EVALUASI CONDITIONING CLAMPING SEBAGAI MEKANISME PROTEKSI KERUSAKAN REMOTE ISCHEMIA REPERFUSION INJURY PADA SALURAN CERNA TIKUS PUTIH

Abstract

Ischemia-reperfusion injury (IRI) merupakan bentuk kerusakan jaringan yang timbul akibat gangguan metabolik dan hipoksia seluler, diikuti oleh lonjakan stres oksidatif setelah aliran darah dipulihkan. Penelitian ini bertujuan mengevaluasi efektivitas conditioning clamping dalam mencegah dampak remote IRI pada saluran cerna. Dua puluh ekor tikus Sprague-Dawley (Rattus norvegicus) jantan dibagi menjadi empat kelompok: kontrol tanpa perlakuan (NTC), kelompok pre conditioning clamping (Pre), kelompok post-conditioning clamping (Post), dan kelompok kombinasi pre- dan post-conditioning clamping (PP). Ligasi arteri femoralis dilakukan selama dua jam pada seluruh kelompok, diikuti reperfusi selama dua jam. Pada kelompok Pre diberikan teknik conditioning clamping sebelum ligasi dilakukan. Kelompok Post, diberikan setelah ligasi a. femoralis dan kelompok PP diberikan sebelum dan setelah prosedur ligasi-reperfusi. Parameter kimia darah (aspartate aminotransferase (AST), alanine aminotransferase (ALT), dan albumin), motilitas usus halus, serta histopatologi usus dievaluasi. Kelompok NTC menunjukkan induksi remote IRI berhasil dengan kerusakan jaringan yang nyata, tercermin dari peningkatan kadar AST, penurunan albumin, dan gangguan motilitas usus (16,09% ± 3,90%). Di antara kelompok conditioning, kelompok Pre menunjukkan efek protektif paling baik karena telah melewati proses adaptasi, dilihat kadar AST terendah, motilitas usus tertinggi (94,97% ± 1,57%), dan integritas mukosa yang terjaga pada pemeriksaan histopatologi. Sebaliknya, kelompok PP tidak menunjukkan perbaikan; kelompok ini justru mengalami kerusakan jaringan paling berat, ditandai lonjakan AST yang nyata dan deskuamasi epitel yang ekstensif, diduga akibat beban stres oksidatif tambahan dari siklus reperfusi berulang. Secara keseluruhan, temuan ini menunjukkan bahwa pre-conditioning memberikan proteksi yang lebih unggul terhadap kerusakan jaringan akibat hipoksia dan lebih efektif meredam respons inflamasi sistemik dibanding strategi conditioning lain yang diuji.

Ischemia-reperfusion injury (IRI) is a form of tissue damage arising from metabolic disturbance and cellular hypoxia, followed by a surge in oxidative stress after blood flow is restored. This study aimed to evaluate the effectiveness of conditioning clamping in preventing the effects of remote IRI on the gastrointestinal tract. Twenty male Sprague-Dawley rats (Rattus norvegicus) were divided into four groups: a non-treatment control group (NTC), a pre-conditioning clamping group (Pre), a post-conditioning clamping group (Post), and a combined pre- and post conditioning clamping group (PP). Femoral artery ligation was performed for two hours in all groups, followed by two hours of reperfusion. The Pre group received the conditioning clamping technique before ligation was performed, the Post group received it after femoral artery ligation, and the PP group received it both before and after the ligation-reperfusion procedure. Blood biochemical parameters (aspartate aminotransferase (AST), alanine aminotransferase (ALT), and albumin), small intestinal motility, and intestinal histopathology were evaluated. The NTC group demonstrated successful induction of remote IRI, evidenced by marked tissue damage, reflected in elevated AST levels, decreased albumin, and impaired intestinal motility (16.09% ± 3.90%). Among the conditioning groups, the Pre group exhibited the most favorable protective effect, attributable to a preceding adaptive process, as shown by the lowest AST level, the highest intestinal motility (94.97% ± 1.57%), and preserved mucosal integrity on histopathological examination. In contrast, the PP group showed no improvement; this group instead sustained the most severe tissue damage, marked by a pronounced surge in AST and extensive epithelial desquamation, presumably due to additional oxidative stress from repeated reperfusion cycles. Overall, these findings indicate that pre conditioning confers superior protection against hypoxia-induced tissue damage and more effectively attenuates the systemic inflammatory response compared with the other conditioning strategies tested.