MANAGEMENT OF HEMORRHOID DISORDERS WITH MESENCYMAL STEM CELLS IN RATS MODEL

M. Hidayat Budi Kusumo

Background Hemorrhoids are anal cushion disorder caused by inflammation that damages connective tissue maintains anal cushions position. Mesenchymal stem cells (MSCs) suppress inflammation by releasing anti-inflammatory mediators. The aim of this research is to analyze and prove the effect of mesenchymal stem cells on hemorrhoid repair.

Methods Thirty male Wistar rats were randomly allocated into 6 groups, consisting of 1 control group (K0) and 5 induced anorectal hemorrhoids groups with Croton oil 6% for 3 days. Group 1, received CMC-Na orally for 5 days (K01); Group 2, received a perianal injection of 0.9% NaCl + PBS (K02); group 3 received diosmin-hesperidin (micronized purified flavonoids/MPFF) orally for 5 days (KP1); group 4 received a perianal injection of 1,5x106 umbilical cord derived mesenchymal stem cells (UC-MSCs) (KP2); group 5 received combination therapy of oral MPFF and perianal injection of UC-MSCs (KP3). The body weight and anal canal resection specimen weight (20 mm from anal opening) were weighed and rectoanal coefficients were measured, then histopathological examination was carried out to determine inflammation (severity score). Western blot were used to evaluate TNF-α, TGF-β, collagen type I/III expressions, then collagen type I/III ratios were determined. Gelatin zymography were used to evaluate MMP-9 activity. The examination and data analysis were assessed on the 9th day with significant value at p < 0>

Results Mesenchymal stem cells administration (MSCs) group was significantly lower in edema, inflammation, TNF-α, MMP-9 and higher in TGF-β, type I/III collagen ratio, compared to control group (without therapy) and was significantly lower in inflammation and higher in TGF-β compared to MPFF group. The combination group was significantly lower in inflammation, MMP-9, as well as higher in TGF-β compared to MPFF group, and significantly higher in type I/III collagen ratio compared to MSCs, or MPFF group.

Summary Administration of mesenchymal stem cells alone or in combination with MPFF can improve hemorrhoids and rectoanal inflammation.