Siregar Rosmayanti S, Ramayani Oke Rina, Haris Delyuzar, Lelo Aznan, Jusuf Nelva Karmila, Eyanoer Putri Chairani, Rusda Muhammad, Amin Mustafa Mahmud
Doctoral Program in Medical Sciences, Faculty of Medicine, Universitas Sumatera Utara, Indonesia.
Department of Pediatric, Faculty of Medicine, Universitas Sumatera Utara, Medan, Indonesia.
Med Arch. 2023;77(6):422-427. doi: 10.5455/medarh.2023.77.422-427.
Proteinuria is a significant clinical manifestation that causes edema in several diseases, including Nephrotic Syndrome (NS). Untreated proteinuria is strongly linked to the progression of kidney failure. One of the adjuvant therapies could be used to reduce proteinuria such as Angiotensin Receptor Blocker (ARB) including Losartan®. Gambier is a traditional medicinal plant widely known for its antioxidant effects. Catechin, a compound contained in Gambier Extract (GE), has been used to reduce microalbuminuria in diabetics. However, its application in NS has not been widely studied.
This study compared the effects of GE and ARB in reducing proteinuria and increasing antioxidant activity levels, as well as reported histopathological findings in the nephrotic Wistar rat model.
An experimental design study with a control group and a posttest was conducted. The experimental animals were divided into four groups: the control group (K1), the group with puromycin aminonucleoside (PAN) injection (K2), the group with PAN injection + GE (K3), and the group with PAN injection + Losartan® (K4). The standard GE used was Sarie Uncariae® by Toyo Brothers, PT while the ARB (Losartan®) was obtained from Novell, PT. Protein urine, the activity level of total superoxide dismutase (T-SOD), and malondialdehyde (MDA) were assessed using the colorimetric method. Renal histopathology was assessed based on Rollerman's criteria.
Gambier extract significantly reduced proteinuria, as depicted by a decrease in protein/volume urine (p = 0.009), increased antioxidant activity, as illustrated by an elevation in T-SOD activity levels (p = 0.007), and tended to decrease MDA levels compared to Losartan®. Based on histopathological findings, GE tended to reduce the percentage of kidney damage in rats induced by puromycin.
Gambier extract has been shown a higher antioxidant effect by increasing T-SOD activity levels, reducing proteinuria and also exhibiting a tendency to diminish kidney damage.
蛋白尿是一种重要的临床表现，可导致包括肾病综合征（NS）在内的多种疾病出现水肿。未经治疗的蛋白尿与肾衰竭的进展密切相关。辅助治疗方法之一可用于减少蛋白尿，如血管紧张素受体阻滞剂（ARB），包括氯沙坦（Losartan®）。儿茶钩藤是一种传统药用植物，以其抗氧化作用而广为人知。儿茶素是儿茶钩藤提取物（GE）中的一种化合物，已被用于降低糖尿病患者的微量白蛋白尿。然而，其在NS中的应用尚未得到广泛研究。
本研究比较了GE和ARB在减少蛋白尿、提高抗氧化活性水平方面的作用，并报告了肾病性Wistar大鼠模型的组织病理学结果。
进行了一项设有对照组和后测的实验设计研究。实验动物分为四组：对照组（K1）、注射嘌呤霉素氨基核苷（PAN）的组（K2）、注射PAN + GE的组（K3）和注射PAN + 氯沙坦（Losartan®）的组（K4）。使用的标准GE是东洋兄弟有限公司的Sarie Uncariae®，而ARB（氯沙坦（Losartan®））购自Novell有限公司。采用比色法评估蛋白尿、总超氧化物歧化酶（T-SOD）活性水平和丙二醛（MDA）。根据Rollerman标准评估肾脏组织病理学。
儿茶钩藤提取物显著降低了蛋白尿，表现为尿蛋白/尿量减少（p = 0.009），提高了抗氧化活性，表现为T-SOD活性水平升高（p = 0.007），与氯沙坦（Losartan®）相比，MDA水平有降低趋势。基于组织病理学结果，GE倾向于降低嘌呤霉素诱导的大鼠肾脏损伤百分比。
儿茶钩藤提取物通过提高T-SOD活性水平、减少蛋白尿以及表现出减轻肾脏损伤的趋势，显示出更高的抗氧化作用。
