The Effect of Ginseng Extract on Serum Interleukin-6 Levels in Patients with Community-Acquired Pneumonia Department of Clinical Pathology, Faculty of Medicine, Sebelas Maret University/Dr. Moewardi Hospital, Surakarta, Indonesia. E-mail: fachrurrodji80@gmail.com ABSTRACT Community-Acquired Pneumonia (CAP) is the most common cause of death and illness in the world. Increased IL-6 can be used as an early indicator of infection or inflammation. Ginseng is a popular herbal medicine. The anti-inflammatory effect of Ginseng is mediated by its ability to inhibit Nuclear Factor Kappa Beta (NF-kB), a proinflammatory regulator to initiate the synthesis of cytokines TNF-α, IL-1β, IL-6, and IL-8. Clinical trial research, quasi-experimental design with a pretest-posttest approach was carried out on 26 community pneumonia patients who were hospitalized at Dr. Moewardi Hospital, Surakarta from October 2020 to January 2021 using purposive sampling. The independent variable was Ginseng extract (GinsanaR) at a dose of 2x100 mg and the dependent variable was serum IL-6 levels. Serum IL-6 levels were measured using the Sandwich Enzyme-Linked Immunoabsorbent Assay (ELISA) method. Mean IL-6 levels in the control group on day 0, day 3, and day 14 were 232,89+156,61 pg/mL, 113,46±83.30 pg/mL and 66.18±66.02 pg/mL, respectively (p=<0.001). Mean IL-6 levels in the treatment group on day 0, day 3, and day 14 were 519,55±609,19 pg/mL, 205.41±329.17 pg/mL and 133,59±291,68 pg/mL, respectively (p=<0.001). Delta IL-6 levels in the control group and the treatment group on day 3 compared to day 0, the mean of the IL-6 control group -119,42±111,70 pg/mL, the mean for the IL-6 treatment group -314,14±532,16 pg/mL; On day 14 compared to day 0, the mean of the IL-6 control group was -166,70±135,54 pg/mL, the mean of the IL-6 treatment group was -385,96±547,10 pg/mL; On day 14 compared to day 3, the mean IL-6 control group was -47.28±47.47, the mean IL-6 control group was -71.82±58.16. The post hoc test (Wilcoxon) obtained a p-value < 0.05, suggesting that Ginseng extract has a significant effect on reducing serum IL-6 serum levels in community pneumonia patients. Keywords: Community-acquired pneumonia, Ginseng, IL-6 PAGE 278 2022 July; 28(3): 278-284 p-ISSN 0854-4263 e-ISSN 2477-4685 Available at www.indonesianjournalofclinicalpathology.org The Effect of Ginseng Extract Fachrurrodji - , et al. Fachrurrodji, B. Rina A. Sidharta, Dian Ariningrum, JB. Suparyatmo, MI. Diah Pramudianti INTRODUCTION Lower respiratory tract infection is one of the main causes of morbidity and mortality, leading to 34-60% of deaths from a total of 3,941,000 deaths worldwide. Pneumonia is an acute infection or inflammation of the parenchyma or lung tissue caused by bacteria, viruses, fungi, or parasites. Community-Acquired Pneumonia (CAP) is a lung infection that is acquired by patients outside the hospital or in the community. Community-acquired pneumonia can be caused by bacteria, fungi, parasites, or viruses and causes death and remains 1-3 the highest cause of death and disease worldwide. The global mortality rate for CAP is estimated at 1.4 million annually. A prospective study of 25,000 males in the United States concluded that CAP patients aged over 65 years had a 4.17 times higher risk of mortality compared to those under 45 years of age. Community-acquired pneumonia is included in the top ten cases of hospitalization in Indonesia. The distribution of patients was balanced between the two genders with 53.95% cases found among male patients and 46.05% cases found among female patients. The CAP case has a Crude Fatality Rate (CFR) of 7.6% and remains the highest. In 2019 there were 225 cases of CAP who were hospitalized at the Dr. Moewardi Hospital, Surakarta. Based on the data of Basic Health Research (RISKESDAS), the prevalence of pneumonia in 2018 and 2013 based on the diagnosis of health workers was approximately 2.0% 3-6 and 1.8%, suggesting an increase of 2%. The mechanism of exacerbation in CAP cases involves various inflammatory factors. In the early stages of pneumonia, alveolar macrophages produce a variety of inflammatory cytokines and chemokines, which attract and activate polymorphonuclear leukocytes and promote an appropriate immune response in the lung parenchyma. In addition, increased production of TNF, IL-1, IL-6, IL-8, IL-12, and IFN-γ was found in the 7 blood circulation of patients with CAP.