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"Latar belakang: PLI awalnya dilakukan pada tahun 1981 untuk mengatasi kasus-kasus klinis seperti keguguran berulang dan meningkatkan keberhasilan In-Vitro Fertilization (IVF) di beberapa negara. PLI menstimulasi dan mengaktifkan imunotoleran pada sistem imun ibu. Toleransi imun pada ibu dibutuhkan untuk terjadinya konsepsi. Keseimbangan Th1/Th2 dan Treg berperan penting dalam kehamilan. Kejadian ASA pada pasangan infertil sebanyak 10-30%. Keberhasilan PLI dalam mengatasi kasus-kasus klinis dan menurunkan ASA telah terbukti, namun mekanisme imun yang terjadi setelah pemberian PLI belum diketahui. Penelitian ini ingin mengetahui mekanisme imun yang terjadi setelah PLI pada perempuan dengan infertilitas yang tidak terjelaskan dengan melakukan analisis terhadap ASA, IL6, IL10, IFNγ, IDO, dan populasi sel Treg CD4⁺CD25⁺Foxp3⁺. Metode: Desain penelitian ini adalah analitik observasional. Penelitian dilaksanakan di RSIA Sayyidah Jakarta pada bulan Juni 2018 s.d April 2019. Sampel penelitian ini adalah 16 perempuan infertil tidak terjelaskan dengan titer ASA > 1:128. Hasil: PLI dapat menurunkan ASA. Rasio kenaikan persentase sel Treg  CD4⁺CD25⁺FoxP3⁺ yang tinggi setelah 6 kali PLI lebih besar (50%) dibandingkan 3 kali PLI (20%) namun belum ditemukan pengaruhnya secara bermakna terhadap frekuensi PLI. Kenaikan rasio IL10 post/awal penelitian yang tinggi lebih besar (75%) pada kelompok dengan persentase penurunan titer ASA sedikit dibandingkan pada kelompok persentase penurunan titer ASA banyak (11,1%), hal ini berbanding terbalik dengan hipotesis. Tidak terdapat perbedaan bermakna rasio IL6 (p 0,089), IFNγ (p 0,959), dan IDO post/awal penelitian dengan persentase penurunan titer ASA setelah PLI. Kenaikan IFNγ yang tinggi diikuti oleh kenaikan rasio IDO post/awal penelitian dan kenaikan persentase populasi sel Treg CD4⁺CD25⁺FoxP3^+. Simpulan: PLI menurunkan ASA pada perempuan dengan infertilitas tidak terjelaskan. Terdapat kenaikan rasio populasi sel Treg CD4⁺CD25⁺FoxP3⁺ setelah PLI namun kenaikan rasio populasi sel Treg CD4⁺CD25⁺FoxP3⁺ belum ditemukan pengaruhnya secara bermakna terhadap frekuensi PLI. Tidak didapatkan peningkatan IL10, IL6, IFNγ dan kadar IDO setelah penurunan ASA pada perempuan infertilitas tidak terjelaskan yang mendapatkan PLI. Terdapat korelasi antara kadar IFNγ, IDO, dan populasi sel Treg

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Background: PLI is firstly introduced in 1981 to treat clinical cases such as recurrent misscarriage or increase success rate of IVF in various countries. PLI stimulate and activate immunotolerancy to maternal immune systems. Maternal immune tolerancy is required for conceptions. Th1 and Th2 balance ratio and Treg play role during pregnancy. ASA occured in 10-30% of infertility couples. PLI successness to overcome clinical cases and decrease ASA has been demonstrated. However, immune mechanism after PLI treatment were remained unclear. This research aim to understand immune mechanism after PLI in female with unexplained infertility by analyzed ASA, IL6, IL10, IFNγ, IDO, Treg CD4⁺CD25⁺Foxp3⁺ cells populations.

Methods : This research using observational analysis. The research were conducted in RSIA Sayyidah Jakarta from Juni 2018 to April 2019. Samples were 16 female with unexplained infertility with ASA titre > 1:128.

Result: PLI can decrease ASA. Increase ratio of Treg CD4⁺CD25⁺FoxP3⁺ percentages was higher after 6 times of PL1 (50%) compared to 3 times of PLI (20%). However no significant effect to PLI frequencies observed. Increase ratio of IL10 at post/early research was higher (75%) in groups with moderate decrease of ASA titre compared to groups with significant decrease of ASA titre (11%), this is contradictive to the hypothesis. No significant differences of IL6 (p 0.089), IFNγ (p 0.959), and IDO at post/early of this research with decrease ASA titre percentages after PLI. A significant increase of IFNγ were followed by increase ratio of IDO at post/early research and increase percentages of Treg CD4⁺CD25⁺FoxP3⁺.

Conclusion: PLI can decrease ASA in female with unexplained infertility. Increase ratio of Treg CD4⁺CD25⁺FoxP3⁺ populations were observed after PLI. However, the effect to PLI frequencies were not observed. No increase of IL10, IL6, IFNγ dan IDO level after decrease of ASA in female with unexplained infertility that received PLI. Correlations of IFNγ , IDO, and Treg populations was founded."

"Preeklamsia dibagi menjadi preeklamsia awitan dini (PEAD) jika terjadi pada usia kehamilan < 34 minggu dan preeklamsia awitan lanjut (PEAL) pada kehamilan > 34 minggu. Intoleransi imun diduga menyebabkan penolakan imun terhadap fetus di plasenta. Dendritic cell 10 (DC-10) dan sel T regulator CD4+CD25+FoxP3 (Treg) di desidua berperan penting dalam menciptakan lingkungan yang tolerogenik selama kehamilan. Namun, peran spesifik dalam patomekanisme PEAD dan PEAL serta faktor-faktor nutrisi yang berperan dalam regulasi DC-10 dan Treg, yaitu seng, vitamin A, dan vitamin D belum diteliti secara jelas. Penelitian ini bertujuan untuk memahami patomekanisme penolakan imun pada preeklamsia melalui jumlah DC-10 dan sel Treg desidua serta hubungannya dengan vitamin A, vitamin D, dan seng.Desain penelitian ini adalah studi potong lintang komparatif antara kehamilan dengan PEAD, PEAL, dan NT antara Oktober 2019 dan Desember 2021. Subjek penelitian direkrut dari RSUP Fatmawati (Jakarta), RSUPN Cipto Mangunkusumo (Jakarta), dan RSUD Karawang (Jawa Barat). Kriteria penerimaan adalah semua ibu hamil 20–40 minggu yang menjalani persalinan dengan seksio sesaria dan setuju untuk dilibatkan dalam penelitian. Kriteria penolakan meliputi pasien dengan penyulit obstetrik, plasenta previa, memiliki riwayat penyakit kronik, hipertensi sebelum kehamilan 20 minggu, terdiagnosis COVID-19, demam dan leukosit >15.000 /mL pada saat pemeriksaan dan kematian janin dalam rahim. Spesimen desidua diperoleh dengan kuretase tajam setelah seksio sesaria. Jumlah DC-10 dan sel Treg dihitung dengan flow cytometry. Konsentrasi faktor nutrisi diperiksa dengan metode ICP-MS dan LC-MS. Perbandingan median dianalisis dengan uji Kruskal-Wallis, sedangkan koefisien korelasi diperoleh dengan uji korelasi Spearman. Subjek penelitian adalah 14 ibu hamil untuk setiap kelompok (total 42 kasus). Jumlah DC-10 lebih rendah secara bermakna pada PEAD dibandingkan NT (p < 0,001) dan lebih rendah secara bermakna pada PEAL dibandingkan NT (p = 0,015). Sebaliknya, sel Treg FoxP3+CD25+ lebih tinggi secara bermakna pada PEAD dibandingkan NT (p = 0,015). Tidak terdapat korelasi antara faktor nutrisi dan jumlah faktor tolerogenik pada kelompok preeklamsia (PE). Namun, terdapat korelasi sedang antara konsentrasi seng desidua dan DC-10 di kelompok NT (r = 0,656; p = 0,011) dan korelasi kuat antara konsentrasi retinol desidua dan DC-10 juga di kelompok NT (r = 0,746; p = 0,002). Korelasi sedang didapatkan antara konsentrasi vitamin D dan jumlah sel Treg FoxP3+CD25+ di kelompok NT (r = 0,590; p = 0,026). Disimpulkan bahwa jumlah DC-10 pada PEAD lebih rendah dibandingkan dengan kehamilan NT, sedangkan jumlah sel Treg pada PEAD secara bermakna lebih tinggi dibandingkan dengan kehamilan NT. Konsentrasi faktor nutrisi desidua tidak berkorelasi dengan jumlah DC-10 atau Treg desidua pada preeklamsia (PEAD dan PEAL). Namun, pada kelompok NT terdapat korelasi positif antara seng dan DC-10, retinol dan DC-10, serta vitamin D dan jumlah sel Treg desidua.

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Preeclampsia is categorized as early-onset preeclampsia (EOPE) at < 34 week of gestation and late-onset preeclampsia (LOPE) at > 34 week of gestation. Immune intolerance is thought to be the underlying cause of immune rejection to the fetus in the placenta. Decidual dendritic cell-10 (DC-10) and T regulator cell CD4+CD25+FoxP3 (Treg) play important role to create a tolerogenic environment during pregnancy. However, the specific role in the pathomechanism of EOPE or LOPE and nutritional factors that play role in the regulation of DC-10 and Treg, i.e. zinc, vitamin A, and vitamin D have not been widely studied. This study was aimed to know the pathomechanism of immune rejection in preeclampsia through the number of decidual DC-10 and Treg cell and their correlations with vitamin A, vitamin D, and zinc.

The study design was cross-sectional comparative among EOPE, LOPE, and NT pregnancies between October 2019 and December 2021. Study subjects were recruited from Fatmawati General Hospital (Jakarta), Cipto Mangukusumo National General Hospital (Jakarta), and Karawang Regional Public Hospital (West Java). Inclusion criteria were all pregnant women between 20–40 weeks of gestation who underwent cesarean delivery and gave their written consent to be included in the study. Exclusion critera were patients with obstetric complications, placenta previa, history of chronic disease, hypertension before 20 weeks of gestation, was diagnosed with COVID-19, fever and leukocyte count of >15.000 /mL at the time of examination and presence of intrauterine fetal death. Decidual specimens were obtained by curettage after the cesarian section. The number of DC-10 and Treg cells were counted using flow cytometry. Concentrations of nutritional factors were assayed using ICP-MS and LC-MS method. Median comparison among groups was analyzed using Kruskal-Wallis test, while correlation coefficient was obtained by using the Spearman correlation test. Study subjects were 14 pregnant women for each group (42 cases in total). The DC-10 was significantly lower in EOPE compared to NT (p < 0.001) and significantly lower in LOPE compared to NT (p = 0.015). On the other hand, Treg FoxP3+CD25+ cells were significantly higher in EOPE compare to NT (p = 0.015). No correlation between nutritional factors and the number of tolerogenic factors in the preeclampsia group. However, there was a moderate correlation between decidual zinc concentration and DC-10 in the NT group (r = 0.656; p = 0.011) and a strong correlation between decidual retinol concentration and DC-10 also in NT group (r = 0.746; p= 0.002). A moderate correlation was found between vitamin D concentration and Treg FoxP3+CD25+ cells in the NT group (r = 0.590; p = 0.026). To conclude, the number of DC-10 in EOPE is lower than NT pregnancy, whereas the number of Treg cells in EOPE is higher than NT pregnancy. Concentrations of dedicual nutritional factors do not correlate with the number of decidual DC-10 or Treg cells in preeclampsia (EOPE and LOPE). However, in NT group, there is positive correlation between decidual zinc and DC-10, retinol and DC-10, and vitamin D and Treg cells."

"ABSTRAKAsma alergi merupakan penyakit atopi degeneratif yang disebabkan alergi atau hipersensitifitas tipe-1. Lebih dari 50% penderita asma alergi disebabkan adanya reaksi hipersensitif terhadap alergen Tungau Debu Rumah (TDR). Skrining subjek penelitian berdasarkan manifestasi asma dan Skin Prick Test (SPT) didapatkan 25 subjek atopi asma yang disebabkan alergi terhadap alergen TDR dan 21 subjek nonatopi. Respon imunitas seluler dievaluasi melalui teknik kultur Kultur sel mononuklear darah tepi (SMDT) yang diisolasi dari darah menggunakan teknik ficoll gradient. Kultur SMDT dari masing-masing subjek distimulasi dengan Alergen TDR, PHA (kontrol positif), dan RPMI (kontrol negatif) selanjutnya diinkubasi dalam inkubator CO2 5%, 37⁰C selama 72 jam. Dengan metode multiplex assay, supernatan hasil kultur dilakukan pengukuran IFNγ untuk menilai mediator proinflamasi tipe-1, Interleukin 13 (IL-13) untuk menilai mediator proinflamasi tipe-2, dan IL-10 sebagai anti inflamasi serta kadar Indoleamine 2,3-Dioxygenase (IDO) diukur dengan metode ELISA Sandwich. Terdapat peningkatan rasio sitokin proinflamasi tipe-2 (IL13) terhadap anti inflamasi (IL10) dan penurunan rasio sitokin proinflamasi tipe-1 (IFN) terhadap proinflamasi tipe-2 (IL-13) yang dihasilkan dari kultur SMDT pada kelompok atopi asma dibandingkan dengan kelompok nonatopi. Perubahan pola keseimbangan mediator pro inlamasi tipe-1, tipe-2 dan anti inflamasi pada subjek asma alergi diduga mempengarui produksi IDO yang ditemukan secara signifikan lebih rendah dibanding subjek non atopi.

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ABSTRACT Allergic asthma is degenerative atopy caused by type 1 allergic or hypersensitivity. More than 50% of people with allergic asthma are caused by hypersensitivity reactions to house dust mite allergens (HDM). Screening of research subjects based on asthma manifestations and Skin Prick Test (SPT) found 25 subjects with atopic asthma caused by allergies to TDR allergens and 21 nonatopic subjects. The cellular immune response was evaluated through a culture of peripheral blood mononuclear cell culture (PBMC) technique isolated from blood using the ficoll gradient technique. PBMC cultures from each subject were stimulated with HDM allergens, PHA (positive control), and RPMI (negative controls) then incubated in a 5% CO2 incubator, 37⁰C for 72 hours. With the multiplex assay method, IFNγ measurements were carried out by the culture supernatant to assess type 1 proinflammatory mediator, Interleukin 13 (IL-13) to assess type 2 proinflammatory mediators, and IL-10 as anti-inflammatory and Indoleamine 2,3-Dioxygenase levels (IDO) is measured by the ELISA Sandwich method. There was an increase in the ratio of type-2 (IL13) proinflammatory cytokines to anti-inflammatory (IL10) and a decrease in type-1 (IFN) proinflammatory cytokine to proinflammatory type-2 (IL-13) resulting from PBMC culture in the asthma atopy group compared to the nonatopic group. Changes in the balance pattern of type 1, type-2 and anti-inflammatory pro-inflammatory mediators in allergic asthma subjects suspected to affect IDO production were found to be significantly lower than non-atopy subjects. "

"Sampai saat ini, etiologi simple bone cyst(SBC) masih belum jelas; terdapat sejumlah teori mengenai terbentuknya SBC. Salah satu teori yang paling populer adalah obstruksi vena yang berakibat pada akumulasi cairan. Cairan-cairan ini diketahui mengandung faktor resorptif tulang, diantaranya adalah interleukin-1b(IL-1b) dan prostaglandin E2 (PGE2). Selain itu, parameter rasio limfosit monosit (LMR) saat ini sering dipakai memprediksi prognosis suatu keganasan, namun belum ada data yang berhubungan dengan tumor jinak. Kortikosteroid diketahui memiliki efek inhibitorik pada resorpsi tulang. Penelitian ini bertujuan untuk menganalisis kadar IL-1bdan PGE2 pada pasien SBC yang dilakukan injeksi steroid serial. Desain studi kohort prospektif dilakukan dengan menganalisis cairan kista pasien SBC yang datang ke RSCM pada bulan Januari 2018 sampai Juli 2019. Dilakukan dekompresi dan injeksi metilprednisolon asetat dosis 80-120mg tergantung dari usia dan berat badan subyek. Interval antar injeksi adalah satu bulan. Cairan dianalisis untuk mengukur kadar IL-1bdan PGE2 dengan menggunakan Quantikine ELISA(R&D System, Minnesota, Amerika Serikat), serta dinilai LMR nya. Kriteria penyembuhan tulang dinilai menggunakan kriteria radiologis Chang. Terdapat 4 subjek dalam penelitian kami, dengan median usia 12 (8-18) tahun. Seluruh subjek berjenis kelamin laki-laki. Dua subjek mengalami SBC pada humerus proksimal, dan dua subjek lainnya mengalami SBC pada femur proksimal. Seluruh kista bersifat aktif. Dua subjek sembuh, satu subjek sembuh dengan defek, dan satu subjek mengalami kista persisten. Didapatkan kadar IL-1bpada 3 subjek berada dibawah 3,9 pg/mlpada serial injeksi dan 1 subjek memiliki kadar 6,7, 13,31, dan 5,42 pg/ml.Sedangkan kadarbaselinePGE2 pada4 subjekadalah411, 122,5, 437,99dan 261,49pg/ml.Nilai LMR pada 4 subjek 6,2, 6,54, 5,4 dan 8,13.Terdapat perubahan kadar PGE2 dalam cairan SBC yang dilakukan pada injeksi steroid serial dengan kecenderungan meningkat paska injeksi yang pertama, lalu menurun paska serial injeksi berikutnya.Kadar interleukin IL-1βberada dibawah 3,9pg/mldalam cairan SBC yang dilakukan injeksi steroid serial.Tidak terdapat hubungan LMR dengan proses penyembuhan dan progresivitas lesi SBC

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To date, the aetiology of simple bone cyst (SBC) remains controversial. Several theories regarding its pathogenesis exist, and one of the most popular ones is venous obstruction which leads to fluid accumulation. This fluid contains bone resorptive factor, such asinterleukin-1b(IL-1b) and prostaglandin E2 (PGE2). Corticosteroid is known to possess an inhibitory effect on bone resorption. The objective of this study is to analyze IL-1bdan PGE2 in patients with SBC who treated with serial steroid injection. This prospective study was conducted by analyzing cyst fluid of patients diagnosed with SBC who went to Cipto Mangunkusumo Hospital, Jakarta, Indonesia during the period between January 2018 and July 2019. The subjects underwent decompression, and subsequently they were injected with methylprednisolone acetate. The dose of the steroid varied from 80 to 160 mg according to the subject's age and weight. The interval of each injection was one month. The fluid was analyzed for its IL-1band PGE2 levels by means of Quantikine ELISA (R&D System, Minnesota, United States). Bone healing was evaluated using Chang criteria. A total of 4 subjects (median age: 12 [8-18] years of age) were included in our study. All subjects were male. Two subjects had SBC on the proximal humerus, and the other two had SBC on the proximal femur. All cysts were active. Two subjects healed, one healed with defect, and one had persistent cyst. We found that the IL-1bof3 subjects were below3.9 pg/mlin serial injection, and one subject had IL-1blevels of6.7, 13.31, and5,42 pg/ml.Whereas, the baseline PGE2 levels in four subjects were 411, 122.5, 437.99and261,49pg/ml.TheLMRin four subjects werepada 4 subjek 6.2, 6.54, 5.4 dan 8.13.We found change in PGE2 levels in SBC fluid that was treated with serial steroid injection. We found an increasing trend after the first injection, which was followed by a decreasing trend in the subsequent injection. The IL-1β levels in all timepoint were below3.9pg/ml."

"Latar Belakang: Panjang interval QTc dipengaruhi oleh berbagai faktor, salah satunya oleh inflamasi. Pada pasien COVID-19 sering terjadi badai sitokin sehingga menyebabkan peningkatan signifikan dari sitokin inflamasi, termasuk interleukin 6. Peningkatan interleukin 6 menyebabkan perubahan pada kanal ion kardiomiosit sehingga menyebabkan pemanjangan interval QTc yang berisiko aritmia.Tujuan: Mengetahui korelasi dengan melihat beda rerata kadar interleukin 6 dan panjang interval QTc, nilai titik potong kadar interleukin 6 terhadap panjang interval QTc > 500 ms dan kekuatan kadar interleukin 6 dalam menilai risiko aritmia ventrikular.Metode: Penelitian ini menggunakan desain studi potong lintang dengan mengambil data sekunder rekam medik pasien COVID-19 yang menjalani rawat inap di RSCM Kiara sejak November 2020 hingga Maret 2021. Pada penelitian ini dilakukan analisis bivariat menggunakan uji Spearman. Selanjutnya dilakukan analisis terhadap beda rerata kadar interleukin 6 pada kelompok subyek dengan panjang interval QTc > 500 ms dan kelompok subyek dengan panjang interval QTc normal. Dilakukan analisis dengan Receiver Operating Curve (ROC) untuk melihat Area under curve (AUC) dan menentukan titik potong kadar interleukin 6 terhadap panjang interval QTc > 500 ms.Hasil: Pada penelitian ini didapatkan korelasi kadar interleukin 6 dan panjang interval QTc (r=0,72). Median kadar interleukin 6 pada kelompok subyek dengan interval QTc > 500 ms yaitu 99,36 pg/ml sedangkan pada kelompok subyek dengan interval QTc normal yaitu 19,51 pg/mL. Didapatkan AUC=0,852 untuk menentukan titik potong kadar interleukin 6 terhadap panjang interval QTc > 500 ms dengan nilai 59 pg/ml, dengan sensitivitas 80,6% dan spesifisitas 80%. Kejadian aritmia ventrikular tidak ditemukan sehingga tidak dapat dilakukan analisis untuk menilai kekuatan kadar interleukin 6 untuk menentukan risiko aritmia ventrikular.Kesimpulan: Terdapat korelasi kadar interleukin 6 dan panjang interval QTc dengan beda rerata kadar interleukin 6 pada subyek dengan interval QTc > 500 ms 5 kali lebih besar dibandingkan kelompok subyek dengan panjang interval QTc normal. Kadar interleukin 6 59 pg/mL ditentukan sebagai nilai titik potong terhadap panjang interval QTc > 500 ms.

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Background: The length of the QTc interval is influenced by various factors, one of which is inflammation. In COVID-19 patients, cytokine storms often occur, causing a significant increase in inflammatory cytokines, including interleukin 6. An increase in interleukin 6 can cause changes in the ion channels of cardiomyocytes, which can lead to prolonged QTc interval which is at risk of arrhythmias.

Objective: Knowing the correlation by looking at the differences in interleukin 6 levels and the length of the QTc interval, the cut-off value of interleukin 6 levels to the length of the QTc interval > 500 ms and the strength of interleukin 6 levels in assessing the risk of ventricular arrhythmias.

Method: This study used a cross-sectional study design by taking secondary data from the medical records of COVID-19 patients who were hospitalized at RSCM Kiara from November 2020 to March 2021. In this study, a bivariate analysis was carried out using the Spearman test. Furthermore, an analysis of the mean difference in interleukin 6 levels was carried out in the subject group with a QTc interval length> 500 ms and the subject group with a normal QTc interval length. Analyzes were performed using the Receiver Operating Curve (ROC) to see the area under curve (AUC) and determine the interleukin 6 cutoff point for the QTc interval length> 500 ms.

Result: The correlation between interleukin 6 levels and the length of the QTc interval (r=0.72) was found. The median level of interleukin 6 in the group of subjects with a QTc interval > 500 ms was 99.36 pg/ml while in the group of subjects with a normal QTc interval it was 19.51 pg/mL. AUC = 0.852 was obtained to determine the cut-off point for interleukin 6 levels to the QTc interval length > 500 ms with a value of 59 pg/ml, with a sensitivity of 80.6% and specificity of 80%. The incidence of ventricular arrhythmias was not found so that an analysis could not be performed to assess the power of interleukin 6 levels to determine the risk of ventricular arrhythmias.

Conclusion: There is a correlation between levels of interleukin 6 and the length of the QTc interval. The mean difference of interleukin 6 levels in subjects with QTc intervals> 500 ms was 5 times greater than those in groups of subjects with normal QTc interval lengths. The level of interleukin 6 59 pg / mL was determined as the cutoff value for the QTc interval length> 500 ms."

"Latar belakang. Graves? Disease (GD) merupakan penyakit autoimun yang paling banyak menyebabkan hipertiroidisme dan ditandai adanya autoantibodi terhadap reseptor hormon tiroid (TSHR). Sel dendritik (DC) berperan penting dalam menentukan jenis respon imun tubuh, berupa aktivasi atau toleransi, salah satunya dengan cara mensekresikan mediator yang dapat mempengaruhi kerja sel-sel lain. Vitamin D merupakan imunoregulator alami yang dalam kondisi normal dapat mempengaruhi DC untuk mensekresikan IDO dan IL-10 serta menekan sekresi IL-12 dari DC. Sekresi IDO dan IL-10 oleh DC dapat mencetuskan respon toleransi dengan meningkatkan aktivitas sel T regulatori (Treg) dalam mencegah dan/atau mengurangi produksi autoantibodi terhadap TSHR. Belum diketahui apakah pemberian vitamin D pada kondisi GD dapat meningkatkan sekresi IDO dan IL-10 serta menekan sekresi IL-12.Tujuan. Melihat pengaruh kadar vitamin D terhadap fungsi DC dan sistem imun pasien GD dalam mensekresikan IL-12, IDO dan IL-10.Metode. Sampel merupakan bahan biologis tersimpan yang berupa supernatan kultur DC dari monosit (kultur MDDC) dan serum dari pasien GD. Kultur MDDC dari pasien GD sebelum perlakuan, diberi pendedahan tanpa atau dengan 1,25(OH)2D3 100 nM, waktu inkubasi 7 hari, dengan penambahan lipopolisakarida (LPS) pada hari ke-5. Kultur MDDC dari pasien GD setelah perlakuan, diinkubasi tanpa 1,25(OH)2D3 selama 7 hari dengan pemberian LPS pada hari ke-5. Serum berasal dari pasien GD sebelum dan sesudah mendapatkan terapi standar PTU 100 mg 3 kali sehari dengan atau tanpa suplementasi 1α(OH)D3. Serum dan supernatan diuji dengan metode ELISA untuk mengukur kadar 25(OH)D3, IL-12, IDO dan IL-10, kemudian diuji secara statistik untuk melihat pola dari tiap parameter.Hasil. Rerata kadar IL-12 lebih rendah secara signifikan pada kultur MDDC dengan pemberian vitamin D 100 nM. Rerata kadar IDO dan IL-10 cenderung tetap pada kultur MDDC dengan pemberian vitamin D 100 nM. Peningkatan kadar vitamin D dalam serum berkorelasi negatif dengan kadar IL-12 dan IDO, baik dalam supernatan kultur MDDC maupun dalam serum pasien GD. Pada kelompok pasien GD dengan peningkatan kadar vitamin D serum tinggi, respon sekresi IL-10 pada MDDC dan sistem imun pasien GD cenderung meningkat. Semakin tinggi rasio kadar IL-12/IL-10 pada supernatan kultur MDDC dan serum pasien GD, maka semakin tinggi juga kadar IDO yang disekresikan.Simpulan. Pemberian vitamin D pada kultur MDDC dari pasien GD dapat menekan respon inflamasi MDDC dengan mengurangi sekresi kadar IL-12 dan mempertahankan kadar IDO dan IL-10. Peningkatan kadar vitamin D serum dapat menekan kadar IL-12 dan IDO, juga berpotensi meningkatkan kadar IL-10, baik pada keadaan in vitro maupun in vivo.

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Background. Graves' disease (GD) is a type of autoimmune disease that causes hyperthyroidism. GD patients have excess autoantibodies specific for thyroid stimulating hormone receptors (TSHR). Dendritic cells (DCs) play an important role in determining the type of immune response, either activation or tolerance, by secreting mediator molecules that affect other cells. Vitamin D is a natural immunoregulator which in normal condition can affect IDO and IL-10 secretion by DC while suppresing IL-12 secretion by this cell. Secretion of IDO and IL-10 by DC can trigger tolerance by increasing regulatory T cells (Treg) activity in preventing and/or reducing the production of autoantibodies against TSHR. There is still no evidence whether administration of vitamin D at GD conditions can increase the secretion of IDO and IL-10 and suppress the secretion of IL-12.

Aim. To identify the effect of vitamin D in vitro and in vivo on IL-12, IDO and IL-10 secretion by DC and on the immune system of GD patients.

Method. Samples were stored biological liquid in the form of serum and monocyte derived dendritic cells (MDDC) culture supernatant from GD patients. MDDC cultures of pre-treatment GD patients were incubated for 7 days with or without 1,25(OH)2D3 100 nM, with an addition of LPS on day 5. MDDC cultures of post-treatment GD patients were incubated without 1,25(OH)2D3 for 7 days, with an addition of LPS on day 5. Serum were obtained from GD patients before and after standard therapy of 100mg PTU 3 times a day with or without 1α(OH)D3 supplementation. Levels of 25(OH)D3, IL-12, IDO and IL-10 in the serum and supernatant were measured by ELISA and the results were statistically analyzed to see the pattern of each parameter.

Results. The mean levels of IL-12 are significantly lower in MDDC culture with 100 nM vitamin D. The mean levels of IDO and IL-10 in MDDC cultures with 100 nM vitamin D are maintained at the same levels with MDDC without vitamin D. Increased levels of vitamin D in serum is negatively correlated with IL-12 and IDO levels, both in the MDDC supernatant and in the serum of GD patients. In the high-increment-serum-vitamin-D-level group of GD patients, IL-10 secretion in vitro and in vivo tends to increase. Higher ratio of IL-12/IL-10 levels affects an increase in IDO secretion, both in MDDC culture and in patient?s serum.

Conclusion. Vitamin D exposure in MDDC culture of GD patients can suppress the inflammatory response by reducing IL-12 secretion and maintaining IDO and IL-10 levels. Increased vitamin D serum level can suppress IL-12 and IDO levels and is also potential in increasing IL-10 level, both in vitro and in vivo."

"Interleukin 6 merupakan sitokin yang berperan penting dalam patogenesis periodontitis. Beberapa penelitian telah menunjukan bahwa polimorfisme promotor gen IL-6 berpengaruh terhadap kerentanan host terhadap penyakit periodontitis. Untuk mengetahui hubungan polimorfisme promotor gen IL-6 - 174G/C dengan tingkat keparahan periodontitis dilakukan penelitian menggunakkan 103 sampel DNA yang terdiri dari 23 kontrol sehat, 9 periodontitis ringan, 41 periodontitis sedang dan 30 periodontitis berat yang dianalisis dengan metode PCR-RLFP. Hasil penelitian ditemukan 100 genotip GG dan 3 genotip GC, tidak ditemukan genotip CC. Tes Kolmogorov-Smirnov menyatakan P=0,773 dan P=0.662 sehingga disimpulkan tidak terdapat hubungan antara polimorfisme promotor gen IL-6 -174G/C dengan tingkat keparahan periodontitis.

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Interleukin 6 is a cytokine that plays a major role in the pathogenesis of periodontitis. Studies have shown that polymorphisms of IL-6 gene promoter affects host susceptibility to periodontitis. To evaluate the correlation of gene promoter polymorphism IL-6-174G/C with severity of periodontitis, 103 stored DNA samples consist of 23 healthy controls, 9 mild periodontitis, 41 moderate periodontitis and 30 severe periodontitis were analyzed by PCR-RLFP, resulting distribution of 100 GG genotypes, 3 GC genotypes, and CC genotype wasn?t found. Kolmogorov-Smirnov?s test was performed (P=0.773, P=0,662), concludes that there was no correlation between polymorphism promoter gen IL-6-174G/C with severity of periodontitis."

"Meningkatnya penggunaan narkoba (narkotika, psikotropika dan berbahaya lainnya) di dunia, berdampak pada penyalahgunaan Methamphetamin (METH) khususnya di Indonesia. Efek METH dapat menginduksi neurotoksik, dimana terjadi kerusakan pada saraf terminal dopaminergik, serotonergik, apoptosis neuron, astroglia dan aktivasi mikroglia yang mengarah pada respon peradangan saraf di dalam otak. Studi menunjukkan efek NAC yang signifikan dalam memperbaiki TNF-α dan IL-6 pada fase infeksi akut atau kronis memotivasi pelaksanaan penelitian untuk mengevaluasi perubahan kadar IL-6 dan TNF-α pada pasien ketergantungan METH yang mengalami withdrawal pada kelompok yang mendapatkan terapi N- asetilsistein.Penelitian ini menggunakan bahan biologis tersimpan (serum), untuk mengetahui kadar IL-6 dan kadar TNF-α sebagai indikator neuroinflamasi pada pasien dengan ketergantungan METH yang mendapatkan terapi NAC (n=30) atau Placebo (n=30) selama 30 hari (cross-sectional). Penelitian dilakukan di Laboratorium Farmakologi Kinetik FKUI Salemba, Jakarta Pusat dan waktu penelitian pada bulan Agustus 2022 sampai bulan November 2022 dengan menggunakan metode ELISA. Hasil penelitian didapatkan 15 sampel yang terukur dan hanya 7 sampel yang dapat dianalisis (NAC-Placebo, Pre-Post Intervensi). Hasil mean TNF-α (Pre NAC) = 78.403 (pg/ml) ± 108,02, dan mean TNF-α (Post NAC) = 55,3176 (pg/ml) ± 75,15. Hasil IL-6 didapatkan pre NAC= 13,52 pg/ml, dan post NAC= 7,57 pg/ml. Kesimpulan penelitian adalah kadar IL-6 pada kelompok yang mendapatkan NAC mengalami penurunan dan kadar TNF-α pada kelompok yang mendapat NAC mengalami penurunan. Saran untuk penelitian selanjutnya diperlukan sampel baru dengan subyek yang lebih banyak dengan parameter inflamasi lainnya, dan kit-reader yang sensitif untuk mendapatkan efek potensial anti-inflamasi NAC pada subyek ketergantungan METH.

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The increasing use of drugs (narcotics, psychotropics and other dangerous drugs) in the world has had an impact on the abuse of Methamphetamine (METH), especially in Indonesia. The effects of METH can induce neurotoxicity, where there is damage to dopaminergic, serotonergic nerve terminals, neuronal apoptosis, astroglia and activation of microglia which leads to a neuroinflammatory response in the brain. The study shows the significant effect of NAC in improving TNF-α and IL-6 in the acute or chronic phase of infection motivating the implementation of research to evaluate changes in IL-6 and TNF-α levels in METH-dependent patients experiencing withdrawal in the group receiving N-acetylcysteine ​​therapy .

This study used stored biological material (serum), to determine IL-6 levels and TNF-α levels as indicators of neuroinflammation in patients with METH dependence who received NAC therapy (n=30) or Placebo (n=30) for 30 days (cross -sectional). The research was conducted at the Kinetic Pharmacology Laboratory, FKUI Salemba, Central Jakarta and the research period was from August 2022 to November 2022 using the ELISA method.

The research results showed that 15 samples were measurable and only 7 samples could be analyzed (NAC-Placebo, Pre-Post Intervention). Results mean TNF-α (Pre NAC) = 78.403 (pg/ml) ± 108.02, and mean TNF-α (Post NAC) = 55.3176 (pg/ml) ± 75.15. IL-6 results showed that pre NAC= 13.52 pg/ml, and post NAC= 7.57 pg/ml. The conclusion of the study was that IL-6 levels in the group that received NAC decreased and TNF-α levels in the group that received NAC decreased. Suggestions for further research require new samples with more subjects with other inflammatory parameters, and sensitive kit-readers to obtain the potential anti-inflammatory effect of NAC in METH-dependent subjects."

"Latar Belakang: Ikterus obstruktif merupakan salah satu komplikasi tersering keganasan sistem bilier. Keadaan ini akan memicu pelepasan sitokin proinflamasi. Terdapat kontroversi mengenai pengaruh drainase bilier terhadap perubahan kadar sitokin proinflamasi pada penderita kanker pankreatobilier.Tujuan: Untuk mengetahui kadar Tumor Necrosis Faktor alfa (TNF-alfa) dan Interleukin 6 (IL6) sebelum dan sesudah Endoscopic Retrograde Cholangio Pancreatography (ERCP) atau Percutaneus Transhepatic Biliary Drainage (PTBD) pada penderita ikterus obstruksi etiologi kanker pankreatobilier.Metode: Desain penelitian adalah one group before after study. Pemilihan sampel secara consecutive sampling. Sampel darah diambil sebelum dan lima hari sesudah ERCP atau PTBD. Pengukuran kadar TNF-alfa dan IL-6 dengan cara Enzyme Linked Immunosorbed Assay (ELISA).Hasil: Terdapat 40 orang responden yang diikutsertakan dalam penelitian ini, 22 laki laki dan 18 perempuan dengan usia rata rata 55,3 tahun. Berdasarkan imaging dan endoskopi, ditegakkan diagnosis kolangiokarsinoma sebanyak 22 orang, tumor ampula Vateri 10 orang, dan tumor pankreas 8 orang. Kadar rata-rata TNF- alfa sebelum tindakan 4,81 (2,91) pg/ml dan sesudah tindakan 8,05 (6,7) pg/ml, terdapat peningkatan yang bermakna setelah tindakan drainase bilier (p:0,02). Kadar rata-rata IL-6 sebelum tindakan 7,79 (1,57) pg/ml dan sesudah tindakan 7,75 (1,76) pg/ml, tidak terdapat perbedaan yang bermakna setelah tindakan drainase bilier (p:0.52). Kadar rata-rata bilirubin sebelum tindakan 15,5 mg% dan sesudah tindakan 11,3 mg%.Simpulan: Terjadi peningkatan kadar rata-rata TNF-alfa secara bermakna setelah drainase. Tidak ada penurunan yang bermakna kadar rata-rata IL-6.

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Background: Obstructive jaundice represents the most common complication of biliary tract malignancy. Obstructive jaundice causes releases of proinflammatory cytokine. There has been controversy about effect of biliary drainage on the change in proinflammatory cytokine level in pancreatobiliary cancer patients.Objective: The present study was designed to determine levels of Tumor Necrosis Factor Alpha (TNF-Alpha) and Interleukin 6 (IL-6) in preprocedure of either Endoscopic Retrograde Cholangio Pancreatography (ERCP) or Percutaneus Transhepatic Biliary Drainage (PTBD) and postprocedure of them in obstructive jaundice patient caused by pancreatobiliary cancer.Methods : The study method is before- and- after case study design with consecutive sampling. Blood was collected five days prior to either Endoscopic Retrograde Cholangio Pancreatography (ERCP) procedure or Percutaneus Transhepatic Biliary Drainage (PTBD) procedure and five days after either of them. Enzyme Linked Immunosorbed Assay (ELISA) was used to determine TNF-Alpha and IL-6.Results: Forty subjects were included in this study which consisted of 22 men and 18 women. The mean age was 55.3 years old. According to the results of imaging and endoscopy procedure, twenty two (22) people were diagnosed cholangi carcinoma, ten (10) people were diagnosed ampulla varteri and eigth (8) people were diagnosed pancreatic tumor. In preprocedure, the mean of TNF-Alpha concentration was 4.81 (2.91) pg/mL, the mean of IL-6 concentration was 7.79 (1.57) pg/mL and the mean of bilirubin concentration was 15.5 mg%. In postprocedure, the mean of TNF-Alpha concentration was 8.05 (6.7) pg/mL, there was significant increase in TNF-Alpha concentration (p:0.02). However, the mean of IL-6 concentration was 7.75 (1.76) pg/mL, there was not any significant chance in IL-6 concentration (p:0.52). The mean of bilirubin concentration was 11.3 mg%.Conclusions: On one hand, there was significant increase in mean concentration value of TNF-Alpha after biliary drainage procedure. On the other hand there was not any significant decrease in mean concentration value of IL-6 after biliary drainage procedure."