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Abstrak :
The pathogenesis of inflammatory bowel disease (IBD) is not yet fully understood A genetic predisposition, some environmental factors and microbial flora of the grit are the key factors. The presence of bacteria in the intestinal lumen is a prerequisite for the development of IBD. In animal models, mice incapable of expressing IL, or IL invariably develop a colitis- or Crohn-like inflammation. No inflammation occurs if they grow up in a pathogen free environment or if they are fed with Lactobacillus sp when exposed to environmental bacteria. Thus, the absence of liminal bacteria or a different make-up there of prevents the development of inflammatory bowel disease in this model. Patients with IBD have been found to have a decreased stool excretion Lactobacillus andlor Bifidobacteria. Furthermore, an increased number of bacteria adherents to the mucosa and within the epithelium has been demonstrated in quantitative studies. It appears that these bacteria trigger a strong abnormal mucosal immunological response, leading to intestinal epithelial cell injury mediated by activated T-cells, mononuclear cells and macrophages. If this response can not be down regulated by regulatory T-cells, mononuclear inflammatory cytokines are activated by stimulation of the intracellular transcription factor NF-kB. Recently it was shown that bacterial lipopolysaccharides can activate NF-kB by binding to two specific receptors on the cell membrane (Toll-like receptors [TLR's]) or intracellular receptors (NOD's). New insights of the role of bacteria in IBD became available by identifying susceptibility genes for IBD. Several IBD susceptibility loci were recently identified. The IBD-l locus on chromosome 16 shows positive evidence for linkage in Crohn's disease and IBD-2 locus on chromosome l2 for ulcerative colitis. The evidence for' an association with Crohn's disease at the IBD-I locus have been shown to be attributed to mutations in the CARDI5/NOD2 gene. This gene is exressed in peripheral blood monocytes and in intestinal epithelial cells and serves as a key factor of innate mucosal response to luminal bacteria as an antibacterial factor. The intact intercellular NOD2 protein binds LPS and activates NF-kB. This activation of the NF-kB signalling pathway in response to bacterial components plays a protective role in the mucosal epithelial cells for the host against inviting pathogens and an increased apoptosis of infected cells. There is evidence, that the defective NOD2 protein variants increase the susceptibility to pathogen invasion and a decrease in cellular apoptosis. NF-kB plays a dual role in IBD. On the mucosal epithelial cells, bacterial components bind on NOD2 proteins and protect bacterial invasion. If this barrier mechanism is not intact, the bacterial invasion stimulates via TLR- and NOD2 receptors in immune-active cells (macrophages, T-cells and monocytes) NF-kB and triggers an aberrant inflammatory response leading to tissue damage. These new insights in the pathogenesis in IBD have led to new treatment possibilities including pre- and probiotics. These therapies are aimed at directly modulating the host immune system to suppress intestinal inflammation. This has prompted considerable interest in manipulating the enteric microenvironment as a novel therapeutic strategy Several clinical studies showed promising results rising pre- and probiotics in patients with ulcerative colitis, pouchitis and Crohn's disease. The introduction of genetically engineered probiotic organism to produce and deliver anti-inflammatory cytokines or other biological relevant molecules to the mucosa offers further new potential for the treatment of IBD.

Abstrak :
ABSTRAK
Inflammatory Bowel Disease (IBD) adalah penyakit yang semakin meningkat prevalensinya selama dua dekade terakhir. Baku emas diagnosis IBD adalah kolonoskopi dan histopatologi. Calprotectin feses merupakan salah satu pemeriksaan yang banyak diminta untuk menapis pasien terduga IBD agar mengurangi kolonoskopi yang tidak perlu. Metode pemeriksaan calprotectin yang banyak digunakan sekarang adalah ELISA, tetapi saat ini terdapat metode baru yaitu CLIA. Penelitian ini bertujuan membandingkan calprotectin feses antara kedua metode tersebut, melakukan uji diagnostik dengan perbandingan baku emas, dan membandingkan calprotectin pada kelompok IBD dan non-IBD. Penelitian dilakukan secara potong lintang dan data disajikan secara deskriptif analitik dengan melibatkan 50 pasien dewasa. Uji korelasi antara kedua metode menemukan hubungan kuat dan bermakna (r=0,865, p<0,001), tetapi persamaan regresi Passing-Bablok mendapatkan perbedaan konstan dan proporsional. Uji Bland-Altman mendapatkan kesesuaian 92% dengan rerata selisih 76,2 μg/g feses dan batas kesesuaian -964,3-1116,7 μg/g feses. Uji diagnostik calprotectin feses metode ELISA menemukan titik potong optimal adalah 194 μg/g dengan sensitivitas 55,6%, spesifisitas 56,5%, NPP 60%, dan NPN 48%. Apabila menggunakan titik potong pabrik 50 μg/g, maka didapatkan sensitivitas 88,9%, spesifisitas 13%, NPP 54,5%, dan NPN 50%. Uji diagnostik calprotectin feses metode CLIA menemukan titik potong optimal adalah 90,5 μg/g dengan sensitivitas 51,9%, spesifisitas 52,2%, NPP 56%, dan NPN 48%. Apabila menggunakan titik potong pabrik yaitu 50 μg/g, maka diperoleh sensitivitas 70,4%, spesifisitas 43,5%, NPP 59,4%, dan NPN 55,6%. Perbandingan calprotectin feses metode ELISA antara kelompok IBD dan non-IBD menemukan perbedaan rerata yang tidak bermakna secara statistik, begitu juga dengan perbandingan kelompok IBD dan non-IBD pada calprotectin feses metode CLIA. Penelitian ini menemukan bahwa kedua kit pemeriksaan tidak dapat saling menggantikan dan uji diagnostik menemukan akurasi diagnostik yang buruk. Penelitian selanjutnya harus mengeksklusi kolitis infektif untuk mempertajam diagnosis terduga IBD dan menemukan pasien IBS dengan melibatkan rumah sakit lain.

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ABSTRACT
Inflammatory Bowel Disease (IBD) prevalence has been increasing since last two decades. Gold standard to diagnose IBD is colonoscopy and histopathology. Fecal calprotectin is frequently ordered test for screening of patient with suspect IBD so unnecessary colonoscopy can be reduced. Method often used today is ELISA, but CLIA method is available nowadays. This study was aimed to compare fecal calprotectin test between this two method, to perform diagnostic test with gold standard, and compare the level of fecal calpoctin between IBD and non-IBD group. Study design was cross sectional and was presented as descriptive-analytic data, involving 50 subjects. Correlation between two method is strong and statistically significant (r=0,865, p<0,001), but Passing-Bablok regression test found constant and proportional difference. Bland-Altman test found agreement was 92% with mean difference 76,2 μg/g faeces and border of agreement -964,3-1116,7 μg/g faeces. Diagnostic test with ELISA method found optimal cut-off was 194 μg/g with sensitivity 55,6%, specificity 56,5%, PPV 60%, and NPV 48%. If cut-off from manufacturer was used (50 μg/g), sensitivity 88,9%, specificity 13%, PPV 54,5%, and NPV 50%. Diagnostic test with CLIA method found optimal cutoff was 90,5 μg/g with sensitivity 51,9%, specificity 52,2%, PPV 56%, and NPV 48%. If cut-off from manufacturer was used (50 μg/g), sensitivity 70,4%, specificity 43,5%, PPV 59,4%, and NPV 55,6% . Difference level of fecal calprotectin between IBD and non-IBD group is not statistically significant, both with ELISA and CLIA method. This study found that these two fecal calprotectin is not interchangeable and diagnostic test found poor result. Future study should give more restriction to diagnose suspect IBD by exclusion of infective colitis and found IBS cases by involving other hospital.

Abstrak :
Inflammatory bowel disease (IBD) in rarely found in clinical practice. However, the incidence of IBD seems to have increased recently. Generally, the patients will come to hospital with chief complain! of chronic diarrhea with or without hematochezia. We reported two cases of IBD in which they had been misdiagnosed as colitis tuberculosis based on colonoscopy examination. Treatment of anti tuberculosis drugs had made no clinical improvement. Further evaluation suggested the diagnosis of IBD. They responded very well clinically after treated as IBD. This case report reminds us to consider the diagnosis of IBD in patient with chronic diarrhea and ulceration in colonic mucosa at colonoscopy.

Abstrak :
Secara global dikatakan bahwa insidens Inflammatory bowel disease (IBD) adalah 10 kasus per 100.000 penduduk. Fokus utama rencana Terapeutik IBD adalah upaya penghambatan kaskade proses inflamasi. Temu mangga (Curcuma mangga val) diketahui memiliki efek anti inflamasi. Dalam penelitian ini ingin diketahui efektivitas ekstrak Temu mangga (Curcuma mangga Val) dalam menurunkan kadar TNF-α dari serum mencit dan perbaikan gambaran histopatologi kolon model mencit Inflammatory bowel disease (IBD). Pengukuran TNF-α dengan metode Elisa dan gambaran histopatologi kolon dengan pewarnaan HE. Pada penelitian ini mencit diinduksi menggunakan DSS 2% yang dicampurkan dengan air minum dan diinduksi selama 9 hari dilanjutkan dengan pemberian ekstrak etanol Temu mangga selama 14 hari. Pada penelitian ini ada 6 kelompok hewan perlakuan yaitu K0 (baseline), DS,  PD, MD4, MD8, MD16. Perhitungan statistik menggunakan uji parametrik ANOVA untuk penurunan TNF-α, dan jumlah sel goblet. Skoring perubahan jaringan kolon (metode cooper). Hasil perhitungan menunjukkan penurunan kadar TNF-αterutama pada kelompok  MD16. Dimana penurunan TNF-α pada MD16 berbeda bermakna (p<0,05) dengan DS. Skor perubahan  jaringan kolon (metode cooper) MD16 memperlihatkan hasil berbeda bermakna (p<0,05) dengan DS. Efek Perlakuan dengan dosis Temu mangga 16 mg/20 gram mencit memberikan hasil yang lebih baik pada regenerasi sel dibanding dosis 8 mg/20 gram mencit dan 4 mg/20 gram mencit. Hal ini ditunjukkan dari gambaran Histopatologi kolon yang ditandai peningkatan jumlah sel goblet dan penurunan jumlah lokasi radang . ......Globally it is said that the incidence of Inflammatory bowel disease. (IBD) is 10 cases per 100,000 population. The main focus of the plan is an attempt IBD Therapeutic inhibition of the inflammatory cascade process. Temu mangga ( Curcuma mangga val) is known to have anti-inflammatory effects. In this study we want to know effectiveness Temu mangga extract (Curcuma mangga Val) in lowering levels of serum TNF-α mice and improvement of colonic histopathology picture mice model of Inflammatory bowel disease (IBD). Measurement of TNF-α with Elisa method and description of colonic histopathology with HE staining. In this study, mice were induced using DSS 2% that is mixed with water and induced for 9 days followed by ethanol extract of Temu mangga appointment for 14 days. In this study, there are six groups of animals ie K0 treatment (baseline), DS, PD, MD4, MD8, MD16. Statistical calculations using ANOVA parametric test for the decline in TNF-α, and the number of goblet cells. Scoring changes in colonic tissue (method cooper). The calculations show decreased levels of TNF-α, especially in group MD16. Where the reduction in TNF-α in MD16 significantly different (p<0,05) with DS. Score changes in colonic tissue (method cooper) MD16 showed significantly different results (p<0,05) with DS. The treatment effects at a dose of 16 mg Temu mangga/20 gram mice provide better results in the regeneration of the cells compared to the dose of 8 mg/20 gram mice and 4 mg/20 gram mice. It is shown on the picture Histopathology of colonic marked increase in the number of goblet cells and decrease the number of locations inflammation.

Abstrak :
Inflammatory Bowel Disease (IBD) adalah istilah untuk dua kondisi, yaitu Ulcerative Colitis (UC) dan Crohn Disease (CD) yang ditandai dengan peradangan kronis pada saluran gastrointestinal. Deksametason memiliki spesifisitas yang kurang sehingga dapat menyebabkan efek samping sistemik apabila digunakan secara jangka panjang. Pengobatan IBD memerlukan suatu sistem penghantaran kolon tertarget untuk mengurangi efek samping deksametason. Penelitian ini bertujuan untuk memperoleh formulasi beads kalsium pektinat yang mengandung deksametason (F1) dan kombinasi deksametason-probiotik (F2) serta mengetahui karakteristik dan profil pelepasannya melalui uji pelepasan in vitro. Jenis probiotik yang digunakan adalah Lactobacillus acidophilus dan Bifidobacterium longum. Beads dibuat menggunakan metode gelasi ionik dan disalut menggunakan Eudragit L100 (FA) dan Eudragit S100 (FB), sehingga didapatkan F1A, F1B, F2A, F2B. Karakterisasi dilakukan terhadap beads sebelum dan sesudah disalut. Uji pelepasan in vitro pada beads tersalut dilakukan dalam medium HCl pH 1,2 selama 2 jam, medium dapar fosfat pH 7,4 selama 3 jam, dan medium dapar fosfat pH 6,8 selama 3 jam. Beads yang dihasilkan berbentuk hampir sferis dan memiliki nilai efisiensi penjerapan yang tinggi, yaitu 82,730% ± 0,774% (F1) dan 94,414% ± 0,477% (F2). Sebagian besar beads terdistribusi pada ukuran diameter 0,841-1,190 mm. Hasil pelepasan obat kumulatif akhir pada F1A, F1B, F2A, dan F2B, berturut-turut adalah 89,919% ± 0,524%, 87,653% ± 0,713%, 98,695% ± 1,486%, dan 97,406% ± 0,459%. Berdasarkan hasil pengujian, beads kalsium pektinat tersalut mampu menahan pelepasan deksametason dalam medium asam, namun belum berhasil menarget kolon. ......Inflammatory Bowel Disease (IBD) is a term for two conditions, namely Ulcerative Colitis (UC) and Crohn's Disease (CD) which are characterized by chronic inflammation of the gastrointestinal tract. Dexamethasone has poor specificity so that it can cause systemic side effects when used in long term. The treatment of IBD requires a colon targeted drug delivery system to reduce the side effects of dexamethasone. This study aimed to obtain a formulation of calcium pectinate beads that containing dexamethasone (F1) and combination of dexamethasone-probiotics (F2) and to determine the characteristics and release profile through in vitro release tests. The types of probiotics used were Lactobacillus acidophilus dan Bifidobacterium longum. Beads were made using the ionic gelation method and coated using Eudragit L100 (FA) and Eudragit S100 (FB), so that formulas were F1A, F1B, F2A, and F2B. Characterization was carried out on the beads before and after they were coated. In vitro release test on coated beads was carried out in HCl pH 1.2 medium for 2 hours, phosphate buffer medium pH 7.4 for 3 hours, and phosphate buffered medium pH 6.8 for 3 hours. The resulting beads were almost spherical in shape and had high entrapment efficiency values, namely 82.730% ± 0.774% (F1) and 94.414% ± 0.477% (F2). Most of the beads were distributed in diameter sizes from 0.841 to 1.190 mm. The final cumulative release results of F1A, F1B, F2A, and F2B was 89.919% ± 0.524%, 87.653% ± 0,713%, 98.695% ± 1,486%, dan 97.406% ± 0.459%. Based on the test results, the coated calcium pectinate beads were able to resist the release of dexamethasone in acidic medium, but had not succeeded in targeting the colon.

Abstrak :
Praktik Kerja Profesi PKP di Apotek Kimia Farma No.375 Depok dilakukan selama empat minggu di bulan Maret. PKP ini bertujuan untuk agar calon apoteker mengetahui tugas dan tanggung jawab apoteker di apotek, selain itu calon apoteker juga dapat memiliki gambaran nyata tentang permasalahan pekerjaan kefarmasian di apotek, memiliki wawasan, pengetahuan, keterampilan, dan pengalaman praktis untuk melakukan pekerjaan kefarmasian di apotek. Tugas khusus yang diberikan yaitu berjudul 'Analisis Resep Pasien Penderita Penyakit Radang Usus Inflammatory Bowel Disease Di Apotek Kimia Farma No 375'. Tujuan dari tugas khusus ini adalah agar mengetahui tentang penyakit radang usus serta pedoman pengobatannya, mengetahui ketepatan terapi radang usus melalui resep yang diberikan kepada pasien dan mengetahui permasalahan terkait ketidaktepatan terapi yang terdapat pada resep, selain itu diharapkan calon apoteker mampu melaksanakan alur pelayanan resep yang rasional berdasarkan standar pelayanan kefarmasian. Secara umum, apoteker penanggungjawab di Apotek Kimia Farma No. 375 telah menyelenggarakan pengelolaan sediaan farmasi dan pelayanan klinis dengan baik dan sesuai dengan peraturan yang berlaku. Selain itu, penulis juga mendapatkan wawasan, pengetahuan dan gambaran nyata tentang masalah dalam praktik kefarmasian, serta strategi dan kegiatan yang dilakukan untuk mengatasinya. ...... Internship at Apotek Kimia Farma No. 375 Depok conducted for four weeks in March. Internship is aimed to get the pharmacist to know the duty and responsibility of the pharmacist in the pharmacy. Besides, the pharmacist can also have insight about the problem in the pharmacy, knowledge, skill, and practical experience to perform pharmaceutical work in the pharmacy. The special assignment given is entitled Analysis of Inflammatory Bowel Disease Prescription in Apotek Kimia Farma No 375. The purpose of this special assignment is to know about IBD and its treatment guidelines, to know the accuracy of IBD therapy through prescriptions given to the patient and to identify issues related to the inappropriateness of the prescription therapy, It is expected that pharmacist candidates are able to carry out a rational prescribing service flow based on the standard of pharmaceutical service. In general, pharmacists of Apotek Kimia Farma No. 375 have conducted the management of pharmaceutical preparations and clinical services well and in accordance with applicable regulations. In addition, the authors also get insight and knowledge of the problem in the practice of pharmaceutical, as well as strategies and activities undertaken to overcome them.

Abstrak :
Inflammatory bowel disease (IBD) merupakan penyakit kronik dan relapsing yang mempengaruhi kualitas hidup pasien. Hingga saat ini penegakkan diagnosis IBD masih menjadi persoalan. Calprotectin merupakan biomarker yang dapat dideteksi di jaringan (intramukosal) dan dinilai memiliki potensi dalam membantu penegakkan diagnosis IBD. Penelitian ini bertujuan untuk menilai ekspresi calprotectin intramukosal pada IBD, kolitis non-IBD dan kontrol. Penelitian bersifat retrospektif analitik. Pengambilan sampel dilakukan secara konsekutif pada sediaan biopsi kolorektal yang didiagnosis IBD, kolitis non-IBD, serta sediaan reseksi dengan bagian kolon tanpa kelainan patologik bermakna dari arsip Departemen Patologi Anatomik FKUI/RSCM tahun 2017-2020. Dilakukan pulasan imunohistokimia untuk menilai ekspresi calprotectin (rerata jumlah sel/LPB) pada tiap kelompok. Dari 45 sampel IBD dan 45 sampel non-IBD, sebagian besar menunjukkan peradangan aktif, derajat keaktifan ringan. Ekspresi calprotectin intramukosal pada kelompok IBD dan non-IBD lebih tinggi dibandingkan dengan kelompok kontrol (p<0,001). Kasus dengan peradangan aktif memiliki ekspresi calprotectin yang lebih tinggi dibandingkan pada peradangan inaktif (p<0,001). Peningkatan ekspresi calprotectin memiliki hubungan bermakna dengan adanya peradangan namun belum dapat direkomendasikan untuk menjadi dasar penentuan etiologi IBD dan non-IBD. ......Inflammatory bowel disease is a chronic relapsing disease affecting patients’ quality of life. To date, IBD diagnosis remains a challenge. Calprotectin is a biomarker that can be detected in tissue (intramucosal) and is considered as a potential marker of IBD. This study aims to determine intramucosal calprotectin expression in IBD, non-IBD colitis and control. Analytic retrospective study including consecutively sampled colorectal biopsy specimens diagnosed as IBD, non-IBD colitis and resection specimens with normal colon mucosa recorded in archives of Anatomical Pathology Department, FKUI/RSCM in 2017-2020. Calprotectin expression (cell/HPF) was detected by immunostaining and evaluated for every group. Most of the samples from IBD and non-IBD group (45 samples each) showed mild active inflammation, with higher mucosal calprotectin expression than that of control group (p<0.001). Subjects with active inflammation showed higher calprotectin expression compared to those with inactive inflammation (p<0.001). The increase of calprotectin expression showed significant association with the presence of inflammation, with higher expression found in active inflammatory conditions. However, the use of calprotectin to determine inflammatory etiology (IBD vs non-IBD) has yet to be recommended.

Abstrak :
Latar Belakang: IBD adalah penyakit gastrointestinal inflamasi kronis yang ditandai dengan sistem kekebalan yang melemah. Ini dibagi menjadi dua jenis utama: penyakit Crohn dan colitis ulserativa. Indonesia memiliki 0,55 per 100,00 UC, 0,33 per 100.000 CD, dan 0,88 per 100.000 pasien IBD. IBD adalah faktor risiko utama kanker kolorektal. Etiologi IBD adalah kombinasi rumit dari genetik, respon imunologi, dan komponen mikroba. Penelitian ini bertujuan untuk mengetahui jumlah TNF-α yang diekspresikan setelah pemberian Lunasin. Metode: Sebanyak 26 ekor mencit webster jantan secara acak dimasukkan ke dalam empat kelompok. Terdiri dari normal, dan dalam tiga kelompok yang diinduksi dengan dekstran natrium sulfat (DSS). Subjek pada kelompok kontrol negatif tidak diberikan Lunasin, sedangkan dosis rendah dan dosis tinggi diberikan Lunasin (masing-masing 12,5 mg/kgBB dan 25 mg/kgBB) selama empat minggu. Pewarnaan imunohistokimia akan digunakan untuk kolon dan akan dilakukan pewarnaan counter dengan pewarnaan Hematoxylin dan eosin (H&E). Bercak kuning kecoklatan akan diperiksa dengan mikroskop dan software “Indomicroview”. Hasilnya akan dianalisis dengan plugin ImageJ “IHC profiler”. Hasil: Penelitian ini menemukan bahwa ekspresi tumor necrosis factor (TNF)-± menurun setelah pemberian Lunasin dengan dosis 12,5 mg/kgBB dan 25 mg/kgBB. Namun 12,5 mg/kgBB dalam penelitian ini lebih signifikan dibandingkan dengan 25 mg/kgBB. Kesimpulan: Studi menunjukkan bahwa, Lunasin dapat menurunkan ekspresi TNF-a pada mencit yang telah dirangsang oleh dekstran natrium sulfat setelah 4 minggu pemberian dosis. Pengujian lebih lanjut dari ekspresi TNF-α dengan cara yang berbeda. Misalnya, tingkat serum TNF-±. ......Introduction: IBD is a chronic, inflammatory gastrointestinal disease characterised by a weakened immune system. It is split into two primary types: Chron's disease and ulcerative colitis. Indonesia has 0.55 per 100.00 UC, 0.33 per 100.000 CD, and 0.88 per 100.000 IBD patients. IBD is a major colorectal cancer risk factor. IBD's aetiology is a complicated combination of genetic, immunological response, and microbial components. This study aims to investigate the amount of TNF-± expressed after the administration of Lunasin. Method: A total of 26 male webster mice were randomly put into four groups. The consist of normal, and in three group that is induced with dextran sodium sulfate (DSS). The subject in the negative control group were not given Lunasin, while the low dose and high dose are given lunasin (12,5 mg/kgBW and 25 mg/kgBW respectively) for four weeks. Immunohistochemical stained will be used for the colon and will be counter stained with Hematoxylin and eosin (H&E) stain. Yellow-brown spot will be investigated with microscope and “Indomicroview” software. The result will be analyzed with ImageJ plugin “IHC profiler”.Results: This study found that the expression of tumor necrosis factor (TNF)-± decreased after the administration of Lunasin with 12.5 mg/kgBW and 25 mg/kgBW. However, 12.5 mg/kgBW (p = 0.022) in this research is more effective in suppressing the TNF-α expression compared to 25 mg/kgBW(p = 0.206), in Tukey Post-Hoc Test. Conclusion: In conclusion, Lunasin can lower the expression of TNF-a in mice that has been stimulated by dextran sodium sulphate after 4 weeks of dosing. Further testing of TNF-α expression in a different way. For instance, serum TNF-± level.

Abstrak :
Mesalazin merupakan agen anti inflamasi yang telah digunakan dalam tata laksana Inflammatory Bowel Disease (IBD). Namun, zat aktif ini dapat menyebabkan nyeri perut apabila digunakan dalam bentuk tablet oral konvensional. Oleh karena itu, untuk menghindari efek samping tersebut mesalazin dibuat menjadi sediaan tertarget kolon. Pektin dipilih karena dapat bertahan dalam bentuk utuh pada saluran cerna bagian atas dan dapat terdegradasi saat mencapai kolon dengan adanya mikroflora. Kombinasi Eudragit S-100 dan Eudragit L-100 dipilih karena keduanya dapat melindungi sediaan dari lingkungan asam pada saluran cerna atas dengan kelarutan yang bergantung pada pH. Penelitian ini bertujuan untuk memperoleh formulasi dan karakteristik tablet matriks mesalazin menggunakan kombinasi pektin dengan Eudragit S-100 dan Eudragit L-100. Sediaan ini dibuat menggunakan metode granulasi basah. Sebanyak 9 formula dibuat dan dievaluasi kemudian dipilih 3 formula paling optimal untuk dilakukan uji profil disolusi. Evaluasi dilakukan terhadap granul dan tablet dari setiap formula. Evaluasi granul meliputi uji organoleptis, uji laju alir, uji kerapatan partikel, uji sudut istirahat, dan uji kandungan lembab. Sedangkan evaluasi tablet meliputi uji organoleptis, uji keseragaman ukuran, uji keregasan, uji kekerasan, uji waktu hancur, uji keragaman bobot, uji kadar obat, dan uji profil disolusi. Berdasarkan evaluasi, diketahui bahwa seluruh formula (F1 – F9) memenuhi karakteristik sebagai sediaan tertarget kolon dengan F2 sebagai formula dengan kriteria terbaik. F2 memiliki karakteristik granul dan tablet yang memenuhi kriteria penerimaan dengan nilai keregasan sebesar 0,13%; kekerasan sebesar 11,43 ± 1,19; dan kadar zat aktif sebesar 94,10%. Selain itu, pada uji profil disolusi In vitro, F2 lebih mampu menahan pelepasan mesalazin pada HCl pH 1,2 dibandingkan formula lain. Namun, tidak ada perbedaan signifikan (p = 0,917) pada pelepasan kumulatif mesalazin untuk 3 formula paling optimal (F2, F4, dan F8). ......Mesalazine is anti-inflammatory agents that have been used in the management of inflammatory bowel disease (IBD). However, this active substance can cause abdominal pain when used in conventional oral tablet form. Therefore, to avoid these side effects, mesalazine is made into colon-targeted drug delivery system. Pectin was chosen because it can survive intact in the upper digestive tract and can be degraded when it reaches the colon due to the presence of microflora. The combination of Eudragit S-100 and Eudragit L-100 was chosen because both can protect against the acidic environment of the upper digestive tract with their pH-dependent solubility. This research aims to obtain the formulation and characteristics of mesalazine matrix tablets using combinations of pectin with Eudragit S-100 and Eudragit L-100. Tablets were prepared using wet granulation method. A total of 9 formulas were made and evaluated and then the 3 most optimal formulas were selected for the dissolution profile test. Evaluation was carried out on granules and tablets of each formula. Granule evaluation includes organoleptic test, flow rate test, particle density test, angle of repose test, and moisture content test. Evaluation of tablets includes organoleptic test, size uniformity test, friability test, hardness test, disintegration time test, weight variation test, drug content test, and dissolution profile test. Based on the evaluation, it was found that all formulas (F1 – F9) fulfilled the characteristics of colon-targeted preparations with F2 as the formula with the best criteria. F2 has the characteristics of granules and tablets that meet the acceptance criteria with friability was 0.13%; hardness was 11.43 ± 1.19; and drug content was 94.10%. In addition, in In vitro dissolution profile test, F2 was better able to withstand the release of mesalazine in HCl pH 1.2 compared to other formulas. However, there was no significant difference (p = 0.917) in the cumulative release of mesalazine for the 3 most optimal formulas (F2, F4, and F8).

Abstrak :
Inflammatory bowel disease (IBD) merupakan penyakit kronis saluran cerna dengan siklus eksaserbasi-remisi. Masih terdapat tantangan dalam mempertahankan remisi dan menunda flare pada pasien IBD. Asupan gizi tertentu dapat memodifikasi mediator inflamasi pada saluran gastrointestinal sementara aktivitas fisik dapat mempengaruhi kadar sitokin sehingga keduanya dapat mempengaruhi perjalanan IBD. Penelitian ini bertujuan untuk menganalisis hubungan antara potensi inflamasi diet dan aktivitas fisik dengan aktivitas penyakit IBD. Metode: Penelitian ini menggunakan desain potong lintang pada pasien IBD yang melakukan kontrol di Poliklinik Gastroenterologi Rumah Sakit Cipto Mangunkusumo (RSCM) selama periode Juli–September 2022. Pengambilan data mengenai potensi inflamasi diet berdasarkan skor Dietary Inflammatory Index (DII) dan aktivitas fisik berdasarkan skor International Physical Activity Questionnaire (IPAQ). Derajat aktivitas penyakit IBD diperoleh berdasarkan kuesioner Indeks Harvey-Bradshaw (HBI) untuk Penyakit Crohn (PC) dan Simple Colitis Clinical Activity Index (SCCAI) untuk Kolitis Ulseratif (KU). Analisis statistik dengan menggunakan uji KruskalWallis, Spearman, dan Regresi linear multipel. Hasil: Sebanyak 100 subjek penelitian didapatkan rerata skor DII pada kelompok PC adalah 0,22± 2,20 dengan tren rerata yang meningkat signifikan seiring dengan keparahan PC: -0,13 ± 2,3 (remisi), 0,17 ± 2,51 (ringan), 0,65 ± 2,11 (sedang), 0,68 ± 1,60 (berat); p=0,02. Rerata skor DII pada kelompok KU adalah 0,11 ± 2,45 dan tidak ditemukan perbedaan bermakna antar subgrup keparahan. Rerata skor aktivitas fisik pada kelompok PC dan KU berturut-turut adalah 5097,4 ± 2955,7 dan 6023,7 ± 4869,4. Tidak ditemukan perbedaan bermakna antara tingkat aktivitas fisik dan derajat aktivitas penyakit IBD. Skor DII secara independen dapat mempengaruhi aktivitas penyakit PC dari analisis multivariat (koefisien Î² 0,370; p= 0,006).  Kesimpulan: Terdapat hubungan signifikan antara potensi inflamasi diet dengan derajat aktivitas penyakit PC. Tidak terdapat hubungan antara potensi inflamasi diet dengan derajat aktivitas penyakit KU maupun antara aktivitas fisik dengan derajat aktivitas penyakit IBD. ......Background: inflammatory bowel disease (IBD) is a chronic gastrointestinal disease with exacerbation-remission cycles. There are still challenges in maintaining remission and preventing flares in IBD patients. Intake of certain nutrients can modify inflammatory mediators of the gastrointestinal tract while physical activity may affect cytokine levels, therefore both can influence the course of  IBD. This study aims to analyze the association between inflammatory potential of diet and physical activity with IBD disease activity. Method: in this cross-sectional study, IBD patients who had regular control at the gastroenterology outpatient clinic of RSCM were recruited during the period of July–September 2022. The data of inflammatory potential of diet obtained through the dietary Inflammatory Index (DII) score and physical activity data obtained through the International Physical Activity Questionnaire (IPAQ) score. The degree of IBD disease activity based on the Harvey-Bradshaw Index (HBI) for Crohn’s Disease (CD) and the Simple Colitis Clinical Activity Index (SCCAI) for Ulcerative Colitis (UC). Statistical analysis using the Kruskal-Wallis test, Spearman test, and Multiple Linear Regression test. Results: A total of 100 subjects obtained the mean DII score in the CD group was 0.22± 2.20 with an upward trend that increased significantly as CD disease severity progressed: -0.13 ± 2.3 (remission), 0.17 ± 2.51 (mild), 0.65 ± 2.11 (moderate), 0.68 ± 1.60 (severe); p=0,02. The mean DII score in the UC group was 0.11 ± 2.45 and there was no significant difference among severity subgroups. The mean physical activity scores in the CD and UC groups were 5097.4± 2955.7 and 6023.7 ± 4869.4 respectively. There was no significant difference of physical activity among various degrees of IBD severity. DII scores independently influenced CD disease activity based on multivariate analysis (β-coefficient 0.370; p= 0.006). Conclusion: A significant association between the inflammatory potential of diet and CD disease activity was observed. There was no association between inflammatory potential of diet and UC disease activity, as well as between physical activity and IBD disease activity.