Hasil Pencarian  ::  Simpan CSV :: Kembali

"Introduction: Constant exposure to a variety of microorganisms in domestic environment plays an important role in the shaping of individual immune response mechanism, which can affect one's susceptibility to the diseases. The aim of the study to get an understanding how the exposure of microorganisms in the the different area where the people living might give a contribution to the profile and the regulation of the immune respons after stimulated to malaria, vaccine BCG and oxLDL antigents in PBMC and whole blood cultures, and to evaluate the character of T reg as a mediator to suppress the cell proliferation.Methode: It is an in vitro experimental study performed at Laboratorium Terpadu, Faculty of Medicine Univertas Indonesia, Jakarta in 2013 2014. As a model of infectious diseases is used pathogenic antigents such as Plasmodium falciparum infected red blood cells malaria and bacille calmette gu rin BCG vaccine, and as a modell of inflammatory disease is used non a patonegic antigen, low density lipoprotein LDL . Whole blood cultures is done for 80 blood samples to know how the regulation of immune respons from people living a rural populatin. PBMC cultures is also done to explore macrophages after stimulated to malaria, BCG and LDL. PHA stimulated to the PBMC culture with and without T reg cells to evaluate the character of T reg. T regulatory cells perhaps play the important roles to suppress the immune respons to microorganisms was also done.Results: The profile of the immune respons of the people living in the unslum area is significantly more inflamatif than that in the slum area. The ratio of pro anti inflammation cytokines TNF IL 10 of the people living in the unslum area is significantly higher than that in the slum area. This is marked by increasing of oxLDL accumulationis that is the important point of the low protection to oxLDL of the people living in the unslum area p 0.01 . T regulatory cell may suppress the proliferation in the PBMC culture for the people living in the slum area marked by increasing not only the expression of IL 10 cytokines but also the sum of T regulatory sells p 0.01 significantly.Conclusion: The immune respons of the people living in the unslum area is more inflamatif and responsive to malaria, BCG vaccine and oxLDL. The character of macrophage of the people living in the slum area is marked by the low ratio of pro anti inflammation cytokines TNF IL 10 to malaria, BCG vaccine and oxLDLstimulations. T regulatory cell may suppress the proliferation in the PBMC culture for the people living in the slum."

"Tuberkulosis (TB) disebabkan oleh infeksi kuman Mycobacterium tuberculosis merupakan satu dari sepuluh penyebab kematian tertinggi di dunia yang dapat dicegah melalui vaksinasi. Vaksin BCG sebagai satu-satunya vaksin TB, memiliki beberapa kekurangan, diantaranya tingkat proteksi yang tidak merata di populasi orang dewasa dan kekhawatiran aplikasinya pada populasi imunokompromais, hal ini mendorong dikembangkannya vaksin TB alternatif. PE11 merupakan protein yang bertanggung jawab dalam rekonstruksi komponen lipid dinding sel M. tuberculosis dan berdasarkan analisis in-siliko diketahui memiliki domain pengenalan terhadap antibodi dan MHC-II. Dalam studi ini, gen pe11 dari M. tuberculosis strain Beijing diinsersikan ke dalam plasmid pcDNA3.1, pcDNA3.1-pe11, yang kemudian diuji kemampuannya dalam menginduksi respon imun humoral dan mediator seluler pada mencit Balb/c sebagai bentuk DNA vaksin. Berdasarkan uji western blot, respon imun humoral berupa IgG spesifik terhadap protein rekombinan PE11-His berhasil dikonfirmasi. Selain itu, mediator imun seluler dari splenosit mencit pasca vaksinasi dan pajanan antigen secara in-vitro menunjukkan adanya peningkatan produksi IL-12, IFN-γ dan IL-4 dibandingkan dengan kelompok kontrol, namun tidak terhadap sitokin IL-10.

---

Tuberculosis (TB) caused by infection bacteria Mycobacterium tuberculosis, one of ten causes of death in the world that can be prevented through vaccination. The BCG vaccine, as the only TB vaccine, has several drawbacks, including an uneven level of protection in adult population and risk application in immunocompromised population, this has led to the development of an alternative TB vaccine. PE11 is a protein that is responsible for the reconstruction of the lipid component of the cell wall of M. tuberculosis and based on in-silico analysis is known to have the recognition domain for antibodies and MHC-II. In this study, the pe11 gene from the Beijing strain of M. tuberculosis was inserted into the plasmid pcDNA3.1, pcDNA3.1-pe11, then tested for its ability to induce humoral immune responses and cellular mediators in Balb/c mice as a form of vaccine DNA. Based on the western blot test, the specific IgG humoral immune response to the recombinant protein PE11-His was confirmed. In addition, cellular immune mediators from post-vaccination mice splenocytes and in-vitro antigen exposure showed increased production of IL-12, IFN-γ and IL-4 compared to the control group, but not to the IL-10 cytokine."

"Pendahuluan: Kondisi permukiman dapat mempengaruhi tingkat pajanan mikroorganisme penduduknya. Penduduk yang tinggal di daerah kumuh memiliki risiko lebih tinggi untuk terpajan mikroorganisme. Penelitian ini bertujuan untuk mengetahui perbedaan ekspresi IFN-γ dan IL-10 pada whole blood culture (WBC) penduduk daerah kumuh dan nonkumuh yang distimulasi oleh phytohemagglutinin (PHA).Metode: Penelitian potong-lintang dilakukan untuk menentukan perbedaan kadar IFN-γ dan IL-10 pada WBC yang berasal dari subjek daerah kumuh dan nonkumuh yang distimulasi dengan mitogen PHA. Data sitokin merupakan data sekunder yang didapatkan dari penelitian utama yaitu “Regulasi Respons Imun Subyek di Permukiman Kumuh: Studi Imunitas Seluler pada Kultur Sel Darah yang Distimulasi Malaria, BCG dan LDL”.Hasil: Kadar IFN-γ pada kondisi basal ditemukan secara signifikan lebih tinggi pada kelompok nonkumuh daripada kelompok kumuh (15,25 [5,00 – 225,00] dan 3,25[2,00 – 11,50] dengan p=0,004). Kadar IL-10 pada kondisi basal secara signifikan lebih tinggi pada kelompok nonkumuh daripada kelompok kumuh (117,75 [88,00 – 191,00] dan 4,00 [3,00 – 121,50] dengan p=0,002). Pascastimulasi PHA, tidak ditemukan perbedaan signifikan pada kadar IFN-γ (8269,31±1679,96 untuk kumuh dan 6906,60±1074,03 untuk nonkumuh, p=0,488), sedangkan kadar IL-10 pascastimulasi PHA secara signifikan lebih tinggi pada kelompok kumuh dibandingkan nonkumuh (1121,20±169,39 dan 335,06±59,54 dengan p=0,001). Rasio IFN-γ terstimulasi/IFN-γ basal secara signifikan lebih tinggi pada kelompok kumuh dibandingkan nonkumuh (2211,97±1698,36 dan 462,14±332,75 dengan p=0,010) dan rasio IL-10 terstimulasi/IL-10 basal juga secara signifikan lebih tinggi pada kelompok kumuh dibandingkan nonkumuh (259,75±214,70 dan 2,67±1,53 dengan p=0,004). Potensi inflamasi dinilai dengan rasio keseimbangan IFN-γ terhadap IL-10, didapatkan potensi inflamasi yang secara signifikan lebih tinggi pada daerah nonkumuh dibandingkan daerah kumuh (2,159±0,49 dan 1,178±0,63 dengan p=0,002). Kedua sitokin menunjukkan korelasi positif yang cukup kuat dan signifikan, terutama terlihat pada kelompok kumuh (R=0,642 dan p=0,002).Kesimpulan: Terdapat perbedaan kadar sitokin IFN-γ dan IL-10 pada kelompok kumuh dan nonkumuh pada kondisi basal. Pascastimulasi PHA perbedaan hanya terlihat pada kadar IL-10. Rasio keseimbangan kedua sitokin di kedua kelompok berbeda, menunjukkan potensi inflamasi kelompok nonkumuh lebih kuat dibandingkan kelompok kumuh. Terdapat korelasi positif antara sitokin IFN-γ dan IL-10 dimana peningkatan IFN-γ akan diikuti dengan peningkatan IL-10, terutama terlihat pada kelompok kumuh.

---

Introduction: Living conditions might affect the pathogenic exposure of its population. People that live in rural areas have a higher risk of being exposed to pathogens from their environment. This study aims to determine differences in the expression of IFN-γ and IL-10 in whole blood culture (WBC) of rural and urban dwellers stimulated by phytohemagglutinin (PHA).Method: A cross-sectional study is conducted to define the different expression of IFN-γ and IL-10 in whole blood culture from rural and urban areas stimulated with phytohemagglutinin (PHA). The data were obtained from previous study “Regulation of immune response to people living in the slum area: a study of cellular immunity on Whole Blood Cultures stimulated malaria, BCG and LDL”.Result: The expression of IFN-γ in the condition before stimulation was found to be higher in the urban group than in the rural group (15.25 [5.00—225.00] and 3.25 [2.00— 11.50], p=0.004). Interleukin-10 levels in basal conditions were also found to be higher in the urban group than in the rural group (117.75 [88.00—191.00] and 4.00 [3.00— 121.50], p=0.002). Post-stimulation with PHA, IFN-γ levels were not different in the rural and urban group (8269.31 ± 1679.96 and 6906.60 ± 1074.03, p=0.488), however IL-10 levels were higher in rural group (rural: 1121.20 ± 169.39 and urban: 335.06 ± 59.54, p=0.001). The ratio of each cytokine after stimulation to basal was performed and IFN-γ levels were higher in the rural group compared to urban group (2211.97 ± 1698.36 and 462.14 ± 332.75, p=0.010), IL-10 levels were also higher high in the rural compared to urban groups (259.75 ± 214.70 and 2.67 ± 1.53, p=0.004). The inflammatory potential was assessed by calculating the ratio of IFN-γ to IL-10, a higher inflammatory potential was found in urban areas compared to rural (2.159 ± 0.49 and 1.178 ± 0.63, p=0.002). Both cytokines showed a strong positive correlation, especially seen in the rural group (r=0.642, p=0.002).Conclusion: There are differences in IFN-γ and IL-10 expressions in rural and urban subjects spontaneuosly. After stimulation with PHA, a difference was only seen on IL-10 level. The balanced ratio between IFN-γ and IL-10, which depicts the inflammation potency, is stronger in urban subjects when compared to rural subjects. There is a positive correlation between IFN-γ and IL-10, wherein an increase of IFN-γ will be followed by an increase of IL-10, which shown better in rural subjects.

"

"ABSTRAKLatar Belakang: Persistensi infeksi HPV onkogenik merupakan penyebab kanker serviks. Retinol sebagai mikronutrien antioksidan memiliki peran esensial dalam sistem imun mencegah persistensi. Retinol memodulasi sel T CD4+/CD8+ serta produksi sitokin. Tumor Necrosis Factor-Alpha (TNF-) adalah sitokin pro-inflamasi yang mampu mengendalikan HPV, namun pada infeksi persisten TNF- justru memicu karsinogenesis. Rasio sel T CD4+:CD8+ dan TNF- yang adekuat di awal infeksi HPV merupakan titik kunci klirens. Penelitian ini bertujuan untuk mengetahui tingkat kecukupan deposit retinol, ekspresi TNF-, dan rasio sel T CD4+:CD8+ pada kelompok serviks normal, infeksi subklinis HPV klirens, persisten, dan kanker serviks.Metode: Tingkat kecukupan deposit retinol diketahui berdasarkan pemeriksaan darah perifer dengan metode ELISA. Stimulasi spesifik epitop E6 HPV tipe 16 dilakukan pada sel sekret servikovaginal yang telah diinkubasi 24 jam, diamati ekspresi TNF- secara semikuantitatif dengan metode ELISpot. Pemeriksaan sel T CD4+ dan CD8+ dari sekret servikovaginal secara kuantitatif dengan metode flowsitometri.Hasil: Deposit retinol yang cukup pada kelompok serviks normal, infeksi subklinis HPV klirens, persisten, dan kanker serviks berturut-turut adalah 85%, 75% (OR 1,89), 33,3% (OR 11,33), dan 75% (OR 1,89). Ekspresi TNF- pada kelompok serviks normal adalah 10%, sedangkan kanker serviks 75% (OR 27,00; p<0,001). Tidak tampak ekspresi TNF- pada kelompok infeksi subklinis HPV klirens dan persisten. Rasio sel T CD4+:CD8+ yang tinggi pada kelompok serviks normal adalah 10% dan kanker serviks 25% (OR 0,33). Tidak terdapat rasio sel T CD4+:CD8+ yang tinggi pada kelompok infeksi subklinis HPV klirens (OR 1,22) dan persisten (OR 0,95). Tidak terdapat hubungan bermakna antara tingkat kecukupan deposit retinol dengan ekspresi TNF- (p=0,147), tingkat kecukupan deposit retinol dengan rasio sel T CD4+:CD8+ (p=0,726), dan rasio sel T CD4+:CD8+ dengan ekspresi TNF- (p=0,690).Kesimpulan: Penelitian ini mampu membuktikan bahwa tingkat kecukupan deposit retinol tertinggi dijumpai pada kelompok serviks normal dan ekspresi TNF- tertinggi pada kelompok kanker serviks (OR 27,00; p<0,001). Tingkat kecukupan deposit retinol terendah bukan pada kelompok kanker serviks, melainkan pada infeksi subklinis HPV persisten (OR 11,33). Tidak terdapat perbedaan bermakna pada tingkat kecukupan deposit retinol dan rasio sel T CD4+:CD8+. Terdapat perbedaan bermakna pada ekspresi TNF- antara kelompok kanker serviks dengan serviks normal (p<0,001), kanker serviks dengan infeksi HPV subklinis klirens (p=0,024), dan klirens dengan persisten (p=0,007). Tidak terdapat perbedaan bermakna ekspresi TNF- antara kelompok kanker serviks dengan infeksi HPV subklinis persisten (p=0,058). Tidak bermaknanya beberapa hasil terkait imunitas masih mungkin dikarenakan tingkat kecukupan deposit retinol kelompok kanker serviks pada penelitian ini sangat baik dimana bertentangan dengan kepustakaan.

---

ABSTRACT

Background: Persistency of oncogenic-HPV infection is the cause of cervical cancer. Retinol is one of antioxidant micronutrients that plays essential roles in immune system to prevent the persistency by modulating CD4+ and CD8+T cells and cytokines production. Tumor Necrosis Factor-Alpha (TNF-) is an acute pro-inflammatory cytokine which has many crucial roles in controlling HPV. In contrast, when persistent infection occurs, TNF- induces carcinogenesis. Ratio of CD4+:CD8+ T cells and adequate TNF- production in acute HPV infection are keypoints for clearance. The aim of this research is to analyze sufficency level of retinol deposit, expression of TNF-, and ratio of CD4+:CD8+ T cells in normal cervix, clearance and persistent HPV subclinical infection, and cervical cancer group.

Methods : Sufficiency level of retinol deposit was analyzed from peripheral blood by ELISA method. The cervicovaginal secretions which had 24 hours incubated were stimulated specifically by E6 epitope HPV type-16, measuring TNF- expression semiquantitatively by ELISpot method and CD4+/CD8+ T cells quantitatively by flowcytometry method.

Results: Sufficient level of retinol deposit in normal cervix, clearance HPV subclinical infection, persistent, and cervical cancer group was 85%, 75% (OR 1.89), 33.3% (OR 11.33), and 75% (OR 1.89), respectively. The expression of TNF- in normal cervix group was 10%, while in cervical cancer was 75% (OR 27.00; p<0.001). There were no expression in clearance and persistent HPV subclinical infection groups. High ratio of CD4+:CD8+ T cells in normal cervix and cervical cancer group was 10% and 25% (OR 0.33). There were no high ratio of CD4+:CD8+ T cells in clearance (OR 1,22) and persistent (OR 0.95) HPV subclinical infection groups. There was no significant correlation between sufficiency level of retinol deposit and TNF- expression (p=0.147), sufficiency level of retinol deposit and ratio of CD4+:CD8+ T cells (p=0.726), ratio of CD4+:CD8+ T cells and TNF- expression (p=0.690).

Conclusions: This study was able to prove that normal cervix group has the highest retinol deposit sufficiency level and cervical cancer group has the highest TNF- expression (OR 27,00; p<0,001). The lowest of retinol deposit sufficiency level was not in cervical cancer, but in persistent HPV subclinical infection group (OR 11.33). There was no significant correlation in sufficiency level of retinol deposit and ratio of CD4+:CD8+ T cells. There was significant correlation in TNF- expression between cervical cancer and normal cervix (p<0.001), cervical cancer and clearance subclinical HPV infection (p=0.024), and between clearance and persistent group (p=0.007). There was no significant correlation in TNF- expression between cervical cancer and persistent subclinical HPV infection group (p=0.058). Not significant some results related immunity that might be due to retinol deposit sufficiency level in cervical cancer group in this study was very good, which conflicted with literatures."

"Pandemi COVID-19 telah menimbulkan tantangan global dalam menghadapi penyebaran virus SARS-CoV-2. Vaksinasi menjadi strategi efektif dalam mengurangi penyebaran virus dan dampak COVID-19 pada kesehatan masyarakat. Platform vaksin yang banyak diberikan di Indonesia antara lain platform virus utuh dan vektor virus. Penelitian ini bertujuan menganalisis imunitas humoral pasca vaksinasi COVID-19 platform virus utuh dan vektor virus pada orang dewasa. Desain penelitian ini adalah longitudinal dengan pengambilan sampel secara berkala sebanyak 6 kali sebelum dan setelah vaksinasi. Penelitian dilakukan pada tahun 2021 sampai 2023 di Kota Bogor dan Kabupaten Sleman. Jumlah subjek yang terlibat sebanyak 150 orang pada setiap kelompok. Pengumpulan data dilakukan melalui wawancara dan pengambilan sampel serum. Serum diperiksa untuk binding antibody menggunakan CMIA, antibodi netralisasi menggunakan SvNT, subkelas IgG menggunakan ELISA, dan mediator imunitas seluler menggunakan multipleks ELISA. Dari hasil pemeriksaan laboratorium pada sampel TP1 didapatkan sebanyak 42% subjek vaksin virus utuh dan 81% subjek vaksin vektor virus positif antibodi SARS-CoV-2. Di antara subjek yang positif mempunyai riwayat gejala sesak napas (100%), demam (89%) dan pilek (82%). Subjek vaksin vektor virus mempunyai tren respons antibodi lebih tinggi dibanding virus utuh. Proporsi subjek positif pada pengukuran antibodi netralisasi selalu lebih tinggi dibanding binding antibody. Berdasarkan imunosenescence, secara umum tidak berbeda bermakna di antara kelompok usia tersebut. Faktor yang secara signifikan memengaruhi respons imun dalam adalah platform vaksin. Respons antibodi tidak berbeda bermakna pada subjek yang mendapatkan vaksin 2 dan 3 dosis, baik pada hasil pengukuran TP1 positif maupun negatif. Pemberian dosis 3 heterolog menimbulkan respons antibodi yang lebih tinggi dibandingkan dengan homolog. Analisis statistik pada kedua kelompok penerima vaksin menunjukkan tidak berbeda bermakna pada semua subkelas IgG. Kadar IFN gamma, IL-2, IL-6, IL-10 dan TNF alpha pada virus utuh lebih rendah dibandingkan vektor virus Hasil penelitian menunjukkan bahwa kedua platform vaksin mampu menginduksi respons antibodi yang signifikan. Namun, terdapat perbedaan dalam pola dan durasi respons imun antara kedua jenis vaksin.

---

The COVID-19 pandemic has become a global challenge with the spread of SARS-CoV-2. Vaccination is an effective strategy to reduce the spread of the virus and the impact of COVID-19 on public health. The research aims to analyse humoral immunity following vaccination with COVID-19 viral platforms and viral vectors in adults. The study design is longitudinal, with samples taken periodically up to 6 times before and after vaccination. The study will be conducted between 2021 and 2023 in Bogor City and Sleman District. The number of subjects involved is 150 people in each group. Data will be collected through interviews and serum sampling. Serum was tested for antibody binding using CMIA, antibody neutralisation using SvNT, subclass IgG using ELISA, and cellular immunity mediators using ELISA multiplex. Laboratory testing of the TP1 sample showed that 42% of the whole inactivated vaccine subjects and 81% of the viral vector subjects were positive for SARS-CoV-2 antibodies. Those who were positive had a history of shortness of breath (100%), fever (89%) and colds (82%). The proportion of positive subjects in the neutralised antibody measurement is always higher than the antibody binding. Based on immunosenescence, there is generally no difference in significance between these age groups. The factor that significantly affects the immune response within the vaccine is the vaccine platform. The antibody response was not significantly different in subjects who received 2 and 3 doses of the vaccine, both in positive and negative TP1 measurements. The administration of 3 heterologous doses results in a higher antibody response compared to homologous doses. Statistical analysis in both groups showed no significant difference in all IgG subclasses. IFN gamma, IL-2, IL-6, IL-10 and TNF-alpha levels were lower in the whole inactivated vaccine than in in the viral vector. However, there are differences in the pattern and duration of immune responses between the two vaccines."

"Indonesia masih menjadi negara yang belum terbebas dari malaria. Terdapat kesenjangan kasus malaria di Indonesia dengan prevalensi tertinggi di Provinsi Papua, Papua Barat dan Nusa Tenggara Timur.Penelitian ini bertujuan untuk mendapatkan model manajemen malaria berbasis wilayah yang nantinya dikembangkan menjadi algoritma manajemen malaria berbasis wilayah. Desain penelitian ini adalah desain penelitian analitik yang menggabungkan studi ekologi dan studi potong lintang. Sampel diambil dari empat desa yang berdekatan di Kecamatan Kodi Balaghar Kabupaten Sumba Barat Daya Provinsi Nusa Tenggara Timur yang memiliki perbedaan prevalensi malaria dan perbedaan ekosistem yaitu Desa Mata Kapore, Desa Waikarara, Desa Kahale dan Desa Karang Indah.Hasil penelitian menunjukkan terdapat variabilitas dinamika transmisi di antara keempat desa tersebut yaitu jenis parasit, densitas parasit, kepadatan nyamuk, perilaku pemajanan, jarak rumah dari tempat perindukan nyamuk. Terdapat variabilitas respons imun di antara keempat desa yaitu kadar IgG dan alel gen MSP2. Pola persebaran kasus dan alel gen MSP2 di masing-masing desa memiliki karakteristik tertentu. Ada hubungan antara jarak rumah dari tempat perindukan nyamuk (p=0,041) dan alel gen MSP2 (p=0,032) dengan densitas parasit. Model akhir menunjukkan alel gen MSP2 memiliki hubungan dengan densitas parasit.Penelitian ini menyarankan algoritma manajemen malaria berbasis wilayah yang memuat manajemen kasus, manajemen faktor risiko, integrasi dan keterlibatan lintas sektor.

---

Indonesia is not malaria-free country. There is a gap of malaria cases in Indonesia with the highest prevalence in the province of Papua, West Papua and East Nusa Tenggara.

This study aims to obtain spatial management of malaria model which will be developed into an spatial management of malaria algorithms. This study design is an analytic study designs that combines ecological study and cross-sectional study. Samples taken from four adjacent villages in the district of Kodi Balaghar Southwest Sumba Regency East Nusa Tenggara Province which have differences in prevalence of malaria and ecosystem diversity. They are Mata Kapore Village, Waikarara Village, Kahale Village and Karang Indah Village.

The results showed there are variabilities in the transmission dynamics among the four villages. The variabilities are the type of parasite, parasite density, density of mosquitoes, behavioral exposure, the distance of house from breeding places. There are variabilities in immune response among the four villages. They are IgG level and MSP2 gene alleles. Distribution patterns of cases distributif and MSP2 gene alleles in each village have certain characteristics. There is a association between the distance of house from breeding place (p=0,041) and MSP2 gene alleles (p=0,032) with parasite density. The final model shows MSP2 gene alleles have a relationship with parasit density.

This study suggested spatial management of malaria algorithm that includes case management, risk factor management, integration and cross-sector involvement."

"Vaksin konjugat pneumokokus 13-valen berperan penting dalam upaya mengurangi penyakit invasif pneumokokus pada anak terinfeksi HIV. Tujuan studi retrospektif ini untuk mengevaluasi respon imun humoral pada anak terinfeksi HIV pra dan pasca vaksinasi PCV13 di Jakarta, Indonesia. Penelitian ini menggunakan sampel serum bahan biologis tersimpan (BBT) dari 66 anak sebelum, 12 dan 18 bulan setelah vaksinasi. ELISA dan uji bakterisidal serum digunakan untuk mengukur konsentrasi antibodi dan antibodi fungsional pasca vaksinasi, secara berurutan. IgG total 13 serotipe S. pneumoniae 12 bulan pasca vaksinasi PCV13 menunjukkan peningkatan konsentrasi yang signifikan dibandingkan dengan pra vaksinasi (p=0.01). Konsentrasi IgG spesifik serotipe 4, 14 dan 23F pasca vaksin 18 bulan terjadi penurunan siginifikan dibandingkan pra vaksinasi (p<0.05) sedangkan IgG spesifik serotipe 6B terjadi peningkatan konsentrasi antibodi (p=0.03). Tidak terjadi perubahan konsentrasi IgG spesifik serotipe 3 yang efektif setelah vaksinasi. Konsentrasi IgG serotipe 19F tidak ada perbedaan signifikan (p>0.05) setelah vaksinasi. Tidak ada korelasi signifikan antara jumlah sel T CD4 dengan konsentrasi IgG total 13 serotipe S. pneumoniae. Rerata konsentrasi IC50 serum bactericidal assay adalah 275,2 U/mL. Kesimpulannya, satu dosis PCV13 untuk anak terinfeksi HIV mampu menghasilkan tingkat antibodi yang kuat dan fungsional terhadap S. pneumoniae.

---

The 13-valent pneumococcal conjugate vaccine plays an important role in efforts to reduce pneumococcal invasive disease in HIV-infected children. The aim of this retrospective study was to evaluate the humoral immune response in HIV-infected children before and after PCV13 vaccination in Jakarta, Indonesia. This study used serum samples of biologically stored material from 66 children before, 12 and 18 months after vaccination. ELISA and serum bactericidal assays were used to measure post-vaccination antibody and functional antibody concentrations, respectively. IgG total of 13 serotypes of S. pneumoniae 12 months after PCV13 vaccination showed a significant increase in concentration compared to pre- vaccination (p=0.01). The concentration of specific IgG serotypes 4, 14 and 23F after the vaccine 18 months decreased significantly compared to pre-vaccination (p<0.05) while the concentration of specific IgG for serotype 6B increased (p=0.03). There was no change in effective serotype 3 specific IgG concentration after vaccination. There was no significant difference (p>0.05) in serotype 19F IgG concentrations after vaccination. There was no significant correlation between the number of CD4 T cells and the total IgG concentration of 13 serotypes of S. pneumoniae. The mean concentration of IC50 serum bactericidal assay was 275.2 U/mL. In conclusion, a single dose of PCV13 for HIV-infected children appears to produce strong and functional antibody levels against S. pneumoniae."

"Latar Belakang: Respons imun berperan pada kerentanan pasien talasemia terhadap infeksi. Defisiensi seng pada talasemia akan memperburuk respons imun. Penelitian ini bertujuan mengetahui profil respons imun pasien talasemia mayor dan pengaruh suplementasi seng dan imunisasi pneumokokus pada respons imun pasien talasemia pasca-splenektomi.Metode: Penelitian dilakukan di Pusat Thalassemia RSCM, Jakarta pada September 2013 ? Februari 2014. Studi observasi dengan metode belah lintang komparatif pada talasemia mayor sehat usia > 12 tahun dan HIV negatif non- dan pasca-splenektomi mendahului studi intervensi dengan metode randomized, double-blinded, controlled trial pada talasemia pasca-splenektomi yang dialokasikan menjadi kelompok seng 1,5 mg/kg/hr maksimum 50 mg, atau plasebo. Dua jenis imunisasi pneumokokus diberikan untuk menguji fungsi limfosit T. Luaran yang diukur adalah respons imun non-spesifik (jumlah dan fagositosis neutrofil) dan respons imun spesifik (kuantitatif dan kualitatif). Respons imun spesifik kualitatif mengukur produksi IgG pneumokokus, IL-2 dan TNF-α pasca pajanan PHA.Hasil Penelitian: Median fagositosis neutrofil kelompok pasca-splenektomi 29,79 (4 sampai 81)% dan kelompok non-splenektomi 55,83 (2 sampai 133)% (p < 0,001). Kelompok pasca-splenektomi mempunyai jumlah netrofil, limfosit total, jumlah limfosit T, jumlah limfosit T CD4+ dan CD8+ yang lebih tinggi dibanding kelompok non- splenektomi. Tidak ada perbedaan respons imun spesifik kualitatif yang bermakna di antara pasien talasemia mayor. Setelah intervensi, hanya 18 dari 28 subjek kadar seng serum kelompok seng yang menjadi normal. Walaupun fagositositosis neutrofil hanya berubah dari 31,36 (4 sampai 81)% menjadi 30,44 (3 sampai 72)% (p = 0,554), namun terdapat kecenderungan perbaikan fagositosis neutrofil pada kelompok seng. Parameter respons imun lainnya tidak menunjukkan perubahan antara kelompok seng dan plasebo selama penelitian 12 minggu (p > 0,05).Simpulan: Terdapat perbedaan respons imun antara pasien talasemia pasca-splenektomi dan non-splenektomi. Belum dapat dibuktikan pengaruh suplementasi seng pada hampir semua parameter respons imun pasien talasemia mayor pasca-splenektomi. Seng mungkin dapat direkomendasikan sebagai suplementasi, tetapi perlu penelitian lanjutan mengenai dosis dan lama pemberian yang tepat untuk perbaikan respons imun pasien talasemia mayor pasca-splenektomi.

---

Introduction: Immune response plays a role in increasing thalassemia patient?s susceptibility to infections. Zinc deficiency in thalassemia patients will alter immune response. The aim of this study is to evaluate immune response of thalassemia major and zinc supplementation effects on immune response quality of post-splenectomy thalassemia major.

Methods: This study was conducted at Thalassaemia Centre, Cipto Mangunkusumo Hospital Jakarta on September 2013 ? February 2014. An observational study using comparative cross-sectional method was done in healthy non- and post-splenectomy thalassemia major aged > 12 year and HIV negative. Then, it was followed by an interventional study using randomized, double-blinded, controlled trial, on post- splenectomy subjects, which were assigned to receive 1.5 mg/kg/d maximum 50 mg/d zinc or placebo. Moreover, 2 type of immunization were also administered in order to assess T lymphocyte function. The outcomes were non-specific (neutrophil count and phagocytosis) and specific immune response (quantitave and qualitative). Qualitative specific immune response measured by detecting IgG pneumococcal, IL-2 and TNF-α after PHA exposure.

Results: Median of neutrophil phagocytosis on post-splenectomy and non-splenectomy were 29.79 (4 to 81)% and 55.83 (2 to 133)% (p < 0.001). Post-splenectomy subjects have higher neutrophil count, total lymphocyte count, lymphocyte T count, lymphocyte T CD4+ and CD8+ than non-splenectomy. There is no significant difference on qualitative specific immune response among thalassemia major. Following the intervention, only 18 out of 28 subjects of zinc group had normal plasma zinc. There was a trend of neutrophil phagocytosis improvement on zinc group despite a little shifting on those value, from 31.36 (range 4 to 81)% to 30.44 (3 to 72)% (p = 0.554). Other immune response parameters showed no different changes between two groups after 12 weeks supplementation (p > 0.05).

Conclusions: There were significant differences on immune response of post- splenectomy and non-splenectomy patients. The significant changes on almost all of immune response parameter after zinc supplementation have not been proved yet. Addition of zinc supplementation may be recommended, but it need further study to evaluate the dose and duration of supplementation to improve immune response in splenectomised thalassemia major patients."

"Latar belakang. Pada penyakit graves (GD), konsentrasi vitamin D berbanding terbalik dengan titer antibodi dan berbanding lurus dengan status remisi. Pembentukan autoantibodi diawali dari pajanan self antigen oleh sel dendritik (DC), sebagai antigen presenting cell (APC), ke sel T naif. Kemampuan DC sebagai APC ditentukan oleh tingkat kematangannya. Sel dendritik, APC utama pada GD, bersifat lebih aktif dalam respons imun dibandingkan dengan subjek sehat. Studi pada SLE, MS, dan penyakit crohn menunjukkan efek imunoregulator vitamin D terutama melalui hambatan pematangan DC sehingga fungsi imunogenitasnya berkurang.Tujuan. Mengetahui efek 1,25-D3 in vitro dan 1α-D3 in vivo terhadap pematangan DC pasien GDMetode. Pada periode Mei 2014 sampai dengan Maret 2015 dilakukan studi eksperimental dan klinis, masing-masing pada 12 dan 25 pasien GD fase hipertiroid. Pada studi eksperimental, dilakukan kultur monocyte derived dendritic cell (MDDC) pasien GD dengan atau tanpa intervensi 1,25-D3 in vitro pada tahap monosit dan maturasi distimulasi dengan lipopolysaccharide (LPS). Pada studi klinis, sebanyak 12 dan 13 pasien GD, masing-masing mendapatkan 1α-D3 dan plasebo selama 8 minggu, di samping mendapatkan terapi standar PTU 100 mg 3 kali sehari. Kultur MDDC dilakukan sebelum dan sesudah suplementasi dan dilakukan perbandingan pematangan DC sebelum dan sesudah suplementasi pada kedua kelompok. Pematangan DC dilihat dari ekspresi penanda DC (HLA-DR, CD80, CD40, CD83, CD14, dan CD206) dan rasio sitokin IL-12/IL-10 pada supernatan kultur.Hasil. Pada studi in vitro, pascastimulasi LPS, DC yang dikultur dengan 1,25-D3 menunjukkan ekspresi HLA-DR, CD80, CD40, dan CD83 lebih rendah serta ekspresi CD14 dan CD206 yang lebih tinggi dibandingkan dengan DC yang dikultur dengan LPS saja. Pada DC yang dikultur dengan 1,25-D3, didapatkan rasio IL-12/IL-10 lebih rendah daripada DC tanpa 1,25-D3. Pada studi klinis, apabila dibandingkan antara ekspresi penanda DC serta rasio IL-12/IL-10 sebelum dan sesudah suplementasi 1α-D3 selama 8 minggu, belum didapatkan perbedaan yang bermakna pada ekspresi penanda DC dan rasio sitokin IL-12/IL-10.Simpulan. Pemberian 1,25-D3 in vitro menghambat pematangan DC pasien GD, sedangkan efek pemberian 1α-D3 in vivo terhadap pematangan DC belum dapat ditunjukkan pada penelitian ini.

---

Background. In graves? disease (GD), vitamin D levels is inversely proportional to antibody titer and proportionally associated with remission status. The development of autoantibody is initiated by self-antigen exposure by dendritic cells (DC) as the antigen presenting cells (APC) to the naïve T cells. The ability of DC as APC is determined by its maturity level. Dendritic cells, the major APC in GD, have more active immune responses than those in healthy subjects. Studies on systemic lupus erythematosus (SLE), multiple sclerosis (MS) and crohn?s disease have demonstrated immunoregulator effects of vitamin D, mainly through inhibition of DC maturation, which may lead to lower immunogenic function.

Aim. To identify the effect of 1,25-D3 in vitro and 1α-D3 in vivo on DC maturation in patients with GD.

Method. Our study consisted of an experimental and a clinical study started from May 2014 until March 2015, which was conducted in 12 and 25 GD patients with thyrotoxicosis, respectively. In the experimental study, cultures of monocyte derived dendritic cell (MDDC) of GD patients were performed, with or without intervention of 1,25-D3 in vitro at monocytic phase and the maturation was stimulated by lipopolysaccharide (LPS). In the clinical study, there were 12 GD patients who received 1α-D3 supplementation and 13 GD patients who received placebo for 8 weeks, in addition to the standard treatment of PTU 100 mg three times a day. MDDC cultures and comparison of DC maturation were performed before and after the supplementation for both groups. DC maturation was evaluated based on the expression of DC markers (HLA-DR, CD80, CD40, CD83, CD14 and CD206) and the ratio of cytokines IL-12/IL-10 levels in the culture supernatants.

Results. In the in vitro study and following the LPS stimulation, DC cells cultured with 1,25-D3 showed lower expression of HLA-DR, CD80, CD40 and CD83 and higher expression of CD14 and CD206 compared to DC cultured with LPS alone. DC, which were cultured with 1,25-D3 had lower ratio of IL-12/IL-10 levels than those cultured without 1,25-D3. In the clinical study, when the expression of DC marker as well as the ratio of IL-12/IL-10 levels between before and after the 8-week supplementation of 1α-D3 were compared, we found no significant difference on the expression of DC markers and the ratio of IL-12/IL10.

Conclusion. In vitro 1,25-D3 supplementation inhibits DC maturation in patients with GD; while the effects of in vivo 1α-D3 treatment on DC maturation have not been clearly demonstrated in the present study yet."