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"ABSTRAKLatar Belakang: Penggunaan PRP autologus banyak dimanfaatkan untuk mempercepat proses penyembuhan berbagai macam luka, namun belum ada kriteria yang mengatur penggunaan tersebut. Penelitian yang menjelaskan bagaimana pengaruh penggunaan PRP terhadap proses tersebut juga masih sangat terbatas. Penelitian ini bertujuan untuk mengalisa pengaruh PRP terhadap produksi mediator pro dan anti-inflamasi dari kultur makrofag.Metode: Penelitian eksperimental ini menggunakan sampel darah perifer dari subyek sehat yang diambil sebanyak 2x dengan interval waktu 1 minggu. Pada pengambilan darah pertama, dilakukan isolasi sel monosit kemudian dikultur selama 1 minggu menjadi sel makrofag. Pada hari ke-7 dilakukan pengambilan darah kedua untuk dilakukan isolasi PRP dan serum, kemudian dilakukan 5 kelompok perlakuan berbeda terhadap masing-masing subyek. Kelompok I, makrofag ditambah serum. Kelompok II, makrofag ditambah serum dan LPS. Kelompok III, makrofag ditambah serum, LPS, dan PRP. Kelompok IV, makrofag ditambah LPS dan PRP. Kelompok V, makrofag ditambah PRP. Pada hari ke-10 dan ke-14, kadar sitokin TNF-a dan IL-10 yang dihasilkan dari kultur makrofag diukur dengan menggunakan teknik ELISA.Hasil: Terjadi penurunan bermakna kadar TNF-a hari ke-14 dibandingkan hari ke-10 pada kelompok II p=0.001 , kelompok III p=0.011 , dan kelompok IV p=0.000 . Kemampuan sel makrofag untuk memproduksi TNF-a menurun pada hari ke-14 dibanding hari ke-10. Terjadi peningkatan bermakna kadar IL-10 hari ke-14 dibandingkan hari ke-10 pada kelompok I p=0.05 , kelompok II p=0.018 , kelompok III p=0.017 , kelompok IV p=0.030 , dan kelompok V p=0.030 . Kemampuan sel makrofag untuk memproduksi IL-10 meningkat pada hari ke-14 dibanding hari ke-10, namun tidak ada perbedaan bermakna antar tiap kelompok.Kesimpulan: Secara umum, kadar TNF-a menurun pada hari ke-14 dibandingkan hari ke-10 sedangkan kadar IL-10 meningkat pada hari ke-14 dibandingkan hari ke-10. Pemberian PRP dapat meningkatkan produksi kadar TNF-a pada awal aktivasi makrofag dan menurunkan produksi TNF-a pada akhir aktivasi makrofag. Pemberian PRP tidak mempengaruhi produksi IL-10 pada awal aktivasi makrofag dan meningkatkan produksi IL-10 pada akhir aktivasi makrofag.

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ABSTRACTBackground Autologous PRP has been used widely to accelerate wound healing, but many are case reports lacking controls. Research explains how the effect of the use of PRP to the process is still very limited. This study was aimed to analyze the effect of PRP on the production pro and anti inflammatory mediators from macrophage culture.Methods This experimental research was prepared from peripheral blood samples collected 2 times from healthy subjects, within an interval of 1 week. In the first blood collection, monocytes were isolated then cultured for 1 week into macrophage Human monocyte derived macrophages . On day 7, the second blood collection was done to isolate PRP and serum, then 5 different treatments were treated to each subject. Group I, macrophage plus serum. Group II, macrophage plus serum and LPS. Group III, macrophage plus serum, LPS, and PRP. Group IV, macrophage plus LPS and PRP. Group V, macrophage plus PRP. On day 10 and day 14, cytokine TNF a and IL 10 that produced by macrophage culture were measured using ELISA technique.Results There was significant decrease of TNF a concentration on day 14 compared to day 10, especially in Group II p 0.001 , Group III p 0.011 , and group IV p 0.000 . Macrophage rsquo s ability to produce TNF a was decrease on day 14 compared to day 10. There was significant increase of IL 10 concentration on day 14 compared to day 10, in Group I p 0.05 , Group II p 0.018 , Group III p 0.017 , Group IV p 0.030 , and Group V p 0.030 . Macrophage rsquo s ability to produce IL 10 was increase on day 14 compared to day 10, but there was no significant difference between each group.Conclusions In general, TNF a concentration decrease on day 14 compare to day 10 but IL 10 concentration increase on day 14 compare to day 10. PRP supplement can increase the production of TNF a in the first phase of macrophage activation and reduce the production of TNF a in the late phase of macrophage activation. PRP supplement doesn rsquo t influence the production of IL 10 in the first phase of macrophage activation but can induce the increasing of IL 10 production in late phase of macrophage activation."

"COVID-19 merupakan penyakit penyebab pandemi pada akhir 2019. Perbedaan manifestasi klinis pada infeksi SARS-CoV-2 ini memicu banyak pertanyaan di kalangan peneliti dan medis. Perbedaan klinis COVID-19 tersebut dapat dipicu oleh faktor hospes, patogen maupun lingkungan. Infeksi SARS-CoV-2 terutama melalui saluran napas atas, tempat kolonisasi mikroba komensal dan patogen. Bagaimana interaksi antara mikroba yang berkolonisasi dengan SARS-CoV-2 dalam menimbulkan respons inflamasi di saluran napas atas masih belum diketahui dengan jelas. Penelitian ini bertujuan menganalisis hubungan antara karakteristik mikrobiota, serta rasio kadar sitokin pro- dan anti-inflamasi dari saluran napas atas dengan beratnya COVID-19.Penelitian ini merupakan studi potong lintang menggunakan 74 swab nasofaring dan orofaring di dalam viral transport medium (VTM) dari pasien COVID-19 berusia 18–64 tahun. Profil mikrobiota di saluran napas atas dan kadar IL-6, IL-1β, IFN-γ, TNF-α dan IL-10 diperiksa dengan metode sekuensing 16S ribosomal RNA dan Luminex assay, secara berurutan. Selanjutnya dilakukan analisis hubungan antara beratnya COVID-19 dengan OTU, keragaman alfa dan beta dari mikrobiota saluran napas atas.Lima filum terbanyak di saluran napas pasien COVID-19 di Indonesia berusia 18-64 tahun adalah Firmicutes (32,3%), Bacteroidota (27,1%), Fusobacteriota (15,2%), Proteobacteria (15,1%) dan Actinobacteria (7,1%). Analisis indeks Shannon dan ACE menunjukkan bahwa tidak ada penurunan keragaman microbiota saluran napas atas dengan bertambah beratnya penyakit. Namun, ada perbedaan bermakna keragaman beta pada mikrobiota saluran napas atas antara COVID-19 ringan dan berat. Keberlimpahan filum Firmicutes (p = 0,012), dan genus Streptococcus (p = 0,033) dan Enterococcus (p = 0,031) lebih tinggi pada COVID-19 berat dibandingkan yang ringan, sedangkan keberlimpahan filum Fusobacteriota (p = 0,021), Proteobacteria (p = 0,030), Campilobacterota (p = 0,027), genus Neisseria (p = 0,008), dan Fusobacterium (p = 0,064), spesies Porphyromonas gingivalis (p = 0,018), Fusobacterium periodonticum (p = 0,001) dan Fusobacterium nucleatum (p = 0,022) lebih tinggi pada COVID-19 ringan dibandingkan berat. Keberadaan bakteri Prevotella buccae (p = 0,005) dan Prevotella disiens (p = 0,043) lebih rendah pada COVID-19 berat. Rasio TNF-α/IL-10 lebih tinggi pada COVID-19 berat (p < 0.05). Selanjutnya, rasio IL-6/IL-10, IFN-γ/IL-10, dan IL-1β/IL-10 juga lebih tinggi pada COVID-19 berat, namun tidak berbeda bermakna jika dikaitkan dengan beratnya penyakit.Penelitian ini mendukung adanya hubungan antara karakteristik mikrobiota di saluran napas atas dengan beratnya COVID-19 pada pasien dewasa. Studi lebih lanjut diperlukan untuk memeriksa mekanisme bagaimana mikrobiota mencegah beratnya COVID-19. Rasio TNF-α/IL-10 dari saluran napas dapat menjadi prediktor beratnya penyakit dan sebagai alternatif pemeriksaan kadar sitokin pada COVID-19 yang kurang invasif dibandingkan serum.

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COVID-19 is a disease that caused a pandemic at the end of 2019. Clinical manifestations difference in SARS-CoV-2 infection has raised many questions in research and medical provider. The clinical differences in COVID-19 can be triggered by host, pathogen and environmental factors. SARS-CoV-2 mainly enters through the upper airway, with colonization of commensal and pathogenic microbes. How the interaction between colonized microbes and SARS-CoV-2 in causing an inflammatory response in the upper airway is still not clearly known. Therefore, we examined the association between the diversity of microbiota, pro- and anti-inflammatory cytokines ratio of upper respiratory and COVID-19 severity.

This research is an observational cross-sectional study using 74 nasopharyngeal and oropharyngeal swabs in viral transport medium from COVID-19 patients aged 18-64 years. We examined microbiota profile in the upper airway using 16S ribosomal RNA sequencing method and levels of IL-6, IL-1β, IFN-γ, TNF-α and IL-10 were examined by Luminex assay. We also examined the association between COVID-19 severities with OTU analysis, alpha and beta diversity of upper respiratory microbiota.

The top five phyla in upper respiratory tract of Indonesian COVID-19 patients with aged of 18–64 years old were Firmicutes (32,3%), Bacteroidota (27,1%), Fusobacteriota (15,2%), Proteobacteria (15,1%) and Actinobacteria (7,1%). Shannon and ACE index analysis showed no decline of microbiota diversity in upper airway with the increase of disease severity. However, there were significant differences of beta diversity in the upper airway microbiota between mild and severe COVID-19. The abundance of the Firmicutes phylum (p = 0,012), Streptococcus (p = 0,033) and Enterococcus (p = 0,031) genera were significantly higher in severe COVID-19 than mild, while the abundance of the Fusobacteriota (p = 0,021), Proteobacteria (p=0,030), and Campilobacterota (p = 0,027) phyla, Neisseria (p = 0,008), and Fusobacterium (p = 0,064) genera, Porphyromonas gingivalis (p = 0,018), Fusobacterium periodonticum (p = 0,001) and Fusobacterium nucleatum (p = 0,022) species were significantly higher in mild. The presence of Prevotella buccae (p=0.005) and Prevotella disiens (p=0.043) bacteria was lower in severe COVID-19. The TNF-α/IL-10 ratio was significantly higher in severe COVID-19 (p < 0.05). Furthermore, IL-6/IL-10, IFN-γ/IL-10, and IL-1β/IL-10 ratio was also higher in severe, but those were not significantly related to the disease severity.

This research supports the relationship between the severity of COVID-19 and microbiota diversity in the upper airway in adults. Further studies are needed to examine the mechanism by which microbiota prevents the COVID-19 severities. The ratio of TNF-α/IL-10 from upper airway swab may be as a predictor of disease severity and alternative for examining cytokine levels in COVID-19 which is less invasive than serum."

"[ABSTRAKTuberkulosis penyakit infeksi yang mematikan terutama di negara berkembang, termasuk Indonesia. Upaya pencegahan dengan vaksinasi BCG yang dapat meningkatkan respon imun masih belum maksimal. Faktor yang mempengaruhi keberhasilan vaksin adalah status imun host, genetik dan kualitas/kuantitas vaksin. Indonesia sebagai negara kaya tanaman obat, misalnya pasak bumi (Eurycoma longifolia Jack) digunakan sebagai antimalaria serta meningkatkan imun tubuh. Penelitian ini menilai efek ekstrak akar pasak bumi sebagai imunomodulator terutama IFN-ɣ, TNF-α dan IL-10 pada mencit yang diberi vaksin BCG. Eksperimental in vivo dan in vitro darah mencit di kultur pada medium RPMI dengan stimulasi PHA dan BCG. Analisis tidak ada perbedaan yang bermakna (p≥0,05) diantara kelompok perlakuan, analisa dari nilai median terlihat adanya efek ekstrak pasak bumi terhadap peningkatan TNF-α, dan tidak berpengaruh terhadap produksi IFN-γ dan IL-10 pada mencit yang divaksin BCG. Ekstrak akar pasak bumi mempengaruhi respon imun tubuh mencit yang diberi vaksin BCG, walau tidak besar maknanya.

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ABSTRACTTuberculosis is a deadly infectious disease that occurs mainly in developing countries, including Indonesia. Preventive efforts by BCG vaccination to improve the immune response is still not maximum. Factors that affect the success of vaccine are the host immune system, the host genetic and the quality/quantity of the vaccine. Indonesia is rich in medicinal plants, one of those is Pasak Bumi (Eurycoma longifolia Jack) that is widely used as antimalaria and to improve immunity. The research assessed the effects of extracts of Pasak Bumi roots as immunomodulator by measuring IFN-ɣ, TNF-α and IL-10 on mice that were given with BCG vaccine. In vivo and in vitro experiments of mice blood cultured in RPMI medium stimulated with PHA and BCG. The result has shown no significant difference (p≥0,05) among the treatment group, result of median values has shown the effect of Pasak Bumi extract to an increase of TNF-α, and has no effect on the production of IFN-γ and IL-10 in mice vaccinated BCG. Extract of pasak bumi roots affects the immune response of mice that have got BCG vaccine, although it has no significant meaning., Tuberculosis is a deadly infectious disease that occurs mainly in developing countries, including Indonesia. Preventive efforts by BCG vaccination to improve the immune response is still not maximum. Factors that affect the success of vaccine are the host immune system, the host genetic and the quality/quantity of the vaccine. Indonesia is rich in medicinal plants, one of those is Pasak Bumi (Eurycoma longifolia Jack) that is widely used as antimalaria and to improve immunity. The research assessed the effects of extracts of Pasak Bumi roots as immunomodulator by measuring IFN-ɣ, TNF-α and IL-10 on mice that were given with BCG vaccine. In vivo and in vitro experiments of mice blood cultured in RPMI medium stimulated with PHA and BCG. The result has shown no significant difference (p≥0,05) among the treatment group, result of median values has shown the effect of Pasak Bumi extract to an increase of TNF-α, and has no effect on the production of IFN-γ and IL-10 in mice vaccinated BCG. Extract of pasak bumi roots affects the immune response of mice that have got BCG vaccine, although it has no significant meaning.]"

"COVID-19 menunjukkan berbagai manifestasi klinis dengan tingkat keparahan berkaitan dengan peningkatan mediator inflamasi yang tidak terkendali. Sebagai terapi potensial COVID-19, penelitian tentang efek imunomodulator SPM telah berlangsung. Penggunaan sekretom SPM memiliki kelebihan daripada penggunaan SPM itu sendiri. Namun demikian, mekanisme dimana sekretom memberikan efek imunomodulatornya sebagai agen terapeutik untuk COVID-19 masih belum jelas. Penelitian ini bertujuan untuk menilai apakah komponen sekretom SPM-TP mampu mengubah karakteristik inflamatorik dari sel-sel imun dengan melakukan studi in vitro dari inkubasi darah lengkap dengan sekretom yang kemudian dipaparkan dengan LPS yang merupakan agen inflamasi kuat. Sebanyak 12 sampel darah subjek COVID-19 dan sehat dikultur ke dalam  tiga kelompok (kelompok kontrol RPMI, kelompok sekretom 3μl, dan 9μl) yang diinkubasi selama 24 jam, kemudian dipaparkan LPS dan diinkubasi selama 48 jam. Supernatan kultur sebelum dan setelah paparan LPS dipanen dan diukur kadar sIL-6R, sgp130, IL-1RA, IL-6, TNF-α, IFN-γ dan IL-10. Hasil penelitian menunjukkan bahwa paparan LPS meningkatkan produksi IL-6, TNF-α, dan IL-10 dan menurunkan produksi  sIL-6R, dan sgp130, sedangkan IFN-γ tidak mengalami perubahan pada kultur darah yang telah diinkubasi dengan sekretom SPM-TP. Analisis rasio post-LPS/pre-LPS dilakukan untuk menyelidiki potensi antiinflamasi sekretom dan ditemukan sekretom SPM-TP ini memberikan efek antiinflamasinya melalui peran IL-1RA.

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COVID-19. However, the precise mechanism by which the secretome exerts its therapeutic effect on COVID-19 remains unclear. This study aims to investigate whether the components of the UC-MSC-derived secretome can alter the inflammatory characteristics of immune cells. To achieve this, an in vitro study will be conducted involving co-incubation of whole blood with secretomes, followed by LPS stimulation. A total of 12 blood samples from severe COVID-19 and healthy subjects were cultured into three groups (RPMI control group, 3μl and 9μl secretome group) incubated for 24 hours. Then, the cultures were exposed to LPS for 48 hours. The levels of sIL-6R, sgp130, IL-1RA, IL-6, TNF-α, IFN-γ, and IL-10 were measured. Results showed that LPS increased IL-6, TNF-α, and IL-10 production, while reducing sIL-6R, and sgp130, but no changes seen in IFN-γ in secretome-incubated blood cultures. The post-LPS/pre-LPS ratio analysis was conducted to investigate the anti-inflammatory potential of secretome. It was found that the secretome provides its anti-inflammatory effects through the role of IL-1RA."

"Latar Belakang: Coronavirus disease 2019 (COVID-19) adalah penyakit infeksi saluran pernapasan yang pertama kali ditemukan di Wuhan. Sejak ditetapkan sebagai pandemi oleh WHO hingga 3 Juli 2021 terdapat sebanyak 183.098.615 kasus terkonfirmasi positif COVID-19 dengan jumlah kematian sebesar 3.964.145 kasus di seluruh dunia. Secara etiologi COVID-19 disebabkan oleh varian coronavirus baru yang dikenal sebagai SARS-CoV-2. Individu yang terinfeksi SARS-CoV-2 sebagian besar mengalami gejala ringan atau asimtomatik. Namun, pada sebagian orang dengan usia lanjut dan mengidap penyakit komorbid manifestasi gejala berat lebih sering ditemui. Salah satu faktor yang berkaitan terhadap manifestasi COVID-19 adalah respons imun host. Molekul sitokin merupakan protein yang berperan untuk mengaktifkan mekanisme perlawanan terhadap virus. Pengetahuan tentang profil imunitas yang diperantarai oleh sitokin dari saluran napas atas masih sangat sedikit sekali yang dipelajari. Penentuan biomarker yang dapat dijadikan penanda keparahan juga perlu untuk diketahui. Metode: Sampel swab NP diperoleh dari pasien terkonfirmasi positif COVID-19. Subjek dibagi menjadi 2 kategori berdasarkan manifestasi COVID-19 gejala ringan dan berat. Kadar sitokin (pg/ml) IL-2, IL-4, IL-10, IL-13, IL-17A, dan GMCSF dianalisis dari sampel swab NP menggunakan Luminex® assay. Hasil: Faktor demografi seperti usia (p=0,024) dan komorbid (p=0,017) secara signifikan berperan dalam menentukan keparahan gejala pada pasien COVID-19. Kadar (pg/ml) IL-2, IL-4, IL-10, IL-13, IL-17A, dan GMCSF antara kedua kelompok pasien COVID-19 gejala ringan dan berat tidak berbeda signifikan. Namun demikian, terdapat kecenderungan bahwa kadar (pg/ml) IL-2, IL-4, IL-13, dan GMCSF meningkat pada kelompok pasien COVID-19 gejala berat. Sedangkan, kadar (pg/ml) IL-10 dan IL-17A cenderung menurun pada pasien COVID-19 yang bergejala berat. Selain itu, rasio antara IL-2/IL-10 secara signifikan (p=0,004) lebih tinggi pada pasien COVID-19 gejala berat. Sebanyak 65,7% pasien COVID-19 dengan gejala berat memiliki nilai rasio IL-2/IL-10 yang tinggi. Kesimpulan: Kadar sitokin (pg/ml) IL-2, IL-4, IL-10, IL-13, IL-17A dan kemokin GMCSF (pg/ml) dari sampel swab NP dapat terdeteksi menggunakan Luminex® assay. Rasio kadar sitokin IL-2/IL-10 dapat dijadikan sebagai kandidat biomarker keparahan infeksi COVID-19 di masa mendatang.

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Background: Coronavirus disease 2019 (COVID-19) is a respiratory tract infectious disease. Since the outbreak in Wuhan, COVID-19 was declared as a pandemic by WHO. Data from July 3rd, 2021, showed that there have been 183,098,615 confirmed positive cases of COVID-19 with a death toll of 3,964,145 worldwide. Etiologically COVID-19 is caused by the new coronavirus known as SARS-CoV-2. The majority of people infected with SARS-CoV-2 experience mild symptoms or even are asymptomatic. However, for some people with older age and having comorbid diseases, severe manifestations are very common. Host immune response is one of the factors which affect disease severity. Playing a vital role in activating the immune system against viruses, cytokine protein can also contribute to the severity. Currently, very little is known about the profile of cytokine-mediated immunity from the upper respiratory tract. This research is aimed to find a potential candidate of biomarkers to predict severity in the early phase of COVID-19 infections.

Methods: NP swab samples were obtained from patients who were positively confirmed for COVID-19. Subjects were divided into 2 categories based on the manifestation as mild or severe symptoms of COVID-19. Cytokine levels (pg/ml) of IL-2, IL-4, IL-10, IL-13, IL-17A, and GMCSF were analyzed from NP swab samples using Luminex® assay.

Results: Demographic factors such as age (p=0.024) and comorbidities (p=0.017) significantly played a role in determining severity of COVID-19 patients. The levels (pg/ml) of IL-2, IL-4, IL-10, IL-13, IL-17A, and GMCSF between the two groups of patients with mild and severe COVID-19 symptoms were not significantly different. However, there was a tendency that the levels (pg/ml) of IL-2, IL-4, IL-13, and GMCSF to increase in the group of patients with severe COVID-19 symptoms. Meanwhile, levels (pg/ml) of IL-10 and IL-17A tend to decrease in COVID-19 patients with severe symptoms. In addition, the ratio of IL-2/IL-10 was significantly (p=0.004) higher in severe COVID-19 patients. A total of 65.7% of COVID-19 patients with severe symptoms had high values of IL-2/IL-10 ratio.

Conclusion: Cytokine levels (pg/ml) of IL-2, IL-4, IL-10, IL-13, IL-17A, and GMCSF from NP swab samples can be detected using the Luminex® assay. The ratio of IL-2/IL-10 cytokine levels can be used as a biomarker candidate to predict severity for COVID-19 infection in the future."

"ABSTRAKPasien kanker umumnya mengalami penurunan berat badan terkait kaheksia. Patofisiologi kaheksia kanker multifaktorial, termasuk efek sitokin pro inflamasi dan inflamasi sistemik. Profil asam amino plasma pada pasien kanker mengalami perubahan. Deplesi protein dapat terjadi akibat asupan yang menurun atau efek langsung dari tumor. Penelitian ini bertujuan untuk mengetahui profil dan hubungan antara asam amino serum, status nutrisi dan sitokin-sitokin pro-anti inflamasi, serta sel T helper 17 pada pasien kaheksia kanker paru. Penelitian potong lintang dengan consecutive sampling pada pasien kanker paru dengan kaheksia ini mengambil subjek berusia lebih dari 18 tahun dan belum diterapi atau sudah selesai terapi lebih dari 2 bulan di Rumah Sakit Kanker Dharmais. Analisis asupan dilakukan dengan food frequency questionnaire semikuantitatif dan 24-hours food recall. Pemeriksaan asam amino serum dengan metode spektofotometri, Sel T helper-17 dengan metode flowcytometry, dan C-reactive protein dengan metode latex agglutination, serta kadar IL 17, IL 6 dan TNFα dengan metode ELISA. Data yg didapat kemudian di analisis dengan uji T atau Mann Whitney untuk melihat hubungan dan untuk menganalisis hubungan dalam tabel digunakan uji Chi-Square atau Fischer Exact, sedangkan untuk korelasi digunakan uji Pearson atau Spearman. Asam amino triptofan, asparagin, glutamin, valin, lisin dan sistein berkorelasi positif dengan sitokin anti-inflamasi dan status nutrisi, sebaliknya negatif dengan sitokin pro inflamasi. Asam amino fenilalanin, treonin, dan glutamat berkorelasi positif dengan sitokin pro-inflamasi dan berkorelasi negatif dengan status nutrisi dan sitokin anti inflamasi. Khusus aspartat, selain berkorelasi positif dengan sitokin pro inflamasi, juga berkorelasi positif dengan indeks massa tubuh, tetapi menunjukkan korelasi negatif dengan penurunan berat badan. Beberapa asam amino serum terbukti berhubungan dengan status sitokin dan status nutrisi pada subjek kanker paru dengan kaheksia, sehingga perlu menjadi perhatian dalam terapi nutrisi pasien kankerKata kunci: asam amino serum, status nutrisi, sitokin, kaheksia kanker

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ABSTRACTCancer patients generally experience weight loss associated with cancer cachexia. The pathophysiology of cancer cachexia is multifactorial, including the effects of pro inflammatory cytokines and systemic inflammation.. The plasma amino acid profile was found to significantly undergo changes in cancer patients. Protein depletion can occur due to decreased intake or direct effects of tumors on protein metabolism. This study aimed to determine the profile and relationship between serum amino acids, nutritional status and pro-anti-inflammatory cytokines, and T helper 17 cells in lung cancer cachexia patients. This cross-sectional study with consecutive sampling in lung cancer patients with cachexia took subjects over the age of 18 years and who had not been treated or who had finished therapy for more than 2 months at the Dharmais Cancer Hospital. Dietary intake analyses were carried out with semiquantitative food frequency questionnaire and 24-hour food recalls. Blood tests were carried out in the form of serum amino acids, cytokines, C-reactive protein and T helper 17 cells. Data obtained were then analyzed by the T or Mann Whitney test to see the relationship and to analyze relationships in the table used chi-square or Fischer Exact, while for correlation used Pearson or Spearman test. The amino acids tryptophan, asparagine, glutamine, valine, lysine and cysteine were positively correlated with anti-inflammatory cytokines and nutritional status, and negatively correlated with pro-inflammatory cytokines. Phenylalanine, threonine and glutamate amino acids were positively correlated with pro-inflammatory cytokines and negatively correlated with nutritional status and anti-inflammatory cytokines. Aspartate showed a positive correlation pro inflammatory cytokines and body mass index, but a negative correlation with weight loss. Some serum amino acids have been shown to be related to cytokines and nutritional status in lung cancer cachexia patients, so it should be a concern in nutritional therapy for cancer patients"

"ABSTRAKObat anti-inflamasi nonsteroid (OAINS) nonselektif banyak digunakan oleh lansia. OAINS nonselektif oral memiliki efek samping terhadap gastrointestinal baik lokal maupun sistemik. Oleh karena itu, diperlukan rute untuk menghantarkan OAINS nonselektif yang nyaman dan efek samping yang minimal. Salah satunya rute alternatif yaitu penghantaran melalui kulit yang disebut rute transdermal. Stratum korneum menjadi tantangan utama dalam rute transdermal. Hal ini dapat dibantu dengan adanya peningkat penetrasi agar jumlah obat dapat mencapai efek terapeutiknya. Peningkat penetrasi sintesis menyebabkan berbagai masalah. Terpen, minyak atsiri, dan asam lemak dapat diperoleh dari alam. Minyak atsiri daun zodia (Evodia suaveolens) memiliki kandungan terpen yaitu linalool, alfa-pinen, dan limonen. Tinjauan ini membahas mengenai hubungan antara OAINS nonselektif dengan sistem penghantaran transdermal, pengaruh peningkat penetrasi dari alam terhadap OAINS nonselektif, serta potensi minyak atsiri daun zodia sebagai peningkat penetrasi pada OAINS nonselektif. Sistem penghantaran transdermal dapat mengurangi efek samping lokal yang terdapat pada gastrointestinal, selain itu sistem transdermal nyaman dan mudah digunakan. Peningkat penetrasi dapat menjadi alternatif untuk peningkat penetrasi sintesis OAINS nonselektif. Dari beberapa penelitian menunjukkan bahwa peningkat penetrasi dari alam mampu meningkatkan penetrasi obat melalui kulit. Kandungan minyak atsiri daun zodia mengandung linalool, alfa-pinen, dan limonen yang dapat berpotensi untuk menjadi peningkat penetrasi OAINS nonselektif. Untuk memperbaiki dari penelitian-penelitian sebelumnya, maka disarankan penelitian dilengkapi dengan membandingkan pengaruh dari kontrol, peningkat penetrasi sintesis (sebagai standar), serta peningkat penetrasi uji; uji kompatibilitas; penggunaan membran hewan (tikus/kelinci) pada uji in vitro; serta uji mekanisme kerja dari peningkat penetrasi

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ABSTRACT

Non-selective anti-inflammatory drugs (NSAIDs) are widely used by the elderly. Oral non-selective NSAIDs have side effects on both local and systemic gastrointestinal. Therefore, a route is needed to deliver convenient non-selective NSAIDs and minimal side effects. One alternative route is delivery through the skin called the transdermal route. The stratum corneum is the main challenge on the transdermal route. This can be helped by increasing penetration so that the amount of drug can reach its therapeutic effect. Synthesis penetration enhancers causes various problems. The terpenes, essensial oil, and fatty acid can be obtained from nature. Zodia (Evodia suaveolens) contain terpenes namely linalool, alpha-pinene, and limonene. This review discusses the relationship between non-selective NSAIDs and transdermal delivery systems, the effect of penetration enhancers from nature on non-selective NSAIDs, and the potential of Zodia as penetration enhancers in non-selective NSAIDs. The transdermal delivery system can reduce the local side effects in the gastrointestinal, besides that the transdermal system is comfortable and easy to use. Penetration enhancers can be an alternative to synthesis penetration enhancers nonselective NSAIDs. Several studies shown that natural penetration enhancers can increase drug penetration through the skin. The zodia leaf oil contains linalool, alpha-pinene, and limonene which can be potential to increase penetration of non-selective NSAIDs. To improve from previous studies, it is recommended that research should be completed by comparing the effects of controls, synthetic penetration enhancers (as a standard), and penetration enhancer test; compatibility test; use of animal membranes (mice/rabbits) for in vitro tests; and the mechanism action of penetration enhancers testing.

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