Hasil Pencarian  ::  Simpan CSV :: Kembali

Abstrak :
Latar Belakang: Keberhasilan terapi Imatinib Mesylate (IM) pada pasien Leukemia Granulositik Kronik (LGK) di Indonesia berbeda dari yang dilaporkan di luar negeri. Diduga karena adanya faktor-faktor lain yang memengaruhi keberhasilan terapi tersebut. Salah satu faktor yang diduga berpengaruh adalah telah terjadinya mutasi gen BCR-Abl sebelum pemberian terapi. Adanya mutasi diperkirakan akan memengaruhi pencapaian CHR bulan ke-3, -6 dan -12, serta MMR bulan ke-18. Metoda: Penelitian nested case control yang dimulai sejak tanggal 1 September 2009 hingga setidaknya 18 bulan pengamatan (waktu untuk melakukan evaluasi, yaitu tercapai atau tidaknya MMR), dilakukan terhadap 88 pasien yang telah dinyatakan positif menderita LGK. Terhadap seluruh subjek penelitian diberikan terapi IM dengan dosis 400 mg sehari. Hasil Penelitian: Pada penelitian ini diikutsertakan 88 pasien, dengan subjek lelaki 55 orang (62,5 %) dan perempuan 33 orang (37,5 %). Untuk mendeteksi mutasi gen BCR-Abl dan selanjutnya dilakukan sekuensing, dari 88 pasien di atas yang berhasil diperiksa hanya 44 pasien. Kaitan antara mutasi gen BCR-Abl hanya bemakna dengan CHR bulan ke-6, tetapi sangat bermakna dengan MMR. Ditemukan 8 jenis mutasi pada 7 pasien pada daerah P-loop dan di luar P-loop, tidak terlihat adanya mutasi yang dominan. Rerata usia pasien adalah 39 tahun, 42 berusia ≥ 39 tahun dan 46 pasien < 39 tahun. Risiko Sokal pada saat pertama kali dilakukan diagnosis, adalah sebagai berikut: low 39,8 %, intermediate 22,7 %, dan high 37,5 %. Berdasarkan pemeriksaan BMP, perincian fase adalah sebagai berikut: kronik 72,7 %, akselerasi 23,9 % dan krisis blastik 3,4 %. Median lama sakit didapatkan nilai 2 bulan. Sebanyak 73,9 % pasien telah mendapat terapi awal dengan HU, sebelum mendapat IM. Berdasarkan lama pemberian HU sebelum terapi IM, sebanyak 27,3 % pasien mendapatkan terapi HU ≥ 6 bulan. Semua faktor-faktor di atas tidak tebukti mempunyai hubungan bermakna dengan pencapaian MMR. Setelah pemberian IM dilakukan evaluasi CHR 3 bulan, 6 bulan, dan 12 bulan. Terbukti adanya hubungan antara pencapaian CHR pada bulan ke-3, ke-6, dan ke-12, dan antara CHR bulan ke-3, ke-6, maupun ke-12 dengan MMR. Belum dapat diformulasikan faktor prediksi untuk pencapaian MMR bulan ke-18, namun mutasi gen BCR-Abl dan pencapaian CHR bulan ke-3 dan ke-12 sangat kuat keterkaitannya dengan pencapaian MMR, sehingga dapat digunakan sebagai prediktor keberhasilan terapi. Simpulan: Mutasi gen BCR-Abl yang dideteksi di awal terapi, cenderung berperan dalam perjalanan klinis pasien LGK di Indonesia. Keberhasilan pencapaian CHR bulan ke-3, dan ke-12 berperan sebagai faktor prediktor untuk tercapainya MMR bulan ke-18. ......Background: The success of Imatinib Mesylate (IM) therapy in patients with Chronic Myeloid Leukemia (CML) in Indonesia is different from abroad. Allegedly there are other factors that influence the success of the treatment. One of the factors suspected is the occurrence of mutation in BCR-Abl gene prior to therapy. Mutation is expected to affect the achievement of CHR in –the 3rd, -6th and -12th months, and MMR in the -18th month. Methods: nested case-control study, started September 1th 2009 until at least 18 months of observation (time to perform the evaluation, namely whether the MMR were achieved or failed), carried out to 88 patients who were proven positive suffered from CML through cytomorphology examination of bone marrow aspirate and qualitative PCR method. All research subjects were given IM therapy dosage 400 mg daily. Results: This study included 88 patients, with 55 male (62.5 %) and 33 female (37.5 %). To detect BCR-Abl gene mutations and continued with sequencing test, from 88 patients recruited, only 44 patients were succeeded performing the test. The correlation between mutation and CHR only significant for CHR 6 months, but the result from MMR was very significant. We found 8 mutations out of 7 patients at P-loop and outside P-loop region, no predominant mutation that was recorded. The mean age of patients was 39 years, 42 were aged ≥ 39 years and 46 were < 39 years. Sokal's risk at the first diagnosis, were as follows: low 39.8 %, intermediate 22.7 %, and high 37.5 %. Based on BMP examination, details of the phases were as follows: chronic 72.7 % patients, acceleration 23.9 % patients and blastic crisis of 3.4 %. Patients. Median duration of illness obtained at a value of 2 months 60.2 % patients had duration of illness ≥ 2 months and 39.8 % patients < 2 months. A total of 73.9 % patients had received initial therapy with hydroxyurea, before given IM. Based on the duration of HU prior IM therapy 27.3 % patients received hydroxyurea therapy ≥ 6 months. All the above mentioned factors were not proven to have significant relationship with the achievement of MMR. After IM administration, CHR evaluated every -3rd, -6th, and 12th months. It was proven that the achievement CHR in the -3rd, -6th, and - 12th month, besides between CHR in the -3rd, -6th and -12th month with MMR. Yet the achievement of CHR in the-3rd and -12th months were strongly related to the achievement of MMR, with the result it can be used as the single predictor of successful therapy. Conclusions: BCR-Abl’s gene mutation that was detected at the early of therapy, tend to play a role in the success therapy of IM in Indonesia. The success of the achievement of CHR of the -3rd and -12th month played a role as a factor of predictor for the achievement of MMR in the -18th month.

Abstrak :
This book focuses on new small molecule approaches to combat viral infections. The chapters describe the discovery and development from bench through the clinic of relatively recently-approved antiviral drugs and compounds in advanced clinical development. Organized by a virus (such as HIV, HCV, RSV, influenza, HBV and CMV) and written by top academic and industrial authorities in the field, the book provides a unique opportunity to study, understand and apply discovery and development principles and learning without the need for an individual to research, analyze and synthesize all immense sourcing references. Topics showcase challenges and solutions of issues encountered, offeringtremendous experience accumulated over many years of research that will be particularly useful to basic and bench scientists as well as clinicians as they continue discovering and developing new drugs and therapies.

Abstrak :
ABSTRACT
Untuk mengantisipasi kemungkinan penggunaan obat anti-integrase sebagai pengobatan infeksi HIV-1 di Indonesia, pengembangan uji resistensi genotipik untuk anti-integrase sangat penting dilakukan untuk mengidentifikasi profil genetik resistensi obat untuk galur HIV-1 di Indonesia. Penelitian ini bertujuan untuk mengamplifikasi daerah sasaran dalam gen integrase yang mengandung mutasi genetik yang diketahui dapat menimbulkan resistensi terhadap obat anti-integrase dari HIV-1 subtipe CRF01_AE dan B di Indonesia. Sebelas sampel plasma dari individu terinfeksi dengan HIV-1 diperoleh dari arsip di PRVKP FKUI-RSCM. Salah satu sampel plasma mengandung HIV-1 subtipe B sedangkan sampel plasma lainnya mengandung subtype CRF01_AE. Daerah sasaran untuk semua sampel telah diamplifikasi melalui RT-PCR, dengan suhu anil 55 C menggunakan pasangan primer AE_POL 4086F dan AE_POL 5232R yang telah dirancang oleh VCPRC FKUI -RSCM. Berdasarkan hasil penelitian ini, 18,2 2/11 dari sampel berhasil diamplifikasi melalui RT-PCR satu langkah. Pasangan primer tersebut efektif untuk mengamplifikasi wilayah sasaran dalam urutan gen integrase untuk subtipe B 100 ; 1/1 tetapi memiliki efektivitas yang rendah 10 , 1/10 untuk subtipe CRF01_AE. Primer pasangan dapat digunakan untuk mengamplifikasi wilayah sasaran di HIV-1 subtipe CRF01_AE dan B di Indonesia. Namun, optimasi kondisi PCR dan jumlah sampel yang lebih banyak diperlukan untuk menentukan efektivitasnya dengan akurat.

---

ABSTRACT
In order to anticipate the potential use of anti integrase drugs in Indonesia for treatment of HIV 1 infection, the development of a drug resistance genotyping assay for anti integrase is crucial in identifying the genetic drug resistance profile of Indonesian HIV 1 strains. This experiment was aimed to amplify a target region in the integrase gene of Indonesian HIV 1 subtypes CRF01 AE and B that contain genetic mutations known to confer resistance to anti integrase drug. Eleven archived plasma samples from individuals living with HIV 1 were obtained from VCPRC FKUI RSCM laboratory. One of the plasma sample contain HIV 1 subtype B while the remaining plasma samples contain subtype CRF01 AE. The target region for all samples were amplified through RT PCR, with an annealing temperature of 55 C using the primer pair AE POL 4086F and AE POL 5232R that were designed by VCPRC FKUI RSCM. Based on the results of this experiment, 18.2 2 11 of the samples were successfully amplified through one step RT PCR. The primer pair was effective in the amplifying the target region in integrase gene sequence for subtype B 100 1 1 but it has a low efficacy 10 , 1 10 for subtype CRF01 AE. In conclusion, the primer pair can be used to amplify the target region in Indonesian HIV 1 strains subtypes CRF01 AE and B. However, optimization of PCR condition and the use of more samples are required to determine its efficacy accurately.