Smoking is one of the main lifestyles that affect human health. Most smokers come from developing countries and low socioeconomic groups. Indonesia is the third country that has the highest number of active smokers in the world, namely 61.4 million smokers after China and India [1]. The Central Statistics Agency (BPS) of North Sumatra Province (Sumut) noted, based on the population of North Sumatra province, as many as 12,982. 204 people, data on the percentage of smokers aged 15 years in 2019 was 27.64 percent, then in 2018 it was 31.10 percent and in 2017 it was 28.47 percent [2].

Cigarette smoke is a source of free radicals. In one inhalation, smokers enter approximately 1016 free radical molecules and various chemicals tar, asbestos, H202, and others into their bodies [3]. Cigarette smoke can affect macrophage metabolism by activating macrophages to release leukotrienes B4, IL- 8, and TNF-α causing increased production of superoxide (O2-) and H2O2, also causing oxidative damage to macromolecules such as lipids, proteins, and DNA, can remove antioxidants and form free radicals such as nitric oxide (NO), nitric peroxide (NO2) in the gas phase as well as quinone (Q), semiquinone (HQ) and hydroquinone (HQ2) in the phase. The levels of free radicals that are greater than anti-oxidants in the body cause oxidative stress conditions and also trigger lipid peroxidation in cell membranes which will produce malondialdehyde (MDA). Thus, MDA levels can be used as a biomarker of free radicals in the body [3].

Lemongrass (Cymbopogon citratus) is one of the plants commonly used as a spice by the people of Indonesia. Lemongrass is rich in citral, which is commonly used by the fragrance and pharmaceutical industries, and bioactive compounds (flavonoid compounds and vitamin C) [4]. The presence of antioxidant activity in the ethanolic extract of lemongrass leaves is due to the content of phenolic compounds in lemongrass leaves which are compounds that prevent oxidation. The phenolic compounds contained in lemongrass leaves can prevent or inhibit the autoxidation process of fats and oils by capturing the free radicals produced during the fat propagation stage and donating their hydrogen radicals so that the fat radicals are not actively carrying out the propagation stage which will damage the fat [5].

It applied an experimental laboratory research with the Pre and Post Test Control Group Design. This study compared the results of observations in the control and treatment groups after being given action and compares the levels of MDA when not treated with levels of MDA after being given treatment. The treatment given was by giving lemongrass (Cymbopogon citratus) leaves and exposure to cigarette smoke in rats, while the output was MDA levels in rat blood.

Phytochemical test results Lemongrass leaves with positive ethanol solvent contain alkaloids, saponins, flavonoids, tannins, triterpenes/steroids, and glycosides. From the results of observations, the results of the Alchaloids test with Bouchardart reagent the formation of a brick red color indicates a positive result, the results of the Saponin test with hot water then shaken indicate a color change to clear indicating a positive result, the results of the Flavonoid test with the reagent Mg Powder+Amyl Alcohol+HClp showed a color change to light yellow which indicated a positive meaning, and the results of the Glycoside test with Mollish reagent+H2SO4 showed a light yellow color change indicating a positive meaning.

The normality test using Shapiro-Wilk resulted in a probability>alpha (5%) in the 4 pre-test and post-test groups. Then the homogeneity test was carried out using Levene and it was found that the data variance was homogeneous in Table 1 and Table 2.

One Way ANOVA statistical test at the 95% confidence level (p<0.05) showed that the MDA levels in the pre-treatment group (pre-test) did not have a significant difference with the p-value of 0.799 (p<0.05). The MDA levels of rats after being given treatment with ethanol extract of lemongrass leaves (post-test) showed a significant difference. Further analysis was carried out using Post Hoc Tukey HSD (Honestly Significance Different) to determine the level of difference in the influence of each group (Figure 1).

The results of the Post Hoc test for the MDA levels of post-test mice shown in Table 3 show that there are significant differences between the pairs of groups after being given treatment, namely the difference in MDA levels in the positive control group (K+) which was only exposed to cigarette smoke and the negative group (K-) which was only exposed to cigarette smoke. Given standard feed, treatment group 1 (P1) and treatment group 2 (P2). The MDA levels of mice in the negative (K-) group showed a significant difference with the positive control group (K+) and did not show a significant difference with treatment group 1 P1 which received ethanol extract of lemongrass leaves at a dose of 400 mg/kg BW per day and the treatment group 2 P2 who received lemongrass leaf extract at a dose of 400 mg/kg BW per day with p>0.05 (Figure 2).

Table 1: Phytochemical Test Results of Ethanol Extract of Lemongrass Leaves (Cymbopogon citratus)

Table 2: Average Plasma MDA Levels (Pre-test)

Table 3: Average Plasma MDA Levels (Post-test)

Figure 1: Box Plot of Pre Test MDA Levels

Figure 2: Box Plot of Post Test MDA Levels

Rats were exposed to cigarette smoke as much as 2 sticks per berry and given 2 times a day at 8 am and 4 pm. Administration of 400 mg/kg BW ethanol extract of lemongrass leaves in treatment group 1 (P1) and 600 mg/kg BW in treatment group 2 (P2) for 21 days was effective in reducing serum MDA levels. If the treatment groups P1 and P2 were compared with the group that was exposed to cigarette smoke without being given ethanol extract of lemongrass leaves (K+), the decrease was statistically significant (p<0.05).

Suggestions

• Further research is needed with a larger dose range to determine the effectiveness and toxicity of lemongrass (Cymbopogon citratus) leaves as an evaluation of its safety limit

• Further research is needed on the bioactive content of the ethanolic extract of lemongrass (Cymbopogon citratus) which plays a role in reducing MDA levels in rats exposed to cigarette smoke

• Further research is needed on the development of appropriate preparations for the ethanolic extract of basil leaves (O. citriodorum) into a product that can be used by the public

1. Adyttia, A. et al. “Efek ekstrak etanol daun Premna cordifolia terhadap malondialdehida tikus yang dipapar asap rokok.” Pharmaceutical Sciences and Research, vol. 1, no. 2, 2016, pp. 104–115.

2. Kurniawan, R. and Soejoto, B.S. Pengaruh pemberian ekstrak jahe merah (Zingiber officinale var. rubrum) terhadap kadar MDA darah tikus setelah terpapar asap rokok. Doctoral dissertation, Diponegoro University, 2016.

3. Astuti, S. “Isoflavon kedelai dan potensinya sebagai penangkap radikal bebas.” Jurnal Teknologi dan Industri Hasil Pertanian, vol. 13, no. 2, 2012, pp. 126–136.

4. Gumilar, J. et al. “Kemampuan serbuk serai (Cymbopogon citratus) menekan peningkatan total bakteri dan keasaman (pH) dendeng domba selama penyimpanan.” Jurnal Ilmu Ternak Universitas Padjadjaran, vol. 17, no. 2, 2017, pp. 103–108.

5. Rizkita, A.D. “Efektivitas antibakteri ekstrak daun sereh wangi, sirih hijau, dan jahe merah terhadap pertumbuhan Streptococcus mutans.” Prosiding Semnastek, 2017.