Ethanolic Extract of Moringa oleifera Leaves Influences NF-κB Signaling Pathway for periodontal tissue regeneration in rats

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Sumintarti Sugiharto
Sri Ramadany
Hendrastuti Handayani
Harun Achmad
Asdar Gani
Maria Tanumihardja
Arrang Sesioria


ALP, Hypercolestrolemia ,Antioxadinat


Periodontitis is a chronic inflammatory disease that causes damage to the supporting structures of the teeth, and if left untreated this disease will lead to impaired function, appearance, pain, and loss of teeth. Periodontitis is caused by bacteria adhering to and growing on the tooth surface and will trigger an inflammatory response in the body. NF-κB has a very important role in the immune system. NFκB can control transcription, cytokines, antimicrobial effectors, and genes that regulate cell differentiation, cell survival, and proliferation so that they can regulate various aspects of innate and adaptive immune responses. Therefore, down-regulating the NF-κB signaling pathway is one way to reduce chronic inflammation. Moringa leaf extract as a natural ingredient for anti-inflammatory
adjunctive therapy can be an alternative in the treatment of periodontitis.
Objective. This study aims to determine the effectiveness of Moringa oleifera leaves in influencing NF-κB expression in the pathway of inflammatory pathways.
Methods. Experimental laboratory research and clinical trials with posttest-only control group design. Twenty- four Wistar rats were divided into two groups. Then the periodontitis was made with an injection of Porphyromonas gingivalis bacteria on the mandible, the control group was given aquades and the treatment group was given a Moringa oleifera gel extract. Wistar rats were sacrificed on days 0,7, 14, and 21, and the mandible bone was then taken for immunohistochemical analysis to determine the levels of NF-κB.
Result. On days 7, 14, and 21, the expression levels of NF-κB were significantly different between the two groups.The group added with Moringa oleifera leaf extract showed a faster decrease in NFκB expression than the control group.
Conclusion. Moringa oilefera extract can inhibit NF-κB expression in inflammatory pathways.

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1. Kurniawan H, Widyastuti W, Hutapea ME. The effectiveness of the combination of moringa oleifera extract and propolis on porphyromonas
gingivalis biofilms compared to 0.7% tetracycline. Dental Journal. 2021;54(2): 63–67.
2. Ministry of Health of the Republic of Indonesia. National riskesdas report. 2019; 184-204.
3. Agung K. The decreasing of NFκB level in gingival junctional epithelium of rats exposed to porphyromonas gingivalis with the application of
1% curcumin on the gingival sulcus. Dent. J. 2015;48(1):35-8.
4. Könönen E, Gursoy M, Gursoy UK. Periodontitis: A multifaceted disease of toothsupporting tissues. Journal of Clinical Medicine.
5. Clais S. Boulet G, Kerstens M, Horemans T, Teughels W, Quirynen M. Importance of biofilm formation and dipeptidyl peptidase IV for the
pathogenicity of clinical Porphyromonas gingivalis isolates. Pathogens and Disease. 2014; 70(3):408–413.
6. Neupane SP, Virtej A, Myhren LE, Bull VH. Biomarkers common for inflammatory periodontal disease and depression: A systematic review. Brain Behav Immun Health.2022;14(21):100450.
7. Siti RR, Juni S. Characterization of moringa (moringa oleifera lam.) leaf water extracts by chemical and microbiology. Jurnal Teknologi dan Seni Kesehatan. 2019;10(2):102-116.
8. Al-Ghutaimel H, Riba H, Al-Kahtani S, AlDuhaimi S. Common Periodontal Diseases of Children and Adolescents. International Journal
of Dentistry. 2014;2014:1–7.
9. Abdel-Daim MM, Khalil SR, Awad A, Abu Zeid EH, El-Aziz RA, El-Serehy HA. Ethanolic extract of moringa oleifera leaves influences nfκb signaling pathway to restore kidney tissue from cobalt-mediated oxidative injury and inflammation in rats. Nutrients. 2020;12(4):1031.
10. Tan WS, Arulselvan P, Karthivashan G, Fakurazi S. Moringa oleifera flower extract suppresses the activation of inflammatory mediators in
lipopolysaccharidestimulated raw 264. 7 macrophages via nfk b pathway. Hindawi Publishing Corporation Mediators. 2015; 1–11.
11. Chiquita P. Immunohistochemical analysis of nfkb (p50/p65) in patient with aggressive and chronic periodontitis. Indonesian Journal of
Tropical and Infectious Disease. 2013;4(4):59-64.
12. Albensi BC. What is nuclear factor kappa b (NFκB) doing in and to the mitochondrion?. Frontiers in Cell and Developmental Biology. 2019;7:154.
13. Sun SC, Chang JH, Jin J. Regulation of nuclear factor-kappa B in autoimmunity. Trends Immunol. 2013;34:282–289.
14. Aminah Syarifah, Tezar Ramdhan, Muflihani Yanis. Nutritional Content and Functional Properties of Moringa (Moringa oleifera). Jakarta. Bulletin of the Jakarta Agricultural Technology Study Center. 2015;5(2):36-39.
15. Ananto FJ, Eko SH, Nayla BN, Yusri CN, Mohamad ZA. Moringa leaf gel as a natural antibiotic in vivo pseudomonas aeruginosa. Pharmacy. 2015;12(01):47-58.
16. Dwika P, Oka DAG, Sudiamartini LM. Identification of chemical compounds of moringa leaf (moringa oleifera) ethanol extract in Bali,
Indonesia. Medicus Veterinus. 2016; 5(5) :464-473.
17. Alegbeleye OO. How Functional Is Moringa oleifera? A Review of Its Nutritive, Medicinal, and Socioeconomic Potential. Food and Nutrition Bulletin. 2017; 39(1):149– 170.
18. Arulselvan P, Tan WS, Gothai S, Muniandy K, Fakurazi S, Esa NM, Alarfaj AA, Kumar SS. Anti-Inflammatory potential of ethyl acetate
fraction of moringa oleifera in downregulating the NF-κB signaling pathway in lipopolysaccharide-stimulated macrophages.
Molecules. 2016;21(11):1-13.
19. Martínez-González CL, Martínez L, MartínezOrtiz EJ, González-Trujano ME, Déciga-Campos M, Ventura-Martínez R, Díaz-Reval I. Moringa
oleifera, a species with potential analgesic and anti-inflammatory activities. Biomedicine & Pharmacotherapy. 2017;87: 482–488.
20. Cafiero C, Spagnuolo G, Marenzi G, Martuscelli R, Colamaio M, Leuci S. Predictive periodontitis: the most promising salivary biomarkers for early diagnosis of periodontitis. J Clin Med. 2021;10(7):2-14.
21. Vergara-Jimenez M, Almatrafi MM, Fernandez ML. Bioactive components in moringa oleifera leaves protect against chronic disease.
Antioxidants (Basel). 2017;6(4):2-14.
22. Djais AI, Oktawati S, Thahir H, Hatta M, Sukmana BI, Dewi N, et al. Effect of the combination of demineralization freeze dried dentin matrix (DFDDM) and Moringa oleifera Lam on nuclear factor kapa B as a marker of bone. Systematic Reviews in Pharmacy. 2020;11(4):515–522.
23. Luetragoon T, Sranujit RP, Noysang C, Thongsri Y, Potup P, Somboonjun J, Usuwanthim K. Evaluation of Anti-Inflammatory Effect of Moringa oleifera Lam. and Cyanthillium cinereum (Less) H. Rob. Lozenges in Volunteer Smokers. Plants. 2021;10(7):2-17.
24. Wiwit DF, Ersam T, Shimizu K, Fatmawati S. Antioxidant Activity of Moringa oleifera Extracts. Indones. J. Chem.2016:16(3):297-301.
25. Kou, X., Li, B., Olayanju, J., Drake, J., & Chen, N. (2018). Nutraceutical or Pharmacological Potential of Moringa oleifera Lam. Nutrients. 2018;10(3),343.
26. Koul B, Chase N. Moringa oleifera Lam.: Panacea to several maladies. Journal of Chemical and Pharmaceutical Research. 2015;7(6):687–707.
27. Coppin JP, Xu Y, Chen H, Pan MH, Ho CT, Juliani R, et al. Determination of flavonoids by LC/MS and anti-inflammatory activity in Moringa oleifera. J. Funct. Foods. 2013;5:1892–1899.
28. Sumintarti, Ramadany S, Handayani H, Achmad H, Mutmainah N, Inayah NH et al. Assessment of the Anti-inflammatory Activities of the Moringa Leaf Extracts in Periodontitis Cases through IL-6 Cytokine Analysis in Wistar (Rattus Copernicus). Macedonian Journal of Medical Sciences. 2022:10(D):124-30.
29. Kim TG, Park Mi-Ryeong, Ku sae-Kwang, Heo Seok-mo, Kim Jong-Lae. Effect of Moringa oleifera L. and Eucomia ulmoides oliver mixed
formula on ligation induced experimental periodontitis and alveolar bone loss in rats. Journal of the Korean society of food science and
nutrition. 2022;51(8):765-79.
30. Makita C, Chimuka L, Steenkamp P, Cukrowska E, Madala E. Comparative analyses of flavonoid content in Moringa oleifera and Moringa ovalifolia with the aid of UHPLC-qTOF-MS fingerprinting. South African Journal of Botany. 2016;05:116–122.
31. Lin M, Zhang J, Chen X. Bioactive flavonoids in Moringa oleifera and their health-promoting properties. Journal of Functional Foods. 2018;47:469–479.
32. Achmad H, Supriatno, Singgih MF, Hendrastuti H. Akt Signal Transduction Pathways and Nuclear Factor-kappa B (NF-κB) Transcription as a Molecular Target of Oral Tongue Squamous Cell Carcinoma (SP-C1) Using Papua's Anthill Plant (Myrmecodia pendans). Pak J Biol Sci. 2016;19(8-9):323-330.
33. Leyva-López N, Gutierrez-Grijalva EP, AmbrizPerez DL, Heredia JB. Flavonoids as Cytokine Modulators: A Possible Therapy for Inflammation-Related Diseases. Int J Mol Sci. 2016;17(6):921.
34. Guo AJ, Choi RC, Zheng KY, Chen VP, Dong TT, Wang ZT, et al. Kaempferol as a flavonoid
induces osteoblastic differentiation via estrogen receptor signaling. Chin Med. 2017;7:10.
35. X Chen. Nuclear factor-kB modulates osteogenesis of periodontal ligament stem cells through competition with b-catenin signaling in inflammatory microenvironments. Cell Death Dis. 2013;4(2):e510.
36. Shahrakary M, Nazemian V, Aghaloo M, Akbari A, shadnoush M, Nasseri B, et al. Treatment with Moringa oleifera extract can reduce gingival inflammatory cytokines in the rat periodontal model. Physiol Pharmacol. 2017;21:102-109.
37. Ding Y, H Yao, Yao Y, Fai LY, Zhang Z, 2013. Protection of dietary polyphenols against oral cancer.Nutrients. 2013:5:2173-2191.
38. Wang F, Long S, Zhang J. Moringa oleifera Lam. leaf extract safely inhibits periodontitis by regulating the expression of p38α/MAPK14-
OPG/RANKL. Archives of Oral Biology. 2021:132:105280.
39. Rieuwpassa IE, Ramadany S, Sumintarti, Israyani, Achmad H, et al.  Journal of International Dental and Medical Research; Diyarbakir. 2022;15(2):611-617.
40. Achmad H, Djais AI, Hatta M, Thahir H. Effect of Moringa Leaf Extract (Moringa Oleifera ) on Increasing the Number of Osteoblas as a Marker of Bone Remodeling. Indian Journal of Public Health Research and Development. 2019;10(9):1394.