The Effectiveness Combination of Soursop Leaf Water Extract (Annona muricata) and Artemisinin Based Combine Therapy on Increased Spleen CCL22 Production

Abstract

Severe Plasmodium falciparum infection can result in cerebral malaria (MS). Giving herbal medicine as an adjuvant may be one solution to help the healing process due to reduce the parasitaemi -level and increase the protective-immunity. The immune response during malaria is mostly associated with the spleen, CCL22 is a chemokine produced by spleen-antigen-presenting-cells and serves to recruit Th2 cell arrivals. This study was a laboratory experimental study with a post test only randomized control group design,used 24 Swiss-mice consisting of 4 groups namely K, T1, T2, and T3 in each group inoculated by 107Plasmodium berghe ANKA(PbA). K-group was kontrol without any treatment, T1 was given Annona muricata leaf-extracted by water (AME) in a preventive dose 4.68 mg/day and subsequently therapy dose 9.36 mg/day. T2 was given ACT 0.819 mg/day. T3 was given both AME and ACT in dose mention before. Statistical tests used were Kruskal-Wallis test followed by Mann-Whitney U test. The statistical analysis showed that each treatment-group had significantly higher spleen-CCL22-
production than K-groups (T1, p=0.003; T2, p=0.009; and T3, p=0.017). T3-group however had no significant difference CCL22 production than T1 or T2-groups. The conclusion is that ADAM-ACT-combination increases spleen-CCL22-production as high as ADAM or ACT-treatment in PbA-infected-Swiss-mice.