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"Latar Belakang: Glioma merupakan tumor otak primer yang sering ditemukan di Indonesia. Sampai saat ini, terapi glioma belum memuaskan karena sering timbul resistens] dan rekurensi sehingga diperlukan terapi tambahan misalnya terapi gen. MnSOD diduga berperan sebagai supresor tumor, namun peran tersebut masih kontroversial. Tumor padat termasuk glioma mempunyai status oksigen yang kurang baik dibandingkan dengan jaringan normal. MnSOD sebagai antioksidan dapat mempengaruhi kadar ROS (Reactive Oxygen Species) yang meningkat pada kondisi hipoksia. Oleh karena itu perlu dianalisis bagaimana ekspresi gen MnSOD pada sel glioma manusia yang hipoksia. Hipoksia pada sel glioma diduga mempengaruhi respon sel tumor terhadap terapi radiasi. Hipoksia tersebut dapat dideteksi dengan suatu petanda Jaringan hipoksia yaitu HIF-1α. Tujuan: Untuk menganalisis ekspresi gen MnSOD, kondisi hipoksia pada sel glioma melalui analisis ekspresi gen HIF-1a serta menganalisis ekspresi gen MnSOD pada sel glioma yang hipoksia. Desain: Cross Sectional Metode: Ekspresi gen MnSOD dianalisis dengan membandingkan leve] mRNA dan aktivitas spesifik enzim MnSOD pada sel glioma dengan sel lekosit (kontrol). Ekspresi gen HIF-1a@ dianalisis dengan mebandingkan level MRNA HIF-1la pada sel glioma dengan sel jekosit. Ekspresi MnSOD dan HIF-1α dideteksi pada 20 pasien glioma menggunakan quantitative Real Time RT-PCR untuk kadar relatif mRNA MnSOD dan HIF-1α, serta pemeriksaan biokimia untuk mengukur aktivitas enzim MnSOD. Analisis statistik dengan menggunakan SPSS 16.0. Hasil: Ekspresi gen MnSOD baik mRNA maupun aktivitas spesifik enzim MnSOD pada sebagian besar sampel sel glioma manusia ditemukan lebih rendah secara signifikan (p< 0.01) dibandingkan dengan sel lekosit. Sedangkan mRNA HIF-la pada sebagian besar sel glioma manusia ditemukan lebih tinggi secara signifikan (p< 0.05) dibandingkan dengan sel lekosit. Sebanyak 80 % (16 sampel) menunjukkan mRNA HIF-1α yang tinggi, yang berarti terdapat hipoksia pada sel glioma. Dari 16 sampel tersebut, 11 sampel menunjukkan ekspresi mRNA MnSOD yang rendah dan 4 sampel menunjukkan ekspresi mRNA MnSOD yang tinggi. Kesimpulan: Ekspresi gen MnSOD pada sebagian besar sampel ditemukan rendah. Ekspresi HIF-1a@ yang tinggi menunjukkan terdapat hipoksia pada sebagian besar sampel scl glioma. Terdapat perbedaan ekspresi MnSOD pada kondisi hipoksia sel glioma.

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Background: Glioma is one of the most frequently found primary brains tumors in Indonesia. Until now, treatment of the glioma is far from succesfull due to resistancy and recurrance. Therefore, additional therapy is required, such as gene therapy. MnSOD is antioxidant enzymes which is suggested as tumor suppressor, despite its controversies. Solid tumor such as glioma have low oxygen level in the tissue compare to normal tissues. MnSOD as antioxidant enzyme have potential effects on increased ROS (reactive oxygen species) concentration in hypoxia condition. Therefore, further analysis is needed to explain MnSOD gene expression in hypoxic human gliomal cells. Hypoxia in gliomal cells are suggested to influence tumor cells responses toward radiotherapy. Hypoxia state can be detected using tissues hypoxic marker, hypoxia inducible factor-la (HIF1α).

Desaign: Cross sectional

Aim: To analyzed MnSOD gene expression, hypoxia condition in human glioma cells by analyzing the gene expression of HIF-αa and to analyzed MnSOD gene expression in hypoxic human gliomal cells.

Methode: MnSOD gene expression was analyzed by comparing MnSOD mRNA level and enzyme specific activity in glioma cells with leucocytes (control). HIF-1α gene expression was analyzed by comparing HIF-la mRNA level in glioma cells with leucocytes. Twenty glioma patients were included in this study. Quantitative Real Time RT-PCR was used to analyzed MnSOD and HIF-1α mRNA level. Biochemistry test was used to analyzed MnSOD enzyme spesific activity. Statistical analysis was performed using SPSS 16.0.

Results: MnSOD gene expression at mRNA level and enzyme spesific activty in most human glioma samples were significantly lower (p< .01) than leucocytes. While HIF-lao mRNA level in most human glioma samples were significantly higher (p< .05) than leucocytes, Eighty percents (16) of the samples showed high HIF-1α mRNA level, this mean that glioma samples were in hypoxic state. Among the 16 samples, 11 samples showed low MnSOD mRNA level and 4 samples showed high mRNA MnSOD level. This mean that there were differences in MnSOD gene expression in hypoxic human glioma cells.

Conclusion: MnSOD gene expression in most human glioma samples were low. High HIF-1α mRNA level were found in mosi of plioma samples, meaning that glioma sample were in hypoxic state. There were differences in MnSOD expression in hypoxic human glioma cells. "

"Latar Belakang: DM merupakan salah satu penyebab morbiditas dan mortalitas tertinggi di dunia, dengan 15-25% pasien akan berkomplikasi menjadi DFU. Data pada tahun 2003 di RSCM menunjukkan bahwa angka kematian akibat DFU adalah 16% dan angka amputasi mencapai 25%. Hingga saat ini belum terdapat strategi tatalaksana DFU yang efektif karena patogenesis molekular yang menyebabkan kegagalan penyembuhan luka masih belum sepenuhnya dipahami. Selain itu pengendalian kadar glukosa darah dalam pengobatan DFU masih belum jelas dan menjadi perdebatan dalam berbagai studi.Tujuan: Penelitian ini bertujuan untuk menganalisis hubungan HbA1c dan GDS dengan faktor angiogenesis HIF-1α, sehingga dapat dijadikan dasar dalam melakukan tata laksana yang tepat untuk pasien DFU.Metode: Desain penelitian potong lintang. Subjek penelitian pasien DFU yang berobat ke RSCM, diambil data dasar (jenis kelamin dan usia), pemeriksaan klinis (TB, BB, dan IMT), pemeriksaan laboratorium (GDS, HbA1c). HIF-1α diperiksa dari sampel biopsi jaringan luka DFU saat operasi debridemen dan amputasi dengan pemeriksaan ELISA. Data dilakukan uji normalitas Saphiro-Wilk dan uji normalitas Kolmogorov Smirnov, dilanjutkan uji korelasi Spearman. Pengaruh variabel perancu dianalisa dengan uji mann whitney dan tes regresi linear sederhana.Hasil: Terdapat 64 pasien yang memenuhi kriteria inklusi dan dilakukan pemeriksaan kadar HiF1α dari sampel jaringan biopsi. Data karakteristik didapatkan hasil kelompok dominan perempuan (54.7%) dengan usia rerata 55.7 ± 10.4 tahun, IMT median 24.9 kg/m² (overweight 48.2%, obesitas 34.6%), dan komorbid anemia (84.3%). Karakteristik laboratorium, GDS median 220 (14-705)mg/dL dengan kelompok kondisi hiperglikemik >200 mg/dL sebanyak 54.7%. HbA1c median 7.7(4.1-13.7)% dengan kelompok kontrol gula darah buruk HbA1c >6.5% sebanyak 85.8%. Tidak didapatkan korelasi bermakna antara GDS dengan HIF-1α p 0.523(p>0.05). Tidak didapatkan korelasi yang bermakna antara HbA1c dengan HIF-1α p 0.792(p>0.05). Didapatkan variable perancu yang bermakna pada kondisi derajat luka DFU p 0.03 (p< 0,05).Kesimpulan: Hasil penelitian ini menunjukkan bahwa baik HbA1c atau GDS tidak mempunyai hubungan yang bermakna dengan kadar HiF-1α. Variabel perancu kondisi derajat luka DFU berpengaruh secara signifikan terhadap ekspresi HIF-1α

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Background: DM is one of the leading causes of morbidity and mortality in the world, with 15-25% of patients developing complications of DFU. Results data in 2003 at the RSCM showed that the mortality rate from DFU was 16% and the amputation rate was 25%. There is no effective DFU management strategy because the molecular pathogenesis that causes wound healing failure is still not fully understood. In addition, the control of blood glucose levels in the treatment of DFU is still unclear and has been debated in various studies.

Objective: This study aims to analyze the relationship between HbA1c and GDS with the angiogenesis factor HIF-1α, so that it can be used as a basis for appropriate management of DFU patients.

Methods: The research design was cross sectional. Body mass index, comorbid disease status were recorded. The laboratory parameters GDS, HbA1c and HiF-1a expression examined in the laboratory. Test the normality data by the Saphiro-Wilk test and the Kolmogorov Smirnov test, followed by the Spearman correlation test. The effect of confounding variables was analyzed by Mann Whitney test and simple linear regression test.

Results: There were 64 patients who met the inclusion criteria and were examined for HiF1α levels from biopsy tissue samples. Characteristic data showed that the dominant group was female (54.7%) with a mean age of 55.7 ± 10.4 years, median BMI 24.9 kg/m² (overweight 48.2%, obesity 34.6%), and comorbid anemia (84.3%). Laboratory characteristics, the median GDS of 220 (14-705)mg/dL with the hyperglycemic condition group >200 mg/dL as much as 54.7%. The median HbA1c was 7.7(4.1-13.7)% with the bad blood sugar control group HbA1c >6.5% as much as 85.8%. There was no significant correlation between GDS and HIF-1α p 0.523 (p>0.05). There was no significant correlation between HbA1c and HIF-1α p 0.792 (p>0.05). A significant confounding variable was found in the condition of the degree of wound DFU p 0.03 (p < 0.05).

Conclusion:The results of this study showed that neither HbA1c nor GDS had a significant correlation with HiF-1α . The confounding variable of DFU wound degree had a significant effect on the expression of HIF-1α"

"Latar Belakang: Indonesia menempati peringkat ke-7 di antara 10 negara dengan jumlah penderita DM terbanyak. Tingginya jumlah penderita DM meningkatkan jumlah komplikasi luka kaki diabetes. Anemia berhubungan dengan luka kaki diabetes, serta menjadi prediktor amputasi dan mortalitas. Pasien anemia tanpa DM mengalami peningkatan ekspresi HIF-1α akibat hipoksia. Akan tetapi, pada pasien luka kaki diabetes tanpa anemia justru memiliki kadar HIF-1α yang rendah. Keadaan hiperglikemia menyebabkan degradasi HIF-1α. Penelitian ini bertujuan mengetahui hubungan kadar hemoglobin dengan ekspresi HIF-1α pada pasien luka kaki diabetes dengan anemia di RS Dr. Cipto Mangunkusumo. Metode: Penelitian ini merupakan observasional analitik jenis potong lintang. Data diambil dari seluruh pasien terdiagnosis luka kaki diabetes dengan anemia di RSCM, meliputi kadar hemoglobin, gula darah sewaktu, HbA1c, dan kadar HIF-1α berdasarkan metode ELISA yang diperoleh dari jaringan hasil biopsi. Analisis statistik dilakukan menggunakan SPSS versi 20. Uji korelasi Spearman dilakuan untuk memperoleh nilai koefisien korelasi. Nilai p <0,05 bermakna signifikan. Hasil: Terdapat 59 subjek luka kaki diabetes dengan anemia di RSCM. Laki-laki sebanyak 30 orang (50,8%) dan mayoritas subjek berusia 40—59 tahun yaitu sebanyak 37 orang (62,7%). Perempuan memiliki median GDS 227,0 mg/dL (IQR: 192) dan HbA1c 8,0 g/dL (IQR: 4,6), lebih besar dibandingkan laki-laki. Sebaliknya, laki-laki memiliki rerata Hb 9,9 g/dL (SB: 2,0) dan median HIF-1α 19,1 pg/mg (IQR: 36,4), lebih besar dibandingkan perempuan. Hanya Hb dan HbA1c yang berhubungan dengan jenis kelamin secara signifikan (p <0,05). Uji korelasi Spearman diperoleh nilai korelasi r = 0,266 (IK95%: -0,14—0,58; p = 0,043). Simpulan: Didapatkan korelasi positif lemah dan signifikan antara kadar hemoglobin dengan ekspresi HIF-1α pada pasien luka kaki diabetes dengan anemia di RSCM. Keadaan hiperglikemi dapat mendegradasi HIF-1α lebih kuat dibandingkan kemampuan anemia dalam memicu ekspresi HIF-1α.

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Background: Indonesia is ranked 7th out of 10 countries with the most diabetes mellitus patients. The high number of DM patients will increase complications of diabetic foot ulcers. Anemia is associated with diabetic foot ulcers as well as a predictor of amputation and mortality. Anemic patients without diabetes have increased HIF-1α expression due to hypoxia. Meanwhile, diabetic foot ulcer patients without anemia have low levels of HIF-1α. Hyperglycemia causes degradation of HIF-1α. This study aims to determine the association of hemoglobin levels and HIF-1α expression in diabetic foot ulcer patients with anemia at Dr. Cipto Mangunkusumo National Hospital.

Method: This is a cross-sectional study. Data were taken from all patients diagnosed with diabetic foot ulcers with anemia at the RSCM, including hemoglobin (Hb) levels, blood glucose (BG), HbA1c, and HIF-1α levels based on the ELISA method obtained from tissue biopsies. Statistical analysis was done using SPSS version 20. Spearman correlation test was performed to obtain the coefficient of correlation. P-value <0.05 was significant.

Results: There were 59 subjects with diabetic foot ulcers with anemia in RSCM. It consisted of 30 male (50.8%) and most of subjects were 40-59 years old (37 subjects; 62.7%). Female subjects have a median BG 227.0 mg/dL (IQR: 192) and median HbA1c 8.0 g/dL (IQR: 4.6), it is higher than male. On the other hand, male subjects have a mean Hb 9.9 g/dL (SB: 2.0) and median HIF-1α 19.1 pg/mg (IQR: 36.4), it is larger than female. Only Hb and HbA1c were significantly related to gender (p <0.05). Spearman correlation test obtained a correlation value of r = 0.266 (95%CI: -0.14-0.58; p = 0.043).

Conclusion: We found a weak but significant positive correlation between hemoglobin levels and HIF-1α expression in diabetic foot wound patients with anemia in RSCM. Hyperglycemia can degrade HIF-1α more strongly than anemia's ability to initiate HIF-1α expression. "

"Praktik menyelam bebas yang dilakukan oleh nelayan tradisional Indonesia dihadapkan pada kondisi lingkungan ekstrim yang mengakibatkan hipoksia dan stress oksidatif yang dapat memicu terjadinya inflamasi. Proses inflamasi berhubungan dengan aktivasi jalur pensinyalan NF-κB yang meregulasi gen-gen sitokin proinflamasi, sedangkan respons seluler terhadap rendahnya kadar oksigen pada hipoksia melibatkan HIF sebagai regulator utamanya. Penelitian ini bertujuan untuk menganalisis ekspresi mRNA HIF-1α, NF-κB, sitokin proinflamasi dan antiinflamasi pada nelayan penyelam bebas serta kontrol non penyelam yang berasal dari Provinsi Maluku. Studi cross-sectional dilakukan dengan pengujian sitokin TNF-α, IL-6 dan IL-10 dari plasma menggunakan sandwich ELISA serta isolasi RNA dari darah lengkap untuk analisis ekspresi mRNA HIF-1α dan NF-κB menggunakan RT-qPCR. Data hasil penelitian diuji normalitas menggunakan uji Shapiro-Wilk, dilanjutkan uji independent T-test untuk data terdistribusi normal dan uji Mann Whitney untuk data tidak terdistribusi normal. Analisis korelasi antara ekspresi mRNA HIF-1α dan NF-κB dengan profil sitokin menggunakan uji korelasi Pearson untuk data yang terdistribusi normal atau Rank Spearman untuk data yang tidak terdistribusi normal. Hasil penelitian menunjukkan tidak terdapat perbedaan yang signifikan dari ekspresi mRNA HIF-1α maupun NF-κB serta kadar TNF-α pada nelayan penyelam bebas dibandingkan dengan kontrol non penyelam. Namun, terdapat perbedaan yang signifikan dari kadar IL-6 dan IL-10 antara nelayan penyelam bebas dengan kontrol non penyelam (p< 0,05). Tidak terdapat korelasi antara ekspresi mRNA HIF-1α dan NF-κB terhadap sitokin TNF-α, IL-6 dan IL-10. Kesimpulan dari penelitian ini terjadi peningkatan ekspresi mRNA HIF-1α, NF-κB serta kadar sitokin TNF-α, IL-6 dan IL-10 secara seluler, tetapi masih dalam rentang respon fisiologisnya.

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Breath-hold diving or freediving in Traditional Indonesian fishermen, is faced with extreme environmental conditions that result in hypoxia and oxidative stress, which can trigger inflammation. The inflammatory process is associated with the activation of the NF-κB signaling pathway, which regulates proinflammatory cytokine genes, while the cellular response to low oxygen levels in hypoxia involves HIF as the main regulator. The aim of this study was to analyze the mRNA expression of HIF-1α, NF-κB, and pro/anti-inflammatory cytokines in freediving fishermen and non-divers from Maluku Province. The study used a cross-sectional design. Blood samples were obtained from both subjects. The blood plasma samples were used to quantify TNF-α, IL-6, and IL-10 by using ELISA. RNA isolation from whole blood specimen was carried out for analysis of HIF-1α and NF-κB mRNA expression using RT-qPCR. The data were analyzed for normality using the Shapiro-Wilk test if the data was normally distributed, followed by the parametric independent T-test; otherwise, the Mann-Whitney non-parametric test was used. Correlation study of HIF-1α and NF-κB mRNA expression with pro-inflammatory and anti-inflammatory cytokine profiles in freedivers and non-diver controls was performed using the Pearson correlation test for normally distributed data or Spearman's Rank for non-normal distribution. There were no significant differences observed in the expression of HIF-1α and NF-κB in freediving fishermen and nondivers, as well as no significant differences in the TNF-α levels among freediving fishermen and non-divers. Both IL-6 and IL-10 are elevated markedly (p<0.05) in freediving fishermen when compared with non-divers. There was no correlation between HIF-1α, NF-κB expression and TNF-α, IL-6, IL-10. The conclusion of this study is that although there was an increase in several parameters, both HIF-1α and NF-κB mRNA expression, as well as pro-inflammatory (TNF-α, IL-6) and antiinflammatory (IL-10) cytokines at the cellular level, were still within the range of physiological responses."

"Risiko kegagalan dapat terjadi pada rekonstruksi dengan flap bebas karena mengandalkan vaskularisasi kecil. Pemeriksaan klinis yang merupakan baku emas dalam evaluasi sirkulasi flap masih bersifat subjektif dan sulit untuk mendeteksi gangguan vaskularisasi secara dini. Indocyanine green (ICG) merupakan instrumen pemeriksaan objektif yang dapat digunakan untuk evaluasi sirkulasi flap, tetapi belum ada konsensus mengenai dosis ICG dan kekuatan fluoresensi bersifat dose-dependent. Pada penelitian awal model in vitro dan hewan coba didapatkan konsentrasi 0,5 mg/mL menghasilkan fluoresensi yang setara dengan konsentrasi standar (5 mg/mL). Analisis dosis titrasi ICG dilakukan pada penelitian ini untuk mengevaluasi (sirkulasi) flap bebas menggunakan kamera near-infrared radiation standar serta korelasinya terhadap pemeriksaan suhu flap, TcPCO2, TcPO2, kadar HIF-1α, dan gambaran histopatologi flap untuk menunjang bedah mikro rekonstruksi. Penelitian menggunakan desain eksperimental uji klinis acak tersamar ganda di Rumah Sakit Umum Pusat Nasional dr. Cipto Mangunkusumo (RSCM) dan Rumah Sakit Persahabatan (RSP) pada bulan September 2022 hingga Januari 2024. Sebanyak 63 pasien yang sesuai dengan kriteria inklusi dari kuesioner skrining dilakukan randomisasi menjadi 3 kelompok konsentrasi ICG, yaitu 5 mg/mL, 2,5 mg/mL, dan 0,5 mg/mL yang diberikan ICG secara intravena, dengan jumlah masing-masing 21 flap. Data diambil segera pasca-operasi, 24 jam, 72 jam, serta 120 jam pasca-operasi. Ketiga kelompok menunjukkan peningkatan fluoresensi ICG dari waktu ke waktu, dengan intensitas fluoresensi pada konsentrasi 2,5 mg/mL serupa dengan konsentrasi standar (p = 0,792), tetapi intensitas konsentrasi 0,5 mg/mL lebih lemah (p = 0,006 dan p = 0,041). Intensitas fluoresensi tidak berkorelasi dengan pemeriksaan objektif lainnya. Disimpulkan besar dosis ICG memengaruhi intensitas fluoresensi karena fenomena quenching effect dan keseimbangan ikatan ICG dengan protein plasma. Analisis konsentrasi 5 mg/mL dan 2,5 mg/mL menghasilkan intensitas serupa sehingga penggunaan dosis 2,5 mg/mL dapat menggantikan dosis standar pada praktik klinis. Pemeriksaan objektif lainnya belum dapat menggantikan pemeriksaan ICG untuk evaluasi sirkulasi flap bebas.

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The risk of failure in free flap reconstruction may occur due to small vascularization. Clinical examination, which is the gold standard for free flap evaluation, is subjective and difficult to detect early vascularization problems. Indocyanine green (ICG) is an objective instrument to evaluate flap circulation, but there is no ICG consensus and the fluorescence emitted is dose-dependent. In the preliminary studies conducted in vitro followed by in vivo with animal models, we found that 0.5 mg/mL concentration produced equivalent fluorescence to the standard concentration (5 mg/mL). This study aimed to analyze the titration dose of ICG to evaluate free flaps using a standard near-infrared radiation camera and its correlation with the examination of flap temperature, TcPCO2, TcPO2, HIF-1α levels, and histopathological to support reconstructive microsurgery procedure. This was a randomized, double-blind clinical trial at Dr. Cipto Mangunkusumo National Central General Hospital and Persahabatan Hospital from September 2022 to January 2024. A total of 63 patients that met the inclusion criteria through screening questionnaire were randomized into 3 ICG concentration groups: 5 mg/mL, 2.5 mg/mL, and 0.5 mg/mL. The ICG was given intravenously to each group which consist of 21 subjects. The data were obtained immediately postoperative, 24 hours, 72 hours, and 120 hours post-operative. There were 63 flaps divided into three groups with 21 flaps each. All three groups showed an increase in ICG fluorescence over time, with fluorescence intensity emitted by 2.5 mg/mL concentration is equivalent to the standard concentration (p = 0.792), but the fluorescence from 0.5 mg/mL concentration emitted weaker intensity (p = 0.006 and p = 0.041). Fluorescence intensity did not correlate with other objective examinations. It was concluded that the titration dose of ICG influenced the fluorescence intensity due to quenching effect and ICG and plasma protein bond equilibrium. Analysis of 5 mg/mL and 2.5 mg/mL concentration groups produced similar intensities, leading to the feasibility of 2.5 mg/mL concentration to replace the standard dose in clinical practice. Other objective examinations can not replace ICG examination for free flap perfusion evaluation."

"Latar Belakang: Penerbang militer berisiko mengalami hipoksia selama melaksanakan tugas terbang oleh karena penurunan tekanan parsial oksigen (O2) yang terjadi seiring pesawat mencapai ketinggian. Tubuh beradaptasi terhadap hipoksia dengan berbagai mekanisme seperti menjaga kestabilan kadar hypoxia inducible factor (HIF) dan merangsang pelepasan heat shock protein (HSP) untuk menjaga kondisi homeostasis. Penelitian ini bertujuan untuk mengetahui respons tubuh terhadap kondisi hipoksia hipobarik dikaitkan dengan kadar HIF-1α dan HSP 70 serum pada penerbang militer yang melaksanakan uji latih hipoksia di Lembaga Kesehatan Penerbangan dan Ruang Angkasa (Lakespra) dr. Saryanto.Metode: Penelitian ini merupakan penelitian eksperimental dengan pendekatan one group pretest-posttest design yang dilaksanakan pada bulan Mei sampai dengan bulan Juli 2023. Subjek penelitian adalah penerbang militer aktif yang terjadwal melaksanakan uji latih hipoksia, memenuhi kriteria inklusi dan eksklusi serta bersedia menandatangani informed consent. Oksigenasi diberikan setelah pajanan hipoksia sebagai bagian dari prosedur latihan. Pengambilan darah diambil sebelum dan sesudah uji latih hipoksia selanjutnya diperiksa dengan metode enzyme linked immunosorbent assay (ELISA).Hasil: Sebanyak 31 orang penerbang militer diikutsertakan dalam penelitian ini dengan rincian 13 (41,9 %) penerbang pesawat angkut, 7 (22,6%) penerbang pesawat helikopter, 6 (19,4%) penerbang pesawat tempur dan 5 (16,1%) penerbang pesawat tanpa awak. Analisis dengan uji t berpasangan mengungkapkan bahwa tidak terdapat perbedaan yang bermakna (p = 0,910) antara kadar HSP 70 serum sebelum (5,59 (1,88- 20,17) ng/dl) dan sesudah (5,59 (1,88-20,17) ng/dl) uji latih hipoksia. Analisis dengan uji Wilcoxon mengungkapkan bahwa terdapat perbedaan yang bermakna (p = 0,008) antara HIF-1α serum sebelum (534,03±261,48 pg/dl) dan sesudah (465,48±209,83 pg/dl) uji latih hipoksia.Kesimpulan: Uji latih hipoksia tidak memengaruhi kadar HSP 70 serum pada penerbang militer. Terdapat penurunan kadar HIF-1α serum yang bermakna pada penerbang militer setelah melaksanakan uji latih hipoksia.

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Background: Military pilots are at risk of experiencing hypoxia during flight duties due to the decrease in oxygen partial pressure that occurs as the aircraft reaches altitude. The body adapts to hypoxia through various mechanisms, such as stabilizing the levels of hypoxia inducible factor (HIF) and stimulating heat shock protein (HSP) release to maintain homeostasis. This study aims to determine physiological response to hypobaric hypoxia conditions in relation to serum HIF-1α and HSP 70 levels in military pilots who carry out hypoxia training tests at Lembaga Kesehatan Penerbangan dan Ruang Angkasa (Lakespra) dr. Saryanto.

Methods: This research is an experimental study with a one group pretest-posttest design conducted from May to July 2023. The research subjects were active military pilots who were scheduled to carry out hypoxia training tests, met the inclusion and exclusion criteria and were willing to sign informed consent. Oxygenation is administered after hypoxic exposure as part of the training procedure. Blood samples were taken before and after the hypoxia training test and then examined using the enzyme linked immunosorbent assay (ELISA) method.

Result : A total of 31 military pilots were included in this study, consist of 13 (41.9%) transport aircraft pilots, 7 (22.6%) helicopter pilots, 6 (19.4%) fighter aircraft pilots and 5 (16.1%) unmanned aircraft pilot. Paired t test revealed that there was no significant difference (p = 0.910) between serum HSP 70 levels before (5.59 (1.88-20.17) ng/dl) and after (5.59 (1.88 -20.17) ng/dl) hypoxia training test. Data analysis using the Wilcoxon test revealed that there was a significant difference (p = 0.008) between serum HIF-1α before (534.03 ± 261.48 pg/dl) and after (465.48 ± 209.83 pg/dl) hypoxia training test.

Conclusion: Hypoxia training test did not affect serum HSP 70 levels in military pilots. There was a significant decline in serum HIF-1α levels in military pilots after performing hypoxia training test."