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"A patient is said to be immuno-compromised (1C) if one or more of his or her natural and adaptive defense mechanisms are unable to function normally. Thus, immuno-compromised patients are easily susceptible to infection. Aim of study; to determine the immune response in immuno-compromised patients that makes them easily susceptible to infection. Method: the study was designed as a cross-sectional analytic observational study using multi-variant statistical tests. The samples were classified into the 1C and Non-iC groups, consisting of 14 people, 10 men, and 4 women, who were examined far the following immunologi-cal variables: IL-10, IFN-y, TNF-a, IL-I& IgG, C3, and C4. The results demonstrated a significant difference in the immune response of subjects from the 1C and NIC groups (p<0.05), with a significantly higher TNF-Ct, IL-10 and IgG levels, and a lower C3 level in the 1C group. Conclusion: during 1C conditions, there is a disorder in the natural as well as adaptive C3 natural immune system, making patients more susceptible to infection."

"In the past couple of years, several studies have demonstrated that T- helper cells play an important role in the induction and reaction process of allergy. The T-helper cell (T-h) is a kind of T lymphocyte. At first, in the year 1921 Praustniz and Kustner, as quoted by Romagnani, stated the concept that allergy is an interaction between allergens and the IgE (Immunoglobulin E) specific antibody that is attached to IgE receptors on mast cells or mastocytes, which would then release its mediators. Other factors that also play a role in the development of allergy is lymphokine, produced by T-cells, which regulate IgE antibody production by the B-cell.1 Lymphokine or cytokine is a hormone-like substance released by T-cells, B-cells, or other cells, that function as intercellular signaling substances in the regulation of immune responses towards outside stimuli.'"

"Human Immunodeficiency Virus (HIV) causes damage to the human immune system and the disease known as Acquired Immune Deficiency Syndrome (AIDS). This virus is a member of the Lentivirus group of viruses of the Retrovirus subfamily, which has a reverse tran-scriptase enzyme. HIV infects cells which expres CD4, mediated by gp 120. HIV infection changes the lymphocyte migration pattern, the activity of cytotoxic T cells and CD4 T cell count. The T cell CD4+ count is related to the progressivity of the disease.Anti gp 120 is the antibody most abundantly produced during HIV infection. Spesific antibody concentration for the antigens vary among individuals and single individual at different stages of the infection. Expression of the HIV antigen and/or antibody can be used to establishing the diagnosis and determine the stage of the disease. CD4+ cells count can be used to determine the stage of HIV infection, to predict the occurance of opportunistic infection and other complications, and to determine as well as to monitor therapy"

"ABSTRAKLatar belakang: Infeksi HIV masih banyak ditemukan di Indonesia saat ini. Terapi antiretroviral telah merubah morbiditas dan mortalitas pasien terinfeksi HIV, dan juga merubah manifestasi oral HIV/AIDS, termasuk kandidiasis orofaring KOF . Dalam penelitian ini dieksplorasi peran faktor genetik dan respons imun pasien terinfeksi HIV dengan dan tanpa KOF, sebelum dan sesudah terapi ARV.Metode: Subyek penelitian sebesar 82 pasien terinfeksi HIV, ARV-na ve dengan jumlah sel T CD4

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ABSTRACTBackground HIV infection remains common in Indonesia nowadays. Antiretroviral therapy ART has altered morbidity and mortality of HIV infected people, and also altered oral manifestation of HIV AIDS, including oropharyngeal candidiasis OPC . Here we explore the role of host genetic factors and immune responses in HIV infected patients beginning ART.Methods This study included 82 ARV na ve HIV infected patients with "

"Latar Belakang: Anak-anak yang menderita stunting memiliki berbagai kekurangan jika dibandingkan anak-anak sebayanya yang memiliki HAZ normal, baik dari segi pertumbuhan fisik, emosional, maupun dalam sistem imun. Salah satu komponen sistem imun yang ada dalam tubuh adalah sitokin proinflamasi interleukin-18 yang berperan sebagai faktor kemotaksis sel T, basofil, serta neutrofil, penginduksi interleukin lainnya, serta menginduksi sel Th1 dan IFN- I³. Tujuan: Menganalisis ekspresi gen IL-18 pada anak stunting jika dibandingkan dengan anak dengan HAZ normal, menganalisis korelasi antara status stunting, ekspresi IL-18, status infeksi cacing, serta status OHI-S. Metode: Sampel diambil dari bahan biologis tersimpan berupa RNA cairan sulkus gingiva anak 6-8 tahun di Nusa Tenggara Timur (NTT) (n=8). Kemudian dilakukan ekstraksi RNA, sintesis cDNA, pre amplifikasi, dan kemudian dilakukan real-time PCR. Hasil: Tidak ditemukan perbedaan bermakna secara statistik pada ekspresi gen IL-18 anak stunting dibanding anak dengan HAZ normal (p ≥ 0,05) dan tidak pula ditemukan korelasi baik antara status stunting dan status infeksi cacing, ekspresi IL-18 dan status infeksi cacing, status stunting dan OHI-S, maupun ekspresi gen IL-18 dan status OHI-S (p ≥ 0,05). Kesimpulan: Meskipun ditemukan adanya downregulation pada ekspresi gen IL-18 anak stunting jika dibandingkan anak normal, perbedaan tersebut tidak bermakna secara statistik Tidak ditemukan korelasi pada ekspresi gen IL-18, status infeksi cacing, serta status OHI-S.

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Background: Stunted children have many handicaps compared to their normal age counterparts who have normal HAZ, either in physical growth, emotional growth, or in their immune system. Interleukin-18 is a part of the immune system, a proinflammatory cytokine that acts as a chemotaxis factor for T-cell, basophil, neutrophil, and inducts IFN- γ, Th1, and other cytokines.

Purpose: To analyze IL-18 expression in stunted children compared to their normal age counterpart, to analyze the correlation between stunting status, IL-18 expression, helminths infection status, and OHI-S.

Methods: Samples were stored biological material, taken from 6 to 7 years old’s gingival crevicular fluid from NTT (n=8). RNA was extracted from samples, then synthesized to cDNA, preamplified, and analyzed in RT-PCR. 

Results: The difference in IL-18 expression in stunted children compared to children with normal HAZ was not statistically significant.  There were no correlation between stunting status and helminths infection status, IL-18 expression and helminths infection status, stunting status, and OHI-S, nor IL-18 expression and OHI-S.

Conclusion: Even though a downregulation in IL-18 expression in stunted children compared to children with normal HAZ was found, the difference was not statistically significant. There was also no correlation between IL-18 expression, helminths infection status, and OHI-S status. "

"Inflamasi periodontal merupakan kelainan periodontal dengan prevalensi tinggi di masyarakat. Periodontitis kronis dipengaruhi oleh akumulasi plak dan kalkulus sebagai faktor local, ditambah faktor sistemis misalnya diabetes mellitus (DM) dan infeksi HIV. Sitokin terutama IL-1β sebagai mediator inflamasi utama penyakit periodontal, menstimulasi ekspresi iNOS (inducible nitric oxide synthase) dan produksi NO (nitric oxide) oleh sel β, menyebabkan disfungsi sel β. Leukotoksin dan protease yang dihasilkan patogen periodontal menyebabkan jejas kemotaktik dan fagositotik, dan menurunkan fungsi fagositosis PMN. Hiperglikemia pada penyandang DM menyebabkan peningkatan kadar kalsium sitosol (Ca2+), yang menyebabkan disfungsi PMN dan menurunkan fungsi fagositosis. Advanced glycosilation endproduct pada DM tipe 2 berikatan dengan monosit menyebabkan peningkatan sitokin proinflamasi (IL-1, TNFα) dan menyebabkan aktivasi makrofag dan osteoklas. Hiperglikemia menyebabkan aktivasi diasil gliserol (DAG)-protein kinase C (PKC), yang menyebabkan peningkatan PGE2 dan ekspresi sitokin yang mempengaruhi proses inflamasi dan destruksi. Penelitian tentang pengaruh scaling (pembersihan karang gigi sebagai tindakan non-bedah pada terapi periodontal) pada penyandang DM terhadap kadar gula darah dan respons imun selular belum pernah dilakukan di Indonesia. Penelitian ini bertujuan menganalisis pengaruh pembersihan karang gigi terhadap kadar IL-1β, fungsi fagositosis PMN dan kadar glukosa darah penyandang DM tipe 2. Subyek penelitian adalah penyandang DM tipe 2, 60 penyandang DM Terkendali dan 60 penyandang DM Tidak Terkendali di Poliklinik Metabolik-Endokrin RSUPN Ciptomangunkusumo, umur 40-60 tahun. Subyek dibagi menjadi kelompok perlakuan dan kelonpok tanpa perlakuan, untuk menilai respons imun selular dan status DM, sebelum dan 6 minggu sesudah perlakuan. Analisis statistik (t test) dengan komputer menggunakan perangkat Stata 7,0 dilakukan untuk membandingkan parameter sebelum dan sesudah scaling pada kedua kelompok. Hasil penelitian menunjukkan bahwa scaling dapat menurunkan kadar IL-1β dan meningkatkan fungsi fagositosis secara bermakna (P<0,05), menurunkan kadar glukosa puasa, glukosa 2 jam PP dan kadar HbA1c, tetapi penurunannya secara statistik tidak bermakna (P>0,05), kecuali penurunan kadar HbA1c pada DM Tidak Terkendali (P=0,00).

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AbstractPeriodontal inflammation is a periodontal disorder of high prevalence in the population. Chronic periodontitis is associated with the accumulation of plaque and calculus as local factors, and systemic factors such an diabetes mellitus (DM) and HIV infection. Cytokine, especially IL-1β as inflammatory mediator for periodontal disease, may directly stimulated iNOS (inducible nitric oxide synthase) expression and NO (nitric oxide) production by β-cells, resulting in NO-mediated β-cell damage. The leucotoxin and proteases produced by periodontal pathogens will induce chemotactic and phagocytotic defect; therefore causing decreased PMN phagocytotic function. Hyperglicemia which occurs in diabetic patients increases calcium influx to the cell, resulting in the increased cytosol?s calcium ([Ca 2+]i) level and; therefore, resulting in dysfunction of PMN and impaired PMN phagocytotic function. Advanced glycosilation endproduct in NIDDM binds to monocytes resulting in the increase of pro-inflammatory cytokines (IL-1, TNFβ) and produces activation of macrophages and osteoclasts. Hyperglicemia activates diacyl glycerol (DAG)-protein kinase C (PKC), thus increasing PGE2 and cytokine expression that induce inflammation and periodontal tissue destruction processes. Studies on the effect of scaling to remove calculus disposition on blood glucose control and cellular immune response in DM patient has never been carried out. The aim of the study was to analyze the effect of scaling as non-surgical periodontal therapy on immune response (IL-1β level and PMN phagocytotic function) and blood glucose level of type 2 diabetic patients. Subjects were diabetic patients, 60 controlled-DM (CDM) and 60 uncontrolled-DM (UCDM), in Metabolic-Endocrinology Clinic of Ciptomangunkusumo Hospital, aged 40-60 years. The subjects were divided into treatment (scaling) and control group, and cellular immune response and diabetic status, before and 6 weeks after treatment were evaluated. Statistical analysis (t test) were done using Stata 7.0 software, to compare the parameters before and after scaling in CDM and UCMD subjects. The results showed that scaling decreased IL-1β level and increased phagocytotic function significantly (P<0.05). Scaling decreased fasting and 2 hours post-prandial blood glucose levels and HbA1c level, but the decrease were not significant statistically (P>0.05), except for the decrease in HbA1c level in uncontrolled DM (P=0.00)."

"The updated second edition of Cutaneous manifestations of infection in the immunocompromised host is an invaluable reference for physicians and ancillary medical professionals involved in the care of patients with impaired immune systems due to cancer, chemotherapy, systemic steroids and other immunosuppressive drugs, HIV/AIDS or organ transplantation. This volume will help you recognize skin lesions and diagnose their infectious cause. Textbook features include, over 350 color images demonstrating pathognomonic, atypical, rare and routine skin lesions. Tables for differential diagnosis of different skin lesions in the immunocompromised host. Complete coverage of infectious pathogens with the patterns of infection and the likely causes in different clinical settings (HIV/AIDS versus solid organ transplantation versus neutropenia post-chemotherapy versus bone marrow recovery post hematopoietic stem cell transplantation. New chapter discussing the role of viruses causing malignancies with cutaneous signs in the immunocompromised patient. "

"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.

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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."