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All Journal Medical Journal of Indonesia Cermin Dunia Kedokteran
Yuyus Kusnadi
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Health Professions Medicine & Pharmacology Public Health

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The application of human umbilical cord blood mononuclear cells in the management of deep partial thickness burn Moenadjat, Yefta; Merlina, Maurin; Surjadi, Camy F.; Sardjono, Caroline T.; Kusnadi, Yuyus; Sandra, Ferry
Medical Journal of Indonesia Vol 22, No 2 (2013): May
Publisher : Faculty of Medicine Universitas Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (1435.845 KB) | DOI: 10.13181/mji.v22i2.534

Abstract

Background: Wound healing in burn is a complex process and early complete wound closure still enfaces many problems. Application of stem cells is found to be the future method of wound healing. Among the available sources of allogenic stem cells, umbilical cord blood is quite easy to be obtained, has less ethical issue, and contain multipotent stem cells, which are characterized by low immunogenicity. The study aims to evaluate the potential of human umbilical cord blood mononuclear cells (hUCBMNCs) treatment in the management of deep partial thickness burns. Methods: Twenty patients with deep partial thickness burns were treated with topical application of 2 x 107 hUCBMNCs and silver sulfadiazine (SSD) cream on the comparable wound size in the other sites. The treatments were applied for six times in every two consecutive days. Wound surface area was measured with Visitrak® on day 0, 7, and 11. Pain intensity was evaluated using Wong Baker’s faces scale on each wound dressing change. Histology examination was performed in some samples of collected skin biopsy of the newly re-epithelialized area of hUCBMNCs and SSD-treated wound at the end of treatment. HLA typing is used to evaluate the issue of safety. Wilcoxon signed rank test was used to compare the rate of wound healing. Results: Sixteen patients of hUCBMNCs-treated showed a significant wound closure in faster than SSD-treated; measured on day 7 (p = 0.041) and day 11 (p = 0.021). Number of patients with reduced pain intensity, from approximately scale 3 to 1/0 on day 7 and 11, were higher in hUCBMNCs-treated compared to SSD-treated wound. In spite of the HLA-mismatch, no allergic reaction, rejection, and infection found on hUCBMNCs-treated wound suggested the safety of this therapy. Histology examination found the formation of dermal-epidermal junction and rete ridges equal to the normal skin on hUCBMNCs-treated wounds. Conclusion: hUCBMNCs are effective and safe to promote re-epithelialization in deep partial thickness burns. (Med J Indones. 2013;22:92-9)Keywords: Deep partial thickness burn, mononuclear cells, re-epithelialization, umbilical cord blood
Tatalaksana Terapi Sel Punca Mesenkimal Otologus untuk Cedera Tulang Rawan Sendi Lutut Merlina, Maurin; C. Ardhianie, Angela; Kusnadi, Yuyus; M.T. Lubis, Andri
Cermin Dunia Kedokteran Vol 42, No 11 (2015): Kanker
Publisher : PT. Kalbe Farma Tbk.

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (1481.726 KB) | DOI: 10.55175/cdk.v42i11.952

Abstract

Cedera tulang rawan merupakan masalah klinis umum akibat kerusakan matriks tulang rawan. Jika diabaikan, degenerasi tulang rawan yang progresif dapat berkembang menjadi osteoarthritis (OA) dan mengganggu mobilitas penderita. Telah diketahui bahwa lesi tulang rawan tidak dapat kembali normal karena kemampuan menyembuhkan diri tulang rawan sendi sangat terbatas. Ketiadaan pasokan darah ke tulang rawan dan rendahnya aktivitas metabolisme kondrosit menghalangi proses penyembuhan alamiah yang melibatkan sintesis tulang rawan hialin baru dan mobilisasi sel punca dari sumsum tulang ke daerah lesi. Saat ini, penggantian sendi lutut total menjadi satu-satunya pilihan tindakan pada kerusakan tulang rawan atau OA tingkat akhir, namun prodesur tersebut harus diulangi dalam 10-15 tahun. Transplantasi sel punca mesenkimal dapat menjadi pilihan terapi untuk memperbaharui tulang rawan yang rusak. Metode ini cocok diterapkan pada tingkat kerusakan sedang hingga lanjut dengan tujuan untuk menunda perluasan cedera dan penggantian sendi lutut.Cartilage injury is a common clinical problem that mainly occurs due to cartilage matrix disruption, partial thickness defect, or full thickness defect as a result of traumatic accident. If left untreated, progressive cartilage degeneration could lead to osteoarthritis (OA) and impede mobility. Cartilage lesions are irreversible because of limitation of self-healing capability of articular cartilage. Lack of blood supply in cartilage and low chondrocytes metabolism activity impair natural healing that suppose to fill the defect by increasing hyaline cartilage synthesis or mobilizing stem cell from bone marrow to the site of injury. Knee joint replacement is currently the only treatment option for the end stage of cartilage damage and OA, yet the procedure should be repeated in 10-15 years. Transplantation of mesenchymal stem cells to regenerate the injured cartilage can be an option. This method is suitable for intermediate to advance stage of cartilage damage to delay the process of injury and joint replacement procedure. 
Co-Authors C. Ardhianie, Angela Camy F. Surjadi Caroline T. Sardjono Ferry Sandra M.T. Lubis, Andri Maurin Merlina Yefta Moenadjat