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. 2018 Nov;52(6):452-458.
doi: 10.1016/j.aott.2018.06.012. Epub 2018 Sep 21.

Role of a combination dietary supplement containing mucopolysaccharides, vitamin C, and collagen on tendon healing in rats

Halil Can Gemalmaz  1 , Kerim Sarıyılmaz  2 , Okan Ozkunt  3 , Seren Gulsen Gurgen  4 , Sena Silay  5
Affiliations

Role of a combination dietary supplement containing mucopolysaccharides, vitamin C, and collagen on tendon healing in rats

Halil Can Gemalmaz et al. Acta Orthop Traumatol Turc. 2018 Nov.

Abstract

Objective: The aim of this study was to investigate the effect of mucopolysaccharide, vitamin C, and collagen supplementation on the healing of Achilles tendon in rats.

Methods: Sixteen rats were separated into 2 groups. Both Achilles tendons of all rats were transected 5 mm above the insertion and repaired using a Kessler suture. After the surgical repair, the study group received the daily recommended amount of the supplement by gastric gavage, while the control group received a placebo. At the end of the third week, the animals were sacrificed. The biomechanical properties of the groups were compared with ultimate tensile strength and stiffness tests. The biological properties of the 2 groups were assessed with a histomorphometric comparison to determine the amount of collagen type I (COL1), proliferating cell nuclear antigen (PCNA), and transforming growth factor β1 (TGF-β1) expression in 3 different tissue subgroups (collagen matrix, tenocytes, and endotenon fibroblasts).

Results: Analysis of histomorphometric results revealed that the rats receiving dietary supplements demonstrated a significant increase in PCNA (mean value of 86 in the control group and 168.85 in the trial group; p < 0.05) and TGF-β1 (mean value of 87.57 in the control group and 161.85 in the trial group; p < 0.05) in the endotenon fibroblasts of the repair site. However, there was no difference between the groups in PCNA or TGF-β1 when the collagen matrix and the tenocytes of the repair site were examined. Furthermore, no significant difference could be found between groups in COL1 in any of the 3 tissue subgroups (collagen matrix, tenocytes, and endotenon fibroblasts). The statistical analysis also indicated that the rats receiving supplements did not demonstrate a significant increase in the ultimate tendon tensile strength or stiffness.

Conclusion: The results of this study revealed no advantage to the oral administration of the trial supplement in collagen synthesis or biomechanical properties in rats after 3 weeks using the presented study design. However, the increased expression of PCNA and TGFβ1 seen in the endotenon fibroblasts of the repair site might play a role in the continuum of tendon healing.

Keywords: Collagen; Dietary supplement; Mucopolysaccharides; Tendon healing; Vitamin C.

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Figures

Fig. 1
Fig. 1
Photograph of the Achilles tendon before transection.
Fig. 2
Fig. 2
Photograph of the Achilles tendon after transection.
Fig. 3
Fig. 3
Photograph of the Achilles tendon after surgical repair.
Fig. 4
Fig. 4
The Achilles tendon and the mount used for mechanical testing.
Fig. 5
Fig. 5
The specimen during the mechanical test.
Fig. 6
Fig. 6
Hematoxylin-eosin staining of the repair site. Control group (A); Study group (B). formula image: Collagen fiber; formula image: Tenocyte; formula image: Blood vessel; formula image: Fibroblasts; E: Endotendineum; TF: Tendon fascicule.
Fig. 7
Fig. 7
Masson's trichrome staining of the repair site. Control group (A); Study group (B). formula image: Collagen fiber; formula image: Tenocyte; formula image: Blood vessel; formula image: Fibroblasts. E: Endotendineum.
See this image and copyright information in PMC

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