Latar belakang: Mahkota dewa (Phaleria macrocarpa) merupakan salah satu tanaman herbal di Indonesia dan ekstrak air buah mahkota dewa telah terbukti memiliki efek hepatoprotektif. Penelitian ini bertujuan untuk mengetahui aktivitas dan mekanisme kerja ekstrak air buah mahkota dewa dalam mencegah terjadinya fibrosis hati.Metode: Penelitian dilakukan pada tikus Sprague-Dawley jantan yang diinduksi karbon tetraklorida (CCl4) secara intraperitoneal setiap 3 hari sekali selama 8 minggu. Hewan coba dibagi menjadi 6 kelompok: normal, CCl4, n-Acetyl cysteine (NAC) dosis 150 mg/kgBB, ekstrak air buah mahkota dewa dosis 50, 100 dan 150 mg/kgBB. Penilaian dilakukan terhadap parameter aspartat aminotransferase (AST), alanin aminotransferase (ALT), alkali fosfatase (ALP), histopatologi hati, kadar malondialdehid (MDA), rasio GSH/GSSG, kadar Tumor Necrosis Factor (TNF)-α dan kadar Transforming Growth Factor (TGF)-β1Hasil: Hasil studi menunjukkan bahwa ekstrak air buah mahkota dewa dan NAC secara bermakna dapat melindungi hati dari cedera melalui penurunan aktivitas enzim ALT, AST, ALP dan penurunan persentase jaringan ikat pada pemeriksaan histopatologi. Ekstrak air buah mahkota dewa dan NAC dapat menghambat stress oksidatif melalui penurunan kadar MDA hati dan peningkatan rasio GSH/GSSG hati. Ekstrak air buah mahkota dewa dan NAC dapat menekan inflamasi melalui penurunan kadar TNF-α dan menghambat aktivasi sel stelata hati (HSC) yang ditandai dengan penurunan kadar TGF-β1.Kesimpulan: Ekstrak air buah mahkota dewa dapat mencegah fibrosis hati pada tikus yang diinduksi CCl4. Pencegahan terhadap fibrosis tersebut terutama melalui aktivitas antioksidan dan kemampuan menekan sitokin inflamasi TNF-α, serta menghambat aktivasi HSC melalui penurunan sitokin fibrogenik TGF-β1.

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Introduction: Mahkota dewa (Phaleria macrocarpa) is one of the Indonesian herbal plants. Hepatoprotective effect of aqueous extract of mahkota dewa fruits have been studied previously. This study was conducted to evaluate the activity of water extract of mahkota dewa in the prevention of liver fibrosis and its mechanism of action.Method: Male Sprague-Dawley rats were induced by carbon tertrachloride (CCl4) given every 3 days by intraperitoneal injection for 8 weeks. Rats were randomly allocated into 6 groups: control group, n-acetyl cysteine/NAC (150 mg/kgBB), aqueous extract of mahkota dewa (50, 100 and 150 mg/kgBB). Aspartate aminotransaminase (AST), alanine aminotransferase (ALT), alkaline phosphatase (ALP), liver histopathology, malondialdehyde (MDA), ratio GSH/GSSG, Tumor Necrosis Factor (TNF)-α and Transforming Growth Factor (TGF)-β1 were examined.Results: This study demonstrates that aqueous extract of mahkota dewa and NAC significantly protects the liver from injury by reducing the activity of AST, ALT, ALP and by reducing fibrosis percentage in histopatological examination. Aqueous extract of mahkota dewa and NAC attenuates oxidative stress by reducing the levels of MDA and increasing GSH/GSSG ratio. Aqueous extract of mahkota dewa and NAC suppresses inflammation by reducing the levels of TNF- α and inhibits hepatic stellate cells (HSC) activation by reducing the levels of TGF-β1.Conclusions: Aqueous extract of mahkota dewa prevents CCl4-induced fibrosis in rats. The prevention of liver fibrosis most possibly through its antioxidant activities, suppression of inflammatory cytokines TNF-α and inhibition of HSC activation by reducing fibrogenic cytokines TGF-β1.