Ethanol Extract of Jati Belanda (Guazuma ulmifolia L.) as Therapy for Chronic Kidney Disease in In Vitro Model

Background: People with diabetes mellitus in Indonesia are predicted to increase until 2035. High glucose in body (hyperglycemia) leads to increased fibronectin synthesis. Fibronectin that gets accumulated in glomerulus (mesangial cells), at the end, will lead to diabetic glomerulosclerosis. Jati belanda (Guazuma ulmifolia L.) leaf is well known as an Indonesian traditional medicine to have effects as antidiabetic by the presence of its secondary metabolites such as alkaloid, tannin, saponin, flavonoid, and terpenoid, which are very important in health recovery. 
Objectives: To evaluate the activity of ethanol extract of jati belanda (EEJB) as a protection agent on induced-glucose mesangial cells of SV40 MES 13 cell line (glomerular mesangial kidney, Mus musculus). 
Materials and Methods: EEJB (3.125 and 6.25 μg/mL) was extracted based on maceration method using ethanol (70%) as the solvent. Proliferation and viability were performed based on (3-(4,5-dimethylthiazol-2-yl)-5-(3-carboxymethoxyphenyl)-2-(4-sulfophenyl)- 2H-tetrazolium) (MTS) method. The level of transforming growth factor β1 (TGF-β1) and fibronectin in glucose-induced mesangial cells was assayed and determined using enzyme-linked immunosorbent assay kit. Reactive oxygen species (ROS) level was measured using flow cytometer. 
Results: EEJB (3.125 and 6.25 μg/mL) increased cell proliferation and viability in glucose-induced mesangial cells and significantly reduced the level of TGF-β1, fibronectin, and ROS compared to that in positive control (glucose-induced cells). 
Conclusion: Our study suggests that EEJB is able to reduce TGF-β1, fibronectin, and ROS levels in glucose-induced mesangial cells, which correlate to diabetic glomerulosclerosis condition and increase the mesangial cell proliferation and viability.