Menurunkan Biomarker Migren Secara Cepat dengan Terapi “Assisted Drainage” (Studi Eksperimental pada Hewan coba)

https://doi.org/10.22146/majkedgiind.8918

Haryono Utomo(1*)

(1) Klinik Spesialis Terpadu Rumas Sakit Gigi dan Mulut Fakultas Kedokteran Gigi Universitas Airlangga, Surabaya, Jawa Timur, Indonesia
(*) Corresponding Author

Abstract


Migren merupakan gejala nyeri kepala rekuren yang paling sering dikeluhkan dalam dunia medis. Di Amerika Serikat, lebih dari 30 juta orang menderita satu atau lebih nyeri kepala migren dalam setahun. Berdasarkan literatur, migren merupakan komorbiditas rinosinusitis dan asma serta melibatkan saraf trigeminus. Tatalaksana migren dalam bidang kedokteran adalah obat-obatan dan tindakan invasif seperti injeksi atau operasi pada saraf. Sangat menarik bahwa menurut laporan kasus telah dibuktikan bahwa migren berhubungan dengan gingivitis karena suatu perawatan periodontal non invasif yang disebut sebagai terapi “assisted drainage” (ADT) dapat mengurangi gejala migren dalam
hitungan menit. Terapi tersebut berupa masase sulkus gingiva dalam 3 menit dengan sisi tumpul scaler manual sampai timbul keluarnya darah secara pasif. Akan tetapi mekanisme kejadian pengurangan gejala migren setelah ADT masih belum jelas. Tujuan penelitian adalah untuk verifikasi pengaruh ADT terhadap penurunan biomarker migren tikus nonalergi
dan alergi yang gingivitis. Tikus Wistar dibagi menjadi dua kelompok secara acak, penelitian dengan control series design study. Kelompok perlakuan adalah tikus alergi yang diinduksi dengan ovalbumin (OVA) dan non-alergi, kelompok ini disuntik dengan lipopolisakarida Porphyromonas gingivalis. Kelompok kontrol positif adalah tikus alergi, kontrol negatif dengan phosphate buffered saline (PBS). Pada beberapa kelompok dilakukan ADT. Ekspresi substans P (SP), leukotrien C4 (LTC4) dan TNF α pada gingiva dan hidung diperiksa dengan imunohistokimia peroksidase. Analisis statistik dengan ANOVA. ADT menurunkan ekspresi SP, LTC4 dan TNFα dengan sangat bermakna (p<0.05) setelah 30 menit dilakukan ADT. Kesimpulan yang didapatkan dalam riset ini adalah ADT dapat mengurangi biomarker migren dalam hitungan menit sehingga dapat diusulkan sebagai terapi ajuvan dalam tatalaksana migren.

 

Rapid Decrease in Migraine Biomarkers with Assisted Drainage Therapy (Experimental Study In Animal model). Migraine is a recurrent headache symptom which is most often suffered in medical community. In the USA, more than 30 million people suffered one or more migraine headaches in one year. According to literature, migraine has comorbidity with rhinosinusitis and asthma involving the trigeminal nerve. Migraine management in medicine is drugs as well as invasive procedures such as trigeminal nerve injection and surgery. Interestingly, case reports revealed that migraine is also connected with gingivitis since a non-invasive periodontal treatment so called “assisted drainage” therapy (ADT) is able to reduce migraine within minutes. It is a gingival sulcus massage for 3 minutes using the blunt side of manual sickle scaler until blood oozes passively. Nevertheless, the mechanism for how ADT reduces migraine is still unclear. The objective of the research is to verify the mechanism for how ADT decreases migraine biomarkers in non-allergic and allergic rats with gingivitis. Two groups of Wistar rats were randomly selected with control series design study. The treament groups were ovalbumin-induced allergic rats and non-allergic rats injected with Porphyromonas gingivalis lipopolysaccharides. The control groups were allergic rats as positive control, and negative control injected with phospate buffered saline (PBS). In several groups, ADT was conducted. Substance P (SP), leukotriene C4 (LTC4) and TNFα expressions in gingiva and nose were examined with peroxidase immuohistochemistry. The statistical analysis was conducted with ANOVA. ADT significantly decreased SP, LTC4 and TNF-α expressions (p<0.05). ADT was able
to decrease migraine biomarkers within minutes, therefore it can be proposed as an ajuvant in migraine management.


Keywords


tatalaksana migren; asma alergi; terapi “assisted drainage”; tikus Wistar; migraine management; allergic asthma; assisted drainage therapy; wistar rats

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DOI: https://doi.org/10.22146/majkedgiind.8918

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