A Review: Oral Lumbrokinase as Potential Agent Prevents Myocardial Reinfarction Post-Reperfusion in ST-Elevation Myocardial Infarction (STEMI) Patients

Authors

  • Muhammad Mufaiduddin Faculty of Medicine, Diponegoro University, Semarang, 50275, Indonesia
  • Innelya Faculty of Medicine, Diponegoro University, Semarang, 50275, Indonesia
  • Alfi Rahmatika Faculty of Medicine, Diponegoro University, Semarang, 50275, Indonesia

DOI:

https://doi.org/10.32734/scripta.v5i2.15156

Keywords:

Lumbricus rubellus, Lumbrokinase, Myocardial reinfarction, Post-reperfusion STEMI, Reinfark miokardium, STEMI pasca reperfusi

Abstract

Background: Coronary Heart Disease (CHD) is a major cause of death and disability worldwide and its prevalence is expected to continue to increase in the coming years. Myocardial infarction is the largest and most dangerous manifestation of CHD, including in ST-Elevation Myocardial Infarction (STEMI). However, early therapy of STEMI cannot prevent the risk of myocardium reinfarction. Reinfarction post-STEMI reperfusion therapy has poor consequences and prognosis. Therefore, prevention of myocardial reinfarction is important. Objectives: The author has an innovation to use Lumbrokinase from Lumbricus rubellus extract in an oral dosage form as an alternative therapy to prevent reinfarction after reperfusion therapy in STEMI. Methods: Our article reviews the effect of lumbrokinase in preventing myocardial reinfarction using a non-systematic review method. Results and Discussion: Lumbrokinase can prevent myocardial reinfarction by several mechanisms, including its thrombolytic effect by activating plasminogen and degrading fibrin, its anti-inflammatory and antioxidant effects, and can prevent further myocardial apoptosis. Lumbrokinase can prevent apoptosis by increasing the activity of Silent Information Regulator 1 (Sirt1) and decreasing the pro-caspase-3 pathway. Lumbrokinase can prevent further inflammation by reducing levels of Nuclear Factor kappa-B (NF-kB) and the Toll-like Receptor 4 (TLR4) pathway, as well as preventing oxidative damage by deacetylating Forkhead Box-O (FoxO). The effect of Lumbrokinase plays an important role in preventing myocardial reinfarction. Oral lumbrokinase is made in capsule form. Conclusion: Oral lumbrokinase can potentially prevent myocardial reinfarction post-reperfusion in STEMI patients.

Keyword: Lumbricus rubellus, Lumbrokinase, Myocardial reinfarction, Post-reperfusion STEMI

Latar Belakang: Penyakit Jantung Koroner (PJK) merupakan penyebab utama kematian dan kecacatan di seluruh dunia dan prevalensinya diperkirakan akan terus meningkat di tahun mendatang. Tingginya angka mortalitas PJK, maka PJK menjadi penyakit yang patut diwaspadai, terutama untuk negara-negara berkembang. Infark miokardium adalah manifestasi terbesar dan paling berbahaya dari PJK, termasuk STEMI. Namun, terapi awal dari STEMI tidak dapat mencegah resiko reinfark. Reinfark yang terjadi setelah terapi reperfusi memiliki konsekuensi dan prognosis yang buruk. Oleh karena itu, pencegahan reinfark miokardium setelah terapi STEMI menjadi penting.  Tujuan: Penulis memiliki inovasi untuk menggunakan Lumbrokinase dari ekstrak Lumbricus rubellus dalam bentuk sediaan oral sebagai upaya terapi alternatif pencegahan reinfark setelah terapi reperfusi pada STEMI. Metode: Tinjauan pustaka ini bertujuan untuk meninjau efek dari lumbrokinase dalam mencegah reinfark miokardium setelah terapi STEMI dengan menggunakan metode non-systematic review. Pembahasan: Lumbrokinase dapat mencegah reinfark miokardium dengan beberapa mekanisme, termasuk efek trombolitiknya dengan mengaktivasi plasminogen dan mendegradasi fibrin, efek anti inflamasi dan anti oksidannya, serta dapat mencegah apoptosis miokardium lanjutan. Lumbrokinase dapat mencegah terjadinya apoptosis dengan meningkatkan aktivitas silent information regulator 1 (Sirt1) dan menurunkan jalur pro-caspase-3. Lumbrokinase juga dapat mencegah inflamasi lanjutan dengan menurunkan level nuclear factor kappa B (NF-Kb) dan jalur toll-like receptor 4 (TLR4), serta mencegah kerusakan oksidatif dengan deasetilasi Forkhead Box O (FoxO). Efek dari Lumbokinase tersebut berperan penting dalam pencegahan reinfark miokardium setelah terapi STEMI. Penggunaan lumbrokinase secara oral dibuat dalam bentuk kapsul. Kesimpulan: Lumbrokinase oral memiliki potensi dalam mencegah reinfark miokardium setelah terapi reperfusi pada STEMI.

Kata Kunci: Lumbricus rubellus, Lumbrokinase, Reinfark miokardium, STEMI pasca reperfusi

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Published

2024-02-29

How to Cite

1.
Mufaiduddin M, Innelya, Alfi Rahmatika. A Review: Oral Lumbrokinase as Potential Agent Prevents Myocardial Reinfarction Post-Reperfusion in ST-Elevation Myocardial Infarction (STEMI) Patients. SCRIPTA SCORE Sci Med J. [Internet]. 2024Feb.29 [cited 2024Jun.24];5(2):121-3. Available from: https://talenta.usu.ac.id/scripta/article/view/15156