Septic associated encephalopathy (SAE) is simply define as an encephalopathy incidence that occurs in sepsis patients. Ironically this entity can increases the mortality rate. Importantly, the clinical presentations of this entity is vary ranging from malaise to coma condition. The central nervous system is susceptible to damage that caused by systemic inflammation including sepsis with complex pathophysiologies such as endothelial dysfunction, neurotransmitter imbalance, oxidative stress, mitochondrial dysfunction and apoptosis. In general, current management of SAE is similar with the management of sepsis incidence which includes infections management, maintaining tissue perfusion and symptomatic therapy to treat delirium and convulsions that may occur. Also, several studies continue to be developed including the use of corticosteroids, magnesium, antioxidants, and immunoglobulin. Early identification and appropriate initial handling significantly affect the output of the SAE patients.
Background: Parkinson disease is characterized with deposition of Lewy Bodies containing αsynuclein happened due to the effect of chronic neuroinflammation that causes the death of dopaminergic neurons through oxidative stress processes, so it involves the response of Nuclear factor erythroid 2-like 2 (Nrf2). Centella asiatica (C.asiatica) contains antioxidant effect, inhibits the aggregation of α-synuclein and improves the locomotor on Parkinson-model animals so it needs to compare to the standard medication. Objective: To compare the C. asiatica extract and Pramipexole to the zebrafish Parkinson model by determining the locomotor activity, α-synuclein expression, and Nrf2. Methods: This study used six groups of zebrafish: negative control, rotenone rotenone [5 μg/L], pramipexole1, 2, 3 (rotenone + pramipexole [3,5] ng/mL, [7] ng/mL, [14] ng/mL), and C. asiatica (rotenone + C. asiatica [10] μg/mL). The observations of locomotor activity of day 0, 14, and 28 were continued to the α-synuclein immunohistochemical examination, and Nrf2 on the midbrain area. Results: There are significant differences in locomotor activity on day 28 among the C. asiatica group with rotenone (p<0,05), while there are no significant differences among the C. asiatica group with pramipexole [7] ng/mL and [14] ng/mL (p>0,05). α-synuclein expression of the C. asiatica group is the lowest and significantly different from all groups (p<0,05), while Nr2 had no significant differences (p>0,05). Conclusion: C. asiatica extract [10] μg/mL is equal to pramipexole [7] ng/mL and [14] ng/mL in improving locomotor activity, but C. asiatica extract holds excellence as it decreases α-synuclein expression better than pramipexole, while Nrf2 expression shows no differences.
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