Efek Gel Ekstrak Gyliserol Propolis Terhadap Ekspresi MMP-2, MMP-9 Dan LOX Pada Luka Stoma Trakeostomi Pada Rattus Norvergicus

Abstract

Background: Post-tracheostomy tracheal stenosis is a serious complication resulting from abnormal wound healing marked by excessive granulation tissue and fibrosis. Enzymes such as Lysyl oxidase (LOX), Matrix metalloproteinase-2 (MMP-2), and MMP-9 play key roles in tissue remodeling and are potential therapeutic targets for fibrosis prevention. Propolis, a natural compound rich in flavonoids and phenolic acids, is known for its anti-inflammatory and antioxidant properties that may affect LOX and MMP expression. Objective: To evaluate the effects of glycerol propolis extract gel on LOX, MMP- 2, and MMP-9 expression in tracheostomy stoma wounds in rats (Rattus norvegicus). Methods: This experimental study used a rat tracheostomy model divided into treatment groups receiving different concentrations of glycerol propolis extract gel on its tracheostomy cannula. Expression levels of LOX, MMP-2, and MMP-9 were assessed using immunohistochemical methods. Results: The mean LOX expression in the control, K1, K2, K3, and K4 groups ranged from 1.25% ± 0.80; 2.78% ± 1.37; and 1.59–2.22%, with the positive control showing the highest value (5.19% ± 3.56). MMP-2 expression in the control, K1, K2, K3, and K4 groups was 0.32% ± 0.56; 2.45% ± 1.89; and 1.95– 2.84%, while MMP-9 expression was 0.23% ± 0.10; 0.76% ± 0.74; and 0.34– 2.10%, respectively. Kruskal–Wallis analysis demonstrated significant differences among groups for all three markers (p < 0.05). Histopathological evaluation showed higher inflammatory cell infiltration in the control and K1, while the K2, K3, and K4 exhibited varying degrees of reduction in inflammatory cell infiltration. Conclusion: Propolis extract did not significantly reduce MMP-2 expression in tracheostomy stoma wounds of Rattus norvegicus, but increased MMP-9 expression, with statistical significance observed only in the K4 group, and reduced LOX expression in the K2, K3, and K4 groups. Overall, the K3 propolis concentration demonstrated the most optimal balance of biological responses in supporting tracheostomy stoma wound healing.