Pengaruh ekstrak daun mimba (Azadirachta indica) terhadap dilatasi sinusoid dan hiperplasia sel kupffer hepar pada mencit BALB/c yang diinduksi Plasmodium berghei

INDONESIA:

Latar belakang: Malaria masih menjadi masalah kesehatan di negara endemis, termasuk Indonesia. Malaria dapat menyebabkan kerusakan hepar melalui mekanisme inflamasi, sekuestrasi eritrosit terinfeksi, dan akumulasi hemozoin. Proses ini berkontribusi pada hiperplasia sel kupffer dan dilatasi sinusoid. Munculnya resistensi terhadap terapi lini pertama mendorong pengembangan alternatif pengobatan. Daun mimba (Azadirachta indica) mengandung senyawa antimalaria, antiinflamasi, dan hepatoprotektif sehingga berpotensi melindungi hepar dari kerusakan akibat infeksi. Tujuan: Untuk mengetahui pengaruh terapi daun mimba terhadap hiperplasia sel kupffer dan dilatasi sinusoid hepar pada mencit BALB/c yang diinduksi Plasmodium berghei. Metode: Penelitian menggunakan BBT jaringan hepar mencit BALB/c terinfeksi Plasmodium berghei yang dibagi menjadi enam kelompok: kontrol sehat, kontrol positif, kontrol negatif, serta perlakuan ekstrak daun mimba dosis 8 mg, 12 mg, dan 16 mg. Jaringan hepar dibuat preparat HE dan diamati menggunakan mikroskop cahaya perbesaran 1000x pada area periporta. Diameter sinusoid diukur dengan ImageJ. Data dianalisis menggunakan uji Kruskal–Wallis, Post Hoc Mann–Whitney, dan korelasi Spearman. Hasil: Ekstrak daun mimba berpengaruh signifikan terhadap penurunan hiperplasia sel Kupffer pada dosis 8 mg (p=0,021), 12 mg (p=0,021), dan 16 mg (p=0,021), serta menurunkan dilatasi sinusoid pada dosis 8 mg (p=0,021), 12 mg (p=0,021), dan 16 mg (p=0,021). Uji korelasi menunjukkan hubungan negatif sangat kuat antara peningkatan dosis dengan penurunan hiperplasia sel Kupffer (r=-0,930) dan dilatasi sinusoid (r= –0.930). Kesimpulan: Estrak daun mimba dapat menurunkan hiperplasia sel kupffer dan dilatasi sinusoid hepar pada mencit BALB/c yang diinduksi Plasmodium berghei dengan dosis yang paling berpengaruh signifikan pada 16 mg.

ENGLISH:

Background: Malaria remains a major health problem in endemic countries, including Indonesia. The disease can cause hepatic damage through inflammatory mechanisms, sequestration of infected erythrocytes, and hemozoin accumulation. These processes contribute to Kupffer cell hyperplasia and sinusoidal dilation. The emergence of resistance to first-line therapies encourages the development of alternative treatments. Neem leaves (Azadirachta indica) contain antimalarial, anti-inflammatory, and hepatoprotective compounds, making them a potential hepatoprotective agent against malaria-induced damage. Objective: To determine the effect of neem leaf extract on Kupffer cell hyperplasia and sinusoidal dilation in the liver of BALB/c mice induced with Plasmodium berghei. Methods: This study used liver histopathological specimens from BALB/c mice infected with Plasmodium berghei, divided into six groups: healthy control, positive control, negative control, and treatment groups receiving neem extract at doses of 8 mg, 12 mg, and 16 mg. Liver tissues were prepared using HE staining and examined under a light microscope at 1000× magnification in the periportal area. Sinusoidal diameter was measured using ImageJ. Data were analyzed using Kruskal–Wallis, Post Hoc Mann–Whitney, and Spearman correlation tests. Results: Neem leaf extract significantly reduced Kupffer cell hyperplasia at doses of 8 mg (p=0.021), 12 mg (p=0.021), and 16 mg (p=0.021), and decreased sinusoidal dilation at doses of 8 mg (p=0.021), 12 mg (p=0.021), and 16 mg (p=0.021). Correlation analysis showed a very strong negative association between increasing doses and the reduction of Kupffer cell hyperplasia (r = –0.930) and sinusoidal dilation (r = –0.909). Conclusion: Neem leaf extract can reduce Kupffer cell hyperplasia and sinusoidal dilation in the liver of BALB/c mice induced with Plasmodium berghei, with the most significant effect observed at a dose of 16 mg.