Pengaruh Pemberian Enteral Ekstrak Cucumis Melo L.C Gliadin sebagai Profilaksis Antioxidan pada Tikus Wistar Model Sepsis dengan Pemeriksaan Kadar SOD, MDA, TNF ALFA dan Laktat Serum

Abstract

Background: Sepsis is one of the most common causes of death in intensive care units. Sepsis is an excessive stimulus response from an organism. In sepsis there is an inflammatory response, several mediators such as cytokines and chemokines are released from the circulation. Cytokine production will induce leukocyte activation and be deployed to the inflammatory site, as well as increase free radicals such as reactive oxygen species (ROS) and reactive nitrogen species (RNS). One of the endogenous antioxidants is Superoxide dismutase (SOD), whose function is to catalyze the conversion of superoxide into H2O2. This reaction is the primary antioxidant defense that prevents the occurrence of ROS. Cucumis melo L.C. is a melon that contains 7 times more SOD than regular melon. In the study of giving this extract in combination with gliadin was found that protected mice from pro- inflammatory, where there was a significant difference in TNF- and Interleukin 10 (IL-10) with mice that were only given unprotected SOD or only gliadin. In addition, this drug is also able to reduce superoxide, nitric oxide, peroxynitrite. Objectives: This study proves the effect of enteral administration of Cucumis melo L.C gliadin extract for 28 days as antioxidant prophylaxis against oxidative stress in Wistar rats with sepsis model. Methods: This study was an experimental study with rats with a randomized controlled trial comparing the control group with the group given SOD extract of Cucumis melo L.C gliadin, for 28 days previously in septic rat model. The research sample used were male white rat Rattus norvegicus Wistar strain (Wistar Rat), then simple random sampling was carried out and put into 4 groups, Group A rats were only given food and drink as a control, Group B rats were given food and drinks and after 28 days sepsis was inducted, Group C rats were given SOD at a dose of 1 IU/day for 28 days, Group D rats were given SOD at a dose of 5 IU/day for 28 days, together with group B, groups C and D also induced sepsis by intraperitoneal injection of LPS. The examination consisted of serum SOD, MDA, TNF- , lactate by ELISA method and the Murine Sepsis Score (MMS) was assessed. Results: There were 32 white Wistar rats as research subjects, 4 rats dropped out in this study. In group B 2 rats, group C 1 rat, group D 1 rat. There were no significant differences in SOD levels between groups on examination before supplementation and day 7 (p = 0.898 and p = 0.626), significant differences were found on day-14 (p < 0.001), day-28 (p < 0.001), after administration of LPS (p < 0.001). There were significant differences between groups in the levels of MDA (p = 0.001), TNF α (p < 0.001), and lactate (p < 0.001) after LPS was given. The comparison of MMS scores between groups was also found to be significant (p < 0.001). In the comparison of giving SOD 1 IU/day with SOD 5 IU/day, no significant results were found in the examination of serum levels of SOD (p = 0.252), lactate (p = 0.963), MDA (p = 0.996) TNFα (p = 0.994) and MMS score (p=0.756). There were significant differences between lactate levels and MMS scores after LPS administration, but lactate levels in groups C and D were still above 1.64 mmol/L and MMS scores were above 10. Conclusion: Administration of SOD from Cucumis melo L.C. gliadin extract for 28 days gave anti-inflammatory, anti-oxidant effects and reduced serum lactate levels in septic rats, but lactate levels and mortality rates in septic rats were still high.