Comparison of Type I Collagen Expression in Prolotherapy Using Nanochitosan and Dextrose in Rat Ligament Injury

Alif Fariz Jazmi^1,2, Belindo Wirabuana*^1,2, Prananda Surya Airlangga^1,2, Christrijogo Sumartono Waloejo^1,2, Dedi Susila^1,2, Atika³

¹Department of Anesthesiology and Reanimation, Faculty of Medicine, Universitas Airlangga, Surabaya, Indonesia ²Department of Anesthesiology and Reanimation, Dr Soetomo General Academic Hospital, Surabaya, Indonesia ³Department of Public Health – Preventive Medicine, Faculty of Medicine, Universitas Airlangga, Surabaya, Indonesia

Received: 14^th Aug, 2025; Revised: 15^th Sep 2025; Accepted: 15^th Nov, 2025; Available Online: 30^th Nov, 2025

ABSTRACT

Introduction: Ligament injury is a musculoskeletal problem th at requires effective regenerative therapy. Prolotherapy with dextrose has been widely used, while nanochitosan has been developed as a new alternative due to its higher biological activity, including anti-inflammatory, antioxidant, and fibroblast and epithelial stimulation effects. This study aimed to compare the effects of 0.4% nanochitosan with 12.5% dextrose prolotherapy on type I collagen expression in wistar rat patellar ligament injury. Methods: The study design was a true experimental randomized post-test only control group. Thirty-three rats were divided into three groups: Control (KK), nanochitosan prolotherapy (KN), and dextrose prolotherapy (KD). Type I Collagen expression was measured on days 8, 14, and 21, calculated from the time of injury or 24 hours, 7 days, and 14 days after prolotherapy using the ELISA method. Results: The results showed that both dextrose and nanochitosan can increase the expression of type I collagen through inflammatory mechanisms and fibroblast activation, supporting ligament tissue remodeling. Nanochitosan exhibits bioactive activities including stimulation of fibroblast proliferation and anti-inflammatory effects that support tissue regeneration. Although there was no statistically significant difference between the administration of nanochitosan and dextrose, there was a significant temporal change from day 8 to 21, indicating stimulation and accumulation of type I collagen expression due to prolotherapy treatment. Conclusion: There was no difference between prolotherapy agents. Both prolotherapy agents stimulated type I collagen expression in ligament injury healing. The numerical trends and additional biological properties of nanochitosan warrant further investigation as an alternative prolotherapy agent. ..

Keywords: Nanochitosan, Chitosan, Dextrose, Type I Collagen, Ligament.

How to cite this article: Jazmi AF, Wirabuana B, Airlangga PS, Waloejo CS, Susila D, Atika. Comparison of Type I Collagen Expression in Prolotherapy Using Nanochitosan and Dextrose in Rat Ligament Injury. Int J Drug Deliv Technol. 2025;15(4): 2002-2008, DOI: 10.25258/ijddt.15.4.53