Review Article

Peran terapi mesenchymal stem cell (MSC) dalam penatalaksanaan luka bakar: sebuah tinjauan sistematis

Zendio Abednego Santoso

Zendio Abednego Santoso
Dokter Umum, Fakultas Kedokteran Universitas Hang Tuah, Surabaya, Indonesia. Email: zendioabe@gmail.com
Online First: December 28, 2021 | Cite this Article
Santoso, Z. 2021. Peran terapi mesenchymal stem cell (MSC) dalam penatalaksanaan luka bakar: sebuah tinjauan sistematis. Intisari Sains Medis 12(3): 927-933. DOI:10.15562/ism.v12i3.1167


Background: Burn cases are still a challenge and a burden in the health sector due to the morbidity and mortality it causes. The current management of burns has not produced satisfactory clinical outcomes in terms of wound healing. Mesenchymal stem cell (MSC) therapy is known to have an effective curative effect in healing burns. This systematic review aims to determine the role of MSCs in the management of burns.

Methods: A systematic literature review was carried out by searching the literature on Google Scholar, Pubmed and Cochrane Library, where the literature selection used PRISMA diagrams. The inclusion criteria used were studies in the form of clinical trials examining the role of MSCs in the management of thermal burns. The study was not a clinical trial, studies with research samples in the form of non-thermal burns, research subjects were not rats or mice, MSC was not used as the main intervention therapy, and did not involve the control group in the study were excluded so that 12 studies that met the eligibility criteria were obtained.

Results: 12 studies carried out the synthetic analysis in randomized clinical trials using research subjects in the form of mice and rats. The MSC therapy was isolated from bone marrow, cord blood and adipose tissue. MSC therapy plays a role in accelerating the healing process of burns through several biomolecular mechanisms such as reducing apoptosis, suppressing inflammatory responses and oxidative stress, triggering angiogenesis, accelerating re-epithelialization and tissue remodeling. MSC therapy has also been shown to minimize the formation of contractures and scar tissue,

Conclusion: The role of MSC therapy in burns is to accelerate the wound healing process, reduce the occurrence of contractures and scar tissue so that it is very potential to be applied in the management of burns.

 

Latar Belakang Kasus luka bakar masih menjadi tantangan dan beban di bidang kesehatan akibat morbiditas dan mortalitas yang ditimbulkannya. Penatalaksanaan luka bakar saat ini belum mampu menghasilkan luaran klinis yang memuaskan dari segi penyembuhan luka. Terapi mesenchymal stem cell (MSC) diketahui memiliki efek kuratif yang efektif dalam proses penyembuhan luka bakar. Tujuan dari tinjauan pustaka sistematis ini adalah untuk mengetahui peranan MSC dalam penatalaksanaan luka bakar.

Metode: Tinjauan pustaka sistematis dilakukan dengan pencarian literatur pada Google Scholar, Pubmed, dan Cochrane Library dimana pemilihan literatur menggunakan diagram PRISMA. Kriteria inklusi yang digunakan adalah studi berupa uji klinis yang meneliti peran MSC dalam tatalaksana luka bakar termal. Studi bukan berupa uji klinis, studi dengan sampel penelitian berupa luka bakar non-termal, subjek penelitian bukan berupa tikus atau mencit, MSC tidak digunakan sebagai terapi intervensi utama, serta tidak melibatkan kelompok kontrol dalam studinya dilakukan eksklusi sehingga didapatkan 12 studi yang memenuhi kriteria eligibilitas.

Hasil: Terdapat 12 studi yang dilakukan analisis sintesis berupa uji klinis acak menggunakan subjek penelitian berupa mencit dan tikus. Terapi MSC yang digunakan diisolasi dari sumsum tulang belakang, darah tali pusat dan jaringan adiposa. Terapi MSC berperan mempercepat proses penyembuhan luka bakar melalui sejumlah mekanisme biomolekuler berupa mengurangi apoptosis, menekan respon inflamasi dan stress oksidatif, memicu angiogenesis, mempercepat re-epitelisasi, serta remodelling jaringan. Terapi MSC juga terbukti meminimalisir terbentuknya kontraktur dan jaringan parut,

Simpulan: Peran terapi MSC dalam luka bakar adalah mempercepat proses penyembuhan luka, mengurangi terjadinya kontraktur dan jaringan parut sehingga sangat potensial untuk diaplikasikan dalam tatalaksana luka bakar.

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