The effect of red yeast rice on delayed union fracture in animal model: a molecular study of IL-6, BMP-2, VEGF, BALP, and N-Mid-OC in fracture healing

Background As serious fracture complications, delayed union and non-union are parts of complications from fracture healing. Growth factors such as BMP-2, VEGF, proinflammatory cytokines including IL-6 and bone formation BALP, N-Mid-OC are important regulators of the fracture healing process. Red yeast rice (RYR), produced by fermenting Monascus purpureus rice, monacolin K, which is the main ingredient in RYR, was found to play a major role in the anti-inflammatory process and increasing the proliferation of osteoblast in osteoporosis cases. This study aims to examine the effect of RYR in the fracture healing process in delayed union rats through molecular studies of levels of IL-6, BMP- 2, VEGF, BALP, and N-Mid-OC. Methods This study was experimental research that used male rats (Rattus novergicus) which were divided into a control and 3 treatment groups using a random sampling method. Group 1 was given orally 25 mg/kg, Group 2 was 50 mg/kg, Group 3 was 100 mg/kg, and the control group was given a placebo. The rats were then subjected to a delayed union fracture model. Observations were made for two periods on the 14th and 28th days. Results There were no significant differences in serology examination between days 0 and 14 between groups. However, there were significant differences between groups on day 28. IL-6, BMP-2, VEGF, BALP, and N-Mid-OC on day 28 between groups (p<0.001). The group with 100 mg/kg RYR extract was found to be the most influencing serology marker level. RYR 100 mg/kg significantly decreased IL-6, and increased BMP-2, VEGF, BALP, and N-Mid-Osteocalcin, thus enhancing the fracture healing process in the delayed union rats model. Conclusion A red yeast rice dose of 100 mg/KgBW significantly reduced IL-6, increased BMP-2, VEGF, BALP, N-Mid-OC, and RUST Score so as to improve the fracture healing process in delayed union rats.