THE ROLE OF ACALYPHA INDICA LINN. EXTRACT ON HEART RATES WITH MYASTHENIA GRAVIS RAT MODEL

Desak Gede Budi Krisnamurti; Rani Wardani Hakim; Radiana Dhewayani Antarianto; Siti Farida; Erni Hernawati Purwaningsih; Jan Sudir Purba

doi:10.22159/ajpcr.2018.v11i1.18616

Authors

Desak Gede Budi Krisnamurti Department of Neurology, Dr. Ciptomangunkusumo, General Hospital Faculty of medicine, Universitas Indonesia
Rani Wardani Hakim Department of Neurology, Dr. Ciptomangunkusumo, General Hospital Faculty of medicine, Universitas Indonesia
Radiana Dhewayani Antarianto Department of Histology, Faculty of Medicine, Universitas Indonesia, Jakarta, Indonesia.
Siti Farida Department of Neurology, Dr. Ciptomangunkusumo, General Hospital Faculty of medicine, Universitas Indonesia
Erni Hernawati Purwaningsih Department of Neurology, Dr. Ciptomangunkusumo, General Hospital Faculty of medicine, Universitas Indonesia
Jan Sudir Purba Department of Neurology, Universitas Indonesia, Jakarta, Indonesia.

DOI:

https://doi.org/10.22159/ajpcr.2018.v11i1.18616

Keywords:

Myasthenia gravis, Extract Acalypha indica Linn, Acetylcholine receptor antibody, Autoimmune disease, Neuromuscular junction, Heart rate

Abstract

Â

Â Objective: Myasthenia gravis (MG) is an autoimmune disease of the neuromuscular junction (NMJ) caused by antibodies that attack components of the postsynaptic membrane, impair neuromuscular transmission, and lead to weakness and fatigue of skeletal muscle. Acetylcholine is also used as a neurotransmitter in the autonomic nervous system. Striated cardiac muscle can be a target for immune attack manifesting as heart failure, arrhythmia, and sudden death. Involvement of the heart rate (HR) has been claimed and reported, but a causal connection between MG and altered cardiac function has not been found.

Methods: For this study of experimental autoimmune MG (EAMG) is used rocuronium, prostigmine, and Acalypha indica (AI) Linn. compared with HR.

Results: From the results, the study found that sympathetic activity of HR variability in EAMG injected with rocuronium 10 mg/kg body weight (BW) in 10 min significantly found increasing in measures of short-term variations in HR variability, indicating parasympathetic impairment.

Conclusion: We conclude that in MG, cholinergic transmission is affected more diffusely than previously thought. Furthermore, AI was given orally 30 mg/kg BW has an effect similar to the injecting of prostigmine 10 mg/kg BW that can reduce HR. Driven by the fact that the pharmacological treatment of MG is unsatisfied, it needs the therapeutic development for MG using herbal ingredients of AI. This means that the AI compositions containing anti-MG whose composition should be investigated for the next research.

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References

AQ2

AQ3

Conti-Fine BM, Milani M, Kaminski HJ. Myasthenia gravis: Past, present, and future. J Clin Invest 2006;116:2843-54.

Willcox N, Leite MI, Kadota Y, Jones M, Meager A, Subrahmanyam P, et al. Autoimmunizing mechanisms in thymoma and thymus. Ann N Y Acad Sci 2008;1132:163-73.

Johannessen KA, Mygland A, Gilhus NE, Aarli J, Vik-Mo H. Left ventricular function in myasthenia gravis. Am J Cardiol 1992;69:129-32.

Harmed SA, Mohamad KO, Adam M. Cardiac autonomic function in patients with myasthenia gravis: Analysis of the heart-rate variability in the time-domain. Neuroimmunol Neuroinflammation 2015;2:21-5.

Peric S, Rakocevic-Stojanovic V, Nisic T, Pavlovic S, Basta I, Popovic S, et al. Cardiac autonomic control in patients with myasthenia gravis and thymoma. J Neurol Sci 2011;307:30-3.

Mygland A, Aarli JA, Hofstad H, Gilhus NE. Heart muscle antibodies in myasthenia gravis. Autoimmunity 1991;10:263-7.

Hoch W, McConville J, Helms S, Newsom-Davis J, Melms A, Vincent A. Auto-antibodies to the receptor tyrosine kinase MuSK in patients with myasthenia gravis without acetylcholine receptor antibodies. Nat Med 2001;7:365-8.

Calin C, Savu O, Dumitru D, Ghiorghiu I, Calin A, Capraru C, et al. Cardiac involvement in myasthenia gravis-is there a specific pattern? Rom J Intern Med 2009;47:179-89.

Helgeland G, Luckman SP, Romi FR, Jonassen AK, Gilhus NE. Myasthenia gravis sera have no effect on cardiomyocytes in vitro. J Neuroimmunol 2008;201-202:74-9.

Puneeth CS, Chandra SR, Yadav R, Sathyaprabha TN, Chandran S. Heart rate and blood pressure variability in patients with myasthenia gravis. Ann Indian Acad Neurol 2013;16:329-32.

Senda Y, Sugimura K, Koike Y, Matsuoka Y, Takahashi A. Concurrence of acute autonomic and sensory neuropathy and myasthenia gravis-a case report and pathogenetic considerations. Rinsho Shinkeigaku 1989;29:332-5.

Pande R, Leis AA. Myasthenia gravis, thymoma, intestinal pseudoobstruction, and neuronal nicotinic acetylcholine receptor antibody. Muscle Nerve 1999;22:1600-2.

Vernino S, Cheshire WP, Lennon VA. Myasthenia gravis with autoimmune autonomic neuropathy. Auton Neurosci 2001;88:187-92.

Iwatsuki N, Hashimoto Y, Amaha K, Obara S, Iwatsuki K. Inotropic effects of non-depolarizing muscle relaxants in isolated canine heart muscle. Anesth Analg 1980;59:717-21.

Alvarez L, Escudero C, Silva L, Castillo-Olivares JL. Electrophysiological effects of atracurium and vecuronium on normal and denervated hearts. J Cardiothorac Vasc Anesth 1992;6:304-7.

KrÃ³l T, Siondalska-Kunicka E. Haemodynamic side-effects of pancuronium. Anaesth Resusc Intensive Ther 1974;2:161-5.

Cornet JP, Abiad M, Coriat P, Saada M, Gosgnach ML, Viars P. Evaluation of the effects of rocuronium bromide on haemodynamics and left ventricular function in patients undergoing abdominal aortic surgery. Eur J Anaesthesiol Suppl 1994;9:78-81.

Cole RN, Reddel SW, GervÃ¡sio OL, Phillips WD. Anti-MuSK patient antibodies disrupt the mouse neuromuscular junction. Ann Neurol 2008;63:782-9.

Cole RN, Ghazanfari N, Ngo ST, GervÃ¡sio OL, Reddel SW, Phillips WD, et al. Patient autoantibodies deplete postsynaptic muscle-specific kinase leading to disassembly of the ACh receptor scaffold and myasthenia gravis in mice. J Physiol 2010;588:3217-29.

Kawakami Y, Ito M, Hirayama M, Sahashi K, Ohkawara B, Masuda A, et al. Anti-MuSK autoantibodies block binding of collagen Q to MuSK. Neurology 2011;77:1819-26.

Shigemoto K, Kubo S, Maruyama N, Hato N, Yamada H, Jie C, et al. Induction of myasthenia by immunization against muscle-specific kinase. J Clin Invest 2006;116:1016-24.

Mori S, Kubo S, Akiyoshi T, Yamada S, Miyazaki T, Hotta H, et al. Antibodies against muscle-specific kinase impair both presynaptic and postsynaptic functions in a murine model of myasthenia gravis. Am J Pathol 2012;180:798-810.

Richman DP, Agius MA. Treatment of autoimmune myasthenia gravis. Neurology 2003;61:1652-61.

Kassab RB, Bauomy AA. The neuroprotective efficiency of the aqueous extract of clove (Syzygium aromaticum) in aluminium-induced neutotoxicity. Int J Pharm Pharm Sci 2014;6:503-8.

Kukkar MR, Saluja AK, Sachdeva PD, Kukkar RR. In vivo investigation of the neuroprotective potential of Cardiospermum halicacabum Linn. Int J Pharm Pharm Sci 2014;6:64-6.

Purwaningsih EH, Ibrahim N, Zain H. The nerve protection and in vivo therapeutic effect of Acalypha indica extract in frogs. Med J Indones 2007;19:96-102.

Lindstrom JM, Seybold ME, Lennon VA, Whittingham S, Duane DD. Antibody to acetylcholine receptor in myasthenia gravis. Prevalence, clinical correlates, and diagnostic value. Neurology 1976;26:1054 9.

Shivamurthy P, Parker MW. Cardiac manifestations of myasthenia gravis: A systematic review. IJC Metab Endocr 2014;5:3-6.

Furlund Owe J, Skulstad Davidsen E, Eide GE, Gerdts E, Gilhus NE. Left ventricular long-axis function in myasthenia gravis. J Neurol 2008;255:1777-84.

Rakocevic-Stojanovic V, Pavlovic S, Apostolski S, Lavrnic D, Vidakovic A, Kozarevic N. Importance of radionuclide exercise ventriculography in patients with myasthena gravis. Med Istrazivanja 1996;30:17-9.