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Abstrak :
Psoriasis merupakan penyakit autoimun yang disebabkan kelainan genetik dan dipicu faktor lingkungan, penyakit ini menyerang kulit dan sistemik seperti sendi dan kuku. Sel punca mesenkim (SPM) asal tali pusat manusia memiliki kapasitas proliferasi yang tinggi, imunomodulator yang luas dan imunogenitas yang rendah. Penelitian ini menggunakan model tikus psoriasis yang diinduksi dengan krim imiquimod 5% selama 6 hari. Tikus dibagi menjadi kelompok 5 kelompok yang diberi SPM atau Phosphate Nuffer Saline (PBS) secara intradermal atau subkutan serta kontrol normal. Pemberian SPM dan PBS dilakukan sebelum pengolesan krim. Penilaian harian kulit tikus dilakukan dengan skoring modified Psoriasis Area and Severity Index (mPASI). Setelah pembedahan, kulit tikus dianalisa terhadap ekspresi relatif gen Interleukin (IL)-17 dan IL-10. Sebagian kulit difiksasi dengan formalin dan dilakukan pemeriksaan histologi dan imunohistokimia dengan antibodi Anti-CD11b. Analisa statistik memperlihatkan skor mPASI kelompok SPM mengalami penurunan bermakna dibanding kelompok PBS. Ekspresi relatif gen IL-17 menurun dan gen IL-10 meningkat pada kelompok SPM dibandingkan PBS. Pewarnaan Hematoksilin dan Eosin memperlihatkan rerata tebal epidermis dan jumlah kapiler mengalami penurunan pada kelompok SPM dibanding PBS. Rerata jumlah infiltrasi sel CD11b+ kelompok SPM menurun secara bermakna dibandingkan PBS. Penyuntikan SPM terutama intradermal mampu menyebabkan remisi pada lesi lokal kulit psoriasis pada model tikus Wistar. ......Psoriasis is a chronic inflammatory disease affecting mainly the skin and other parts such as nails and joints. Human umbilical cord-derived mesenchymal stem cells (hUC-MSCs) are highly proliferative immunomodulator cells with low immunogenicity. The Psoriasis rat model was induced with 5% imiquimod cream for 6 days. The rats were divided into 5 groups receiving intradermal or subcutaneous injections of hUC-MSCs or Phosphate Buffer Saline (PBS), and a normal control group. MSCs and PBS were administered before cream application. Daily skin assessments were performed using a modified Psoriasis Area and Severity Index (mPASI) scoring system. After harvest, rat skin was analyzed for relative expression of Interleukin (IL)-17 and IL-10 genes. Some skin samples were fixed with formalin for histological examination and immunohistochemistry with Anti-CD11b antibodies. Statistical analysis showed a significant reduction in mPASI scores in the hUC-MSCs group compared to the PBS group. Histology staining revealed a decrease in epidermal thickness and capillary in the hUC-MSCs group. The infiltration of CD11b+ cells significantly decreased in the hUC-MSCs group.  The relative gen expression of IL-17 decreased, while IL-10 gene increased in the hUC-MSCs group. Particularly, intradermal injection of hUC-MSCs induced remission of local psoriasis skin lesions in the rat model.

Abstrak :
This volume of current topics in microbiology and immunology covers diverse topics related to intradermal immunization. The chapters highlight the effectiveness of intradermal immunization in experimental animal models or in clinical practice, all supporting the view that intradermal immunization is at least as good as other immunization routes. Keeping in mind that current vaccines are not specially designed for intradermal immunization, but show comparable efficiency even at reduced dosages, this underlines the great potential for the skin as a vaccination site.

Abstrak :
Pendahuluan: Berbagai modalitas terapi yang tersedia untuk melasma belum memberikan hasil yang memuaskan serta kekambuhan sering terjadi setelah terapi dihentikan. Asam traneksamat merupakan penghambat plasmin yang dapat mencegah melanogenesis. Beberpa studi telah membuktikan efek injeksi asam traneksamat (AT) intradermal sebagai terapi melasma, namun belum ada sebuah konsensus yang menentukan konsentrasi injeksi AT intradermal yang paling tepat dan efektif. Di Indonesia, belum pernah dilakukan uji klinis yang membandingkan efektivitas dan keamanan injeksi AT intradermal dengan konsentrsi yang berbeda untuk tata laksana melasma. Tujuan Penelitian: Membandingkan efektivitas dan keamanan injeksi AT intradermal konsentrasi 25 mg/ml dengan 10 mg/ml sebagai terapi ajuvan pada tata laksana melasma. Metodologi penelitian: Penelitian ini merupakan uji klinis acak terkontrol tersamar ganda dengan metode split-face. Sebanyak 30 subjek penelitian (SP) dirandomisasi untuk mendapatkan injeksi AT intradermal 25 mg/ml atau 10 mg/ml pada salah satu sisi wajah. Penelitian dilakukan selama 8 minggu dan terapi injeksi diberikan sejak minggu ke-2 dengan interval 2 minggu. Seluruh SP mendapatkan terapi krim tabir surya SPF 45 dan krim tretinoin 0,05% yang dioleskan sekali sehari malam hari selama 8 minggu. Penilaian skor MASI modifikasi (mMASI) dan pemeriksaan mexameter yang terdiri atas indeks melanin (IM) dan eritema (IE) dilakukan pada setiap kunjungan. Hasil penelitian: Terdapat 27 SP yang menyelesaikan penelitian dengan rerata usia 49,67 tahun dan sebagian besar memiliki melasma tipe campuran. Terdapat penurunan bermakna skor mMASI dan IM pada pemberian terapi ajuvan injeksi AT intradermal 25 mg/ml dan 10 mg/ml, namun besar dan kecepatan penurunan skor tersebut tidak berbeda bermakna pada konsentrasi 25 mg/ml dibandingkan dengan 10 mg/ml. Mayoritas SP tidak mengalami efek samping bermakna akibat injeksi AT. Kesimpulan: Terapi ajuvan injeksi AT intradermal 25 mg/ml dan 10 mg/ml efektif dan aman dalam menurunkan skor mMASI dan IM pada pasien melasma dengan tipe kulit Fitzpatrick IV dan V. ......Background: The various treatment modalities available for melasma have yet to provide satisfactory results, and recurrence often occurs after discontinued therapy. Tranexamic acid (TA), a plasmin inhibitor, can prevent melanogenesis. Several studies have demonstrated the effectiveness of intradermal injections of TA as a treatment for melasma. However, there is no consensus on the most appropriate and effective concentration for these injections. In Indonesia, no clinical trials have been conducted to compare the effectiveness and safety of intradermal TA injections at different concentrations to manage melasma. Research Objective: Comparing the effectiveness and safety of intradermal TA injections at 25 mg/ml and 10 mg/ml concentrations as adjuvant therapy for melasma. Methods: A double-blind, randomized controlled trial was performed with the split-face method. A total of 30 subjects were randomized to receive intradermal TA 25 mg/ml or 10 mg/ml either on the right or the left side of their face. The study research was conducted over eight weeks, with injection therapy administered starting from the second week at 2-week intervals. All subjects received SPF 45 sunscreen and 0.05% tretinoin cream for eight weeks. Assessment for modification MASI (mMASI) score and mexameter examination, which includes melanin index (MI) and erythema index (EI), were performed on every visit. Results: Twenty-seven subjects completed the study, with an average age of 49.67 years, and most had mixed-type melasma. There was a significant decrease in mMASI and MI scores with adjuvant therapy using 25 mg/ml and 10 mg/ml intradermal tranexamic acid injections. However, the score reduction did not significantly differ between the 25 mg/ml and 10 mg/ml concentrations. The majority of subjects did not experience significant side effects from the tranexamic acid injections. Conclusion: Adjuvant therapy with intradermal injection of TA 25 mg/ml and 10 mg/ml effectively and safely reduces the mMASI and MI scores in melasma patients with Fitzpatrick skin types IV and V.