Efek Analgesik dan Antiinflamasi Tanaman Patah Tulang (Euphorbia tirucalli) pada Nyeri Nosiseptif, Nyeri Neuropati dan Inflamasi

RIFKI KURNIASARI, Dr. drg. Archadian Nuryanti, M.Kes.; drg. Ruslin, M. Kes., Ph.D

2021 | Skripsi | S1 KEDOKTERAN GIGI

Nyeri merupakan penanda adanya kerusakan pada jaringan tubuh. Nyeri terjadi pada kondisi inflamasi karena mediator pro-inflamasi mengaktivasi nosiseptor. Manajemen nyeri dan inflamasi dengan analgesik dan antiinflamasi konvensional menimbulkan efek samping bagi kesehatan. Euphorbia tirucalli mengandung eufol, steroid, dan terpenoid yang diduga memiliki efek analgesik dan antiinflamasi sehingga berpotensi digunakan sebagai bahan herbal analgesik dan antiinflamasi. Tujuan penulisan narrative review ini adalah untuk mengkaji efek antiinflamasi dan analgesik Euphorbia tirucalli beserta mekanismenya. Literatur yang digunakan dalam narrative review berasal dari database Pubmed, Science Direct, Springer, dan NCBI berdasarkan kata kunci Euphorbia tirucalli, euphol, pain, neuropathic, inflammation, drug, analgesic, cannabinoid, anti-inflammatory, management, therapy, pathophysiology, dan extract. Berdasarkan studi literatur, kandungan eufol, steroid, dan terpenoid dalam Euphorbia tirucalli memiliki efek antiinflamasi diamati dari penurunan respon inflamasi secara histologis dan klinis. Mekanisme antiinflamasi Euphorbia tirucalli melibatkan penghambatan fosforilasi NF-KB, ekspresi kemokin, serta ekspresi sitokin pro-inflamasi seperti IL-1β, IL-6, IL-12, COX-2, dan TNF-α. Aktivitas antiinflamasi tersebut menyebabkan penurunan nyeri terinduksi inflamasi. Eufol juga memiliki efek analgesik pada nyeri nosiseptif terinduksi inflamasi dan stimulus kimia, maupun pada nyeri neuropati terinduksi kerusakan saraf dan terapi kanker. Mekanisme analgesik eufol melibatkan inhibisi PKC ε serta interaksi dengan reseptor CB1 dan CB2. Hasil kajian studi tersebut mendukung pemanfaatan Euphorbia tirucalli sebagai bahan herbal analgesik dan antiinflamasi.

Pain is a signal of tissue damage. Pain occurs in inflammatory conditions due to pro-inflammatory mediators activate nociceptor. Management of pain and inflammation using conventional analgesics and anti-inflammatory causes side effects. Euphorbia tirucalli contains euphol, steroid, and terpenoid that have analgesic and anti-inflammatory effects which is potential to be used as analgesic and anti-inflammatory herbal ingredients. The purpose of writing this review is to examine the anti-inflammatory and analgesic effects of Euphorbia tirucalli and their mechanisms. Literature used in this review were sourced from Pubmed, Science Direct, Springer, and NCBI based on the keywords Euphorbia tirucalli, euphol, pain, neuropathic, inflammation, drug, analgesic, cannabinoid, anti-inflammatory, management, therapy, and pathophysiology. Based on the literature study, euphol, steroid, and terpenoid of Euphorbia tirucalli present anti-inflammatory effects which were observed from a decrease in the inflammatory response histologically and clinically. The anti-inflammatory mechanism of Euphorbia tirucalli involves inhibition of NF-KB phosphorylation, chemokine expression, and pro-inflammatory cytokines expression such as IL-1β, IL-6, IL-12, COX-2, and TNF-α. The anti-inflammatory activity causes a decrease in inflammation-induced pain. Euphol also has an analgesic effect on nociceptive pain induced by inflammation and chemical stimuli, as well as on neuropathic pain induced by nerve damage and cancer therapy. The analgesic mechanism of euphol involves inhibition of PKC as well as interaction with CB1 and CB2 receptors. The results of this study support the use of Euphorbia tirucalli as an analgesic and anti-inflammatory agent.

Kata Kunci : Euphorbia tirucalli, analgesik, antiinflamasi, nyeri, inflamasi