Molecular Mechanism of Red Ginger Ethanol Extract (Zingiber officinale var. rubrum) through Ovarian Cell Flow Cytometry Results: MDA, NF-ҝβ and Blood Glucose Levels as a Protector Against Polycystic Ovary Syndrome (PCOS) in Rattus norvegicus Rats

Abstract

Polycystic ovary syndrome (PCOS) is a common endocrine disorder affecting 5–21% of women of reproductive age. Insulin resistance is present in 50–75% of cases, resulting in a 35–40% reduction in insulin sensitivity compared to healthy women. Mareta’s study reported that 92.2% of 249 women with PCOS were obese, with infertility rates of 61–89.6%, and an 8.5-fold higher risk of infertility compared to women without PCOS. In experimental models, intraperitoneal administration of 100 mg/kg body weight of testosterone propionate elevates testosterone levels, induces ovarian inflammation, and disrupts the balance between protective and damaging cellular factors, leading to PCOS. This investigation endeavored to appraise the influence of red ginger (Zingiber officinale var. rubrum) ethanol extract on ovarian cellular flow-cytometric parameters—MDA, NF-κB, and glycemic indices—in mitigating the onset of polycystic ovary syndrome (PCOS) in Rattus norvegicus. In this laboratory experiment, a randomized post-test–only control group framework was utilized to examine ovarian cell MDA and NF-κB expression through flow cytometry, as well as blood glucose concentrations. Thirty Rattus norvegicus subjects were randomly assigned to five groups: K1 (negative control), K2 (positive control), P1 (200 mg/kg BW), P2 (400 mg/kg BW), and P3 (800 mg/kg BW). Treatment groups received red ginger extract for three days, followed by 21 days of combined extract and testosterone propionate (100 mg/kg BW, intraperitoneally). On day 22, rats were euthanized, and blood and ovarian tissues were collected. Ethical approval was obtained from Universitas Airlangga (No. 2.KEH.59.04.2025). Flow cytometry analysis of ovarian cells demonstrated that treatment with red ginger extract significantly reduced MDA and NF-κB expression, as well as blood glucose levels, compared to the positive control group. All treatment groups (P1, P2, and P3) showed significant improvements, with p = 0.001 for each parameter. One-way ANOVA confirmed these findings, indicating highly significant differences among groups (p = 0.001). The ethanol extract derived from red ginger (Zingiber officinale var. rubrum) was shown to diminish MDA and NF-κB expression in ovarian cells and to decrease blood glucose levels, suggesting its potential as a protective agent against polycystic ovary syndrome (PCOS).