POTENSI METILKOBALAMIN SEBAGAI TERAPI NYERI NEUROPATI TRIGEMINAL PASCATRAUMA Kajian pada Model Chronic Constriction Injury Nervus Infraorbitalis Tikus Sprague Dawley Jantan

Amilia Ramadhani, drg. Nunuk Purwanti, MKes., PhD.; Dr.drg. Maria Goreti Widiastuti, Sp.BMM(K); Dr. Med. dr. Indwiana Astuti

2025 | Disertasi | S3 Kedokteran Gigi

Latar belakang. Terapi nyeri neuropati trigeminal pascatrauma (NNTP) dengan obat golongan anti depresan menunjukkan tingkat keberhasilan yang rendah. Metilkobalamin (MeCbl) yang telah digunakan untuk membantu regenerasi saraf, diketahui memiliki kemampuan memodulasi inflamasi pada saraf akut dan kronis, serta memiliki bioavailabilitas di dalam sirkulasi dan sel yang lebih baik dibandingkan sianokobalamin (CNCbl). Penelitian ini bertujuan untuk mengetahui potensi MeCbl sebagai terapi NNTP dengan model Chronic Constriction Injury di nervus infraorbitalis (CCI-ION). 

Metode. Sebanyak 36 tikus Sprague Dawley jantan (3 bulan, 300 – 400g) dikelompokkan menjadi 2 kelompok CCI-ION dan non CCI-ION. Setelah diinduksi, setiap subjek diberi terapi MeCbl, CNCbl (dosis 100µg setiap 2 hari sekali), dan aquades (volume 0,2 mL) secara acak melalui injeksi intramuskular. Setiap subjek dalam kelompok terapi terbagi berdasarkan durasi terapi yaitu 15 dan 30 hari. Perubahan berat badan tikus, konsumsi pakan, uji perilaku nyeri spontan dan akibat stimulus diamati dari sebelum induksi hingga akhir terapi (15 dan 30 hari). Jaringan saraf yang terligasi diambil pada hari ke-16 dan ke-31 untuk pemeriksaan kadar IL-1? dengan ELISA dan pemeriksaan histologis ketebalan selubung mielin. Pengaruh faktor induksi CCI-ION, terapi MeCbl, durasi terapi serta interaksi antar faktor terhadap kadar IL-1?, ketebalan selubung mielin, perubahan respon nyeri spontan dan akibat stimulus, serta perubahan konsumsi pakan dan berat badan dianalisis dengan three-way ANOVA. 

Hasil Penelitian. Faktor induksi CCI-ION menyebabkan penurunan konsumsi pakan dan berat badan yang bermakna (p<0 p=0,0001).>nervus infraorbitalis (p=0,0075) dan memperbaiki gejala alodinia mekanik (p=<0 p=0,0060;>0,05). 

Kesimpulan. MeCbl dapat meningkatkan ketebalan selubung mielin serta perbaikan gejala nyeri alodinia mekanik pada kondisi NNTP.

Background: Post-traumatic trigeminal neuropathy pain (PTNP) therapy using antidepressant drugs has shown a low success rate. Methylcobalamin (MeCbl) supports nerve regeneration and manages both acute and chronic nerve inflammation. Furthermore, MeCbl has superior bioavailability in circulation and within cells compared to cyanocobalamin (CNCbl). This study aimed to determine the potency of MeCbl as a PTNP therapy after chronic infraorbital nerve constriction injury (CCI-ION). 

Methods: Thirty-six male Sprague Dawley rats, aged 3 months and weighing between 300 and 400 grams, were divided into two groups: the CCI-ION group and the non-CCI-ION group. Following induction, each rat was randomly assigned to receive either MeCbl or CNCbl, at a dose of 100 µg every two days or 0,2 mL distilled water via intramuscular injection. Rats in the treatment group were further divided based on the duration of therapy: 15 days and 30 days. Changes in body weight, feed consumption, and both spontaneous and stimulus-induced pain behaviors were monitored from before the induction through the end of therapy (at 15 and 30 days). The ligated nerve tissues were collected on days 16 and 31 to assess IL-1? levels using ELISA and to conduct a histological examination of myelin sheath thickness. The impact of CCI-ION induction, MeCbl therapy, therapy duration, and interactions between these factors on IL-1? levels, myelin sheath thickness, pain responses, and changes in feed consumption and body weight were analyzed using a three-way ANOVA. 

Results: The CCI-ION induction factor affected food consumption and body weight (p<0 p=0,0001), p=0,0075) xss=removed p=0,0060;>0,05). 

Conclusion: MeCbl demonstrated the increase of myelin sheath thickness and improved mechanical allodynia pain symptoms in NNTP conditions.

Kata Kunci : Mecobalamin; nyeri; selubung mielin; cedera konstriksi kronis; regenerasi saraf;