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Hemostatik Ajan Olarak Kullanılan Mecsina Hemostopper®, Ankaferd Blood Stopper® ve Tranexamic Asidin İmmunolojik Özelliklerinin Farklılıklarının Hücre Kültürü Çalışması ile Araştırılması

Year 2018, Volume: 25 Issue: 3, 311 - 316, 01.09.2018
https://doi.org/10.17343/sdutfd.384428

Abstract

Amaç:
Tıp ve diş hekimliğinin birçok dalında kanama komplikasyonu, gerçekleştirilen
tedaviler sonrası veya sırasında, yapılan işlemin büyüklüğünden bağımsız olarak
gelişebilir. Cerrahi işlemler öncesinde ve sonrasında, tıp ve diş hekimliği
uygulama prosedürlerinde bir çok biyomalzeme kullanılmıştır. Bu çalışmada
kanama durdurucu ajan olarak kullanılan Ankaferd Blood Stopper, Tranexamic acid
ve yeni bir kanama durdurucu olan Mecsina Blood Stopper ’ın immünolojik
etkinliklerinin ve etkilerinin karşılaştırılması amaçlanmıştır.

Yöntem:
Çalışma için insan unbrikalkord hücreleri olan pıhtılaşma ve fibrin oluşumu
üzerinde en çok çalışma yapılan HUVEC (Human
Umbilical Vein  Endothelial Cell )
ölümsüz hücre hatları ticari olarak satın alındı. Her flaska her bir ilaç için
5000 hücre olacak şekilde 5 gruba (ankaferd, Tranexamic acid, mecsina, distile
su uygulanan negative ve hiçbir sey uygulanmayan kontrol ) hücreler dağıtıldı.

Bulgular:
Elde ettiğimiz verilere göre 1:2 ve 1:10 konsantrasyonda; mecsina uygulaması
yapılan hücrelerde TNF alpha (
Tümör Nekrozis Faktör Alfa) seviyeleri diğer ilaç
gruplarına göre daha düşük olduğu görülmüştür (p<0,05). IL-1B (İnterlökin 1B) ve IL6 (İnterlökin 6) seviyelerinde hem 1:2
hem de 1:10 konsantrasyonlarında ki tüm ilaç uygulamalarında kontrol grubuna
kıyasla anlamlı derecede artış olduğu gözlenmiştir (p<0,05).  TNF alpha seviyelerinde ise 1:2
konsantrasyonda tüm ilaç uygulamalarında kontrole göre artış (p<0,05)
gözlenmişken, 1:10 konsantrasyonda mecsina uygulamasında anlamlı bir ilişki
görülmemiş (p>0,05) ancak tranexamic acid (TA)  ve ankaferd uygulamalarında ise anlamlı
derecede artış olduğu belirlenmiştir (p<0,05).







Sonuç:
Sonuç olarak, HUVEC hücre gruplarında farklı konsantrasyonlarda uygulanan
farklı anti hemorajik ajanların hücre içi sitokin seviyelerinde önemli ölçüde
bir artış meydana getirdiği görülmüştür. Sonuçlar göz önüne alındığında MH
(Mecsina Hemostopper) uygulamasının ABS (Ankaferd Blood Stoper) ve özellikle TA
(Tranexamic Acid) uygulamalarına kıyasla daha etkili bir anti hemorajik ajan
olduğunu söyleyebilmekteyiz. 

References

  • Simsek HO, Tuzum MS, Baykul T, Gurer IE, Bassorgun CI. Experimental investigation of the effects of a blood stopper agent (ankaferd blood stopper) on bone surfaces. Turkish Journal of Hematology 2013; 30(2): 177-183.
  • Lee SJ, Umano K, Shibamoto T, Lee KG. Identification of volatile components in basil (Ocimum basilicum L.) and thyme leaves (Thymus vulgaris L.) and their antioxidant properties. Food Chem 2007; 91(1): 131-137.
  • Goker H, Haznedaroglu IC, Ercetin S, Kirazli S, Akman U, Ozturk Y, et al. Haemostatic actions of the folkloric medicinal plant extract, Ankaferd Blood Stopper. J Int Med Res 2008; 36(1): 163–170.
  • Emes Y, Aybar B, Vural P, Issever H, Yalcın S, Atalay B, et al. Effects of hemostatic agents on fibroblast cells. Implant Dent 2014; 23(6): 641-647.
  • Nuttall GA, Gutierrez MC, Dewey JD, Johnson ME, Oyen LJ, Hanson AC, et al. A preliminary study of a new tranexamic acid dosing schedule for cardiac surgery. J Cardiothorac Vasc Anesth 2008; 22(2): 230-235.
  • Henry DA, Carless PA, Moxey AJ, O'Connell D, Stokes BJ, McClelland B, et al. Anti-fibrinolytic use for minimising perioperative allogeneic blood transfusion. Cochrane Database Syst Rev 2007; 17(4): CD001886.
  • Balvers K, Van Dieren S, Baksaas-Aasen K, Gaarder C, Brohi K, Eaglestone S, et al. Combined effect of therapeutic strategies for bleeding injury on early survival, transfusion needs and correction of coagulopathy. Br J Surg 2017; 104(3): 222-229
  • Cole E, Davenport R, Willett K, Brohi K. Tranexamic acid use in severely injured civilian patients and the effects on outcomes: a prospective cohort study. Ann Surg 2015; 261(2): 390-394.
  • Jimenez JJ, Iribarren JL, Lorente L, Rodriguez JM, Hernandez D, Nassar I, et al. Tranexamic acid attenuates inflammatory response in cardiopulmonary bypass surgery through blockade of fibrinolysis: a case control study followed by a randomized double-blind controlled trial. Crit Care 2007; 11(6): R117.
  • Yılmaz E, Gülec ŞS, Torun D, Haznedaroglu IC, Akar N. The effects of Ankaferd® Blood Stopper on transcription factors in HUVEC and the erythrocyte protein profile. Turk J Hematol 2011; 28(4): 276-285.
  • Bilgili H, Captug O, Kosar A, Kurt M, Kekilli M, Shorgabi A, et al. Oral systemic administration of Ankaferd Blood Stopper has no short-term toxicity in an in vivo rabbit experimental model. Clin Appl Thromb Hemost 2010; 16(5): 533-536.
  • Porte RJ, Leebeek FW. Pharmacological strategies to decrease transfusion requirements in patients undergoing surgery. Drugs 2002; 62(5): 2193-2211.
  • Murkin JM, Falter F, Granton J, Young B, Burt C, Chu M. High-dose tranexamic acid is associated with nonischemic clinical seizures in cardiac surgical patients. Anesth Analg 2010; 110(2): 350-353.
  • Later AF, Sitniakowsky LS, Van Hilten JA, Van De Watering L, Brand A, Smit NP, et al. Antifibrinolytics attenuate inflammatory gene expression after cardiac surgery. J Thorac Cardiovasc Surg 2013; 145(6): 1611-1616.
  • Jones KL, De Kretser DM, Patella S, Phillips DJ. Activin A and follistatin in systemic inflammation. Mol Cell Endocrinol 2004; 225(1-2): 119-125.
  • Lange J, Sapozhnikova A, Lu C, Hu D, Li X, Miclau T et al. Action of IL-1β during fracture healing. J Orthop Res 2010; 28(6): 778-784.
  • Amanvermez R, Gunay M, Piskin A, Keles G, Tomak L. TNF-α, IL-1β, and oxidative stress during fracture healing with or without ankaferd. Bratisl Lek Listy 2013; 114(11): 621-624.

Investigation of the Differences of Immunological Characteristics of Mecsina Hemostopper®, Ankaferd Blood Stopper® and Tranexamic Acid Used as Haemostatic Agents with Cell Culture Study

Year 2018, Volume: 25 Issue: 3, 311 - 316, 01.09.2018
https://doi.org/10.17343/sdutfd.384428

Abstract

Objective: Hemorrhagic complications may develop in many branches
of medicine and dentistry after or during the treatment independently of the
extent of the procedure performed. Various biomaterials have been used in the
medical and dental practice procedures before and after surgical procedures.
The aim of this study was to compare the immunological efficacies and effects
of Ankaferd Blood Stopper, Tranexamic acid used as anti-hemorrhagic agents and
Mecsina Blood Stopper, a new anti-hemorrhagic agent.

Method: The immortalized HUVEC (Human Umbilical Vein
Endothelial Cell) cell lines, which are human umbilical cord cells and used in
many studies on coagulation and formation of fibrin, were commercially
purchased for the study. The cells, 5000 cells per flask for each drug, were
distributed into the 5 groups (ankaferd, Tranexamic acid, mecsina, distilled
water-administered negative and control without any administration).

Results: According to the data we obtained, TNF alpha (Tumor Necrosis
Factor

Alpha) levels were found to be lower in the cells, to which mecsina was
administered at concentrations of 1: 2 and 1:10, than other drug groups
(p<0,05). There was a significant increase in IL-1B (Interleukin 1B) and IL6
(Interleukin 6) levels in all drug administrations at both concentrations of 1:
2 and 1: 10 compared to the control group (p <0,05).   While there was no significant increase in
TNF alpha levels in all drug administrations at a concentration of 1: 2 (p
<0,05), there was no significant correlation in mecsina administration at a
concentration of 1:10 (p> 0,05), but a significant increase was found in
tranexamic acid (TA) and ankaferd administrations (p <0.05).







Conclusion: In conclusion, it has been
observed that different anti-hemorrhagic agents administered at different
concentrations in HUVEC cell groups produced a significant increase in intracellular
cytokine levels.  Considering the
results, we can say that MH (Mecsina Hemostopper) administration is a more
effective anti-hemorrhagic agent than administrations of ABS (Ankaferd Blood
Stoper) and especially TA (Tranexamic Acid). 

References

  • Simsek HO, Tuzum MS, Baykul T, Gurer IE, Bassorgun CI. Experimental investigation of the effects of a blood stopper agent (ankaferd blood stopper) on bone surfaces. Turkish Journal of Hematology 2013; 30(2): 177-183.
  • Lee SJ, Umano K, Shibamoto T, Lee KG. Identification of volatile components in basil (Ocimum basilicum L.) and thyme leaves (Thymus vulgaris L.) and their antioxidant properties. Food Chem 2007; 91(1): 131-137.
  • Goker H, Haznedaroglu IC, Ercetin S, Kirazli S, Akman U, Ozturk Y, et al. Haemostatic actions of the folkloric medicinal plant extract, Ankaferd Blood Stopper. J Int Med Res 2008; 36(1): 163–170.
  • Emes Y, Aybar B, Vural P, Issever H, Yalcın S, Atalay B, et al. Effects of hemostatic agents on fibroblast cells. Implant Dent 2014; 23(6): 641-647.
  • Nuttall GA, Gutierrez MC, Dewey JD, Johnson ME, Oyen LJ, Hanson AC, et al. A preliminary study of a new tranexamic acid dosing schedule for cardiac surgery. J Cardiothorac Vasc Anesth 2008; 22(2): 230-235.
  • Henry DA, Carless PA, Moxey AJ, O'Connell D, Stokes BJ, McClelland B, et al. Anti-fibrinolytic use for minimising perioperative allogeneic blood transfusion. Cochrane Database Syst Rev 2007; 17(4): CD001886.
  • Balvers K, Van Dieren S, Baksaas-Aasen K, Gaarder C, Brohi K, Eaglestone S, et al. Combined effect of therapeutic strategies for bleeding injury on early survival, transfusion needs and correction of coagulopathy. Br J Surg 2017; 104(3): 222-229
  • Cole E, Davenport R, Willett K, Brohi K. Tranexamic acid use in severely injured civilian patients and the effects on outcomes: a prospective cohort study. Ann Surg 2015; 261(2): 390-394.
  • Jimenez JJ, Iribarren JL, Lorente L, Rodriguez JM, Hernandez D, Nassar I, et al. Tranexamic acid attenuates inflammatory response in cardiopulmonary bypass surgery through blockade of fibrinolysis: a case control study followed by a randomized double-blind controlled trial. Crit Care 2007; 11(6): R117.
  • Yılmaz E, Gülec ŞS, Torun D, Haznedaroglu IC, Akar N. The effects of Ankaferd® Blood Stopper on transcription factors in HUVEC and the erythrocyte protein profile. Turk J Hematol 2011; 28(4): 276-285.
  • Bilgili H, Captug O, Kosar A, Kurt M, Kekilli M, Shorgabi A, et al. Oral systemic administration of Ankaferd Blood Stopper has no short-term toxicity in an in vivo rabbit experimental model. Clin Appl Thromb Hemost 2010; 16(5): 533-536.
  • Porte RJ, Leebeek FW. Pharmacological strategies to decrease transfusion requirements in patients undergoing surgery. Drugs 2002; 62(5): 2193-2211.
  • Murkin JM, Falter F, Granton J, Young B, Burt C, Chu M. High-dose tranexamic acid is associated with nonischemic clinical seizures in cardiac surgical patients. Anesth Analg 2010; 110(2): 350-353.
  • Later AF, Sitniakowsky LS, Van Hilten JA, Van De Watering L, Brand A, Smit NP, et al. Antifibrinolytics attenuate inflammatory gene expression after cardiac surgery. J Thorac Cardiovasc Surg 2013; 145(6): 1611-1616.
  • Jones KL, De Kretser DM, Patella S, Phillips DJ. Activin A and follistatin in systemic inflammation. Mol Cell Endocrinol 2004; 225(1-2): 119-125.
  • Lange J, Sapozhnikova A, Lu C, Hu D, Li X, Miclau T et al. Action of IL-1β during fracture healing. J Orthop Res 2010; 28(6): 778-784.
  • Amanvermez R, Gunay M, Piskin A, Keles G, Tomak L. TNF-α, IL-1β, and oxidative stress during fracture healing with or without ankaferd. Bratisl Lek Listy 2013; 114(11): 621-624.
There are 17 citations in total.

Details

Primary Language English
Subjects Clinical Sciences
Journal Section Research Articles
Authors

Mehmet Kemal Tümer 0000-0002-6250-0954

Mustafa Çiçek This is me

Publication Date September 1, 2018
Submission Date January 26, 2018
Acceptance Date March 29, 2018
Published in Issue Year 2018 Volume: 25 Issue: 3

Cite

Vancouver Tümer MK, Çiçek M. Investigation of the Differences of Immunological Characteristics of Mecsina Hemostopper®, Ankaferd Blood Stopper® and Tranexamic Acid Used as Haemostatic Agents with Cell Culture Study. Med J SDU. 2018;25(3):311-6.

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