Potensi buah delima (punica granatum) sebagai terapi adjuvan preeklampsia: A scoping review
DOI: https://doi.org/10.33024/hjk.v19i5.616
Buah Delima Ibu Hamil Preeklampsia Terapi Adjuvan
Abstract
Background: Preeclampsia is a leading cause of maternal mortality and a global health problem. Preeclampsia can be triggered by increased free radicals, which cause oxidative stress, endothelial dysfunction, and other organ damage. However, to date, no therapy has been proven to prevent preeclampsia other than pregnancy termination. A scoping review is needed to gather evidence related to the use of pomegranate and its derivatives for preeclampsia therapy as a basis for further basic and applied research.
Purpose: To identify, evaluate, and summarize previous research evidence on the potential of pomegranate as an adjuvant therapy for preeclampsia.
Method: A systematic review of literature published between January 2014 and June 2024 was conducted using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Articles were searched through Scopus, Sciencedirect, Proquest, and PubMed databases. The search used the keywords "punica granatum" OR "pomegranate" AND "preeclampsia" OR "gestational hypertension."
Results: Five articles were identified, and it was found that pomegranate has potential as an adjuvant therapy for preeclampsia and may be a valuable adjunct in preeclampsia management. The rich content of antioxidant, anti-inflammatory, and vasodilatory bioactive compounds in pomegranate may contribute to risk reduction and symptom management of preeclampsia.
Conclusion: Pomegranate has potential as an adjuvant therapy for preeclampsia.
Suggestion: Further in vitro and in vivo studies with more robust designs, including controlled clinical trials, are needed to confirm the efficacy and safety of pomegranate. The optimal dosage and underlying mechanism of action of pomegranate in preeclampsia are also needed.
Keywords: Adjuvant Therapy; Pomegranate; Preeclampsia; Pregnant Women.
Pendahuluan: Preeklampsia menjadi penyebab utama kematian dan masalah kesehatan ibu di dunia. Preeklampsia dapat dipicu oleh peningkatan radikal bebas yang menyebabkan stres oksidatif, disfungsi endotel, dan kerusakan organ lainnya. Namun, hingga kini belum ada terapi yang mampu menghentikan preeklampsia kecuali dengan mengakhiri kehamilan. Diperlukan scoping review untuk mengumpulkan bukti terkait penggunaan buah delima dan turunannya untuk terapi preeklampsia sebagai pijakan penelitian dasar dan terapan selanjutnya.
Tujuan: Untuk mengidentifikasi, mengevaluasi, dan merangkum bukti hasil penelitian sebelumnya tentang potensi buah delima sebagai terapi adjuvan preeklampsia.
Metode: Penelitian literatur sistematis yang diterbitkan antara Januari 2014 - Juni 2024 menggunakan pedoman Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA). Pencarian artikel melalui database Scopus, Sciencedirect, Proquest, dan PubMed. Pencarian artikel menggunakan kata kunci “punica granatum” OR “pomegranate” AND “preeclampsia” OR “gestational hypertension.”
Hasil: 5 artikel diidentifikasi dan ditemukan bahwa buah delima memiliki potensi sebagai terapi adjuvan untuk preeklampsia dan berpotensi juga menjadi terapi tambahan yang berharga dalam manajemen preeklampsia. Buah delima yang kaya zat antioksidan, antiinflamasi, dan efek vasodilator dari senyawa bioaktif dapat berkontribusi pada pengurangan risiko dan pengelolaan gejala preeklampsia.
Simpulan: Buah delima memiliki potensi sebagai terapi adjuvan untuk preeklampsia.
Saran: Diperlukan untuk melakukan penelitian, baik in vitro dan in vivo lebih lanjut dengan desain yang lebih kuat, termasuk uji klinis yang terkontrol untuk mengkonfirmasi efektivitas dan keamanan penggunaan buah delima dan juga diperlukan untuk menentukan dosis yang optimal dan mekanisme kerja yang mendasari efek terapeutik buah delima pada preeklampsia.
Kata Kunci: Buah Delima; Ibu Hamil; Preeklampsia; Terapi Adjuvan.
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References
Amaral, L. M., Cunningham Jr, M. W., Cornelius, D. C., & LaMarca, B. (2015). Preeclampsia: long-term consequences for vascular health. Vascular health and risk management, 403-415.
Ambarwati, D., Fatmawati, F., Nooryanto, M., Santoso, S., Baktiyani, S. C. W., & Nurdiana, N. (2017). Punica granatum fruit extract inhibits the production of pro-inflammatory cytokines and angiogenic factors of HUVEC cells induced by plasma from patients with pre-eclampsia. Clinical Nutrition Experimental, 15, 9-14.
Badan Pusat Statistik. (2023). Angka Kematian Ibu/AKI (Maternal Mortality Rate/MMR) Hasil Long Form SP2020 Menurut Provinsi, 2020. Diakses dari: https://www.bps.go.id/id/statistics-table/1/MjIxOSMx/angka-kematian-ibu-aki-maternal-mortality-rate-mmr-hasil-long-form-sp2020-menurut-provinsi-2020.html
Cornelius, D. C. (2018). Preeclampsia: from inflammation to immunoregulation. Clinical medicine insights: Blood disorders, 11, 1179545X17752325.
Dimitriadis, E., Rolnik, D. L., Zhou, W., Gutierrez, G. E., Koga, K., Francisco, R. P., & Menkhorst, E. (2023). Pre-eclampsia. Nature reviews Disease primers, 9(1), 8.
El Hosry, L., Mitri, C. B., Dargham, M. B., Jaoudeh, M. A., Farhat, A., El Hayek, J., & Maroun, E. B. (2023). Phytochemical composition, biological activities and antioxidant potential of pomegranate fruit, juice and molasses: A review. Food Bioscience, 55, 103034.
Gathiram, P., & Moodley, J. J. C. J. O. A. (2016). Pre-eclampsia: its pathogenesis and pathophysiolgy: review articles. Cardiovascular journal of Africa, 27(2), 71-78.
Hod, T., Cerdeira, A. S., & Karumanchi, S. A. (2015). Molecular mechanisms of preeclampsia. Cold Spring Harbor perspectives in medicine, 5(10), a023473.
Horidah, S., Prameswar, R. D., Erlinawati, N. D., Sasmito, P., & Muntasir, M. (2023). Riwayat penyakit infeksi dan kejadian stunting pada balita usia 24–60 bulan.
Jena, M. K., Sharma, N. R., Petitt, M., Maulik, D., & Nayak, N. R. (2020). Pathogenesis of preeclampsia and therapeutic approaches targeting the placenta. Biomolecules, 10(6), 953.
Kementerian Kesehatan Republik Indonesia. (2021). Peringatan Hari Preeklamsia Sedunia 2021. Diakses dari: https://ayosehat.kemkes.go.id/peringatan-hari-preeklamsia-sedunia-2021.
Kementerian Kesehatan Republik Indonesia. (2023). Profil Ditjen P2P Tahun 2022. Diakses dari: https://www.slideshare.net/slideshow/profil-ditjen-p2p-tahun-2022/260387484.
Kementerian Kesehatan Republik Indonesia. (2023). Profil Kesehatan Indonesia 2021. Diakses dari: https://kemkes.go.id/id/profil-kesehatan-indonesia-2021.
Kusumawati, W., Keman, K., & Soeharto, S. (2016). Inhibitory Effect of the Punica granatum Fruit Extract on Angiotensin‐II Type I Receptor and Thromboxane B2 in Endothelial Cells Induced by Plasma from Preeclamptic Patients. Advances in Preventive Medicine, 2016(1), 6028989.
Mansur, S. A., Deroyeen, A. F., Indriyanti, M. N., Annisak, A. K., Fajriati, D. R., & Amiruddin, M. (2022). Kandungan buah delima (Punica granatum L.) dalam perspektif Al-Qur'an, sunnah, dan sains. Proceedings of International Pharmacy Ulul Albab Conference and Seminar (PLANAR),.
Mayasankaravalli, C., Deepika, K., Lydia, D. E., Agada, R., Thagriki, D., Govindasamy, C., & Kim, H. J. (2020). Profiling the phyto-constituents of Punica granatum fruits peel extract and accessing its in-vitro antioxidant, anti-diabetic, anti-obesity, and angiotensin-converting enzyme inhibitory properties. Saudi Journal of Biological Sciences, 27(12), 3228-3234.
Moura, M. S. D. F., Linhares, J. J., Noronha, E. C., Fernandes, W. C. D. P., Tavares, K. C. S., Antunes, A. S. L. M., & Silva, A. W. B. (2022). Evaluation of the association of the Renalase rs10887800 polymorphism with the risk of preeclampsia in Brazilian women. Pregnancy Hypertension, 27, 176-180.
Nasifah, I., Soeharto, S., & Nooryanto, M. (2017). Effects of anti-lipid peroxidation of Punica granatum fruit extract in endothelial cells induced by plasma of severe pre-eclamptic patients. Journal of Ayurveda and Integrative Medicine, 8(4), 215-217.
Ożarowski, M., Karpiński, T. M., Szulc, M., Wielgus, K., Kujawski, R., Wolski, H., & Mrozikiewicz, A. S. (2021). Plant phenolics and extracts in animal models of preeclampsia and clinical trials—Review of perspectives for novel therapies. Pharmaceuticals, 14(3), 269.
Poon, L. C., Shennan, A., Hyett, J. A., Kapur, A., Hadar, E., Divakar, H., & Hod, M. (2019). The International Federation of Gynecology and Obstetrics (FIGO) initiative on preeclampsia (PE): a pragmatic guide for first trimester screening and prevention. International journal of gynaecology and obstetrics: the official organ of the International Federation of Gynaecology and Obstetrics, 145(Suppl 1), 1.
Psilopatis, I., Vrettou, K., Fleckenstein, F. N., & Theocharis, S. (2023). The role of peroxisome proliferator-activated receptors in preeclampsia. Cells, 12(4), 647.
Puneeth, H. R., & Chandra, S. S. P. (2020). A review on potential therapeutic properties of Pomegranate (Punica granatum L.). Plant Sci. Today, 7(1), 9-16.
Rana, S., Lemoine, E., Granger, J. P., & Karumanchi, S. A. (2019). Preeclampsia: pathophysiology, challenges, and perspectives. Circulation research, 124(7), 1094-1112.
Rini, S., Soetrisno, S., Andayani, T. R., & Suminah, S. (2023). Complementary and alternatives care for postpartum preeclampsia: A scoping review. Pharmacia (0428-0296), 70(4).
Salsabila, A. (2023). Pohon Delima: Taksonomi, Status Kelangkaan, Jenisnya, dan Manfaat (2023). Hutanpedia Diakses dari: https://lindungihutan.com/blog/serba-serbi-pohon-delima/
Shahkoomahally, S., Shin, D., Habibi, F., Kim, J., & Sarkhosh, A. (2023). Profiling phenolic compounds in juice and peel of fourteen pomegranate (Punica granatum L.) varieties grown in Florida, USA. Food Chemistry Advances, 2, 100225.
Stockton, A., Farhat, G., McDougall, G. J., & Al-Dujaili, E. S. (2017). Effect of pomegranate extract on blood pressure and anthropometry in adults: a double-blind placebo-controlled randomised clinical trial. Journal of Nutritional science, 6, e39.
Taylor, E. B., & George, E. M. (2022). Animal models of preeclampsia: mechanistic insights and promising therapeutics. Endocrinology, 163(8), bqac096.
Tenório, M. B., Ferreira, R. C., Moura, F. A., Bueno, N. B., de Oliveira, A. C. M., & Goulart, M. O. F. (2019). Cross‐talk between oxidative stress and inflammation in preeclampsia. Oxidative Medicine and Cellular Longevity, 2019(1), 8238727.
Wang, P., Wang, W., Jia, Y., Yu, Y., & Wang, X. (2022). Interaction between CD81 and NCC is associated with LPS induced preeclampsia. The FASEB Journal, 36.
Wang, Y., Huang, M., Yang, X., Yang, Z., Li, L., & Mei, J. (2018). Supplementing punicalagin reduces oxidative stress markers and restores angiogenic balance in a rat model of pregnancy-induced hypertension. The Korean journal of physiology & pharmacology, 22(4), 409-417.
Yisimayili, Z., & Chao, Z. (2022). A review on phytochemicals, metabolic profiles and pharmacokinetics studies of the different parts (juice, seeds, peel, flowers, leaves and bark) of pomegranate (Punica granatum L.). Food Chemistry, 395, 133600.
Zafar, S., & Ara, C. (2020). Pomegranate juice ameliorates atenolol toxic effects on embryo development. JAPS: Journal of Animal & Plant Sciences, 30(5).
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