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Abstrak :
Background systemic sclerosis (SSc) is a chronic autoimmune disease which presents immunological, endothelilal dysfunction, skin and organs fibrosis. The inflammatory process is an important pathopshsiology of systemic sclerosis. Disease activity assessment using clinical parameters of c creative protein (CRP), erytrocyte sedimentation rate (ESR) and soluble CD40 lingand.

Abstrak :
Background: Interstitial Lung Disease is one of the major cause of morbidity and mortality in Systemic Sclerosis. The gold standard to diagnose ILD is using High Resolution Computed Tomography scan. HRCT scan need a lot of cost and not always available, so another diagnosing test is needed as an alternative modality to diagnose ILD. ILD is a restrictive lung disease caused by lung fibrosis which is proved by the decrease of Forced Vital Capacity in spirometry, and followed by the increase of soluble CD40L level in plasma. This sCD40L may become a potential biomarker to evaluate lung fibrosis in SSc patients. The aim of this study is to analyze the correlation of sCD40L levels with FVC score in SSc patients with restrictive lung disease. Method: This cross sectional study was enrolled by the SSc patient who has restrictive lung disease based on spirometry test, at Rheumatology outpatient clinic dr. Hasan Sadikin Hospital from May 2015 to May 2016. All subject took underwent history, physical examination, spirometry and blood test for sCD40L. Data were analyzed using Pearson correlation.Result There were 38 subjects involved in this study, dominated bywoman 92.1 pecent with mean age 41years. Subjects consist of 22 57,9 pecent with limited SSc, 16 42,1 pecent with diffuse SSc patients and 33 subjects treated with DMARD. Mean sCD40L serum in this study was 6.690,3 pg/mL, with no statistical difference between limited and diffuse type p 0.154. Mean FVC score in this study was 58.2. There was no significant correlation between sCD40L serum with FVC r 0.058, p 0.366. There was weak correlation on DMARD naïve subject between sCD40L serum and FVC r 0.058, p 0.366 but statistically insignificant. There was no significant correlation between sCD40L serum with mRSS r 0,066 p 0,346. Conclusion: This study founds no correlation between sCD40L with FVC in SSc at dr. Hasan Sadikin Hospital.

Abstrak :
Pendahuluan: Graves' disease merupakan etiologi dari hipertiroidisme yang paling sering ditemukan dan salah satu manifestasi klinis yang sering muncul adalah oftalmopati. Jalur persinyalan CD40-CD40L memiliki peranan yang penting dalam patogenesis penyakit autoimun, salah satunya adalah Graves' disease. Graves' disease melibatkan jalur persinyalan CD40-CD40L yang berperan pada proses diferensiasi, proliferasi, dan aktivasi sel B dewasa sebagai respons dari antigen yang berbeda. Penelitian ini bertujuan menganalisis gen CD40L pada rs3092951, yang terletak pada 5' flanking region bagian promoter. Metode: Sampel berasal dari 60 penderita Graves' disease yang dianalisis dengan metode SSP-PCR untuk mengetahui variasi genetik dan metode ELISA untuk mengetahui kadar sCD40L. Hasil: Variasi genetik CD40L rs3092951 tidak berperan pada risiko kekambuhan dan derajat oftalmopati (p>0,05). Ditemukan perbedaan kadar sCD40L yang signifikan pada pasien kambuh dengan tidak kambuh (p<0,05) dan pada pasien dengan derajat oftalmopati (p<0,05). Kesimpulan: Terdapat hubungan yang signifikan antara kadar sCD40L terhadap risiko kekambuhan dan derajat oftalmopati pada penderita Graves' disease, hubungan yang signifikan tidak ditemukan pada variasi genetik gen CD40L rs3092951. Introduction: Graves disease is the most common etiology of hyperthyroidism. Graves' ophthalmopathy occurs in patients with hyperthyroidism and one of the most common clinical manifestations is ophthalmopathy. The CD40- CD40L signaling pathway play an important role in the pathogenesis of autoimmune diseases, one of them is Graves' Disease. Graves' disease involves the CD40-CD40L signaling pathways which play a role in differentiation, proliferation, and activation of mature B cells in response to different antigen. This study analyzed the CD40L gene at rs3092951 which is located at the promoter of the 5' flanking region. Methods: Samples were taken from 60 Graves' disease patients analyzed by SSP-PCR method to determine the genetic variation and ELISA method to determine the levels of sCD40L. Results: Significant correlation was not found between genetic variation of CD40L rs3092951 with the risk of recurrence and the degree of ophthalmopathy (p>0.05). There is a significant difference in sCD40L levels in patients with recurrence and without recurrence (p <0.05) and in patients with degrees of ophthalmopathy (p<0.05). Conclusion: There was a significant correlation between the sCD40L levels with the risk of recurrence and the degree of ophthalmopathy, no significant correlation was found in genetic variation of CD40L rs3092951.