetin-Based Nhac/PLGA As Bionano Bone Graft to Improved Osteoinductivity and Osteoconductivity ORIGINAL ARTICLE Bali Anatomy Journal (BAJ) 2019, Volume 2, Number 2: 51-57 E-ISSN : 2620-3154 ; P-ISSN : 2621-2021 Potential syringetin-based nHAC/PLGA as bionano bone graft to improved osteoinductivity and osteoconductivity I Kadek Wahyu Putra Dyatmika*, Jonathan Hubert Prasetya, I Wayan Windi Artha DOI: 10.36675/baj.v2i2.30 ABSTRACT Background: According to the data of Riskesdas in 2013, fracture which has explicit inclusion and exclusion criteria. incident rate in Sulawesi gets a 16% increase. The most common Discussion: Syringetin-based nHAC usage has some targets like fracture incident happens to elderly age group, and its predominant BMSC. Syringetin-based nHAC affects in increasing the expression cause is a traumatic incident like falls and traffic accident. Treatment of BMP-2 and miRNA-21. BMP-2 and miRNA-21 are factors that take now such as ORIF and External Fixation is far from cheap and has part in osteoblast proliferation and differentiation. That expression a high risk to the patient. Syringetin-based nHAC/PLGA usage can increase is marked by ALP activity and osteocalcin increase. be a new bionano bone graft because it can target specific cells to Conclusion: Significantly, the usage of syringetin-based nHAC/ increase osteoinductivity in bones. PLGA can increase the proliferation and differentiation rate of BMSC Method: This literature review is established by the literature to osteoblast. review method of collecting sources from valid scientific literature Keywords: Syringetin, nHAC/PLGA, Osteogenesis, Osteoinductivity Undergradute Program in INTRODUCTION age range of 85 and above in both genders.5 Other Medicine, Medical Faculty, than vertebral fracture (24%), leg fracture (10,5% is Universitas Udayana Fractures are defined as discontinuity of bone the second most common fracture and the third structure and are generally a common occurrence most common is rib fracture (10.3%).5 in the elderly age group; the incidence of fractures 1,2 The cause of the fracture in the report in the elderly tends to increase with age. The from Amin et al. divided into four, namely prevalence of fractures is 4.4% of the population severe trauma (33,4%), moderate trauma of South Sulawesi and 5.8% of in Indonesian 2 (60,2%), pathological (2,1%), and those not population. Increased prevalence of fractures in included in that category (4.3%).5 From this study, South Sulawesi was also reported in Riskesdas severe trauma usually causes leg fractures (20%); Indonesia 2013 by comparing Riskesdas in 2007 moderate trauma and pathological conditions often and 2013; there was a 16% increase in the incidence 2 cause thoracic vertebral fractures (32% and 38% of fractures from 3.7% to 4.3%. The incidence of respectively).5 fractures in South Sulawesi often occurs in the age 2 Treatment of fracture patients can be classified as group 65-74 years (11.1%). In South Sulawesi, the non-operative and operative handlers. Handling of incidence of fractures in Indonesia is lower in the 3 non-operative fractures can be done conservatively young group than the older one. such as elevation, the application using ice, and Gender also influences on fracture rates, studies splints.6 Management of orthopaedic operations of hip fracture incidents in Japan and Singapore *Correspondence to: such as open reduction and internal fixation (ORIF) indicate that the incidence of hip fracture is 2.6 I Kadek Wahyu Putra and external fixation. Treatment after operating and to 3.5 times more common in women.4 There Dyatmika ; Undergradute non-operating fractures are currently only focusing have also been reported increases in Japan over Program in Medicine, Medical on the reduction of short-term complications and Faculty, Universitas Udayana; the past 30 years. The increment was concluded long-term. Both postoperative treatment and non- [email protected] due to the increasing population of the elderly in 4 operation strategies aim to relieve both the pain Japan. Increasing the elderly population occur and venous thromboembolic state.7 However, there in Indonesia, and the prevention and treatment is still no bone graft treatment that has the target of of fractures need to be improved to maintain and increasing osteoinductivity in the fractured bone. improve the quality of life of the elderly in the future. Received: : 16 October 2019 Inducing the osteoblast will improve the process Accepted: 25 Nopember 2019 Data taken from Olmsted County reports the most of forming osteoblast cells. Osteoblast cells will Published: 1 December 2019 frequenting fractures are vertebral fractures with an Open access: http://balianatomyjournal.org 51 ORIGINAL ARTICLE build new bone tissue so that it will reshape the because of its biocompatibility, bioactivity, bone tissue structure to become new. and osteoconductive properties.10 Various Various limitations of the treatment of fractures studies have shown that it can be absorbed offer opportunities for the development of new by osteoblasts and affect the fusion therapies. One of the natural ingredients that have the of osteoclast mononuclear precursors. These effect of increasing osteoinductivity is syringetin. properties make nHAC potentially able to deliver Syringetin is a flavonoid derivative that has drugs directly to the desired tissue and are useful a mechanism of action on improving BMP- as a tool to improve the treatment of several bone 2 and miRNA-21 to accelerate the process of diseases such as osteomyelitis and cancer.11 differentiation and maturation of osteoblast. One of the essential ingredients The low bioavailability of syringetin was of hydroxyapatite derived from natural materials enhanced by the use of encapsulation of HAC/ is an eggshell. Hydroxyapatite (EHA) of eggshell PLGA nanoparticles. Those nHAC / PLGA also has formulation showed excellent biocompatibility and excellent properties as a bone graft for fractures. material properties in vitro. It is a promising graft With these advantages, syringetin-based nHAC/ material with unique features for grafting. It is PLGA has the potential to be a bio-nano bone graft hydrophilic, absorbs fluid and blood around it, in the treatment of fractures. making it easy to handle and put on the surgical site. It can be implemented as a graft material for METHOD grafting bone defect secondary to periodontal disease, trauma, tooth extraction, intra- The study was a literature review that consisted bone defects, sinus removal procedures, and so on.12 of relevant journals from search engines such Poly lactic-co-glycolic acid (PLGA) is a as Pubmed, Google Scholar, and Proquest. copolymer compound which is synthesized Writers searched the keywords “Syringetin”, through the opening of the copolymerization ring “Nanohidroxyapatite”, “PLGA”, “Bone remodelling”, of two different monomer compounds that form “Fracture”, “Osteogenesis”, and “Osteoinductivity”. cyclic dimers (1,4-dioxide-2,5-diones) of lactic acid The inclusion criteria were all syringetin, and glycolic acid. The ratio of the amount between nanohydroxyapatite, PLGA, osteogenesis, lactic acid and glycocalyric is 50:50. PLGA has osteoinductivity. The collected references then excellent biocompatibility and biodegradability noted and analyzed for validity and reliability, properties. It is useful in making nanoparticles.13,14 interpreted and compiled into a scientific literature In reconstructive or regenerative bone review. surgery, ideal material functions not only as a carrier for drug delivery but also as a porous DISCUSSION scaffold for cellular activity. So that the combination Syringetin: Flavonoids Induces Osteogenesis of nHAC with type one collagen and PLGA will be Flavonoids are compounds that can be a useful scaffold for bone cell growth, and drug 15 extracted from various types of fruits and delivery such as syringetin. vegetables. Some flavonoids have been shown to affect osteoblastic diffraction,Fracture healing mechanism and Bone such as daidzein, genistein, quercetin, Remodeling kaempferol, naringin, myricetin, and diosmetin. Fracture Healing divided into several steps. First, Syringetin (3,5,7,4’- tetrahydroxy-3’,5’ there is a hematoma and inflammation at the site dimethoxyflavone) is a derivative of flavonoids, of the fracture; second, chondrogenesis begins and which can be found in grapes and khamar. The callus formation occurs (cells that become vascular concentration of syringetin found in grapes reached bone was also at this stage); third, osteoblast cells 3.22%.8 begin to form hard bones and connect the two Hsu et al. research showed that syringetin could broken bone segments (osteogenesis); fourth, increase BMP-2 synthesis and activate SMAD1/ bone remodelling occurs with the ended result of a 16-18 5/8 and ERK1/ 2. These effects can contribute to its stronger lamellar bone structure. The four steps activity to induce maturation and differentiation above can also be divided into two phases, namely of osteoblasts followed by an increase in bone mass.9 the anabolic phase (the cell recruitment phase and matrix mineralization) and the catabolic phase Nanohydroxyapatite and Its Application (the accumulation phase of mineral accumulation 18 Nanohydroxyapatite collagen (nHAC) and vascularisation). is a nanoparticle delivering drugs for Bone remodelling belongs to the catabolic phase. bone therapy. It is frequently applied In that phase, osteoclasts begin to absorb the 52 Open access: http://balianatomyjournal.org ORIGINAL ARTICLE matrix which has been mineralized during with the insertion of the nHA (scaffold)
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