Efektivitas Ekstrak Etanol Pegagan (Centella asiatica (Linn.) Urban) Terstandar sebagai Agen Kemoprevensi terhadap Sel Displasia Rongga Mulut Tikus Wistar Jantan (Rattus norvegicus)

Abstract

Background: Carcinogenesis is the process of normal cells being gradually transformed into cancer cells due to genetic mutations, leading to uncontrolled cell division due to a disruption in the balance between cell proliferation and apoptosis. Dimethyl benz(a)anthracene (DMBA) has been shown to mediate oral carcinogenesis through precancerous lesions (dysplasia) to malignant tumours. Cancer chemoprevention is the control of cancer, i.e. the occurrence of disease is prevented by the administration of one or more natural or chemical mixtures. Centella asiatica or gotu kola is one of the traditional plants that has been widely used in the treatment of various diseases, including cancer. Objective: To analyse the effectiveness of standardised Centella asiatica ethanol extract that can be used as a chemoprevention agent against oral dysplasia cells of male Wistar rats (Rattus norvegicus). Research method: Laboratory experimental research with post-test only control group design on 28 male wistar rats (Rattus norvegicus) divided into four groups, namely the treatment group giving Centella asiatica ethanol extract doses of 375 mg/kgBW, 750 mg/kgBW, 1500 mg/kgBW for 61 days and negative control without treatment. The ethanol extract of Centella asiatica was standardised and phytochemical identification was carried out, then the dysplasia model was made by inducing the buccal mucosa of rats with DMBA for 28 days, then assessing the picture of dysplasia and the degree of dysplasia histopathologically and semi-quantitative assessment of protein expression of EGFR, p53, Ki67 by immunohistochemical examination. Quantitative data analysis test of all groups using Oneway ANOVA and qualitative data using Chi square (X2). Results: Centella asiatica ethanol extract showed that all phytochemical assessment parameters met the standards based on the reference value of the Indonesian Herbal Pharmacopoeia. The histological picture of the Centella asiatica ethanol extract treatment group at a dose of 1500 mg/kgBW showed a mild dysplasia picture in all samples compared to other groups with an average dysplasia score of 1.00 ± 0.00, statistical tests showed significant differences in all groups (p<0.05). While immunohistochemical images on EGFR biomarkers, p53 and Ki67 most of the groups did not show staining and statistical tests did not show significant differences (p>0.05) in all groups. Conclusion: Centella asiatica ethanol extract is proven to contain secondary metabolites that effectively prevent the development of oral mucosal dysplasia in male Wistar rats histologically.