Histopathological Profile of Therapeutic Doses of Methanolic Extract Combination of Tea and Mango Mistletoes in Cardiac of Preventive Hypertensive Rats (DOCA-sal. Model Durrotul Hasanah1. Nour Athiroh Abdoes Sjakoer1. Nurul Jadid Mubarakati1 Department of Biology. Faculty of Mathematics and Natural Sciences. Universitas Islam Malang. East Jawa. Indonesia Correspondence: Nour Athiroh Abdoes Sjakoer. Department of Biology. Faculty of Mathematics and Natural Sciences. Universitas Islam Malang. Jl. MT. Haryono 193. Malang. East Jawa. Indonesia Zip Code: 65144 Email: nour. athiroh@unisma. Received: January 25, 2022 Revised: June 24, 2022 Accepted: July 4, 2022 Published: October 30, 2022 DOI: 10. 33086/ijmlst. Abstract Tea and mango mistletoes have to lower blood pressure by improving oxidative stress and endothelial dysfunction. The flavonoid compounds found in these two mistletoes act as Hypertension is a risk factors that influences the incidence of cardiac disease. This study examines the histopathological of the cardiac of hypertensive rats . reventive mode. after treatment of methanolic extract combination of tea and mango This study used a completely randomized experimental design with 25 Wistar rats in total for five treatments, namely negative control (-), positive control ( ), treatment 1 . ose of 50 mg/kg BW), treatment 2 . oses of 100 mg/kg BW), and treatment 3 . oses of 200 mg/kg BW). In this study. Deoxycorticosterone acetate (DOCA) were used to induce hyperttension in experimental animals. Data were analysed with one-way ANOVA test using JAMOVI . and posteriori. There was a significant difference between all groups . <0. Administration of a methanolic extract combination of tea and mango mistletoes as the preventive model can significantly reduce hypertrophy of cardiac muscle cells. This effect occured with a dose of 50 mg/kg BW, the optimal dose to reduce hypertrophy of cardiac muscle cells in Wistar rats male. Keywords Hypertrophy. Hypertension. Mango mistletoe. Muscle Cells Cardiac. Tea Mistletoe. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. A2021 by author. Durrotul Hasanah, et al. weaken the cardiac muscle and cause INTRODUCTION Convention on International Trade in Endangered Species of Wild Fauna and Traditional medications can be an Flora (CITIES) stated that the use of materials uses approximately Therefore, on this occasion, 60,000 plant species worldwide for both the authors examine the histopathological traditional and modern medicines . profile of the cardiac in male Wistar rats Mistletoes tea (Escurrula atropurpure. with a preventive model of hypertension and mango mistletoes (Dendrophthoe after administration of a methanolic extract pentandra L. ) Miq is a plant that has combination of tea and mango mistletoes. benefits for maintaining health and fitness . Tea mistletoes have been shown to reduce contractility of the tail arteries of This hypertensive rats in vitro. While in vivo, randomized experimental design with 25 tea mistletoes reduce blood pressure by Wistar rats in total for five treatments of improving oxidative stress and endothelial administration of the extract combination MDA methanolic tea leaf mistletoe and mango (Malondialdehyd. levels, and increasing mistletoe, namely negative control (-). NO (Nitrix Oxyge. ,4,5,. positive control ( ). P1 with a dose of 50 mg/kg BW. P2 with a dose of 100 mg/kg Dendrophthoe BW and P3 with a dose of 200 mg/kg BW. pentandra L. act as antihypertensives. MATERIALS AND METHODS A methanolic extract combination of tea and Hypertension, known as the silent mango mistletoes was exposed to Rattus killer, is a condition of increased systolic novergicus . ale Wistar rat. for 28 days of more than 140 mmHg and diastolic and followed by the administration of blood pressure of more than 90 mmHg Deoxycorticosterone acetate (DOCA)- . In the incidence of cardiac and blood salt in the last 14 days as a preventive . ascular hypertension is one of the most influential The research was carried out in risk factors . ,10,11,12,. People with March Ae May 2021 in the animal house hypertension have a narrow blood vessel. Faculty of Dentistry. Laboratory of known as vasoconstriction, which increases Anatomical Histopathology. Faculty of Medicine Universitas Brawijaya Malang, throughout the body. This condition can Laboratory of the Faculty of Medicine Ina. Med. Lab. Sci. Tech. : 99Ae110 Durrotul Hasanah, et al. Islamic University Malang, and Batu. East Java. All experiments were evaporator to produce leaf extract of tea performed with ethical approval from the mistletoe and mango mistletoe in the form Islamic University Malang Faculty of of a paste. Medicine Test Animal Acclimatization Process Ethics Commission (No. 006/LE. 001/IV/03/2. Preparation Research Laboratory of Balai Materia Medica Health Wistar rats (Rattus norvegicu. 2-3 months old with a bodyweight of 150- Methanolic Extract 250 were acclimatized at the Animal Combination of Mistletoe Tea Leaves House. Faculty of Dentistry. Universitas and Mistletoe of Mango Mistletoe Brawijaya Malang for five days at room The methanolic extract combination temperature A 24 oC with humidity of of tea and mango mistletoes is produced approximately 50-60% protected from using Simplicia derived from mashed the smoke of industry, motor vehicle dried mistletoe leaves. The maceration fumes, and other pollutants as well as process includes immersing the material being fed and drinking. with a solvent that is by following per Test Animal Care extracted . before and after the acclimatization . re- The powder or simplicia leaves of tea The test animals were weighed Weekly monitoring of body measured at 100 grams were put into five weight is required to determine the dose 5 liter plastic bottles. Then, 1 litre of Wistar rats use a cage with a 90% methanol solution was put into each cover in the form of woven wire and bottle and shaken until the solution was wood shavings given as a base for mice. homogeneous for 1 hour. After 1 hour. The husks are regularly replaced once the homogeneous solution was allowed every two days. Feeding was performed to stand and precipitated for 24 hours. every morning and evening with a feed This weight of 7 grams per rat. once a week for 28 days of equilibrium was reached . The result Treatment Methanolic Extract of the deposition process for 24 hours Combination Tea and Mango Mistletoes This study used a dose of methanolic natant, while the top layer is called a extract combination of tea and mango Part supernatant will be mistletoes in a ratio of 3:1 with the first Ina. Med. Lab. Sci. Tech. : 99Ae110 will form a bottom layer in the form of a Durrotul Hasanah, et al. dose of 50 mg/kg BW, the second dose of After 3 hours of fasting, the rats 100 mg/kg BW, and the third dose of 200 were given either intramuscular ketamine mg/kg BW. The methanolic extract injections of anesthesia. Then dissection combination of tea and mango mistletoes was administered for four weeks . Then the cardiac organ was times/wee. taken and put in an organ tube with a 10% formalin solution. The organ taken was Provision DOCA-salt as A Preventive used as a microscopic preparation and Hypertension Model then processed following the standard DOCA is a precursor of the adrenal cortex mineralocorticoid hormone, which has and Eosin (HE) staining. an analogous effect to the mineralocorticoid Histopathological Examination aldosterone, which causes retention of Na Histopathological and H2O in the distal tubule. DOCA-salt is cardiac organs were performed after one model of secondary hypertension due to staining using Hematoxylin and Eosin by endocrine . DOCA taking 400x and 200x magnification was administered twice a week during photos with five fields of view under a the last two weeks of treatment which was also at the same time as the TV0. 5XC-3. T7 Tokyo. Japan. The administration of a methanolic extract photos with 400x magnification were combination of tea and mango mistletoes. DOCA ImageJ Olympus subcutaneous injection in the positive diameter of cardiac muscle cells, while control ( ), the first treatment (P. , (P. , the photos with 200x magnification were and (P. Blood pressure readings were used as visualizations. taken in rats before and after DOCA Data Analysis DOCA given to rats was first histological method with Hematoxylin The data obtained were statistically tested using the JAMOVI application according to the dose. One-way analysis of Surgery variance (ANOVA). A post-hoc test was Surgery on the test animals was conducted after additional tests. performed after 28 days of treatment by employed ANOVA with post hoc testing to examine differences between means The organ observed is while reducing the family error rate. Ina. Med. Lab. Sci. Tech. : 99Ae110 Durrotul Hasanah, et al. Based on Table 1, the positive control RESULTS The Measure of Cardiac Muscle Cell (K ) group had the widest cell diameter. Diameter The result also showed there was a Microscopic measurement of the diameter of the cells in the cardiac muscle significant difference between treatment Observations ImageJ measuring the diameter of cardiac muscle cardiac histopathology was observed cells in the myocardium layer. The under a trinocular microscope with an normality test showed that the data were objective magnification of 400x in 5 fields of view. Histopathological features results of the One Way ANOVA test of the cardiac in male Wistar rats were obtained a p-value of <0. 001, in which Previously, methanolic extract combination of tea and mango mistletoes for 28 days and followed The post . <0. Hoc test was The by injection of DOCA-salt as a model of comparing the positive control (K ) induced hypertension in rats in the last two weeks. by DOCA-salt, the negative control (K-) The results were obtained based on the without DOCA-salt induction. P1. P2 and P3. treatment in each group (Table . The result showed a statistically significant difference between positive control (K ) Table 1. Histopathological Observations on the Mean Cell Diameter in Cardiac Muscle (AA. Male Wistar Rats After Treatment 28 Treatment Mean Cell Diameter in Cardiac Muscle (AA. 5 A 0. 2 A 2. Ina. Med. Lab. Sci. Tech. : 99Ae110 control (K-) without DOCA-salt induction. contrast, there was no significant difference in the P1. P2, and P3 . reatment grou. Histopathological Observation Observations obtained photos of cardiac muscle cells both at 200x and 400x magnification (Figure 1-. From positive control mice were significantly different from the negative control mice (-) and the treated mice (P1. P2, and P. On the contrary, there was no significant Negative Control Positive Control (DOCA-sal. P1 (Dose 50 6 A 0. mg/KgBB DOCA-sal. P2 (Dose 100 1 A 0. mg/KgBB DOCA-sal. P3 (Dose 200 4 A 0. mg/KgBB DOCA-sal. The different letters in the same column indicate significant difference at p<0. Data are presented as mean A SD induced by DOCA-salt and the negative Durrotul Hasanah, et al. difference between the negative control and treatment groups (P1. P2, and P. 50 AAm 50 AAm 50 AAm Figure 1. Microscopic observations . ross section: 200. Myocardial tissue. (A) Control Group (-), (B) Control Group ( ), (C) Group P1 . mg / KgBW), (D) Group P3 . mg / KgBW). Description: 1,2,3,4 : cell nucleus 50 AAm 50 AAm 50 AAm 50 AAm 50 AAm Figure 2. Microscopic observations . ertical section: 200. Myocardial tissue. (A) Control Group (-), (B) Control Group ( ), (C) Group P1 . mg / KgBW), (D) Group P2 . mg / KgBW), (E) Group P3 . mg / KgBW). Description: 1,2,3,4,5 : cell nucleus Ina. Med. Lab. Sci. Tech. : 99Ae110 Durrotul Hasanah, et al. 50 AAm 50 AAm 50 AAm 50 AAm 50 AAm Figure 3. Microscopic observations (Cross section: 400. Myocardial tissue. After 28 (A) Control Group (-), (B) Control Group ( ), (C) Group P1 . mg / KgBW), (D) Group P2 . mg / KgBW), (E) Group P3 . mg / KgBW). Description: 1,2,3,4,5: cell nucleus. 50 AAm 50 AAm 50 AAm 50 AAm 50 AAm Figure 4. Microscopic observations . entricular section: 400. Myocardial tissue. (A) Control Group (-), (B) Control Group ( ), (C) Group P1 . mg / KgBW), (D) Group P2 . mg / KgBW), (E) Group P3 . mg / KgBW). Description: Ie1,2,3,4,5 : cell Ie1 : Hypertrophy. Ie 1 : Intercalated disc DISCUSSION Tea and mango mistletoes are parasitic The research conducted by Atiroh et al. , . efficacious as herbs. These two plants found that mistletoe tea reduced the contain flavonoids, compounds in herbal contractility of the artery blood vessels on Ina. Med. Lab. Sci. Tech. : 99Ae110 plants but have also proven to be Durrotul Hasanah, et al. the rat tail and blood pressure by improving hypertensive rats that received DOCA-salt Meanwhile, treatment groups 1, 2 and The parameters observed in this study were cardiac histopathology, precisely by measuring the diameter of cardiac muscle treatments >0. 05 to the negative control The cardiac diameter muscle cell group (K-). This means that exposure to the chose because of the cardiac function as a methanolic extract combination of tea and blood pump throughout the body . mango mistletoe can prevent the increase cardiac function decreases because of in the diameter of cardiac muscle cells. The cardiac muscle infection, this can affect average of the three treatment groups (P1, body oxygen (O. and nutrient demand P2. has a value close to the control . In the same way as the adaptation group negative (K-). This indicates that the administration of dose variations in each hypertrophy will occur in the cardiac treatment group has been able to prevent the increase in the diameter of cardiac muscle cells. The P1 group . mg/Kg Cardio output increases because it BW) had an average of 15. 6 AAm and was able to reduce hypertrophy. Tea mistletoe cardiac is forced to work extra to meet the and mango mistletoe have antioxidants and blood supply for the body. As a result, the can protect the body against damage cardiac muscle is forced to work hard while caused by ROS . eactive oxygen specie. the cardiac muscle is not strong enough . then the cells develop hypertrophy. 3 showed the results of the p-value From various studies, tea and mango The administration of the methanolic mistletoes contain flavonoid compounds. extract of the combination of tea mistletoe Flavonoids can act as natural antioxidants and mango mistletoe showed a significant that protect biological systems and inhibit difference with a p-value <0. <0. cell oxidation by reducing and capturing between all treatment groups. There are active oxygen and free radicals, especially differences in each treatment group. The longest mean cell diameter of cardiac flavonoids is quercetin. Quercetin is found muscle was found in the positive control in abundance both in tea mistletoe and in group (K ), which was 26. 2 AAm. This mango mistletoe. The activity of this positive control group is a group of compound as an antioxidant is by releasing One Ina. Med. Lab. Sci. Tech. : 99Ae110 Durrotul Hasanah, et al. or donating hydrogen ions to peroxyl free response to the increased workload of the radicals to become stable. In addition. Hypertension occurs with an increase in anti-inflammatory intracellular pressure which then causes effects that can reduce the risk of cardiac high blood pressure experiencing shear disease . stress on endothelial cells. The endothelial . From the ANOVA test, the standard cells which are found in the tunica intima deviation (SD) value was also obtained, blood vessel will cause shear stress leading namely in the negative control group (K-) to endothelial dysfunction when exposed to 918, positive control (K ) of 2. high blood pressure . Endothelial 982. P2 of 0. 691, and P3 of 0. The dysfunction causes vasoconstriction, a results of the analysis data obtained show decrease in O2 and an upgrade growth that the standard deviation value in all groups has a value smaller than the average dysfunction and increased growth factor. The data obtained in this study the arteries of people with hypertension shows that the overall average of the data usually lose their elasticity. Therefore, the obtained is representative. cardio output cannot be the same as in The cell data obtain from cells that are people without hypertension. The cardiac not tangential or cells that have a ratio. of hypertensive people will increase its Histopathological work to pump blood to meet the amount of showed that the P1. P2, and P3 groups CO. On the contrary, the cardiac muscle is improved precisely in the diameter of not strong, and the cells swell because they cardiac muscle cells. Those groups had a wider diameter size of the cardiac muscle hypertrophy of the cardiac muscle cells or myocardium than the average size . AAm-20AA. Meanwhile, in the group One of the flavonoid contents in tea with DOCA-salt injection or the group with mistletoe and mango mistletoe is quercetin. hypertension, the diameter of the cardiac In this case, quercetin can act on the muscle cells exceeded the normal size . stimulating or activating Endothelium Hypertrophy is a progressive disorder Derived Relaxing Factor (EDRF) that can tissue or organ. The increase in cardiac endothelial cells has the potential to muscle cell diameter is an adaptation increase the production of NO. Quercetin Ina. Med. Lab. Sci. Tech. : 99Ae110 Quercetin of an increase in the volume of cells in a Durrotul Hasanah, et al. can diffuse directly and synthesize NO in AUTHOR CONTRIBUTIONS the endothelium and smooth muscle, which Durrotul Hasanah: conceptualization, stimulates guanylate cyclase to form cGMP investigation, writing-original draft. Nour . The occurrence of vasodilation can prevent Athiroh hypertrophy because the cardiac will not administration, funding acquisition. Nurul work harder, which causes cardiac muscle Jadid Mubarokati: data curation, writing- cells to widen. original draft preparation, visualization. AS: and writing-reviewing. CONCLUSIONS A methanolic extract combination tea ACKNOWLEDGEMENT leaves and mango mistletoes on male wistar I am grateful to Ministry of Education, rats in a preventive model of hypertension Culture. Research and Technology of the enlargement/widening Republic 549/G164/U. LPPM/K/B. 07/Vi/2021 Indonesia. Number: The three variations of the dose which has supported grant funds for showed that the result data did not show a University Leading Applied significant difference. This effect was Research (PTUPT) AuCombination Herbal combination tea and mango mistletoes at a Phytopharmaceutical Product Preparation dose of 50 mg/KgBW which was the an Alternative Candidate for Indonesian optimum dose in reducing the diameter of Traditional cardiac muscle cells in Wistar rats. The DrugsAy. Natural Antihypertensive methanolic extract of the combination of tea mistletoe leaves and mango mistletoe CONFLICT OF INTEREST can be used as herbal ingredients to increase preparations in the field of The author declares that there is no conflict of interest. https://doi. org/10. 21776/ub. REFERENCES