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Abstrak :
ABSTRAK
TB Paru masih menjadi masalah kesehatan utama di dunia termasuk di Indonesia sebagai satu negara dengan prevalensi TB paru yang tinggi. Menurut WHO (2013) dalam Global Report 2013 bahwa prevalensi tuberculosis di Indonesia diperkirakan sebesar 297 kasus per 100.000 penduduk. Sumber penular serumah, faktor lingkungan fisik rumah (pencahayaan, ventilasi, kelembaban, kepadatan penghuni) dan faktor karakteristik individu berpengaruh terhadap kejadian TB Paru. Tujuan penelitian ini adalah untuk menganalisis hubungan antara keberadaan sumber penular serumah dengan kejadian TB Paru BTA (+) di Wilayah Kerja Puskesmas Kecamatan Palmerah tahun 2013. Penelitian ini menggunakan disain studi kasus kontrol dengan sampel untuk kasus adalah orang dengan hasil pemeriksaan sputum BTA (+) dan kontrol orang dengan hasil pemeriksaan sputum BTA (-) berusia ≥15 tahun dan bertempat tinggal di wilayah kerja Kecamatan Palmerah. Hasil penelitian ini menunjukkan bahwa variabel yang berhubungan dengan kejadian TB Paru yaitu keberadaan sumber penular serumah OR=4,38 (95% CI:2,19-8,74), status gizi OR = 5,250 (95% CI: 2,376-10,074), faktor lingkungan fisik rumah berupa pencahayaan alami rumah OR = 4,151 (95% CI: 2,049?8,412), ventilasi rumah OR = 2,8 (95% CI: 1,366?5,569), kelembaban dalam rumah OR = 8,088 (95% CI: 4,146-15,77), dan kepadatan hunian dalam rumah OR = 2,034 (95% CI = 1,080?3,830). Berdasarkan model akhir hasil analisis multivariate diperoleh hasil bahwa seseorang yang di dalam rumahnya terdapat sumber penular berisiko 1,85 kali lebih tinggi untuk mengalami TB Paru BTA (+) dibandingkan dengan seseorang yang di dalam rumahnya tidak terdapat sumber penular setelah dikendalikan oleh faktor status gizi dan kelembaban dalam rumah.

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ABSTRACT
Lung TB still becomes a main health problem in the world, including in Indonesia, as one of countries with a high prevalence of Lung TB. According to WHO (2013) in Global Report 2013, the tuberculosis prevalence in Indonesia is estimated around 297 cases per 100.000 people. The same living-house transmitter, the factor of physical environment of house (lighting, ventilation, moisture, and occupancy) and factors of individual characteristics affect an incident of Lung TB. The purpose of this research is to analysis the correlation between the existence of same living-house transmitter with the incident of Lung TB BTA (+) in Public Health Centre in Palmerah year of 2013. This research uses a study design of case-control with sample, for case are people with the result of sputum BTA (+) check and control, people with the result of sputum BTA (-) whose age is ≥ 15 years old and live in Palmerah. The result of this study shows that the variables which are related with the incident of Lung TB is the existence of same living house transmitter OR=4.38 (95% CI;2, 19-8, 74), nutrition status OR = 5,250 (95% CI: 2,376-10,074), factor of physical environment of a house, such as natural lighting OR = 4,151 (95% CI: 2,049-8,412), house ventilation OR=2,759 (95% CI: 1366-5569), moist in house OR = 8,088 (95% CI:4,146-15,77), and the house occupancy OR = 2,034 (95% CI=1,080-3830). Based on the model from the result in multivariate analysis, it can be concluded that a person whose house contains a transmitter risks 1,85 times higher than someone whose house does not contain a transmitter who has a Lung TB, after being controlled by factors of nutrition status and moist in house.

Abstrak :
Mortalitas yang disebabkan oleh Tuberkulosis (TB) masih tinggi dan saat ini hanya tersedia vaksin BCG untuk mencegah TB. Lebih dari 90 % individu yang terinfeksi adalah laten, bakteri dalam kondisi tersebut dorman, namun dapat terjadi reaktivasi saat imunitas melemah atau bakteri mengalami resusitasi. Vaksin BCG menunjukkan efikasi yang bervariasi pada orang dewasa dan tidak dapat mencegah reaktivasi pada TB laten. Protein RpfB yang disekresikan M. tuberculosis dalam tahap resusitasi diketahui imunogenik, sehingga berpotensi dikembangkan sebagai kandidat vaksin TB. Penelitian ini bertujuan untuk mengisolasi, mempurifikasi, dan mengetahui imunogenitas protein rekombinan RpfB hasil konstruksi Departemen Mikrobiologi FK UI secara invitro pada splenosit mencit. Protein rekombinan RpfB diekpresikan dalam strain bakteri MRB4 (E. coli BL21 pGEX6p-1 RpfB). Protein diekstraksi dengan sonikasi dan sentrifugasi bertahap kemudian disolubilisasi dengan dapar urea 8M. Protein direnaturasi dalam dapar refolding kemudian diisolasi dengan kolom kromatografi afinitas terhadap GST. Keberadaaan protein dikonfirmasi dengan SDS-PAGE dan Western Blot kemudian dihitung konsentrasinya menggunakan metode Bradford. Uji imunogenitas dilakukan secara invitro menggunakan kultur splenosit mencit yang distimulasi masing-masing dengan 25 μg/ml protein rekombinan RpfB, 25 μg/ml protein GST, 1-2 % mitogen PHA, dan satu kelompok kultur tidak stimulasi sebagai kontrol negatif. Selanjutnya dilakukan booster pada jam ke-24 dan ke-72. Supernatan kultur splenosit dikoleksi pada jam ke-96 kemudian digunakan untuk menganalisis respon IFNγ, IL-12, IL-4, dan IL-10 dengan kit ELISA. Perbedaan respon yang dihasilkan dianalisis secara statistika menggunakan uji T independen pada nilai P<0.05. Hasil penelitian menunjukkan bahwa protein rekombinan RpfB terekspresi dalam bentuk badan inklusi dengan berat molekul sekitar 66 kDa dan berhasil dipurifikasi dengan konsentrasi 53 μg/ml. Uji imunogenitas menunjukkan protein rekombinan RpfB dapat menstimulasi respon IFNγ dan IL-12, namun tidak menstimulasi respon IL-4 dan IL-10 pada splenosit mencit. ......Mortality rate caused by tuberculosis (TB) is high all over the world and only BCG vaccine is currently available. More than 90% of TB infection is latent, where Mycobacterium tuberculosis in dormant state that can be active when host immune response is insufficient or the bacteria promote resucitation. As a vaccine, BCG shows varied efficacy in adults and can not give protection against resucitation of latent TB infection. Resucitation Promoting Factor B (RpfB) is one protein produced by M.tuberculosis in resucitation state and proved to be immunogenic as make it suitable to be use as TB vaccine. Microbiology Department, University Indonesia has successfully construct recombinant pGEX6p-1-RpfB plasmid in BL21 E.coli (known as MRB4 strain) as the aim of this study is to isolate, purify, and analyze recombinant RpfB-GST protein in mice splenocytes in-vitro. After induction with IPTG, protein was extracted by sonication and differential centrifugation then solubilized with buffer contain 8M urea. Protein then renaturated followed by purification with GST chromatography. Protein was confirmed by SDS-PAGE and Western blot using anti-GST. Concentration of isolated protein was measured using Bradford method. Each group of mice splenocytes was treated with 25 μg/ml of recombinant protein RpfB, GST, PHA, and one culture group without treatment; and boosted twice at 24h and 72h. Cell supernatant was collected at 96h and level of IFNγ, IL-12, IL-4, and IL-10 was measured by ELISA. The results showed that RpfB recombinant proteins expressed in the form of inclusion bodies with a molecular weight of about 66 kDa and purified at 53μg/ml. Based on independent t-test analysis, RpfB can stimulate IFNγ and IL-12 but not IL-4 and IL-10.

Abstrak :
Tuberkulosis adalah penyebab utama kematian global tepat di bawah COVID-19 dan peringkat di atas HIV. Penyakit ini disebabkan oleh patogen yang disebut Mycobacterium tuberculosis yang menyebar dengan mudah melalui udara dan diketahui tetap laten di tubuh kebanyakan orang, yaitu sekitar seperempat dari populasi dunia. Masalah TB saat ini juga mencakup dua perhatian utama, vaksin resmi tidak benar-benar efektif, dan bakteri terus menjadi resisten terhadap obat. Dalam penelitian ini, kami mengusulkan strategi untuk membuat obat baru yang didesain untuk melewati resistensi tersebut dengan mensimulasikannya melalui metode in silico yang dijalankan melalui penambatan molekul, simulasi dinamis, dan prediksi farmakologi. Kami mengusulkan lima obat (peptida) yang kemudian dikonjugasikan dengan peptida penembus sel (CPP) yang dikenal akan kekuatan transferensinya, dengan protein QcrB sebagai reseptor. Kandidat tersebut ialah Noopept, Glycyl-L-Proline, Leuteonosticon, Alaptide, dan NNZ-2591. Semua kandidat dipilih mengikuti Ro5 Lipinski serta merunjuk pada ADME dan Toksisitas. ......Tuberculosis is a global leading cause of death, just below COVID-19 and ranked above HIV. This disease is caused by a pathogen called Mycobacterium tuberculosis which spreads easily through the air and is known to remain latent in most people's bodies, about a quarter of the world's population. The current problems with TB also include two main concerns: the official vaccine is ineffective, and the bacteria keeps gaining resistance to drugs. In this research, we proposed a strategy to create a new drug to pass this resistance by simulating it through in silico methods by running molecular docking, dynamic simulation, and pharmacological prediction. We proposed five drugs (peptides) that were then conjugated with a cell-penetrating peptide (CPP) known for its transference prowess, with QcrB protein as the receptor. Those candidates are Noopept, Glycyl-L-Proline, Leuteonosticon, Alaptide, and NNZ-2591. All candidates were picked following Lipinski's Ro5 along with ADME and Toxicity.

Abstrak :
Keberhasilan deteksi tuberkulosis (TB) relatif rendah pada negara berkembang dengan beban TB tinggi akibat kurangnya akurasi diagnosis. Penegakan diagnosis yang dilakukan dengan uji BTA dan TCM sebagai metode deteksi TB baku emas memiliki kelemahan dalam hal penggunaan spesimen sputum yang kemungkinan tidak tersedia pada pasien pediatrik, serta tidak representatif terhadap infeksi Mtb di luar jaringan paru. Urin dapat menjadi kandidat spesimen alternatif dikarenakan bersifat non-invasif. Deteksi antigen Mtb dalam urin menggunakan kit diagnostik Fujifilm SILVAMP TB LAM berhasil dilakukan pada populasi TB-HIV, namun deteksi gen Mtb secara langsung dalam urin belum banyak diteliti. Metode molekuler PCR telah digunakan dalam studi diagnostik karena memiliki nilai sensitivitas dan spesifisitas yang tinggi, sehingga dapat memberikan hasil diagnosis yang akurat. Tujuan penelitian adalah melalukan uji deteksi TB pada sampel urin populasi yang telah dinyatakan TB secara bakteriologis (kelompok Definite TB) dan populasi yang didiagnosa TB secara klinis namun tidak menunjukkan hasil laboratorium TB (kelompok Clinically TB) melalui metode multiplex PCR dengan gen target ESAT6, IS6110, dan MPT64 dan mengevaluasi potensi sampel urin sebagai spesimen alternatif diagnosis TB. Nilai positivity rate yang diperoleh adalah 71,43% (10/14) pada kelompok Definite TB dan 60,71% (17/28) pada kelompok Clinically TB. Metode multiplex PCR dengan spesimen urin dapat menjadi petunjuk pada kasus TB non-paru dan populasi yang tidak dapat mengeluarkan sputum berkualitas. ......Tuberculosis (TB) screening and diagnostic accuracy is relatively low in developing countries, which has contributed to the high TB burden in such regions. The diagnostic gold standard is the acid-fast bacillus (AFB) smear and GeneXpert test. A major disadvantage for both tests is the utilisation of sputum specimens, which may not be available in paediatric cases and is not representative of extrapulmonary Mtb infection. Urine may be used as an adjunct specimen because of its non-invasive nature of collection. Previous studies have focused on detecting Mtb antigens in urine using the Fujifilm SILVAMP TB LAM diagnostic kit in TB-HIV populations, however direct Mtb DNA detection has not been intensively evaluated. In recent years, PCR techniques have been widely used due to high sensitivity and specificity values which provides rapid and accurate diagnoses. Therefore, the primary objective of this is to conduct a TB detection test in urine samples of two population groups previously tested with AFB smear and GeneXpert test; (1) definite bacteriological cases (Definite TB group), and (2) clinically diagnosed cases (Clinically TB group), using multiplex PCR with target genes ESAT6, IS6110, and MPT64. Specifically, the study aims to evaluate urine as an alternative specimen and supporting tool in TB diagnostics. Observed positivity rate of urine samples was 71.43% (10/14) in the Definite TB group and 60.71% (17/28) in the Clinically TB group. Multiplex PCR using urine specimens indicates effectiveness in rapid detection of extra-pulmonary TB and sputum-scarce cases.

Abstrak :
Kultur sampai saat ini masih merupakan standar emas pemeriksaan diagnosis tuberkulosis. Metode yang sering dilakukan adalah menggunakan Medium Lowenstein-Jensen dan BACTEC MGIT 960, namun kontaminasi oleh bakteri lain maupun jamur dapat terjadi dan dapat mengganggu hasil interpretasi. Penelitian ini bertujuan untuk mengetahui perbandingan tingkat kontaminasi kultur Mycobacterium tuberculosis pada Medium Lowenstein-Jensen dan BACTEC MGIT 960. Penelitian ini menggunakan desain studi potong lintang dengan 204 sampel dari Laboratorium Mikrobiologi Klinik FKUI-RSCM yang memenuhi kriteria penelitian. Data dianalisis menggunakan uji McNemar untuk data komparatif kategorik berpasangan. Dari 204 subjek, mayoritas berada pada rentang usia 26-35 tahun 34,3 dan merupakan laki-laki 62,8. Dari hasil uji McNemar, didapatkan tidak adanya perbedaan yang signifikan antara tingkat kontaminasi pada medium LJ dan BACTEC MGIT 960 p=1.000. Proporsi hasil kultur positif pada medium LJ dan BACTEC MGIT 960 juga tidak menunjukkan adanya perbedaan yang signifikan p=1.000. Tidak ada perbedaan proporsi tingkat kontaminasi pada medium LJ dan BACTEC MGIT 960. Kata kunci: tingkat kontaminasi, Mycobacterium tuberculosis, Lowenstein-Jensen, BACTEC MGIT 960. ......Culture is remaining a gold standard for tuberculosis diagnostic test. Lowenstein Jensen and BACTEC MGIT 960 are two mediums that are recently used, however, contamination by other bacteria or fungal may interfere the result rsquo s interpretation. This study aims to find out the contamination rate comparison between Lowenstein Jensen media and BACTEC MGIT 960. This is a cross sectional study with 204 samples from Clinical Microbiology Laboratory of FKUI RSCM which meet the research criteria. Data were analyzed using McNemar test for paired proportion data. Out of the 204 subjects, the majority are male 62,8 between the age group of 26 35 years 34,3. Based on McNemar test, there is no significant difference of contamination rate between LJ media and BACTEC MGIT 960 p 1.000. Significant difference in the proportion of positive culture result between samples cultivated with LJ media and BACTEC MGIT 960 was not shown either p 1.000. In conclusion, there is no significant difference of contamination rate between LJ media and BACTEC MGIT 960. Keywords contamination rate, Mycobacterium tuberculosis, Lowenstein Jensen, BACTEC MGIT 960

Abstrak :
Tuberkulosis sejak lama merupakan salah satu penyebab utama kematian manusia karena penyakit infeksi, terutama didaerah yang dilanda kemiskinan dan malnutrisi. Penyakit ini menyerang banyak organ pada tubuh manusia terutamanya adalah paru-paru. Peningkatan jumlah kasus tuberkulosis dipengaruhi oleh infeksi HIV dan resistensi terhadap berbagai macam kombinasi obat. Di Indonesia, infeksi M. tuberculosis oleh strain Beijing diyakini memiliki penyebaran yang paling luas dibandingkan dengan strain lainnya. BCG merupakan vaksin tunggal yang digunakan untuk pencegahan tuberkulosis, namun daya proteksi dan efikasinya berbeda-beda. Protein Mce1A merupakan protein yang diduga berperan penting pada hal invasi dan pertahanan M. tuberculosis didalam makrofag. Beberapa studi telah melakukan penelitian ini, namun di Indonesia belum pernah dilakukan penelitian mengenai ekspresi protein Mce1A Mycobacterium tuberculosis strain Beijing sebagai isolat lokal. Oleh karena itu, pada penelitian ini akan dilakukan pengklonaan dan ekspresi protein Mce1A Mycobacterium tuberculosis strain Beijing lokal dan strain standar H37Rv sebagai pembanding. Gen Mce1A M. tuberculosis strain Beijing dan H37Rv diamplifikasi dengan teknik PCR dan diinsersikan kedalam vektor pET28a. Escherichia coli BL21 kemudian ditransformasi dengan plasmid rekombinan tersebut. Protein Mce1A rekombinan diekspresikan dengan induksi IPTG. E. coli BL21 berhasil ditransformasi dengan plasmid rekombinan yang mengandung sisipan gen Mce1A dengan arah orientasi dan kerangka baca yang benar. Tidak ada mutasi yang ditemukan pada asam amino yang menjadi epitope pengenalan sel B dan sel T. Hasil ekspresi protein Mce1A pada E.coli BL21 menunjukkan pita protein yang lebih tinggi dari seharusnya. Konfirmasi keberadaan protein dilakukan menggunakan teknik Western Blot dengan anti-his detector. Protein Mce1A rekombinan yang telah berhasil diekspresikan pada E.coli BL21 diduga berada dalam bentuk dimer. Hal ini dapat digunakan sebagai data awal kondisi ekspresi untuk pengembangan vaksin subunit pada penelitian berikutnya. ......For past centuries until nowadays, tuberculosis remains the leading cause of death in the world from infectious disease wherever poverty, malnutrition and poor housing prevail. Tuberculosis is primarily a disease of the lungs, but may spread to other sites or proceed to a generalized infection. The wide spread of tuberculosis has been further aggravated by another infection disease such as HIV-AIDS and drug resistance. Many strain of Mycobacterium tuberculosis caused tuberculosis infection in Indonesia, but Beijing strain are the most. Bacille Calmette-Guerin (BCG) is the current vaccine for tuberculosis but it has different protection function and efficacy. According to function analysis, mce1A gene predicted has a role in host invasion by Mycobacterium tuberculosis and survival of the pathogen in human macrophages. Several studies abroad have done this research, but in Indonesia, study about protein expression of Mce1A gene of Mycobacterium tuberculosis Beijing strain as local isolates has not much being done. Therefore, in this study we will performed cloning and protein expression of Mce1A gene Mycobacterium tuberculosis Beijing strain as local isolate and standard strain H37Rv as a comparison on expression vector Escherichia coli BL21. Mce1A gene from M. tuberculosis Beijing and H37Rv strain was amplified by PCR and inserted in the vector pET28a. E. coli BL21 then transformed with the recombinant plasmid. Mce1A recombinant protein then expressed with IPTG induction. This study indicate that E. coli BL21 succesfully transformed with a recombinant plasmid containing the Mce1A gene insertion with correct orientation and reading frame. There is no mutation found in the amino acids sequence for B and T cell epitope. Mce1A expression in E. coli BL21 showed protein bands that higher than expected. The protein was confirmed with western blotting using anti-his detector. We assume that Mce1A recombinant protein that have been expressed in E. coli BL21 is in dimeric form. This explanation should be valuable in further studies of expression at the protein level and exposure of proteins on the cell surface of M. tuberculosis under different experimental conditions.

Abstrak :
[ABSTRAK
Kemampuan Mycobacterium tuberculosis yang dapat memanipulasi dan menghindari respon imun adalah tantangan dalam mencari terapi dan vaksinasi efektif. Penelitian ini untuk menguji potensi ekstrak metanol akar Eurycoma longifolia Jack dalam memodulasi peningkatan IgA dan IgG mencit putih jantan yang divaksinasi BCG, sekaligus untuk menganalisis peningkatan sitokin proinflamasi yang berhubungan dengan produksi IgA dan IgG. Plasma diambil sebelum dan setelah vaksinasi BCG pada 18 ekor mencit yang dibagi ke dalam 2 kelompok; perlakuan dan kontrol. Kadar IgA, IgG, TNF-! dan IL-10 diukur dengan metode ELISA. Hasil menunjukkan bahwa peningkatan IgA kelompok air (0,33±0,16) lebih tinggi dibandingkan kelompok pasak bumi (0,30±0,30), sedangkan peningkatan IgG kelompok pasak bumi (0,38±0,25) terlihat lebih tinggi dibandingkan kelompok air (0,29±0,35). Rasio TNF-!/IL-10 kelompok pasak bumi (0,46±0,07) lebih tinggi dibandingkan kelompok air (0,41±0,05). Terdapat korelasi antara TNF-! dengan IgA pada kelompok air (r=0,601, p=0,035) juga dengan IgG pada kelompok pasak bumi (r=0,559, p=0,059). Disimpulkan, pemberian pasak bumi cenderung berpotensi memodulasi peningkatan IgG, tetapi tidak IgA. Selain itu, pemberian pasak bumi juga cenderung meningkatkan sitokin proinflamasi yang mempengaruhi produksi IgA dan IgG.

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ABSTRACT
The ability of Mycobacterium tuberculosis to manipulate and evade host?s immune response is a challenge in finding an effective therapy and vaccination. The purpose of this research were to investigate the potency of methanol extract of the roots of Eurycoma longifolia Jack as immunomodulators for male white mice vaccinated with BCG, as well as to analyze the increase of proinflammatory cytokines associated with IgA and IgG production. Plasma were taken before and after BCG vaccination from 18 mice, that were divided into 2 groups; treatment and control. IgA, IgG, TNF-! and IL-10 levels were measured by using ELISA. The results showed that the enhancement of IgA group with water (0,33±0,16) was higher than group with pasak bumi (0,30±0,30). On the other hand the enhancement of IgG group with pasak bumi (0,38±0,25) was higher than group with water (0,29±0,35). The ratio of TNF-!/IL-10 group with pasak bumi (0.46±0.07) was higher than group with water (0.41±0.05). There are correlarions between TNF-! and IgA in the group with water (r=0.601, p=0.035) as well as between TNF- ! and IgG in group with pasak bumi (r=0.559, p=0.059). As the conclusion, methanol extract of pasak bumi root tend to potentially modulate the increase IgG production, but not IgA. In addition, it also tends to increase the proinflamasi cytokines associated with IgA and IgG production.;The ability of Mycobacterium tuberculosis to manipulate and evade host’s immune response is a challenge in finding an effective therapy and vaccination. The purpose of this research were to investigate the potency of methanol extract of the roots of Eurycoma longifolia Jack as immunomodulators for male white mice vaccinated with BCG, as well as to analyze the increase of proinflammatory cytokines associated with IgA and IgG production. Plasma were taken before and after BCG vaccination from 18 mice, that were divided into 2 groups; treatment and control. IgA, IgG, TNF-! and IL-10 levels were measured by using ELISA. The results showed that the enhancement of IgA group with water (0,33±0,16) was higher than group with pasak bumi (0,30±0,30). On the other hand the enhancement of IgG group with pasak bumi (0,38±0,25) was higher than group with water (0,29±0,35). The ratio of TNF-!/IL-10 group with pasak bumi (0.46±0.07) was higher than group with water (0.41±0.05). There are correlarions between TNF-! and IgA in the group with water (r=0.601, p=0.035) as well as between TNF- ! and IgG in group with pasak bumi (r=0.559, p=0.059). As the conclusion, methanol extract of pasak bumi root tend to potentially modulate the increase IgG production, but not IgA. In addition, it also tends to increase the proinflamasi cytokines associated with IgA and IgG production., The ability of Mycobacterium tuberculosis to manipulate and evade host’s immune response is a challenge in finding an effective therapy and vaccination. The purpose of this research were to investigate the potency of methanol extract of the roots of Eurycoma longifolia Jack as immunomodulators for male white mice vaccinated with BCG, as well as to analyze the increase of proinflammatory cytokines associated with IgA and IgG production. Plasma were taken before and after BCG vaccination from 18 mice, that were divided into 2 groups; treatment and control. IgA, IgG, TNF-! and IL-10 levels were measured by using ELISA. The results showed that the enhancement of IgA group with water (0,33±0,16) was higher than group with pasak bumi (0,30±0,30). On the other hand the enhancement of IgG group with pasak bumi (0,38±0,25) was higher than group with water (0,29±0,35). The ratio of TNF-!/IL-10 group with pasak bumi (0.46±0.07) was higher than group with water (0.41±0.05). There are correlarions between TNF-! and IgA in the group with water (r=0.601, p=0.035) as well as between TNF- ! and IgG in group with pasak bumi (r=0.559, p=0.059). As the conclusion, methanol extract of pasak bumi root tend to potentially modulate the increase IgG production, but not IgA. In addition, it also tends to increase the proinflamasi cytokines associated with IgA and IgG production.]

Abstrak :
Penyakit tuberkulosis (TB) merupakan penyakit infeksi yang disebabkan oleh bakteri Mycobacterium tuberculosis. Infeksi TB telah menjadi masalah kesehatan utama di seluruh dunia. Peningkatan jumlah kasus TB disebabkan oleh munculnya TB yang resisten terhadap obat (MDR-TB/ Multi Drugs Resistant) dan koninfeksi dengan HIV. BCG merupakan vaksin yang tersedia saat ini, efisien melindungi manifestasi penyakit parah pada anak, tetapi vaksin ini tidak mencegah pembentukan TB laten atau reaktivasi penyakit paru pada orang dewasa. Protein rpfB M.tuberculosis merupakan faktor virulensi dan resusitasi dari dormansi M. tuberculosis. Protein ini diketahui berperan dalam pemecahan peptidoglikan dari dinding sel bakteri dan menstimulasi pertumbuhan bakteri dan resusitasi dari keadaan laten. Hal ini menjelaskan bahwa protein rpfB mempunyai sifat imunogenik yang tinggi dan berpotensi untuk dikenali oleh sistem imun dan dikembangkan strategi vaksin yang berbasis vaksin subunit yang dapat digunakan untuk menstimulasi sel T. Strain yang digunakan pada penelitian ini adalah strain Beijing yang diisolasi di Indonesia dan strain H37Rv sebagai kontrol. Strain Beijing diketahui bersifat lebih virulen, relatif resisten terhadap obat dan cenderung menyebabkan penyakit paru pada orang dewasa dibandingkan strain lain. Gen rpfB strain Beijing dan H37Rv diamplifikasi dengan teknik PCR dan diinsersikan ke dalam vector pGEX-6P-1. Plasmid rekombinan pGEX 6P-1-rpfB ditransformasi ke E.coli BL21 untuk diekspresikan. Protein rpfB diekspresikan dengan induksi IPTG. E.coli BL21 berhasil ditransformasi dengan plasmid rekombinan dengan arah orientasi yang benar. Analisis epitop sel T CD4+ dan CD8+ memperlihatkan tidak ada mutasi yang ditemukan pada asam amino yang menjadi epitop pengenalan sel T CD4+ dan CD8+. Protein rpfB rekombinan berhasil diekspresikan pada E.coli BL21. Hasil ekspresi protein rpfB menunjukkan pita protein yang berada pada ukuran 66 kDa. Analisis western blot mengkonfirmasi kebenaran protein rpfB dengan antibodi anti-GST. ......Tuberculosis is an infectious disease caused by Mycobacterium tuberculosis pathogen. TB infection has been a major threat to global health. The wide spread of TB cases attributed by TB drug resistant (MDR-TB/ Multi Drugs Resistant) and HIV coinfection. BCG is a current available vaccine for TB, is efficient for protection manifestations of childhood disease, but it has failed to prevent latently TB form or reactivation adult pulmonary. rpfB protein need for virulent and resuscitation from dormant Mtb. rpfB protein is known to involved in peptidoglycan cleaveage from bacteria cell wall and stimulate bacteria growth and resuscitation of latently. It suggests that rpfB protein has highly immunogenic characteristic and potent to recognized immune respons and to be developed vaccine strategy based on subunit vaccine which can use to stimulate T cells. Strains that used in this research, consist of Beijing strain that isolated from Indonesia and H37Rv strain as control. Beijing strain is known more virulent, relatively resistant to drug and tend to caused adult pulmonary disease compared to other strain. rpfB gene of Beijing strain and H37Rv amplify by PCR and insert to pGEX-6P-1 vector. Recombinant plasmid (pGEX-6P-1-rpfB) is transformed to Escherichia coli BL21 for protein expression. rpfB protein expressed by IPTG induction. E.coli BL21 was successed to transformed with recombinant plasmid in correctly orientation. Epitope analysis of CD4+ T cell and CD8+ T cell shown no mutation found in amino acid that encoded recognized epitope of CD4+ T cell and CD8+ T cell. Recombinant protein has been expressed in E.coli BL21. The result of expression showed the molecular weight of protein band is in 66 kDa. Western blot analysis confirmed correct rpfB protein using anti-GST antibody.

Abstrak :
Tuberkulosis (TBC) masih menjadi penyebab utama kematian akibat penyakit menular oleh adanya infeksi. Rifampisin dan isoniazid adalah obat lini pertama yang paling efektif melawan infeksi Mycobacterium tuberculosis. Deteksi resistansi OAT yang tepat, akurat, dan komprehensif, serta pemilihan sampel diperlukan untuk memastikan diagnosis penyakit tuberkulosis pasien. Penelitian ini bertujuan untuk menganalisis perbandingan hasil targeted drug sequencing dari hasil dekontaminasi sputum dengan isolat Mycobacterium tuberculosis dan mengetahui kesesuaian DST fenotipik MGIT, genotipik GeneXpert dalam mendeteksi resistansi rifampisin dan isoniazid. Sampel penelitian ini adalah sampel sputum yang sudah ada hasil GeneXpert positif dan isolate kultur dengan hasil DST MGIT. Hasil dekontaminasi sputum langsung dan kultur positif dari sampel yang sama dilakukan targeted drug sequencing dengan Oxford Nanopore technology menggunakan flowcell MinION Mk1B. Hasil penelitian menunjukkan bahwa pada target gen rpoB pada 5 dari 6 sampel isolat kultur memberikan hasil gen resistan rpoB dan 1 undetermined. Pada sebagian besar dekontaminasi sputum yaitu 5 dari 6 sampel juga memberikan hasil resistan terhadap rpoB dan 1 dekontaminasi sputum yang undetermined. Hasil resistansi obat isoniazid didapatkan pada target gen inhA sebanyak 5 dari 6 isolat kultur memberikan hasil sensitif pada inhA dan 1 isolat undetermined. Sedangkan pada dekontaminasi sputum 4 dari 6 sampel memberikan hasil sensitif pada inhA dan 2 undetermined. Lalu, pada target gen katG terdapat 3 dari 6 isolat kultur memberikan hasil sensitif, 2 isolat resistan, dan 1 undetermined. Sedangkan pada dekontaminasi sputum memberikan 2 hasil sensitif, 2 hasil resistan, dan 2 hasil undetermined. Metode targeted drug sequencing dapat dilakukan dari sampel hasil dekontaminasi sputum dan isolat. Keberhasilan banyak didapatkan dari hasil kultur dibandingkan dekontaminasi sputum. Pemeriksaan dengan targeted drug sequencing memberikan hasil yang sesuai dengan hasil DST MGIT dan GeneXpert untuk deteksi gen resisten Rifampisin (rpoB) dan Isoniazid (inhA dan katG). ......Tuberculosis (TBC) is still the main cause of death due to infectious diseases. Rifampicin and isoniazid are the most effective first-line drugs against Mycobacterium tuberculosis infection. Precise, accurate and comprehensive detection of OAT resistance, as well as sample selection are needed to confirm the patient's diagnosis of tuberculosis. This study aims to compare the results of targeted drug sequencing from sputum decontamination results with Mycobacterium tuberculosis isolates and determine the suitability of MGIT phenotypic and GeneXpert genotypic DST in detecting rifampicin and isoniazid resistance. The samples for this study were sputum samples that had positive GeneXpert results and culture isolates with DST MGIT results. The results of direct sputum decontamination and positive culture from the same sample were subjected to targeted drug sequencing with Oxford Nanopore technology using a MinION Mk1B flowcell. The results showed that for the rpoB gene target, the majority of culture isolates from 5 of the 6 culture isolate samples gave rpoB resistance gene results and 1 was undetermined. In the majority of sputum decontamination, 5 out of 6 samples also gave resistance to rpoB and 1 sputum decontamination was undetermined. Isoniazid drug resistance results were obtained for the inhA gene target, 5 of the 6 culture isolates gave sensitive results for inhA and 1 isolate was undetermined. Meanwhile, in sputum decontamination, 4 of the 6 samples gave sensitive results for inhA and 2 were undetermined. Then, for the katG gene target, 3 of the 6 culture isolates gave sensitive results, 2 isolates were resistant, and 1 was undetermined. Meanwhile, sputum decontamination gave 2 sensitive results, 2 resistant results, and 2 undetermined results. The targeted drug sequencing method can be carried out from samples resulting from decontamination of sputum and isolates. Much success comes from culture results rather than sputum decontamination. Examination with targeted drug sequencing provided results that were in accordance with the results of DST MGIT and GeneXpert for the detection of Rifampicin (rpoB) and Isoniazid (inhA, and katG) resistance genes.