Evaluating the Effect of Polyherbal Extract of Allium sativum, Curcuma mangga, and Acorus calamus on Immunomodulation and Ovarian Activity in Cisplatin-Induced Rats

Background: Exogenous antioxidants come from synthetic or natural ingredients are often used to reduce oxidative stress caused by free radicals. Allium sativum, Curcuma mangga, and Acorus calamus are known to have a good number of antioxidants that has many benefits, such as antimicrobial, antiviral, anti-inflammatory and immunomodulatory properties. Aim: This study aims to determine the polyherbal effect of Allium sativum (garlic), Curcuma mangga (mango ginger), and Acorus calamus (sweet flag) on ovarian antioxidant activity, follicles profile, and immunomodulation activity in cisplatin-induced rat. Materials and Methods: Fourty-two female rats (Rattus norvegicus) of three-month-old (180-230 gBW) were used and were divided into seven treatment groups. All experimental groups except the negative control (C-) were intraperitoneally injected with 5 mg of cisplatin. After ten days of cisplatin induction, each group (T1, T2, T3, T4, and T5) was orally given several type of treatments such as polyherbal dose of 50, 75, 100 mg/kg BW, Subur KandunganTM, and clomiphene citrate dose of 75 and 0.9 mg/kg BW, respectively. These treatments were given for 15 days. The activity of ovarian superoxide dismutase (SOD) in the polyherbal groups was significantly increased compared to the C- group (p <0.05). Results and Discussion: The T4 group showed the highest SOD activity followed by T5, T2, T3, C+, T1, and C-, respectively, whereas the ovarian MDA activity revealed the opposite pattern. Additionally, we showed that the administration of polyherbal increased the number of primary follicles, secondary follicles, tertiary follicles, de Graf follicles, and ovulation significantly compared to C+ group. The relative number of CD4+TNFa+ and CD11b+TNFa+ were significantly increased in polyherbal groups compared to C- group (p <0.05). The C+ group showed the highest expression of CD4+TNFa+ followed by T5, T3, T4, T1, and C-, while the T4 group expressed the highest CD11b+TNFa+ (p <0.05). Conclusion: In sum, the polyherbal extract of Allium sativum, Curcuma mangga, and Acorus calamus at the dose of 75 mg/kg BW produced the highest ovarian antioxidant, ovarian follicles profile, and immunomodulatory activities in cisplatin-induced rats.