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Doctoral Thesis
DOI
10.11606/T.42.2018.tde-16042018-100138
Document
Author
Full name
Diego Pulzatto Cury
Institute/School/College
Knowledge Area
Date of Defense
Published
São Paulo, 2018
Supervisor
Committee
Watanabe, Ii Sei (President)
Bauer, Jarbas Arruda
Chavez, Victor Elias Arana
Marcos, Rodrigo Labat
Moriscot, Anselmo Sigari
Title in Portuguese
Influência da sutura-U e de Kessler-Tajima associadas à proteína F1 sobre o reparo do tendão calcâneo. Estudo ultraestrutural, bioquímico e funcional.
Keywords in Portuguese
Atrogin1
colágeno
MuRF1
proteína F1
Tendão
ultraestrutura
Abstract in Portuguese
Tendões são descritos como tecido conjuntivo denso modelado que inserem os músculos aos ossos. Sua principal função é servir como tecido de transição das forças contráteis geradas pelos músculos aos ossos, podendo assim gerar movimentos. Entre todos os tendões, o calcâneo é um dos mais frequentemente lesados. As lesões ocorrem principalmente em homens e são mais frequentes entre a terceira e quarta década de vida. Dentre os vários métodos de sutura existentes, do ponto de vista clínico, a de Kessler-Tajima com os nós entre os cotos é muito utilizada por evitar o estrangulamento da microcirculação. Após a cirurgia o paciente retorna ao trabalho após 85 dias, em média, podendo atingir até 270 dias. O objetivo do presente estudo foi testar a eficiência da aplicação da proteína biocompatível F1, uma proteína extraída a partir do látex natural da Hevea brasiliensis, sobre tendões lesados, buscando uma melhora no reparo, assim como, a influência da sutura-U e de Kessler-Tajima. Alterações musculares decorrentes da lesão no tendão também foram avaliadas. Para isso, utilizamos ratos Sprague Dawley machos de 3 meses, que foram submetidos a tenotomia completa, a lesão foi corrigida com ambas as suturas, seguido da aplicação da proteína e avaliados após duas e quatro semanas. As técnicas utilizadas para análises no tendão foram as de microscopia de luz, microscopia eletrônica de varredura e transmissão, bem como, a síntese de colágeno tipos I e III, TIMP-1 e 2, MMP-2 e 9 por western blot. Para analisar as alterações musculares, a expressão dos genes MuRF1 e Atrogin1 foram quantificadas por RT-qPCR, seguido de análises de contração muscular máxima e teste de fadiga. Os resultados sugerem uma melhora no reparo do tendão no grupo que utilizamos a sutura-U associada à proteína após quatro semanas, devido ao aumento na síntese de colágeno tipo I e a diminuição de MMP-9, assim como, a capacidade de contração muscular máxima retorna aos níveis do grupo controle. A sutura-U também influencia menos na fadiga muscular.
Title in English
Influence of the suture-U and Kessler-Tajima associated with F1 protein on the calcaneal tendon repair. Ultrastructural, biochemical and functional study.
Keywords in English
Atrogin1
collagen
F1 protein
MuRF1
Tendon
ultrastructure
Abstract in English
Tendons are described as dense modeled connective tissue which insert the muscles to the bones. Its main function is to serve as transition tissue of the contractile forces generated by muscles to the bones, and thus generate movements. Among all the tendons, the calcaneal is the most frequently injured one. The lesions occur mainly in men and are more frequent between the third and fourth decade of life. Among the several existing suture methods, from a clinical point of view, the Kessler-Tajima with the nodes between the stumps is used to a great extent in order to avoid the microcirculations strangling. After surgery, the patient returns to work after 85 days, on average, and can reach up to 270 days. The objective of this study was to test the efficiency of the application of biocompatible F1 protein, a protein extracted from natural latex from the Hevea brasiliensis, on injured tendons, seeking an improvement in the repair, as well as the influence of the suture-U and Kessler-Tajima. Muscle changes arising from the tendon injury were also evaluated. For this reason, Sprague Dawley male rats at 3 mounths-old were used, which underwent complete tenotomy, the lesion was corrected with both sutures, followed by the application of protein and evaluated after two and four weeks. The techniques used for analyzes in the tendon were the light microscopy, scanning electron microscopy and transmission, as well as the synthesis of collagen types I and III, TIMP-1, -2, MMP-2, and -9 by Western blot. In order to analyze the muscular alterations, the expression of genes MuRF1 and Atrogin1 were quantified by RT-qPCR, followed by analysis of maximum muscle contraction and fatigue testing. The results suggest an improvement in the tendon repair in the group that the suture-U was used associated with protein after four weeks, due to the increase in the synthesis of collagen type I and the decrease of MMP-9, as well as the ability of maximum muscle contraction to return to the levels of the control group. The suture-U also influences on less muscle fatigue.
 
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Release Date
2020-04-18
Publishing Date
2018-10-25
 
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