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Abstrak :
Latar Belakang: Non alcoholic fatty liver disease (NAFLD) merupakan kondisi perlemakan hati yang merupakan salah satu faktor risiko karsinoma hepatoselular (KSH). NAFLD melibatkan berbagai faktor dalam patogenesisnya, salah satunya mikrobiota saluran cerna. Disbiosis mikrobiota saluran cerna dianggap sebagai faktor utama dalam peristiwa disregulasi sistem imun dan inflamasi pada patogenesis NAFLD. Tujuan: Studi ini bertujuan untuk melihat profil dan konfigurasi mikrobiota saluran cerna pasien dengan NAFLD dan pengaruhnya terhadap nilai kondisi fibrosis dan stratosis hati yang tercermin dalam nilai controlled attenuation parameter (CAP) dan transient elastography (TE). Metode: Dilakukan studi potong lintang analitik terhadap 37 pasien dengan NAFLD yang memenuhi kriteria inklusi di Rumah Sakit Cipto Mangunkusumo pada Desember 2018 hingga Maret 2019. Dilakukan anamnesis, wawancara food recall, pemeriksaan fisik, pemeriksaan laboratorium, pemeriksaan CAP-TE, dan pengambilan sampel feses pada pasien subjek penelitian. Mikrobiota saluran cerna disekuensing dengan Next-Generation Sequencing (NGS) platform Miseq (Illumina). Hasil: NAFLD lebih dominan pada wanita dan penderita penyakit sindrom metabolik. Firmicutes, Bacteroidetes, dan Proteobacteria berturut-turut merupakan filum dengan proporsi terbesar. Disbiosis mikrobiaota saluran cerna didapatkan pada separuh dari sampel subjek penelitian. Rasio Firmicutes/Bacteroidetes (RFB) pada setiap pasien berbeda-beda dan tidak berkorelasi secara signifikan terhadap variabel sindrom metabolik. Diversitas mikrobiota saluran cerna didapatkan menurun pada pasien NAFLD dengan trigliserida tinggi dan obesitas sentral. Simpulan: Sejumlah mikrobiota saluran cerna pada tingkat taksonomi yang berbeda memiliki korelasi positif maupun negatif terhadap fibrosis dan steatosis. ...... Background: Non alcoholic fatty liver disease (NAFLD) is fatty liver condition that can lead to hepatocellular carcinoma (HCC). NAFLD is multifactorial component in its pathogenesis, one of which is gut microbiota. Dysbiosis of gut microbiota is considered as main factor in the dysregulation of immune system and inflammatory condition in the pathogenesis of NAFLD. Aim: This study aim to investigate the profile and configuration of gut microbiota in patient with NAFLD dan its correelation withfibrosis and steatosis condition as reflected in controlled attenuation parameter (CAP) dan transient elastography (TE) value. Method: cross sectional study was done upon 37 NAFLD patients in Cipto Mangunkusumo National General Hospital from December 2018 to March 2019. All subjects undergone food recall examination, physical and laboratory examination, CAP-TE value measurement, and fecal sample examination. The gut microbiota was investigated through 16s RNA sequensing by Next-Generation Sequencing (NGS) platform Miseq (Illumina). Result: NAFLD was predominant in female subjects and those with metabolic syndrome. Firmicutes, Bacteroidetes, dan Proteobacteria was the predominant phylum consecutively. Dysbiosis was appeared in half of the study subjects. The Ratio of Firmicutes/Bacteroidetes was different in each patients and has no significnat correlation with metabolic syndrome variables. The diversity of gut microbiota was decresed in NAFLD patients with high tryglicerides and central obesity. Conclusion: Certain gut microbiota at different taxonomy level have positive and negative correlation with fibrosis and steatosis.

Abstrak :

Latar Belakang: Non alcoholic fatty liver disease (NAFLD) merupakan kondisi perlemakan hati yang merupakan salah satu faktor risiko karsinoma hepatoselular (KSH). NAFLD melibatkan berbagai faktor dalam patogenesisnya, salah satunya mikrobiota saluran cerna. Disbiosis mikrobiota saluran cerna dianggap sebagai faktor utama dalam peristiwa disregulasi sistem imun dan inflamasi pada patogenesis NAFLD.

Tujuan: Studi ini bertujuan untuk melihat profil dan konfigurasi mikrobiota saluran cerna pasien dengan NAFLD dan pengaruhnya terhadap nilai kondisi fibrosis dan stratosis hati yang tercermin dalam nilai controlled attenuation parameter (CAP) dan transient elastography (TE).

Metode: Dilakukan studi potong lintang analitik terhadap 37 pasien dengan NAFLD yang memenuhi kriteria inklusi di Rumah Sakit Cipto Mangunkusumo pada Desember 2018 hingga Maret 2019. Dilakukan anamnesis, wawancara food recall, pemeriksaan fisik, pemeriksaan laboratorium, pemeriksaan CAP-TE, dan pengambilan sampel feses pada pasien subjek penelitian. Mikrobiota saluran cerna disekuensing dengan Next-Generation Sequencing (NGS) platform Miseq (Illumina).

Hasil: NAFLD lebih dominan pada wanita dan penderita penyakit sindrom metabolik. Firmicutes, Bacteroidetes, dan Proteobacteria berturut-turut merupakan filum dengan proporsi terbesar. Disbiosis mikrobiaota saluran cerna didapatkan pada separuh dari sampel subjek penelitian. Rasio Firmicutes/Bacteroidetes (RFB) pada setiap pasien berbeda-beda dan tidak berkorelasi secara signifikan terhadap variabel sindrom metabolik. Diversitas mikrobiota saluran cerna didapatkan menurun pada pasien NAFLD dengan trigliserida tinggi dan obesitas sentral.

Simpulan: Sejumlah mikrobiota saluran cerna pada tingkat taksonomi yang berbeda memiliki korelasi positif maupun negatif terhadap fibrosis dan steatosis.

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Background: Non alcoholic fatty liver disease (NAFLD) is fatty liver condition that can lead to hepatocellular carcinoma (HCC). NAFLD is multifactorial component in its pathogenesis, one of which is gut microbiota. Dysbiosis of gut microbiota is considered as main factor in the dysregulation of immune system  and inflammatory condition in the pathogenesis of NAFLD.

Aim: This study aim to investigate the profile and configuration of gut microbiota in patient with NAFLD dan its correelation withfibrosis and steatosis condition as reflected in controlled attenuation parameter (CAP) dan transient elastography (TE) value.

Method: cross sectional study was done upon 37 NAFLD patients in Cipto Mangunkusumo National General Hospital from December 2018 to March 2019. All subjects undergone food recall examination, physical and laboratory examination, CAP-TE value measurement, and fecal sample examination. The gut microbiota was investigated through 16s RNA sequensing by Next-Generation Sequencing (NGS) platform Miseq (Illumina).

Result: NAFLD was predominant in female subjects and those with metabolic syndrome. Firmicutes, Bacteroidetes, dan Proteobacteria was the predominant phylum consecutively. Dysbiosis was appeared in half of the study subjects. The Ratio of Firmicutes/Bacteroidetes was different in each patients and has no significnat correlation with metabolic syndrome variables. The diversity of gut microbiota was decresed in NAFLD patients with high tryglicerides and central obesity.

Conclusion: Certain gut microbiota at different taxonomy level have positive and negative correlation with fibrosis and steeatosis.

Abstrak :
Tempeh is sliceable soybean-cake fermented by Rhizopus oligosporus. Various bacteria were detected in tempeh employing cultivation technique with limited information about their origin or sources. The present study aimed to examine the source/s of bacterial community in tempeh by combining metagenomics analysis and cultivation technique. Samples were obtained from a number of steps in tempeh production employing two-times boiling of soybean (WJB tempeh production). All samples were plated on Enterobacteriaceae and Lactic Acid Bacteria medium. Total DNA were extracted directly from tempeh for metagenomics analysis, employing High-Throughput Sequencing (HTS) and cloned 16S rRNA genes. Firmicutes and Proteobacteria were the predominant and second dominant bacteria existed in fresh tempeh (FT) obtained by metagenomics analysis. In contrast, cultivation technique showed that Proteobacteria was the predominant phylum, suggested that most of the Firmicutes were not culturable. FT was dominated by Lactobacillus and Acetobacter. Both FT and soaking water (SW) were dominated by same species of Lactobacillus, i.e. L. delbreuckii and L. mucosae, indicated that SW was probably the source of bacterial community established in the final product of fermentation. Predominant bacteria in starter culture (SC), Acinetobacter, was not detected in FT, indicating that bacteria in SC might not play significant role in bacterial community development in FT.

Abstrak :
Latar Belakang. Pada lupus eritematosus sistemik (LES) ditemukan prevalensi ansietas dan depresi yang cukup besar. Beberapa aspek menjadi kaitan antara lupus eritematosus sistemik dengan ansietas dan depresi, di antaranya disbiosis usus. Rasio Firmicutes/Bacteroidetes rendah menunjukkan disbiosis dan nilainya rendah pada LES. Tujuan. Mengetahui profil mikrobiota usus pada ansietas dan depresi pada LES serta secara khusus mengetahui korelasi rasio Firmicutes/Bacteroidetes dengan skor gejala ansietas dan depresi pada LES. Metode. Penelitian ini mengambil data studi Pengaruh sinbiotik terhadap aktivitas penyakit, respons imun, serta permeabilitas dan mikrobiota usus pada pasien lupus eritematosus sistemik. Dari studi besar tersebut, diambil data dasar (baseline) berupa data demografik, Hospital Anxiety and Depression Scale (HADS), Systemic Lupus Erythematosus Disease Activity Index 2000 (SLEDAI-2k), obat-obatan yang dikonsumsi, pola diet, serta proporsi mikrobiota usus tingkat filum. Keseluruhan data dijabarkan secara deskriptif. Dilakukan analisis korelasi antara rasio Firmicutes/Bacteroidetes dengan HADS-Ansietas dan HADS-Depresi. Hasil. Dari 41 subjek, didapatkan proporsi ansietas 53,66% dan depresi 14,63%. Kelompok ansietas memiliki proporsi Bacteroidetes lebih tinggi dan indeks diversitas lebih rendah daripada kelompok tidak ansietas. Kelompok depresi memiliki proporsi Bacteroidetes lebih tinggi, Firmicutes lebih rendah, dan rasio Firmicutes/Bacteroidetes lebih rendah dibandingkan kelompok tidak depresi. Diagram sebar menunjukkan tidak adanya hubungan yang linear antara rasio Firmicutes/Bacteroidetes dengan skor gejala ansietas dan depresi sehingga tidak dapat dilakukan analisis korelasi. Simpulan. Secara deskriptif didapatkan kecenderungan disbiosis pada kelompok yang mengalami ansietas dan depresi daripada kelompok yang tidak mengalami gangguan psikis.

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Background. There was a high prevalence anxiety and depression in systemic lupus erythematosus (SLE). Some aspects interconnecting them, such as intestinal dysbiosis. Firmicutes/Bacteroidetes ratio, one of dysbiosis parameter, found low in SLE patients and also depressed patients. Objectives. This research aim to study intestinal microbiota profile among anxious and depressed SLE patients, and also to know the correlation between Firmicutes/Bacteroidetes ratio with anxiety and depression score in SLE patients. Methods. We used secondary data from research entitled Effects of synbiotic supplementation on disease activity, immune response, gut permeability, and microbiota of systemic lupus erythematosus patients. We used baseline data of demographic data, Hospital Anxiety and Depression Scale, Systemic Lupus Erythematosus Disease Activity Index 2000, drugs used, nutrients intake, and intestinal microbiota profile at phylum level. All those data were described descriptively and also analysed for the correlation between Firmicutes/Bacteroidetes ratio with anxiety score and depression score. Results. From all 41 subjects, the proportion of anxiety was 53,66% and depression 14,63%. Anxiety group had more Bacteroidetes than not anxiety group. Depressed group had more Bacteroidetes, less Firmicutes, and lower Firmicutes/Bacteroidetes ratio than not depressed group. The scatterplot shows that there is no linear relationship between the Firmicutes/Bacteroidetes ratio with anxiety and depression symptom scores so that correlation analysis cannot be done. Conclusion. Descriptively there was a tendency for dysbiosis in the group that experienced anxiety and depression than the group that did not experience psychological disorders.

Abstrak :
Penyakit ginjal kronik (PGK) sudah menjadi masalah kesehatan global dengan prevalensi dan insidensi gagal ginjal yang meningkat dan memberikan prognosis buruk. Salah satu penyebab beratnya morbiditas pada PGK adalah terjadinya disbiosis mikroflora usus yaitu peningkatan flora patogen dibandingkan dengan flora normal pada pasien PGK dengan hemodialisis (PGK-HD). Studi ini bertujuan untuk mendapatkan pola mikrobiota usus pada pasien PGK dengan hemodialisis dengan metode kuantitatif PCR dengan pendekatan analisis ΔCt. Desain penelitian potong lintang dengan 71 subjek pasien PGK usia >18 tahun dengan hemodialisis rutin di RS. Umum Pusat Nasional Dr. Cipto Mangukusumo. Sampel berupa feses yang disimpan di suhu -20oC selama kurang dari setahun. Ekstraksi dan purifikasi DNA dengan teknik pengikatan silika dan metode buffer kit Exgene Stool DNA, Bioneer. Pengukuran konsentrasi DNA dengan spektrofotometer NanoVue dilanjutkan dengan standarisasi konsentrasi DNA dengan pengenceran sampel berdasarkan konsentrasi DNA terkecil. Pemeriksaan real-time q-PCR mesin Bioneer ExicyclerTM 96 dengan menggunakan 13 macam primer yaitu E.coli, Parasuterella excrementihominis, Prevotella, Bacteroides, Bifidobacterium, L.casei, L.acidophillus, Enterococcus faecalis, Enterococcus faecium, Clostridium difficile, Clostridium cocoides, Akkermansia muciniphila dan Beta-actin sebagai housekeeping gene (HKG). Hasil penelitian didapatkan dominasi mikrobiota usus E. coli dan rasio F/B pasien PGK-HD 2,76. Terdapat hubungan bermakna antara hipertensi dengan rasio F/B 9,35 4,0. Penelitian ini merupakan penelitian pertama tentang disbiosis mikrobiota usus pada pasien PGK dengan hemodialisis di Indonesia dengan menggunakan sampel feses dengan metode PCR kuantitatif pendekatan analisis ΔCt. Dengan diketahui profil mikrobiota usus pada PGK dapat dijadikan saran pemberikan suplementasi probiotik Bifidobacteria, sehingga diharapkan dapat meningkatkan konsentrasi mikrobiota filum Bacteroides. ......Chronic kidney disease (CKD) has become a global health problem with increasing in prevalence and incidence of kidney failure. One of the causes of severe morbidity in CKD is the occurrence of intestinal microflora dysbiosis, an increase in pathogenic flora compared to normal flora in CKD patients with hemodialysis (CKD-HD). This study aims to obtain patterns of gut microbiota in CKD patients on hemodialysis by quantitative PCR method with Ct approach analysis The design was a cross-sectional study with 71 CKD patients aged >18 years with routine hemodialysis in the hospital. General National Center Dr. Cipto Mangukusumo. Samples are feces that are stored at -20oC for less than one year. Extraction and purification of DNA with silica binding techniques using Exgene Stool DNA buffer kit method, Bioneer. Measurement of DNA concentration with the NanoVue spectrophotometer, followed by standardization of DNA concentration by diluting the sample based on the smallest DNA concentration. Real-time q-PCR examination of the Boneer ExicyclerTM 96 machine using 13 kinds of primers, namely E.coli, Parasuterella excrementihominis, Prevotella, Bacteroides, Bifidobacterium, L.casei, L.acidophillus, Enterococcus faecalis, Enterococcus faecium, Clostridium difficile, Clostridium cocoides, Akkermansia muciniphila and Beta-actin as a housekeeping gene (HKG). There was the dominance of the gut microbiota of E. coli and the F/B ratio of CKD-HD patients 2.76. There is a significant relationship between hypertension and the F/B ratio of 9.35 ± 4.0. This study is the first study on gut microbial dysbiosis in CKD patients on hemodialysis in Indonesia using stool samples using quantitative PCR method with Ct approach analysis. Knowing the gut microbiota profile in CKD, can be used as a suggestion for Bifidobacteria probiotic supplementation, as is expected to increase the concentration of the Bacteroides phylum microbiota.