Effects of Eurycoma Longifolia on Fracture Healing of Androgen-Deficient Osteoporosis Model: A Micro Computed Tomograph Analysis

Abstract

ABSTRAK Tomografi berkomputer mikro (mikro-CT) adalah peralatan yang berguna untuk memantau pemulihan patah tulang pada model osteoporosis. Ia menyediakan imej 3D kalus fraktur yang boleh digunakan untuk mengira parameter tulang secara kuantitatif. Dalam kajian in, mikro & Health 2016;11(2): 267-277 Azri J. et al. osteoporotic fracture in males was associated with significant morbidity and has huge impact emotionally and financially on their families and the society (Johnell et al. 2001).There are three phases of fracture healing; the reactive phase, reparative phase and remodeling phase. In the reactive phase, platelets are activated to release products such as transforming growth factor-β that triggers inflammation. At the same time, haematoma is formed to seal off the fracture area (Grundnes & Reikeras 1993;Marsh & Li 1999). In the reparative phase, granulation tissue is replaced by fibrocartilage and external callus is formed by intramembranous ossification at the periosteum. Finally, in the remodeling phase, the callus and ABSTRACTMicro computed tomography (micro-CT) imaging is a useful tool to monitor fracture healing in osteoporosis model. It creates a 3-D image of the fracture callus which can be analysed to assess bone parameters quantitatively. In this study, micro-CT was used to assess the fracture healing of orchidectomised rats, an androgen-deficient osteoporosis model. The effects of Eurycoma longifolia, a medicinal plant with proandrogenic effects, on fracture healing were assessed. The rats were grouped into orchidectomised-control (ORX), sham-operated (SHAM), orchidectomised and injected with testosterone intramuscularly once weekly (TEN) and orchidectomised and daily oral gavage of Eurycoma longifolia (EL). Treatment duration was six weeks following bone fracture. Fracture was induced in the right tibia of all the rats. A total of 100 axial slices above and below fracture line were scanned with a micro-CT. The micro-CT analysis was able to detect significant difference in the fracture healing rate of ORX and TEN groups. The bridging cortices and fraction of mineralized tissue of the bridging cortices of the callous of ORX group was significantly lower than TEN group. No significant micro-CT changes were seen in the fracture healing of the EL group. The effect of EL on fracture healing was not demonstrable in orchidectomised rat model.

An Evidence-Based Review: The Effects of Malaysian Traditional Herbs on Osteoporotic Rat Models

“…Even though EL treated groups recorded a significantly higher trabecular separation and a significantly lower trabecular number compared to the Sham and testosterone treatment groups, the group which supplemented with 90 mg/kg of EL extracts showed a significantly more positive result in preserving bone volume. Recent studies by Azri et al (35) reported that the 3D images of refractured healed bones of an EL group showed better bridging cortical connections compared to the bones of orchidectomised rats, but more inferior to the Sham and standard testosterone replacement treatment groups. In addition, the fraction of mineralised callouses was increased but not significantly different compared to that of the negative control group.…”

“…The non-metric parameters include connectivity density, structural model index and degree anisotropy. The μ CT80 scanner used in the studies was set at an energy source of 70KVp and 11A μ A, with high 0.5 mm filter and high resolution (35–39). Also, a study conducted by Estai et al (25) investigated the bone callous stage in the area of fracture healing cases by grading the stages using a 5-point radiograph-based scoring system.…”

“…Six studies evaluated the effects of Eurycoma longifolia (EL) on the androgen-deficiency osteoporosis of orchidectomised rat models. Two out of the six studies exclusively investigated bone microarchitecture (Azri et al (35), Ramli et al (36)); one was a biomechanical strength study (Azri et al (18)). The remaining were a combination of tests on bone microarchitecture, biomechanical strength biochemical markers, histomorphometry, and gene expression (Shuid et al (37); Ariff et al (39); Saadiah et al (45)).…”