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"Penggunaan alat-alat listrik saat ini tidak bisa dihindari, sehingga manusia terpajan dengan Extremely Low Frequency ? Electromagnetic Field (ELF-EMF). Pemajanan ini dapat menyebabkan gangguan perkembangan folikel ovarium. Penelitian ini bertujuan untuk mengetahui pengaruh pemajanan ELF-EMF terhadap jumlah dan morfologi folikel sekunder serta untuk melihat efek kumulatif pemajanan tiap generasi. Metode penelitian yaitu eksperimental terhadap mencit betina strain Swiss Webster. Digunakan 12 pasang mencit parental yang mendapatkan empat perlakuan pemajanan. Beberapa mencit dari tiap perlakuan akan dikawinkan untuk mendapatkan mencit generasi pertama, kedua dan ketiga. Mencit lainnya akan dietanasi untuk diambil ovariumnya dan dijadikan preparat. Jumlah preparat yang digunakan yang dianalisis adalah 60 sampel. Setiap sampel diamati untuk mendapatkan jumlah folikel sekunder normal dan folikel sekunder atresia. Uji hipotesis dilakukan uji One-Way ANOVA dan Kruskal-Wallis. Pada analisis data didapatkan perbedaan yang bermakna pada folikel atresia sekunder berbagai tegangan di generasi F2 (p=0,002) dan F3 (p=0,027), dan dilanjutkan ke analisis Post Hoc. Didapatkan perbedaan yang bermakna antar tegangan di generasi F2 dan F3. Sementara pada analisis data folikel sekunder dan folikel atresia sekunder antar generasi tidak terdapat perbedaan bermakna. Dapat disimpulkan bahwa terdapat pengaruh pemajanan ELF-EMF berbagai tegangan terhadap morfologi folikel sekunder ovarium. Namun, tidak didapatkan efek kumulatif tiap generasi.

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We can hardly avoid the use of electricity tools, so human are exposed to Extremely Low Frequency ? Electromagnetic Field (ELF-EMF). This exposure can affect development of ovarian follicles. Aim of this study is to determine the effects of ELF-EMF exposure on number and morphology of secondary follicles, also to see the inter-generational cumulative effects. This study use experimental design and strain Swiss Webster female mice as the subject. There are 12 pairs of parental mice who received four treatments. Some mice from each treatment will be mated to obtain the first, second and third generation of mice. Other mice's ovaries will be taken. There are 60 samples of ovaries preparation to be observed under microscope. Hypothesis testing is done by One-Way ANOVA test and Kruskal-Wallis. There is significant differences in the secondary atresia follicles at the various voltages in the F2 (p = 0,002) and F3 (p = 0,027). The analysis than continue to Post-Hoc analysis. There are significant differences in voltage between F2 and F3 generations, while there are no significant differences in data analysis of secondary follicles and secondary atresia follicles between generations. The conclution is there are significant effects of ELF-EMF exposure to various voltages on secondary ovarian follicles morphology. However, there are no cumulative effects in each generation."

"Energi listrik telah menjadi bagian yang penting dalam kehidupan manusia, terlebih lagi di zaman modern seperti saat ini, dimana dengan semakin meningkatnya perkembangan teknologi dan informasi, penggunaan alat elektrik rumah tangga yang diketahui merupakan sumber Extremely Low Frequency - Electromagnetic Field (ELF-EMF) tidak dapat dielakkan lagi. Pemajanan ELFEMF dalam jangka panjang diketahui memiliki banyak dampak bagi kesehatan manusia, termasuk sistem reproduksi. Penelitian ini bertujuan melihat pengaruh pajanan ELF-EMF terhadap jumlah dan morfologi folikel tersier ovarium mencit.Penelitian ini menggunakan metode eksperimental dengan mencit strain Webster sebagai hewan coba. Kelompok penelitian yang digunakan, yaitu kelompok kontrol dan kelompok perlakuan. Kelompok perlakuan merupakan kelompok mencit yang diberikan pajanan ELF-EMF dengan tegangan masing-masing 3 kV, 4 kV, dan 5 kV. Masing-masing kelompok tersebut akan diamati pada setiap generasi, mulai dari generasi pertama hingga ketiga. Kemudian sampel diambil dari setiap kelompok penelitian untuk diamati di bawah mikroskop.Hasilnya menunjukan bahwa terdapat penurunan jumlah folikel tersier yang bermakna pada generasi pertama dan ketigadi semua besar tegangan yang diberikan. Didapati juga peningkatan jumlah folikel tersier atresia yang bermakna pada generasi pertama dan generasi kedua di semua besar tegangan. Sedangkan efek akumulasi pajanan ELF-EMF terhadap jumlah dan morfologi folikel tersier belum dapat dibuktikan.

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Electrical energy has become an important part of human life, especially in this modern society where the increasing development of information technology led to increase use of electrical appliances household that known as a source of Extremely Low Frequency - Electromagnetic Field (ELF-EMF). Prolonged exposure of ELF-EMF can cause many effects on human health, including reproductive system. This study aimed to examines the effect of ELF-EMF exposure on the number and morphology of ovarian tertiary follicles of mice.This research uses experimental methods with Webster strain mice as experimental animals. There are two research group, the control and the treatment group. Treatment group is the group of mice given exposure to ELF-EMF voltage of 3kV, 4kV and5 kV. Each group will be observed from the first to the third generation. Then the samples were taken from each study group to be observed under a microscope.The result shows that there is a significant decreasing number of tertiary follicles in the first and third generation for all of the voltage. There is also an significant increasing number of tertiary follicle atresia in the first and second generation for all of the voltage. While the cumulative effects of exposure to ELF-EMF and the number of tertiary follicles morphology has not been proven."

"Exremely low frequency-electromagnetic field (ELF-EMF) merupakan salah satu jenis radiasi non-ion yang dapat dihasilkan dari perangkat listrik rumah tangga atau alat komunikasi elektronik. Paparan ELF-EMF jangka panjang diduga mengganggu pelepasan hormon gonadotropin yang berperan dalam perkembangan dan pematangan folikel ovarium, terutama perkembangan folikel pre antral menjadi folikel antral ataupun folikel de Graaf. Oleh karena itu, melalui penelitian ini dapat diamati pengaruh paparan ELF-EMF dengan berbagai tegangan terhadap jumlah dan morfologi folikel de Graaf. Penelitian ini juga melihat apakah ada efek kumulatif pajanan medan elektromagnetik pada generasi-generasi selanjutnya. Dua belas pasang mencit strain Swiss Webster (P) dikelompokkan menjadi empat kelompok, yaitu kelompok kontrol, kelompok perlakuan 3 kV 5,5 μT, kelompok perlakuan 4 kV 5,4 μT, dan kelompok perlakuan 5 kV 5,3 μT. Perlakuan ini dilanjutkan dan diberikan pada mencit generasi pertama (F1), generasi kedua (F2), dan generasi ketiga (F3). Selanjutnya lima ekor mencit usia 2,5 bulan dari masing-masing kelompok perlakuan pada tiap generasi diperiksa ovariumnya untuk mengevaluasi jumlah dan morfologi folikel de Graaf. Uji hipotesis Kruskall-Wallis menunjukkan tidak ada perbedaan bermakna jumlah folikel de Graaf (p=0,480) dan folikel atresia de Graaf (p=0,336) di antara kelompok. Hasil penelitian ini membuktikan bahwa pemajanan ELF-EMF tidak mempengaruhi jumlah dan morfologi folikel de Graaf mencit strain Swiss Webster serta tidak dijumpai efek kumulatif pemajanan pada generasi-generasi seterusnya.

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Extremely low frequency- electromagnetic fields are categorized as non-ionising radiation which could be produced by electrical household appliances or communication devices. ELF-EMF long term exposure suggested can disturb releasing gonadotropine hormon (GnRH) which have a role in follicle development and maturation, especially pre antral follicle development. Therefore, this study aims to evaluate the influence of extremely low frequency-electromagnetic field in varying frequencies on number and morphology of follicle de Graaf. This study also evaluate ELF-EMF cumulative effect on multiple generation (F1, F2, and F3). Twelve pairs mice strains Swiss Webster as parental mice (F0) were divided into four groups. One group as control and three other groups were exposed by magnetic field,which doses were 3kV 5,5μT, 4kV 5,4μT,and 5kV 5,3μT. These treatments were also given to first, second, and third generation. Five female mices aged 2,5 months from each first (F1), second (F2),and third (F3) generation on each groups were examined to evaluate number and morphology (atresia follicle) of de Graaf follicle from their ovarium. The hypothesis was tested using Kruskall-Wallis which show no significant difference between groups on follicle de Graaf number (p=0,480) and atresia follicle de Graaf (p=0,336). These results suggest ELF-EMF exposure don?t affect number and morphology of follicle de Graaf and there are no cumulative effect on multiple generation."

"Latar Belakang: Varikokel merupakan penyebab infertilitas yang paling umum terjadi pada pria. Varikokel dapat menyebabkan kerusakan pada testis, seperti penurunan volume dan hambatan spermatogenesis. Hambatan spermatogenesis dapat menyebabkan kadar FSH meningkat. Sebuah studi menunjukkan bahwa dari 37 pasien azoospermia dengan varikokel bilateral, didapatkan 32 hasil biopsi dengan gambaran Sertoli Cell-Only Syndrome SCOS. Tujuan: Mengetahui hubungan antara SCOS dengan riwayat varikokel pada pasien azoospermia. Metode: Studi cross sectional dengan sampel berjumlah 110 pasien azoospermia yang termasuk 36 pasien varikokel dan 25 pasien SCOS berdasarkan data rekam medis dan hasil biopsi pasien. Pasien sampel merupakan pasien Departemen Urologi RSUPN Cipto Mangunkusumo tahun 2011-2015 yang melakukan biopsi pada kedua testisnya. Hasil: Dari 110 pasien azoospermia, nilai Kriteria Johnsen dengan frekuensi terbesar dan reratanya adalah 5. Terdapat 10 27.8 pasien SCOS dengan varikokel dan 59 79.7 pasien tidak SCOS dengan varikokel. Secara statistik, tidak terdapat hubungan bermakna antara SCOS dan varikokel p>0.05. Kelompok SCOS memiliki kadar FSH yang lebih tinggi daripada kelompok non-SCOS.

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Background: Varicocele is the most common infertility cause in males. Varicocele can lead to testicular changes, like volume depletion and spermatogenic arrest. Spermatogenic arrest can lead to FSH level increase. A study shown that from 37 azoospermic patients with bilateral varicocle were found 32 biopsies of Sertoli Cell Only Syndrome.

Aim: Determined the assosiaction between Sertoli Cell Only Syndrome and varicocele in azoospermic patients.

Method: A cross sectional study with sample amount of 174 azoospermic patients, including 36 varicocele cases and 25 Sertoli Cell Ony Syndrome cases according to patients rsquo medical record and biopsy result. Samples were patients taken from Urology Department in RSUPN Cipto Mangunkusumo from the year 2011 until 2015 that had underwent biopsy in both testes.

Result: From 110 azoospermic patients, highest frequency and mean of the Johnsen score is 5. There were 10 27.8 of which were SCOS patients with varicocele and 59 79.7 of which were SCOS patients without varicocele. Statistically, there was no significant association between SCOS and varicocele p 0.05. SCOS group had higher FSH level than non SCOS group."

"Air susu ibu adalah makanan bayi yang terbaik karena mengandung komposisi nutrisi yang lengkap dan mengandung faktor-faktor penting untuk kekebalan tubuh bayi termasuk leukosit. Pemberian ASI ekslusif kepada bayi banyak mengalami hambatan, akibat ibu yang harus bekerja kembali  setelah cuti melahirkan. Berbagai upaya dilakukan agar bayi tetap mendapatkan ASI pada saat ibu bekerja, salah satunya adalah dengan cara penyimpanan ASI. Penelitian ini bertujuan untuk mengetahui pengaruh proses penyimpanan ASI pada wadah plastik terhadap jumlah, viabilitas dan morfologi leukosit. Sampel penelitian ini adalah ASI yang diperoleh dari 7 ibu menyusui selama periode bulan September tahun 2022 hingga Februari tahun 2023, kemudian dibagi menjadi 4 kelompok perlakuan berdasarkan suhu, lama penyimpanan dan metode pencairan ASI beku berdasarkan  rekomendasi CDC. Hasil penelitian menunjukkan tidak adanya penurunan yang signifikan pada jumlah total dan viabilitas sel  pada ASI yang disimpan pada wadah plastik. Walaupun terjadi perubahan pada gambaran morfologi leukosit namun proses penyimpanan dan pencairan tidak mempengaruhi populasi CD45+ secara keseluruhan.  Tetapi, perubahan yang signifikan ditemukan pada jumlah monosit dan basofil. Hasil penelitian ini menunjukkan bahwa rekomendasi penyimpanan berdasarkan rekomendasi CDC dengan menggunakan wadah plastik tidak memengaruhi kuantitas leukosit. Meskipun demikian, masih diperlukan penelitian lebih lanjut untuk memahami apakah perubahan morfologi ini mempengaruhi fungsional dari sel tersebut.

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Mother's milk is the best baby food because it contains a complete nutritional composition and contains important factors for the baby's immune system including leukocytes. Exclusive breastfeeding for babies is increasingly experiencing obstacles, due to social changes that affect women who work after maternity leave. Various efforts have been made so that the baby continues to get breast milk when the mother is working, one of which is by storing breast milk. This study aims to determine the effect of the storage process on the number, viability and morphology of breast milk leukocytes. The sample for this study was breast milk obtained from 7 breastfeeding mothers during the period September 2022 to February 2023, then divided into 4 treatment groups based on temperature, storage time and method of thawing frozen breast milk from the recommendation guide at the CDC. The results showed that there was no significant decrease in the total number and viability of cells in breast milk. Although there was a change in the leukocyte morphology, the storage and thawing processes did not affect the CD45+ population as a whole. However, there were significant changes in the number of monocytes and basophils. The results of this study indicate that the storage recommendations from the CDC do not affect the quantity of leukocytes. Nevertheless, further research is still needed to understand whether these morphological changes affect the function of these cells."

"Platelet rich plasma (PRP) sebagai bahan suplemen medium kriopreservasi, mengandung plasma yang merupakan bagian dari darah dan mengandung banyak sekali albumin. Albumin diketahui sebagai CPA ekstraseluler alami yang bekerja dengan cara menstabilkan membran sel yang dapat terganggu akibat kriopreservasi. Bahan suplementasi medium kriopreservasi selama ini menggunakan bahan yang berasal dari hewan. Penggunaan bahan suplementasi dari hewan telah diketahui memiliki berbagai kendala seperti tersandung dengan komunitas perlindungan hewan dan juga dapat mencetuskan reaksi immunologi jika digunakan pada manusia. Karena itu, perlu dicari alternatif lain untuk bahan suplementasi medium kriopreservasi. Penelitian ini meneliti apakah PRP dapat digunakan sebagai alternatif FBS sebagai medium kriopreservasi sel punca asal tali pusat manusia dengan menilai viabilitas, morfologi dan proliferasi sel punca pasca kriopreservasi. Penelitian diawali dengan isolasi dan propagasi sel punca asal tali pusat manusia dari satu buah tali pusat manusia yang memenuhi kriteria dengan metode eksplan. Sel punca kemudian disubkultur sampai mencapai jumlah sel yang dibutuhkan untuk kriopreservasi. Kriopreservasi sel punca dilakukan dalam delapan protokol kriopreservasi dengan variasi bahan suplemen, konsentrasi bahan suplemen dan konsentrasi sel. Hasil penelitian menunjukkan tidak ada perbedaan antara FBS dan PRP dalam mempertahankan viabilitas dan morfologi sel bahkan PRP lebih baik ketika dilihat dari ukuran dan proliferasi pasca kriopreservasi. Sebagai kesimpulan, penelitian ini menunjukkan bahwa PRP dapat digunakan sebagai alternatif penggunaan FBS dalam medium kriopreservasi sel punca asal tali pusat manusia.

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Platelet rich plasma ( PRP ) as supplemental material cryopreservation medium , containing plasma which is part of the blood and contains a lot of albumin. Albumin is known as a natural extracellular CPA works by stabilizing cell membranes that can be disrupted by cryopreservation .One of the materials in cryopreservation medium that is used nowadays is derived from animals. Use of animal derived metarial has been known to pose various problems such as facing the animal protection community and also can trigger immunological reactions when used in humans. So it is necessary to find an alternative for animal derived material in cryopreservation medium. This study examined whether PRP could be used as an alternative to FBS as cryopreservation medium for human umbilical cord stem cells by assessing the viability, morphology and proliferation of stem cells after cryopreservation. The study began with the isolation and propagation of human umbilical cord stem cells from one human umbilical cord that meets the criteria using explant method. Stem cells then subcultured to achieve the required number of cells for cryopreservation. Cryopreservation of stem cells was done in eight cryopreservation protocols with various supplements, concentrations of the supplements, and cell concentrations. The results showed no difference between FBS and PRP in maintaining cell viability and morphology. PRP was even better when viewed from the size and proliferation of the cells after cryopreservation . In conclusion, this study shows that PRP can be used as an alternative to FBS in cryopreservation medium for human umbilical cord stem cells."

"ABSTRAKLatar Belakang: Laki-laki menyumbang sekitar 40% kasus untuk infertilitas. Salah satu penyebab infertilitas yakni kasus azoospermia. Pada beberapa kasus azoospemia yang ditangani melalui teknologi reproduksi berbantu dengan kegagalan perolehan sperma dari testicular sperm extraction (TESE), maka Spermatogonial Stem Cells (SSCs) dapat menjadi salah satu alternatif terapi. SSCs dapat diperoleh dari isolasi dan kultur sel spermatogenik. Sejak abad ke 19, berbagai metode isolasi dan kultur sel spermatogenik mulai dikembangkan. Akan tetapi berbagai metode ini belum ada yang optimal. Oleh karena itu, dibutuhkan suatu teknik kultur untuk mengoptimalisasi proses ekspansi sel spermatogenik, dari segi faktor apoptosis.Metode: Pada penelitian ini dilakukan pemberian suplemen kultur berbeda pada medium kultur yakni FBS 10%, PRP 10%, dan PRP 10% ditambah faktor pertumbuhan (GDNF, bFGF, EGF) untuk proses kultur. Hasil kultur dilakukan identifikasi marka permukaan CD90 dan GFRA1 menggunkan flowsitometri dan dilakukan uji apoptosis. Fenomena apoptosis yang muncul diamati berdasar adanya fragmentasi pada DNA dengan metode TUNEL serta adanya peran eksekutor apoptosis yakni kaspase-3 yang teramati pada pengujian imunositokimia.Hasil Penelitian: Hasil analisis marka permukaan CD90 dan GFRA1 memiliki nilai berbeda- beda pada pemberian medium yang berbeda. Pertumbuhan sel kultur lebih baik dengan indeks apoptosis yang lebih rendah pada medium dengan pemberian PRP dan PRP ditambah faktor pertumbuhan (FBS= 25.01%, PRP = 9.99%, PRP+ GF= 2.47%). Nilai ekspresi kaspase-3 pada sel yang diberi suplemen FBS sekitar 21%, PRP 13% dan PRP + GF 7%.Kesimpulan: PRP lebih baik dibandingkan dengan FBS sebagai medium kultur sel spermatogenik, dari segi apoptosis.

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ABSTRACTBackground: Males contribute to 40% of the infertility cases over the universe. One of the causes of men infertility is azoospermia. In some cases of azoospemia which are handled through assisted reproductive technology with the failure of sperm retrieval from testicular sperm extraction (TESE), the Spermatogonial Stem Cells (SSCs) could be an alternative therapy. SSCs can be obtained from isolation and culture of spermatogenic cells. Since the 19th century, various methods of isolation and spermatogenic cell culture began to be developed. However, there are not optimal condition of this yet. Therefore, we need to optimize the spermatogenic cell expansion method, particularly in apoptotic factor.Method: In this study, the culture system were administrated by thesupplementation with 10% FBS, 10% PRP, and 10% PRP plus growth factors (GDNF, bFGF, FGF). Spermatogenic cells were identified the surface markers CD90 and GFRA1 using flowsitometry and apoptosis tests were performed. The apoptotic phenomenon was observed based on the presence of DNA fragmentation by the TUNEL method and the caspase-3 expression by immunocytochemical.Result: The result of surface marker had different value. The results showed better that cell culture growth and lower apoptotic index in the medium with PRP and PRP+ GF (FBS= 25.01%, PRP= 9.99%, PRP+ GF= 2.47%). Immuno-expression of caspase-3 in cells cultured with FBS 21%, PRP 13%, dan PRP+ GF 7 %.Conclusion: PRP was better than FBS as the spermatogenic cell culture medium based on apoptotic phenomenon."

"[ABSTRAKPendahuluan: Di Indonesia belum ada penelitian tentang injeksi silikon dan komplikasinya, walaupun kasusnya banyak. Patogenesis granuloma silikon masih belum jelas. Beberapa penelitian mengemukakan peran sel T dan sitokin, namun belum ada yang meneliti tentang toleransi imun.Metode: Penelitian ini merupakan penelitian deskriptif analitik meliputi rancangan potong lintang membandingkan 3 kelompok, yaitu 31 jaringan granuloma dan 31 kulit submental pasien dengan suntikan silikon di dagu (kasus) dan 37 kulit normal (kontrol), terhadap gambaran klinis, histopatologis, dan respons imun melalui ekspresi sitokin TNF-a, IFN-g, IL-10, enzim IDO, serta sel Treg (CD4+CD25+); Penelitian eksperimental membiakkan darah penuh kasus dan orang normal, pada RPMI, dan RPMI yang distimulasi PHA, dan silikon. Dilanjutkan dengan mengukur kadar sitokin TNF-a, IFN-g, IL-10 dan IDO supernatan biakan darah. Penelitian dilakukan di klinik spesialis JMB, FMIPA, FKUI, FKUNAIR, dan lembaga Eijkman, tahun 2012 - 2014.Hasil Penelitian: Sebanyak 31 pasien granuloma akibat suntikan silikon di dagu umumnya datang berobat 12,5 tahun setelah penyuntikan, perubahan bentuk dagu terjadi pada tahun ke-4, perubahan warna pada tahun ke-5. Kadar sitokin proinflamasi di supernatan biakan darah lebih tinggi pada pasien granuloma daripada normal. Terdapat korelasi bermakna antara TNF-a di supernatan biakan darah dengan ekspresi TNF-a di jaringan granuloma. Enzim IDO, Treg, IL-10 di kulit submental berkorelasi bermakna dengan sitokin di granuloma. Sitokin anti inflamasi berperan pada kulit submental. Rasio TNF-a/IL-10 di supernatan biakan darah berkorelasi terbalik dengan ekspresi sel Treg di granuloma, membuktikan fungsi Treg sebagai toleransi imun, bekerja melalui IL-10. Enzim IDO di granuloma berkolerasi bermakna dengan rasio TNF-a/IL-10 di supernatan biakan darah dan Treg kulit submental.Simpulan: Enzim IDO bekerja sama dengan fungsi sel Treg dalam toleransi imun pada granuloma akibat suntikan silikon. TNF-a di supernatan biakan darah dan sitokin anti inflamasi di kulit submental dapat dijadikan prediktor untuk menilai respons imun yang terjadi akibat suntikan silikon.;

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ABSTRACTBackground: There is no study on silicone injections and its complications in Indonesia, yet, although the number of cases increased. The pathogenesis of silicone granulomas is still unclear. A few studies have been made to investigate the role of T cells and cytokines, however, none investigates the role of immune tolerance.Method: An analytical descriptive study encompassing cross sectional research was designed to compare 3 groups of 31 granuloma tissue and 31 submental skin of the patients with silicone injection in the chin (case) and 37 normal skin (control) on the clinical pictures, histopathological features and immune response through the expression of TNF-a, IFN-g, IL-10 cytokines, IDO enzyme, and Treg cells (CD4+CD25+). The experimental study cultured whole blood of the case and control patients and measured the level of TNF-a, IFN-g, IL-10 cytokines and IDO enzyme. The study was conducted in JMB specialist clinics, FMIPA, FKUI, FKUA, and Eijkman foundation from the year 2012 to 2014.Result: Thirty one patients with granuloma caused by silicone injection in the chin commonly seek medical advice 12.5 years after the injection, the chin shape changed on the fourth year and the skin color changed on the fifth year. Patients with granuloma had higher level of proinflammatory cytokines in their blood cultured supernatant. There was a significant correlation between TNF-a in blood cultured supernatant with the expression of TNF-a in the granuloma tissue. IDO enzyme, Treg cells, IL-10 in the submental skin significantly correlated with the cytokines in the granulomas. Anti inflammatory cytokines played a role on the submental skin. The ratio of TNF-a/IL-10 in blood cultured supernatant reversely correlated with the expression of Treg cells in the granuloma, demonstrating the function of Treg cells as an immune tolerance working through IL-10. IDO enzyme in the granulomas significantly correlated with the ratio of TNF-a/IL-10 in blood cultured supernatant and Treg in the submental skin.Conclusion: IDO enzyme collaborates with Treg cells in the immune tolerance caused by silicone injection. TNF-a in blood cultured supernatant and anti inflammatory cytokines in the submental skin can be utilized as predictors to assess the resulting immune response due to silicone injection.;Background: There is no study on silicone injections and its complications in Indonesia, yet, although the number of cases increased. The pathogenesis of silicone granulomas is still unclear. A few studies have been made to investigate the role of T cells and cytokines, however, none investigates the role of immune tolerance.Method: An analytical descriptive study encompassing cross sectional research was designed to compare 3 groups of 31 granuloma tissue and 31 submental skin of the patients with silicone injection in the chin (case) and 37 normal skin (control) on the clinical pictures, histopathological features and immune response through the expression of TNF-a, IFN-g, IL-10 cytokines, IDO enzyme, and Treg cells (CD4+CD25+). The experimental study cultured whole blood of the case and control patients and measured the level of TNF-a, IFN-g, IL-10 cytokines and IDO enzyme. The study was conducted in JMB specialist clinics, FMIPA, FKUI, FKUA, and Eijkman foundation from the year 2012 to 2014.Result: Thirty one patients with granuloma caused by silicone injection in the chin commonly seek medical advice 12.5 years after the injection, the chin shape changed on the fourth year and the skin color changed on the fifth year. Patients with granuloma had higher level of proinflammatory cytokines in their blood cultured supernatant. There was a significant correlation between TNF-a in blood cultured supernatant with the expression of TNF-a in the granuloma tissue. IDO enzyme, Treg cells, IL-10 in the submental skin significantly correlated with the cytokines in the granulomas. Anti inflammatory cytokines played a role on the submental skin. The ratio of TNF-a/IL-10 in blood cultured supernatant reversely correlated with the expression of Treg cells in the granuloma, demonstrating the function of Treg cells as an immune tolerance working through IL-10. IDO enzyme in the granulomas significantly correlated with the ratio of TNF-a/IL-10 in blood cultured supernatant and Treg in the submental skin.Conclusion: IDO enzyme collaborates with Treg cells in the immune tolerance caused by silicone injection. TNF-a in blood cultured supernatant and anti inflammatory cytokines in the submental skin can be utilized as predictors to assess the resulting immune response due to silicone injection., Background: There is no study on silicone injections and its complications in Indonesia, yet, although the number of cases increased. The pathogenesis of silicone granulomas is still unclear. A few studies have been made to investigate the role of T cells and cytokines, however, none investigates the role of immune tolerance.Method: An analytical descriptive study encompassing cross sectional research was designed to compare 3 groups of 31 granuloma tissue and 31 submental skin of the patients with silicone injection in the chin (case) and 37 normal skin (control) on the clinical pictures, histopathological features and immune response through the expression of TNF-a, IFN-g, IL-10 cytokines, IDO enzyme, and Treg cells (CD4+CD25+). The experimental study cultured whole blood of the case and control patients and measured the level of TNF-a, IFN-g, IL-10 cytokines and IDO enzyme. The study was conducted in JMB specialist clinics, FMIPA, FKUI, FKUA, and Eijkman foundation from the year 2012 to 2014.Result: Thirty one patients with granuloma caused by silicone injection in the chin commonly seek medical advice 12.5 years after the injection, the chin shape changed on the fourth year and the skin color changed on the fifth year. Patients with granuloma had higher level of proinflammatory cytokines in their blood cultured supernatant. There was a significant correlation between TNF-a in blood cultured supernatant with the expression of TNF-a in the granuloma tissue. IDO enzyme, Treg cells, IL-10 in the submental skin significantly correlated with the cytokines in the granulomas. Anti inflammatory cytokines played a role on the submental skin. The ratio of TNF-a/IL-10 in blood cultured supernatant reversely correlated with the expression of Treg cells in the granuloma, demonstrating the function of Treg cells as an immune tolerance working through IL-10. IDO enzyme in the granulomas significantly correlated with the ratio of TNF-a/IL-10 in blood cultured supernatant and Treg in the submental skin.Conclusion: IDO enzyme collaborates with Treg cells in the immune tolerance caused by silicone injection. TNF-a in blood cultured supernatant and anti inflammatory cytokines in the submental skin can be utilized as predictors to assess the resulting immune response due to silicone injection.]"