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Abstrak :
Latar Belakang: Radioterapi adalah salah satu terapi kanker yang telah banyak digunakan untuk mengendalikan tumor secara lokal dan regional. Namun, tumor yang resisten terhadap radiasi dapat mengurangi efektivitas terapi. Radiosensitizer adalah agen penting untuk meningkatkan sensitivitas radiasi. Ulva lactuca (U. lactuca) adalah sejenis ganggang dan sudah terbukti memiliki efek antitumor. Diketahuinya jalur kerja U. lactuca mungkin memberikan pemahaman dasar terkait perannya sebagai radiosensitizer. Metode: Telaah sistematis dilakukan melalui pencarian literatur pada beberapa database. Pedoman PRISMA digunakan untuk melaporkan hasil pencarian. Studi in vivo atau in vitro yang menganalisis efek U. lactuca pada kanker dimasukkan dalam penelitian ini. Telaah kritis dinilai menggunakan Systemic Review Centre for Laboratory animal Experimentation Risk of Bias (SYRCLE RoB) tool pada studi in vivo dan Science in Risk Assessment and Policy (SciRAP) pada studi in vitro. Hasil: Tujuh artikel dimasukkan dalam telaah sistematis ini. Semua studi in vivo memiliki bias risiko rendah. Dua penelitian melaporkan bahwa U. lactuca memiliki efek antitumor (CEA, AFP, kadar bcl-2 menurun dan kadar p53 meningkat). Enam studi menunjukkan bahwa U. lactuca juga memiliki efek antioksidan (MDA, TNF alpha, kadar NO menurun, sementara TAC, MPO, SOD, CAT dan GR, GST, kadar GSH meningkat, dengan aktivitas pembersihan radikal). Lima penelitian menunjukkan bahwa U. lactuca memiliki aktivitas antikanker terhadap Caco-2 dan HT-29 CRC, MCF-7, Fem-x, HepG2, dan lini sel Hela. Kesimpulan: Aktivitas radikal bebas, p53, dan caspase-8, 9 adalah jalur utama efek antitumor U. lactuca. Jalur ini mungkin mengungkap potensinya sebagai radiosensitizer, yang memerlukan penelitian lebih lanjut. ......Introduction: Radiotherapy is one of the main treatments for cancer. It had been widely used to control tumor locally and regionally. However, a radioresistant tumor might compromise efficacy of the therapy. Radiosensitizer is an important agent to improve radiation sensitivity. Ulva lactuca (U. lactuca) is a type of algae with known antitumor effects. Analysis of its molecular pathway might provide basic understanding of its role as radiosensitizer. Method: A systematic review was conducted through literature searching on several databases. PRISMA guideline was used to present the results. In vivo or in vitro study which analyzed U. lactuca effects on cancer were included in this study. In vivo studies were critically appraised using Systemic Review Centre for Laboratory animal Experimentation Risk of Bias (SYRCLE RoB) tool and in vitro studies were critically appraised using Science in Risk Assessment and Policy (SciRAP). Result: Seven articles were included in this systematic review. All in vivo studies had low risk bias. Two studies reported that U. lactuca had antitumor effect (CEA, AFP, decreased bcl-2 levels and increased p53 level). Six studies showed that U. lactuca also had antioxidant effect (MDA, TNF alpha, decreased NO levels, while TAC, MPO, SOD, CAT and GR, GST, increased GSH levels, with radical scavenging activity). Five studies showed that U. lactuca had anticancer activities against Caco-2 and HT-29 CRC, MCF-7, Fem-x, HepG2, and Hela cell lines. Conclusion: Free radicals scavenging activity, p53, and caspase-8, 9 were the primary pathways of U. lactuca antitumor effects. These pathways might unravel its potential as radiosensitizer, which needs further analysis in future studies.

Abstrak :
Latar belakang: Penelitian sistematik untuk kanker payudara dilakukan di Indonesia dengan flora dan potensi terapeutik yang berlimpah berkesempatan sebagai prospek terhadap sel kanker melalui studi tentang kandungan fitokimia, aktivitas antioksidan, dan antikanker. Penelitian ini bertujuan untuk mengetahui kelimpahan potensi Ulva lactuca yang terdapat di Indonesia sebagai antioksidan dan inhibitor pertumbuhan kanker payudara terhadap sel kanker payudara MCF-7. Metode: Ulva lactuca diekstraksi dengan metode maserasi menggunakan pelarut n-heksana, etil-asetat dan etanol dan menghasilkan ekstrak n-heksana, ekstrak etil-asetat, dan ekstrak etanol Ulva lactuca. Hasil ekstraksi diuji dengan analisa fitokimia dan KLT. Aktivitas antioksidan sebagai radical scavenger dinilai melalui uji DPPH, sedangkan sitotoksisitas terhadap sel kanker payudara MCF-7 dievaluasi melalui uji MTT. Hasil: Analisa fitokimia menunjukan senyawa metabolit sekunder triterpenoid, steroid, dan glikosida terkandung dalam Ulva lactuca. KLT menunjukan adanya 11 komponen fitokimia. Dari uji DPPH, ekstrak Ulva lactuca dengan etanol dan etil asetat diklasifikasikan memiliki aktivitas antioksidan yang sangat aktif terhadap radikal bebas DPPH, dengan nilai IC50 3.514 μg/mL dan 33.770 μg/mL secara berurutan. Dari uji MTT, ekstrak n-heksana Ulva lactuca memberikan nilai IC50 70.496 μg/mL dan ekstrak etil asetat Ulva lactuca memberikan nilai 50.883 μg/mL terhadap sel kanker payudara MCF-7, dimana keduanya memiliki aktivitas antikanker sedang. Sedangkan ekstrak etanol Ulva lactuca menunjukan nilai IC50 11.920 μg/mL pada sel MCF-7 yang memiliki aktivitas antikanker yang aktif. Kesimpulan: Ekstrak etanol Ulva lactuca yang memiliki kandungan antioksidan dan aktivitas sitotoksik yang kuat terhadap sel MCF-7 perlu dikembangkan lebih lanjut sebagai agen antikanker payudara. ......Background: Systematic researches for breast cancer is ran in Indonesia with its flora resources and therapeutic potentials as prospective towards cancer cells through studies concerning phytochemical contents, antioxidant activity, and cytotoxicity. The aim of this research is to obtain Ulva lactuca abundant potential that is available in Indonesia as antioxidant and anticancer towards breast cancer cell MCF-7. Method: Ulva lactuca is extracted by maceration with solvents which are n-hexane, ethylacetate, and ethanol, ensuing extracts of n-hexane, ethyl-acetate and ethanol. The extracts later collected and tested through phytochemical and TLC analysis. The DPPH assay determines the extracts’ antioxidant activity as a radical scavenger and MTT assay evaluates the cytotoxicity towards MCF-7 cells. Results: Phytochemical screening revealed secondary metabolites triterpenoids, steroids, and glycosides in Ulva lactuca. The TLC resulted that there are 11 phytochemical components. From DPPH assay, ethanol and ethyl acetate extracts of Ulva lactuca are classified to have very active antioxidant activity against DPPH free radicals, with IC50 of 3.514 μg/mL and 33.770 μg/mL, respectively. From MTT assay, n-hexane extract gives IC50 value of 70.496 μg/mL, and ethyl-acetate extract gives IC50 value of 50.883 μg/mL towards MCF-7 cells, both have moderate anticancer activity. Whereas the ethanol extract gives IC50 value of 11.920 μg/mL on MCF-7 cells which considered to have active anticancer activity. Conclusion: Ethanol extract of Ulva lactuca that has a strong antioxidant and cytotoxic activity against MCF-7 cells should be further develop as an anti-breast cancer agent.