Introduction: Endometriosis is the most common disease that affects the reproductive health and function of women of reproductive age. Treatment for endometriosis includes surgery and medication. Phaleria macrocarpa is a plant native to Indonesia that contains bioactive fractions known to have antiproliferative and apoptotic effects. Therefore, this study aimed to evaluate the effect of Phaleria macrocarpa extract on matrix metalloproteinases (MMP-2 and MMP-9) and NF-KB expression in the endometriosis mice model (Mus musculus).
Methods: This study used a Randomized Post-Test Only with Control Group Design. Involves six groups, namely a negative control group (healthy mice without flavonoids from Phaleria macrocarpa fruit extract), a positive control group (an endometriosis model without being given flavonoids from Phaleria macrocarpa fruit extract), and a treatment group, namely a group given four different doses of flavonoids from Phaleria macrocarpa fruit extract: 3.75 milligrams per day, 7.5 milligrams per day, 11.25 milligrams per day and 15 milligrams per day. expressions of NF-KB, MMP-2, and MMP-9 were seen using Immunohistochemistry staining and observed under a microscope with 40x magnification. The data collection used an immunoratio technique with ImageJ analysis software. Furthermore, data analysis using the one-way ANOVA method.
Results: In this study, the treatment group with four different doses of Phaleria macrocarpa extract could reduce the expression of MMP-2, MMP-9, and NF-KB. Groups with higher doses of Phaleria macrocarpa extract showed lessen of MMP-2, MMP-9, and NF-KB expression.
Conclusion: In the endometriosis mice model, Phaleria macrocarpa fruit can reduce NF-KB, MMP-2, and MMP-9 expression.

/pdf/effect-of-phaleria-macrocarpa-extract-on-nf-kb-mmp-2-and-mmp-39xbwomv.pdf

Effect of Phaleria macrocarpa Extract on NF-KB, MMP-2, and MMP-9 Expression in Endometriosis Mice Model

Endometriosis is a complex and multifactorial disease causing severe pelvic pain, infertility, and reduced quality of life in women. Therefore, this study aimed to evaluate the preventive potential of Phaleria macrocarpa (PM) mesocarp ethanol extract on endometriosis. The animals used for the experiment were divided into eight groups, each comprising four mice. The first group served as control comprising healthy mice without PM treatment and adenomyosis (ADM) implantation. The second group was the control negative consisting of mice with ADM implantation and without PM treatment. The remaining six groups consisted of ADM mice treated with several doses of PM including 3.75, 7.5, 11.25, 15, 18.75, and 22.5 mg/kg/day orally for 14 days. On day 1 PM treatment, endometriosis was induced by implanting ADM tissue intraperitoneally in mice given an immunosuppressant, cyclosporin. Furthermore, mice were injected with estradiol intramuscularly (54 IU/mice) on the first and fifth day after ADM implantation. At day 15, the samples were sacrificed, endometriosis tissue was isolated to measure the implant area, and the ascites of peritoneal were collected to evaluate the level of Cyclooxygenase-2 (COX-2). The evaluation was performed using Enzyme-Linked Immunosorbent Assay (ELISA), and Nuclear Factor kappa-light-chain-enhancer of activated B cells p65 subunit (NF-κB p65), Vascular Endothelial Growth Factor A (VEGF-A), and Kiel-67 (Ki67) of peritoneal tissue expression level by immunohistochemistry. The results showed that PM could prevent inflammation and the development of endometriosis by reducing the level of COX-2 in a dose-dependent method. Additionally, PM extract inhibited the expression level of NF-κB p65, VEGF-A, and Ki67, reducing the ADM implant area. 

&lt;i&gt;Phaleria Macrocarpa&lt;/i&gt; Extract Reduced Endometriosis Lesions by Regulating Inflammatory Protein and Inhibiting Ki67 and Vegf-A Protein

Introduction: Incidence of ectopic pregnancy can be an acute or chronic condition. The condition of chronic ectopic pregnancy itself is unique, arises from a minor rupture, and then develops into a hematocele. Chronic ectopic pregnancy is quite complicated to diagnose because it usually has a prolonged clinical course and can disappear spontaneously.
Case Presentation: A woman aged 31-32 weeks, aged 24 years, complained of right abdominal pain accompanied by nausea and vomiting. Examination of vital signs was 120/80 mmHg, pulse 84 x/min, RR 20x/min, temperature 36.70C, and SpO2 of 98% with pale conjunctiva and abdominal tenderness in the right upper quadrant. On laboratory examination, the patient found severe microcytic normochromic anemia (Hb 4.5 mg/dl; MCV 96.6 Fl; MCH 30.2 pg), thrombocytopenia (platelets 133,000 L) and hypoalbumin (albumin 2.82 L). Ultrasound examination showed a mass in the right adnexa accompanied by intrauterine pregnancy. The patient underwent a laparotomy and found a mass in the form of a blood clot (hematocele) of 30x20x20 cm.
Conclusion: Chronic ectopic pregnancy is a rare condition, especially in developed countries. A clinician should be more detailed in diagnosing and considering the ultrasound, an amorphous mass with avascularity to amass with complex vascular formation. This is very necessary considering that this hematocele mass can develop progressively to cause fetal growth disorders.

Case Report: Massive Hematocel with An Intrauterine Pregnancy

Introduction: Endometriosis is a gynaecological disorder in women and causes infertility. Several therapeutic were developed to reduce endometriosis cases, one of them was matrix metalloproteinase (MMP) inhibitor. This study investigated the potential activity of the flavonoids in Phaleria macrocarpa fruit as MMP1 inhibitors for endometriosis.
Methods: In silico modelling was used in this study. Six flavonoid structures were retrieved from PubChem NCBI database. A targeted protein, MMP1 was taken out from Protein Data Bank with ID 1CGE and predicted the active sites. Six flavonoids and MMP1 was interacted by molecular docking using Molegro virtual Docker version 5 and analyzed using PyMol 2.2 and Discovery Studio version 21.1.1. Three-dimensional complex structure of flavonoids – MMP1 showed interaction in the same active sites and performed an amino acid residue Glu219 as catalytic site.
Results: Six flavonoids of Phaleria macrocarpa were divided into two patterns and generated varied binding energy. Glycitin and Catechin 7-O-beta-D-xyloside showed low score of binding energy and depicted similar structure with four aromatic rings. 8-Prenylnaringenin performed lower binding energy than naringenin, eriodictyol, and 5-O-methylgenistein.
Conclusion: In silico analysis suggested that six flavonoids compounds is potent as MMP1 inhibitor and might be interfered endometriosis pathophysiology. In vivo and in vivo investigations are required for further analysis.

/pdf/phaleria-macrocarpa-flavonoid-as-a-potent-mmp-1-inhibitor-207bcd2z.pdf

Phaleria macrocarpa Flavonoid as a Potent MMP-1 Inhibitor for Endometriosis Therapy: In silico Study

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Case Report: Massive Hematocel with An Intrauterine Pregnancy

Phaleria macrocarpa Flavonoid as a Potent MMP-1 Inhibitor for Endometriosis Therapy: In silico Study