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All Journal SAINS MEDIKA : JURNAL KEDOKTERAN DAN KESEHATAN Jurnal Kedokteran Diponegoro Althea Medical Journal Journal of Biomedicine and Translational Research The Indonesian Biomedical Journal Majalah Patologi Indonesia Medica Hospitalia PREPOTIF : Jurnal Kesehatan Masyarakat Medica Arteriana (Med-Art) Diponegoro International Medical Journal (DIMJ) Indonesian Journal of Cancer Zona Kebidanan : Program Studi Kebidanan Universitas Batam Indonesian Journal of Biomedicine and Clinical Sciences Ophthalmologica Indonesiana Acta Odontologica Indonesia
Hermawan Istiadi
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Biochemistry, Genetics & Molecular Biology Dentistry Health Professions Immunology & microbiology Medicine & Pharmacology Neuroscience Nursing Public Health

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Journal : The Indonesian Biomedical Journal

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Soursop Leaf Extract Reduces AST, ALT, Bilirubin Levels, and Liver Damage Scores in Sorafenib-treated Wistar Rats with Hepatocellular Carcinoma Susilaningsih, Neni; Prajoko, Yan Wisnu; Budijitno, Selamat; Prabowo, Erik; Istiadi, Hermawan; Muniroh, Muflihatul; Riwanto, Ignatius
The Indonesian Biomedical Journal Vol 18, No 1 (2026)
Publisher : The Prodia Education and Research Institute (PERI)

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.18585/inabj.v18i1.3883

Abstract

BACKGROUND: Sorafenib, the standard therapeutic agent for advanced hepatocellular carcinoma (HCC), may induce hepatic dysfunction, thereby necessitating adjunctive therapy to mitigate this adverse effect. While preliminary research has suggested that Soursop (Annona muricata) leaves exhibit anti-tumor and hepatoprotective properties, their efficacy in mitigating liver damage associated with sorafenib treatment remains unexplored. This study was conducted to assess the liver-protective effects of soursop leaf extract in Wistar rats receiving sorafenib for HCC treatment.METHODS: Ethanol extract of soursop leaves was prepared using the maceration method. Twenty-nine Wistar rats were divided into five groups: healthy control (HC) group, HCC groups receiving no treatment, sorafenib only, sorafenib + 50 mg/kgBW/day soursop extract, and sorafenib + 100 mg/kgBW/day soursop extract. All groups, except the HC group, were given Diethyl Nitrosamine (DEN) to cause HCC. Following a two-week treatment period, serum levels of aspartate aminotransferase (AST) and alanine aminotransferase (ALT) were assessed using colorimetric methods, while total bilirubin was assessed using diazo with sulphanilic acid method. From histopathological specimen, relative liver weight was measured and liver damage score was assessed using Hematoxylin and Eosin.RESULTS: Administration of sorafenib resulted in a reduction of AST, ALT, total bilirubin, relative liver weight, and liver damage scores. Furthermore, the combined administration of sorafenib with soursop leaf extract at dosages of 50 and 100 mg/kgBW/day led to a dose-dependent amelioration of these indicators. The most pronounced improvement was observed with the highest dose of soursop extract, which significantly reduced AST, ALT, total bilirubin, relative liver weight, and liver damage scores compared to the sorafenib-only group.CONCLUSION: Soursop leaf extract at 100 mg/kgBW/day effectively reduced AST, ALT, bilirubin levels, and liver damage score in sorafenib-treated Wistar rats with HCC, indicating its hepatoprotective effects. These findings suggest that soursop leaf extract may be a promising adjuvant therapy for mitigating sorafenib-induced hepatotoxicity in HCC treatment.KEYWORDS: Annona muricata, hepatocellular carcinoma, sorafenib, AST, ALT, bilirubin, hepatoprotective
Co-Authors Almaz, Ayyasi Izaz Anna Mailasari kusuma Dewi Ardiani, Zefania Regina Arga Purlina Wijayanti Ariani, Resti Arianto, Adi Arief Wildan Arief Wildan, Arief Arinta Puspita Wati, Arinta Puspita ARNILA NOVITASARI Astika Widy Utomo Astuti, Meira Dewi Kusuma Astuti, Ratih Kusuma Awal Prasetyo Darmawati Ayu Indraswari Devia Eka Listiana, Devia Eka Dharma, Andhika Guna Dik Puspasari, Dik Dwi Pudjonarko Eka Yudhanto Elim, Marlion Anthonius Elnitiarta, Jasmine Excelinda, Tifanni Fauzi, Muhammad Iqbal Fifin Luthfia Rahmi Firawan, Kurnia Nisa Putri Firdauzi Putri, Nabila Zenska FRANSISKA BANJARNAHOR Hadi Hadi Halim, Fenny Halleyantoro, Ryan Hamidiyah, Silpi Haryanto, Julia Ike Ida Ayu Putu Sri Widnyani Ignatius Riwanto, Ignatius Ika Pawitra Miranti Ika Pawitra Miranti Ilham, Dimas Muhammad Intan Rahmania Eka Dini Jenifer Marsela Tarius Jessica Yolanda Hadisusanto Kanti Yunika Karlowee, Vega Kesumayadi, Irfan Kusuma, Ira Anggar Maftikhati, Dora Maharani Maharani Maharani, Maharani Margareth, Ezra Meita Hendrianingtyas Muniroh, Muflihatul Nabila, Alin Neni Susilaningsih Nugroho, Trilaksana Nuh Gusta Ady Yolanda Nurkholis, Fathur Oedijani Santoso Prabowo, Erik Purnawati, Ratna Dama Puspita`, Rina Rahmi, Fifin L Retnoningrum, Dwi Riski Prihatningtias Riski Prihatningtias, Riski Rizqa Wahyuni Rohma, Intarniati Nur RR. WIDYASTUTI PASPARINI Sadana, Aqsa Aufa Syauqi SALMAH ALAYDRUS Saubig, Arnila Novitasari Selamat Budijitno Sudarmanto, Alif Muhammad Trilaksana Nugroho Trimahendra, Alfin Ihza Tun Paksi Sareharto Udadi Sadhana, Udadi Utami, Asih Ratna Widodo Sarjana AS, Widodo Widyarini, Andriati Nadhilah Wikanta, Edmond Rukmana Yan Wisnu Prajoko Yora Nindita