Kecemcem Leaf Extract Has the Potential to Protect the Liver from Side Effects of Anti-Tuberculosis Drugs

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• Senin, 28 Juli 2025
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Kecemcem Leaf Extract Has the Potential to Protect the Liver from Side Effects of Anti-Tuberculosis Drugs

Held in the Postgraduate Hall on the 3rd Floor of the Udayana University Postgraduate Building, the Doctoral Program in Medical Sciences, Faculty of Medicine, Udayana University, held an open doctoral promotion defense with candidate Ni Putu Aryadnyani, S.S.T., M.Biomed., entitled "The Effect and Mechanism of Action of 70% Ethanol Extract of Kecemcem Leaves (Spondias pinnata) on Liver Damage in Rattus norvegicus Rats Induced by Isoniazid and Rifampicin Through Analysis of 8-OHdG, TNF-α, RIPK3, Aminotransferase Enzymes, and the Grade of Liver Damage." (July 25, 2025)

Isoniazid and Rifampicin are first-line anti-TB drugs that produce toxic metabolites and have side effects of liver damage caused by oxidative stress that leads to inflammation and cell death. This study aimed to demonstrate the effectiveness of 70% ethanol extract of Kecemcem (Spondias pinnata) leaves at doses of 200 mg/kgBW and 600 mg/kgBW in Rattus norvegicus mice induced by Isoniazid and Rifampicin at 500 mg/kgBW to reduce liver damage through oxidative stress (8-OHdG), inflammation (TNF-α), and necroptosis (RIPK3), as indicated by decreased levels of AST, ALT, and liver damage grade.

This study used Rattus norvegicus mice divided into four groups: K0 (normal control), K1 (negative control), P1 (Treatment 1), and P2 (Treatment 2). Rats in groups K1, P1, and P2 were administered Isoniazid-Rifampicin for 28 days. Groups P1 and P2 were administered ethanol extract of Kecemcem (Spondias pinnata) leaves for 35 days at doses of 200 mg/kgBW (P1) and 600 mg/kgBW (P2). The rats' 8-OHdG, TNF-α, and RIPK3 concentrations were measured using ELISA, AST and ALT enzyme activity using spectrophotometry, and liver damage grade was determined using microscopy.

The increase in 8-OHdG, TNF-α, RIPK3, AST, ALT, and liver damage grade in K1 compared to K0 indicated that isoniazid-rifampin caused liver damage. Administration of 70% ethanol extract of Kecemcem (Spondias pinnata) leaves at 200 mg/kgBW (P1) and 600 mg/kgBW (P2) reduced liver damage, with P2 yielding superior results compared to P1.

This study demonstrates the ability of a 70% ethanol extract of Kecemcem (Spondias pinnata) leaves as a hepatoprotector to prevent liver damage caused by Isoniazid-Rifampicin. The results of this study can serve as a starting point for further research in humans.

This examination was led by the Vice Dean for General Affairs and Finance of the Faculty of Medicine, Udayana University, Prof. Dr. dr. I Made Sudarmaja, M.Kes., with the following examiners:

1. Prof. Dr. dr. I Gusti Ayu Sri Mahendra Dewi, Sp.PA(K) (Promoter)

2. Prof. Dr. dr. I Wayan Putu Sutirta Yasa, M.Si (Co-Promoter I)

3. Dr. dr. I Nyoman Wande, S.Ked., Sp.PK(K) (Co-Promoter II)

4. Prof. drh. I Nyoman Mantik Astawa, Ph.D.

5. Prof. Dr. dr. I Made Jawi, M.Kes.

6. Prof. Dr. Drs. I Made Oka Adi Parwata, M.Sc.

7. Prof. Dr. dr. I Made Sudarmaja, M.Kes.

8. Prof. Dr. dr. Sianny Herawati, Sp.PK, Subsp.BDKT(K), Subsp.NR(K)

9. Dr. dr. Ni Made Linawati, S.Ked., M.Sc.

10. Dr. dr. Putu Ayu Asri Damayanti, M.Kes.

By academic invitation:

1. Dr. dr. I Gusti Ayu Artini, S.Ked., M.Sc.

2. Desak Ketut Ernawati, S.Si, Apt., P.G.Pharm., M.Pharm., Ph.D.

3. Dr. dr. Made Agus Hendrayana, M.Ked.

4. Dr. dr. Kadek Mulyantari, Sp.PK., Subsp.BDKT(K)

5. Ida Bagus Nyoman Putra Dwija, S.Si., M.Biotech., Ph.D.

During this examination, Dr. Ni Putu Aryadnyani, S.S.T., M.Biomed., was declared the 464th Doctoral Graduate Degree of the Doctoral Program in Medical Sciences, Faculty of Medicine, Udayana University, with the distinction of Cum Laude.

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