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Abstrak :
Kejadian kardiovaskular adalah penyebab kematian utama pada artritis reumatoid AR . Periodontitis diketahui berperan dalam patogenesis disfungsi endotel pada AR. E-selectin merupakan penanda disfungsi endotel yang spesifik dihasilkan oleh endotel. Tujuan penelitian ini adalah mengetahui efek terapi periodontal terhadap kadar E-selectin pada pasien AR. Penelitian ini merupakan uji klinis randomisasi pada penderita AR yang berobat di Poliklinik Reumatologi RSCM periode Maret-Mei 2017. Pengambilan sampel dilakukan secara konsekutif. Randomisasi dilakukan dengan randomisasi blok. Subyek dibagi menjadi kelompok terapi periodontal dan kontrol. Dilakukan Uji t untuk melihat perbedaan selisih E-selectin awal dan akhir studi antara kelompok intervensi dengan kontrol. Periodontitis ditemukan pada 31 subyek 64,5 . Tidak didapatkan perbedaan selisih E-selectin awal dan akhir studi yang signifikan secara statistik antara kelompok intervensi dengan kontrol p=0,303 . Sebagai kesimpulan tidak didapatkan pengaruh terapi periodontal terhadap kadar E-selectin pada pasien AR.

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Cardiovascular event is the main cause of mortality in rheumatoid arthritis RA . Periodontitis is known to be involved in the pathogenesis of endothelial dysfunction in RA. E selectin is a marker of endothelial dysfunction and was expressed specifically in endothelial cells. The objective of this study was to determine the effect of periodontal treatment on E selectin level in RA patients. This was a randomized clinical trial in RA patients visiting Rheumatology Clinic RSCM between March May 2017. Samples were collected using consecutive sampling method. Randomization was done using block randomization. Subjects was divided into nonsugical periodontal treatment group and control group. T test was used to measure the difference of delta E selectin before after study between periodontal treatment group and control. Periodontitis was found in 31 subjects 64,5 . There was no statistically significant difference of delta E selectin before after treatment between periodontal treatment group and control. As a conclusion, periodontal treatment has no effect on E selectin level in RA patients.

Abstrak :
Pendahuluan: Andrografolida, konstituen aktif utama diisolasi dari Andrographis paniculata yang digunakan untuk terapi artritis reumatoid. Namun, senyawa ini memiliki bioavailabilitas oral yang rendah. Masalah ini dapat diatasi dengan memformulasikan andrografolida dalam etosom melalui pemberian transdermal. Tujuan: Penelitian ini bertujuan untuk mengetahui profil farmakokinetik, bioavailabilitas relatif, dan efektivitas sediaan transdermal etosom andrografolida pada hewan model artritis reumatoid. Metode: Metode hidrasi lapis tipis digunakan untuk memformulasikan etosom andrografolida. Karakterisasi etosom meliputi ukuran partikel, indeks polidispersitas, potensial zeta, dan efisiensi penjerapan. Pada uji farmakokinetik, digunakan GE, GNE dan SO dosis 50 mg/kgbb kemudian sampel plasma diambil dari sinus retro-orbital dengan 10 titik pengambilan dalam 24 jam. Parameter farmakokinetik dianalisis dengan KCKT fase terbalik. Pada uji aktivitas antiartritis, GE dosis 25, 50, dan 100 mg/kg diberikan secara transdermal pada tikus uji yang diinduksi CFA 0,1 mL. Selama fase induksi dan setelah pemberian obat, manifestasi klinis artritis dipantau menyeluruh. Hasil: Hasil penelitian didapatkan etosom dengan ukuran partikel 76,35±0,74 nm, zeta potensial -40,17±1,03 mV dan efisiensi penjerapan 97,87±0,23%. Studi farmakokinetik menghasilkan Cmax pada GE, GNE, dan SO berturut-turut adalah 53,07±4,73; 27,34±1,48; dan 11,72±0,74 μg/mL, AUC0-∞ masing-masing 152,10±16,53; 77,15±12,28; dan 23,20± 3,46 μg.jam/mL. Tmax rute transdermal dicapai jam ke-6 sementara rute oral jam ke-2 setelah pemberian sediaan. Hasil uji aktivitas antiartritis mengungkapkan, GE 50 dan 100 mg/kgbb menunjukkan persentase penghambatan edema hampir serupa dengan metotreksat 0,135 mg, subkutan. Kesimpulan: Hasil penelitian disimpulkan bahwa GE 50 mg/kgbb menghasilkan peningkatan Cmax, Tmax dan AUC0-∞. Bioavailabilitas relatif dicapai sebesar 655,60% pada rute transdermal dibandingkan dengan rute oral. Hasil uji aktivitas antiartritis, GE 50 mg/kg secara efektif mengurangi volume edema, diameter kaki, dan skor artritis tikus model yang diinduksi CFA. ......Intoduction: The main active constituent isolated from Andrographis paniculata, andrographolide, is used to treat rheumatoid arthritis. This compound, however, has a low oral bioavailability. This issue can be solved by incorporating andrographolide into ethosomes for transdermal administration. Aim: This study was designed to determine the pharmacokinetic profile, relative bioavailability, and efficacy of andrographolide ethosomal transdermal preparations in animal models of rheumatoid arthritis. Method: Andrographolide was prepared into ethosomal dosage forms before being characterized in terms of particle size, polydispersity index, zeta potential, and entrapment efficiency. In the pharmacokinetic test, plasma sampels were collected from the retro-orbital sinus at 10 collection points over the course of 24 hours using GE, GNE, and SO at a dose of 50 mg/kg each. Reverse-phase HPLC was used to assess pharmacokinetic parameters. In the anti-arthritic activity test, GE doses of 25, 50, and 100 mg/kg were administered transdermally to rats induced by 0.1 mL CFA. The clinical manifestations of arthritis are closely monitored during the induction phase and after drug administration. Result: According to the results, the ethosomes with a particle size of 76.35±0.74 nm, a zeta potential of -40.17±1.03 mV, and an entrapment efficiency of 97.87±0.23%. Pharmacokinetic studies revealed that the Cmax in GE, GNE, and SO was 53.07±4.73, 27.34±1.48, and 11.72±0.74 μg/mL, and the AUC0-∞ was 152,10±16,53; 77,15±12,28; and 23,20± 3,46 μg.jam/mL, respectively. The transdermal route had a Tmax of 6 hours, while the oral route had a Tmax of 2 hours after administration of the preparation. GE 50 and 100 mg/kg inhibited edema with nearly the same percentage as methotrexate 0.135 mg subcutaneously, according to the anti-arthritis activity test. Conclusion: The researchers concluded that GE 50 mg/kg caused an increase in Cmax, Tmax, and AUC0-∞. The transdermal route has a relative bioavailability of 655.60% compared to the oral route. The anti-arthritis activity study showed that GE 50 mg/kg effectively reduced edema volume, paw diameter, and arthritis scores in CFA-induced rat models.

Abstrak :
Ketoprofen merupakan obat non selektif siklooksigenase-2 untuk terapi rheumatoid arthritis dan osteoarthtritis. Pemberian ketoprofen secara peroral dapat mengalami first pass metabolism, sedangkan dalam bentuk sediaan topikal tingkat penetrasi ke dalam kulit masih rendah. Ketoptofen juga memiliki kelarutan rendah dalam air, sehingga penelitian ini bertujuan untuk memformulasikan ketoprofen dalam bentuk mikroemulsi transdermal yang stabil dan memiliki tingkat penetrasi yang baik. Lemon essential oil digunakan sebagai fase minyak sekaligus penetration enhancer, mikroemulsi dibuat dengan metode titrasi fase. Mikroemulsi yang jernih dan stabil yaitu pada konsentrasi smix 60% dengan perbandingan 1:1. Konsentrasi lemon essential oil adalah FA (3%), FB (5%), dan FC (10%). Evaluasi dilakukan dengan mengukur ukuran globul, tegangan permukaan, bobot jenis, pH, viskositas, uji sentrifugasi, uji stabilitas fisik, cycling test dan penetapan kadar ketoprofen. Uji penetrasi dilakukan dengan menggunakan sel difusi Franz selama 8 jam. Hasil penelitian menunjukkan ketiga formula stabil secara fisik selama penyimpanan 12 minggu dan hasil uji penetrasi pada jam ke-8, jumlah kumulatif Formula A sebesar 821,6031 ± 112,4390 μg/cm2, Formula B 1591,1888 ± 275,3595 μg/cm2, dan Formula C sebesar 3515,9289 ± 385,7081 μg/cm2. Penelitian ini menunjukkan bahwa semakin tinggi konsentrasi lemon essential oil yang digunakan dalam formula mikroemulsi maka semakin tinggi tingkat penetrasinya. ......Ketoprofen is a non-selective cyclooxygenase-2 that is used to treat rheumatoid arthritis and osteoarthritis. Oral administration of ketoprofen has disadvantages on first-pass metabolism. Also, the penetration rate into the skin is relatively low if it is given in topical dosage forms. Ketoprofen is a drug which has low solubility in water, therefore this study aimed to formulate ketoprofen in the form of a transdermal microemulsion that is stable and has a good penetration rate. Lemon essential oil is used as an oil phase as well as a penetration enhancer, microemulsions are made using the phase titration method. The microemulsion was clear and stable at 60% smix concentration with a ratio of 1:1. The concentration of lemon essential oil is FA (3%), FB (5%), and FC (10%). Microemulsion evaluation was carried out by measuring globule size, surface tension, density, pH, viscosity, centrifugation test, physical test, cycling test, and determination of ketoprofen content. Ketoprofen penetration test was carried out using a Franz diffusion cell for 8 hours. The result of the triplicate test showed that the formula was physically stable for 12 weeks of storage and based on the results of the penetration study at the 8th hour, the cumulative amount of Formula A was 821.6031 ± 112.4390 μg/cm2, Formula B was 1591.1888 ± 275.3595 μg/cm2, and Formula C was 3515.9289 ± 385.7081 μg/cm2. This study showed that higher the concentration of lemon essential oil used in the microemulsion formula increases its penetration rate.