PERBEDAAN DERAJAT FIBROSIS HEPAR TIKUS WISTAR YANG DILAKUKAN LIGASI DUKTUS KOLEDOKUS ANTARA KELOMPOK PEMBERIAN KOMBINASI UDCAGLUTATHIONE DENGAN PEMBERIAN TUNGGAL UDCA

Abstract

Background: Cholestasis leads liver cell death, fibrosis, cirrhosis, and eventually liver failure. Despite limited benefits, ursodeoxycholic acid (UDCA) is the only Food and Drug Administration–approved treatment for cholestatic disorders. Glutathione (GSH) plays important roles in antioxidant defense and regulation of cellular processes, including cell differentiation, proliferation and apoptosis. Disturbances in GSH balance have been associated with liver diseases. Objective: To evaluate the differences of the degree of liver fibrosis between supplementation of UDCA-Glutathione and UDCA in bile duct-ligated rats. Method: This true experiment research design with “posttest only control group design“ using 15 Wistar rat strain, divided into 3 group K, P1 and P2. Each rat undergoes bile duct ligation. Group K act as control with no treatment, P1 received UDCA 20 mg orally, P2 received UDCA 20 mg orally and Glutathione 15 mg intramuscular. After 21 days of intervention, all subjects were terminated and livers were taken and stained with Masson-trichrome for microscopic examination. Degrees of fibrosis were evaluated using Laennec’s scoring system. Kruskal-Wallis were used and followed by Mann-Whitney test. Result: The evaluation demonstrates statistically significant differences of degree of liver fibrosis in P2 – K group (p = 0.013) and P2 - P1 group (p = 0.006) but there was no difference between P1 and K group (p= 0.469). Conclusion: Combination of UDCA-Glutathione improved liver histology with decreased fibrosis Keywords: Cholestasis, UDCA, Glutathione, Fibrosis