Background: Systemic Lupus Erythematosus (SLE) is a complex autoimmune disease and involves many organ systems in the body. Glucocorticoids are potent anti-inflammatory and immunosuppressive agents used in patients with SLE. The cumulative dose of steroids is a major risk factor for bone loss. A sensitive indicator that reflects bone remodeling activity is a bone turnover marker (BTM), one of which is N-MID Osteocalcin. Bone Mineral Density (BMD) with DXA can be used to assess osteoporosis. DXA is thus not feasible for screening because of its high cost and lack of machine availability. N-MID Osteocalcin is cheaper and more accessible than DXA. The majority of SLE patients at Moewardi Hospital, Surakarta, received the main therapy for methylprednisolone. Objectives: This study aims to prove the correlation between serum N-MID Osteocalcin values and BMD values in female SLE patients who received oral methylprednisolone therapy based on cumulative doses. Methods: This is a cross-sectional study with random sampling techniques at Rheumatology Clinic Moewardi Hospital, Surakarta. The 38 samples that met the inclusion criteria were measured BMD by DXA and examined for N-MID Osteocalcin by using the Elecsys N-Mid Osteocalcin Kit with the ECLIA method. The cumulative dose of methylprednisolone is calculated in grams. Data analysis used the Shapiro Wilk test, 2 mean difference test (t-test and Mann Whitney test), Chi-Square test, bivariate correlation analysis and, Moderated Regression Analysis. Results: There were 38 samples, 34 (89.47%) normal BMD and, 4 (10.53%) Osteoporosis. The N-MID Osteocalcin has a positive and significant correlation both with the BMD Total L1-L4 as well as the BMD NLF (p <0.05). The cumulative dose of MP has a negative and significant correlation both with the BMD Total L1-L4 also with the BMD NLF (p <0.05). MP cumulative dose can significantly function as a moderation of the effect of N-MID Osteocalcin both on the BMD Total L1-L4 or the BMD NLF. The effect of the N-MID Osteocalcin on the total BMD of L1-L4 or the BMD NLF at the Cumulative Dose MP ≥ 8 g was weaker than that of the MP Cumulative Dose <8 g, and the moderating effect of the correlation between N-MID Osteocalcin and BMD was larger on the total BMD of L1-L4. Conclusion: There is a positive correlation between serum N-MID Osteocalcin values and BMD values in SLE female patients receiving oral methylprednisolone therapy and the cumulative dose of Methylprednisolone affects the correlation between N-MID Osteocalcin values and BMD values in SLE female patients receiving oral methylprednisolone therapy. References: [1]Suarjana I N. 2014. Imunopatogenesis Lupus Eritematosus Sistemik, Dalam: Setiati, S, Alwi, I, Sudoyo, AW, Simadibrata, M, Setiyohadi, B & Syam, AF (editor). Buku Ajar Ilmu Penyakit Dalam vol 6. BP FKUI. Jakarta. [2]Ruiz-Irastorza G, Danza A & Khamashta M. 2012. Glucocorticoid use and abuse in SLE. Rheumatology, 51, 1145-1153. [3]Arslan S, Çeliker R & Karabudak R. 2010. Cumulative Corticosteroid Doses and Osteoporosis in Patients with Muliple Sclerosis. Turk J Rheumatol, 25,191-5. [4]PEROSI. 2010. Panduan diagnosis dan penatalaksanaan osteoporosis. Pengurus Besar Perhimpunan Osteoporosis Indonesia. [5]Kalaiselvi VS, Prabhu K, Ramesh M, Venkatesan VS. 2013. The Association of Serum Osteocalcin with the Bone Mineral Density in Post Menopausal Women. Journal of Clinical and Diagnostic Research, Vol-7(5), 814-816. [6]Ghazi M, Mounach A, Nouijai A, Ghozlani I, Bennani L, Achemlal L, Bezza A, El Maghraoui A. 2007. Performance of the osteoporosis risk assessment tool in Moroccan men. Clin Rheumatol, 26(12), 2037-41 Disclosure of Interests: None declared
The covid pandemic that has occurred for more than two years is still not over. Even in January 2022, with the new variant, Omicron, the number of COVID-19 cases has increased dramatically. According to statistics, on January 25 there were 3,559,000,464 new cases of COVID-19 and an average of 7 days as many as 3,397,073 cases. Therefore, it is important to take preventive measures to avoid the COVID-19 virus. One of them by eating foods high in antioxidants. Some fruits that are high in antioxidants are Averrhoa bilimbi L and Phaleria macrocarpa. Flavonoids are one of the types of antioxidants found in Averrhoa bilimbi L and Phaleria macrocarpa which function to inhibit the formation of Reactive Oxygen Species (ROS) by inhibiting enzymes in the formation of ROS and increasing the regulation and protection of antioxidants to prevent various negative impacts such as degenerative diseases and decreased immunity so that it can prevent exposure to the COVID-19 virus. The purpose of this study was to determine the levels of flavonoids in the combination of extracts of Averrhoa bilimbi L and Phaleria macrocarpa. The method used is the UV-VIS spectrophotometry method. The result of this research is that the flavonoid content of Averrhoa bilimbi L is 2.32 mg/g, the extract of Phaleria macrocarpa is 4.83 mg/g and the combination of the two is 4.77 mg/g. From these results, it can be said that the extract of Phaleria macrocarpa has the highest flavonoid content of 4.83 mg/g. Abstrak: Pandemi COVID-19 yang sudah terjadi lebih dari dua tahun masih belum berakhir bahkan pada Januari 2022 dengan adanya varian baru yaitu omicron, jumlah kasus COVID-19 meningkat drastis. Menurut statistik, pada 25 Januari terdapat 3.559.000.464 kasus baru COVID-19 dan rata-rata 7 hari sebanyak 3.397.073 kasus. Oleh karena itu pentingnya upaya pencegahan agar terhindar dari virus COVID-19. Salah satunya dengan mengonsumsi makanan tinggi antioksidan. Beberapa buah yang tinggi antioksidan adalah buah belimbing wuluh dan buah mahkota dewa. Flavonoid merupakan salah satu jenis antioksidan yang terdapat pada buah belimbing wuluh dan buah mahkota dewa yang berfungsi menghambat pembentukan Reactive Oxygen Species (ROS) dengan menghambat enzim dalam pembentukan ROS dan meningkatkan regulasi serta proteksi dari antioksidan sehingga dapat mencegah berbagai dampak negatifnya seperti penyakit degenerative dan penurunan imunitas sehingga dapat mencegah dari terpaparnya virus COVID-19. Tujuan penelitian ini yaitu untuk mengetahui kadar flavonoid pada kombinasi ekstrak buah belimbing wuluh dan buah mahkota dewa. Metode yang digunakan yaitu metode spektrofotometri UV-VIS. Hasil penelitian ini yaitu didapatkan kadar flavonoid buah belimbing wuluh sebesar 2.32 mg/g, ekstrak buah mahkota dewa sebesar 4.83 mg/g dan kombinasi dari keduanya sebesar 4.77 mg/g. Dari hasil tersebut dapat disimpulkan bahwa ekstrak buah mahkota dewa memiliki kadar flavonoid tertinggi yaitu 4.83 mg/g.
Background: Systemic Lupus Erythematosus (SLE) is an auto-immune disease that is vary since its relapse period (flare) and remission period. The occurence of flare on SLE consist of many factors, one of them is depression that is caused by stress. While, the optimists are known as people who have good ability on dealing with stress. This research is aimed to find out the relation between optimism and living quality of patients who suffered from SLE. Research Method: This research was an analytic observational research with cross sectional approach. The sample was SLE patients who are fused in Griya Kupu Surakarta community. This research conducted by filling out the quetionnaires, optimism quetionnaire (Life Orientation Test-Revised) and quality of life quetionnaire (SF-36). From these two data, the researcher did the analysis using Pearson’s product moment correlation analysis. Then, the data were treated by using SPSS 14,0 for Windows application. Result: Based on the analysis, there were some result obtained: there was a strong unidirectional relation (r = 0,613) and significant (sig = 0,000) between optimism and quality of life. There was varied relationship between optimism and quality of life on each domain. Optimism had strong unidirectional relation on physical function domain (r = 0,515, sig = 0,003), pain domain (r = 0,570, sig = 0,001), social function domain (r = 0,602, sig = 0,000) and general health (r = 0,614, sig = 0,000). Optimism had quite strong unidirectional relation with physical role domain (r = 0,329, sig = 0,071), the role of emotion domain (r = 0,429, sig = 0,016) and energy domain (r = 0,498, sig = 0,004). But, on physical role domain (sig = 0,071) this result was not significant. Optimism had inversely relation with mental health (r = -0,318, sig = 0,087), this result was not significant. Conclusion: Based on this research, it can be concluded that there is a strong relation (r = 0,613, sig = 0,000) between optimism and quality of life of Systemic Lupus Erythematosus patients. Key Words: Systemic Lupus Erythematosus, Optimism, Quality of Life
<p><strong>Pendahuluan </strong><strong><br /> </strong><em>Systemic Lupus Erythematosus </em>(SLE) adalah penyakit inflamasi autoimun kronis yang belum jelas penyebabnya dengan gambaran klinis yang luas serta tampilan perjalanan penyakit beragam. Sitokin tertentu seperti IL-17 dan TNFα sangat terkait dengan pathogenesis SLE. Sel punca mensekresikan sejumlah protein (<em>secretome</em>) termasuk <em>growth factor</em>, kemokin, sitokin, metabolit dan lipid bioaktif yang mengatur secara autokrin atau parakrin<br /> sambil merekayasa interaksi dengan lingkungan mikro sekitarnya. Penelitian ini bertujuan mengetahui pengaruh <em>secretome </em>sel punca mesenkimal terhadap ekspresi Interleukin 17 (IL-17) dan Tumor <em>Necrosis Factor Alpha </em>(TNF-α) pada mencit model lupus.</p><p><strong>Metode Penelitian</strong></p><p>Penelitian ini merupakan penelitian eksperimental dengan metode <em>post test only control group design </em>dengan randomisasi, sampel 21 mencit Balb/c betina, dibagi menjadi kelompok kontrol (injeksi NaCl 0,9% 0,5ml intraperitoneal), pristan (injeksi pristane 0,5ml intraperitoneal) dan pristan+<em>secretome </em>(injeksi pristan 0,5ml + <em>secretome </em>0,45 ml intraperitoneal). Dilakukan pemeriksaan ekspresi IL-17 dan TNF- α jaringan ginjal ketiga<br /> kelompok. Analisa statistik menggunakan SPSS 22 <em>for windows</em>. Uji beda rerata antara kelompok menggunakan uji F Anova bila distribusi data normal dan bila signifikan akan dilanjutkan dengan LSD <em>Post Hoc Test</em>. P bermakna jika p<0,05.</p><p><strong>Hasil Penelitian</strong></p><p>Hasil penelitian menunjukkan bahwa didapatkan hasil yang bermakna antara kelompok kontrol, pristan dan pristan+<em>secretome </em>baik pada kadar IL-17 (kontrol 6,9±1,95 ; pristan 9,9±2,27; pristan+<em>secretome </em>6,1±1,95; =0,016), dan TNF-α (kontrol 6,9±1,95; pristan 11,7±3,40; pristan+<em>secretome </em>7,9±2,03; p=0,005).</p><p><strong>Kesimpulan</strong><strong><br /> </strong>Penelitian ini menunjukkan bahwa pemberian <em>secretome </em>sel punca mesenkimal berpengaruh menurunkan ekspresi IL-17 dan TNF- α pada mencit model lupus.</p><p><strong>Kata kunci : Secretome, Interleukin 17, Tumor Necrosis Factor Alpha, Lupus</strong></p>
Abstract Inflammatory response in COVID-19 contributes greatly to disease severity. Mesenchymal Stem Cells (MSCs) have the potential to alleviate inflammation and reduce mortality and length of stay in COVID-19 patients. We investigated the safety and effectiveness of normoxic-allogenic umbilical cord (NA-UC)-MSCs as an adjunctive treatment in severe COVID-19 patients. A double-blind, multicentric, randomized, placebo-controlled trial involving severe COVID-19 patients was performed from January–June 2021 in three major hospitals across Java, Indonesia. Eligible participants (n = 42) were randomly assigned to two groups (1:1), namely the intervention (n = 21) and control (n = 21) groups. Either NA-UC-MSCs or NaCl placebo were administered daily. The primary outcome was the duration of hospitalization. Meanwhile, the secondary outcomes were radiographical progression (Brixia score), respiratory and oxygenation parameters, and inflammatory markers, in addition to the safety profile of NA-UC-MSCs. NA-UC-MSC administration did not affect the length of hospital stay of severe COVID-19 patients, nor did it improve the Brixia score or mMRC dyspnoea scale better than placebo. Nevertheless, NA-UC-MSCs led to a better recuperation in oxygenation index (120.80 ± 72.70 baseline vs 309.63 ± 319.30 D + 22, p = 0.038) and oxygen saturation (97.24 ± 4.10% vs 96.19 ± 3.75% in placebo, p = 0.028). Additionally, compared to the placebo group, the treatment group had a significantly smaller increase in PCT level at D + 22 (1.43 vs. 12.76, p = 0.011). No adverse effects, including serious ones, were recorded until D + 91. NA-UC-MSC therapy is a very safe adjunct for COVID-19 patients. It improves the oxygenation profile and carries potential to suppress inflammation.
Systemic Lupus Erythematosus merupakan penyakit inflamasi autoimun kronis dengan gambaran klinis luas dan perjalanan penyakit beragam. Pemberian pristan intraperitoneal dapat menginduksi lupus pada mencit. Secretome sel punca mesenkimal bekerja secara parakrin memberikan efek antinflamasi dan imunomodulasi antara lain mensupresi sel T dan sel B autoreaktif. High Sensitivity C-Reactive Protein (hsCRP) terkait dengan patogenesis SLE dan selaras dengan aktifitas penyakit.Tujuan Penelitian adalah untuk mengetahui pengaruh secretome sel punca mesenkimal terhadap kadar hsCRP pada mencit model lupus dengan induksi pristan. Desain penelitian adalah eksperimental dengan randomisasi, post test only control group design, sampel 21 ekor mencit betina Mus Musculus galur Balb/C, dibagi 3 kelompok yaitu kelompok kontrol (injeksi intraperitoneal NaCl 0,9% 0,5 ml), kelompok perlakuan (injeksi pristan intraperitoneal 0,5 ml) dan kelompok terapi (injeksi intraperitoneal pristan 0,5 ml dan secretome 0,45 ml). Penelitian dilakukan selama 3 minggu, secretome diberikan pada akhir penelitian. Sesudah perlakuan dinilai kadar hsCRP secara ELISA. Analisis statistik menggunakan SPSS 22 for windows dengan uji Kruskal-Wallis dilanjutkan Mann-Whitney U test. P bermakna jika p<0,05. Hasil penelitian menunjukkan bahwa rata-rata kadar hsCRP pada ketiga kelompok yaitu kontrol 440.68(110.08-564.29) ng/ mL; perlakuan (pristan) 2964.26(601.13-3926.10) ng/mL; terapi pristan+secretome) 506.93(207.62-1473.46) ng/mL, dengan kemaknaan p=0.008. Terdapat perbedaan bermakna kadar hsCRP antara kelompok pristan vs pristan+secretome (2457.33 ng/mL; p=0.047). Secretome sel punca mesenkimal mampu menurunkan kadar hsCRP pada mencit model lupus dengan induksi pristan.Kata Kunci: High Sensitivity C-Reactive Protein, Nefritis lupus, Secretome
Introduction: Diabetic kidney disease (DKD) progression resulted in increased intrarenal oxidative stress and increased inflammatory resulting in further renal fibrosis. Achatina fulica mucus was regarded to exerts anti-oxidative and anti-inflammatory effect. Objectives: This study aims to observe the effect of administration of A. fulica mucus on oxidative stress and inflammation biomarkers in DKD-induced rats. Methods and Materials: In this study, we used 32 males white Wistar rats divided into four groups; a control, and other three different groups induced with 45 mg/kg streptozocin (STZ) and 110 mg/kg nicotinamide (NA) intra-peritoneally. Achatina fulica mucus was administered orally in the last groups; 3.5 mL/d (S1), and 7 mL/d (S2). Post-test measurement of inflammatory and oxidative biomarker was used to determine the outcome. Results: The study resulted in reduction of malondialdehyde (MDA), transforming growth factor-β (TGF-β), tumor necrosis factor-α (TNF-α), high sensitivity C-reactive protein (hs-CRP), vascular endothelial growth factor (VEGF), and interleukin-1β (IL-1β) in A. fulica mucus administration in our STZ-NA induced rats, with higher dose of the mucus further reduce the inflammatory and oxidative stress biomarkers. Conclusion: Current study showed the potential of A. fulica mucus usage in future management of inflammation and oxidative stress in diabetes and DKD.
Systemic lupus erythematosus (SLE) is a chronic autoimmune inflammatory disease requiring a long-term therapeutic approach. Low compliance with medication leads to the worsening of the disease. Evaluating medication compliance rates and factors associated with low compliance are important to design further compliance interventions.
Methods
We conducted a cross-sectional analysis of adult individuals with SLE from Tittari Community, Surakarta. Patient completed the 5-item version of Compliance Questionnaire for Rheumatology (CQR5), Quick Systemic Lupus Activity questionnaire (Q-SLAQ), and Hamilton Anxiety Depression Rating Scale (HADS). Association between compliance and demographic, disease-related characteristics, and medication characteristics were explored.
Results
A total of 78 individuals with SLE participated in the study, 76 (96.4%) were female with a mean age of 36±10.9 years. The Majority of SLE patients reported disease duration >5 years (52.7%), were prescribed <5 drugs (52.7%) and had side effect complaints in 28 (35.89%). Low compliance was found in 29.49% of patients. In logistic regression analysis, having mental health issues such as anxiety (OR 4.3, CI 95% 0.6–28.7), depression (OR 3.7, CI 95% 0.9–14.1), or both anxiety and depression (OR 2.6, CI 95% 0.5–13.5) tend to increase the risk of low compliance. Other factors associated with low compliance were disease duration of 1–3 years (OR 4.9, CI 95% 0.5–47.7), and the presence of medication adverse events (OR 1.7, CI 95% 0.6–5.1).
Conclusions
The prevalence of low medication compliance among SLE patients was high. SLE patients with anxiety and/or depression who had been living with the disease for 1–3 years, or experienced medication adverse events were found to have a higher risk of low compliance.
Backgroumd : Lupus nephritis is a common and serious complication in SLE with deposition of autoanti-bodies in the glomerulus. HsCRP is an acute-phase reactant serum which usually parallel with disease activity in inflammatory states. TNF ? was reported to be increased in Lupus Nephritis and correlated with disease activity and it has been proposed to contribute to the immunopathogenesis of SLE. Injection Pristan intraperitoneal can induce lupus Nephritis in mice. Secretome mesenchymal stem cells act as anti-apoptotic agents, suppress B cells and autoreactive T cells, and have anti-inflammatory propertiesAim : This study aimed to determine the effect of secretome mesenchymal stem cells on the HsCRP levels and expression of TNF ? in mice model of Lupus Nephritis.Methods : An experimental study with randomization, with post test only control group design, the sample of 21 female mice Mus musculus strain Balb / C, divided into 3 groups: control group (intraperitoneal injection of 0.5 ml of 0.9% NaCl), the group Pristan (injection Pristan intraperitoneal 0.5 ml) and Pristan + secretome group (intraperitoneal injection of 0.5 ml Pristan and secretome 0.45 ml). Research carried out for 24 days, secretome given on the day 21st of the study. After treatment, we performed measurements of HsCRP levels and TNF expression. Statistical analysis using SPSS 22 for windows with ANOVA and post hoc LSD. p significant if p
ABSTRACT Aim This study evaluates the prevalence, risk factors, and quality of life of patients with knee osteoarthritis (OA) in the Indonesian population. Method A cross‐sectional study of 3597 adults (≥ 18 years old) was conducted in 2023 involving 15 different cities in Indonesia. Knee OA was classified according to the clinical ACR criteria. The COPCORD questionnaire was used for all subjects. The quality of life (QoL) was assessed using the WOMAC score. Results The prevalence of knee OA was 15.0%. Banda Aceh has the highest prevalence of knee OA at 70.79%, whereas Bandung has the lowest (4.18%)—the odds of having knee OA increased with age. The adjusted odds ratio (aOR) were 5.01 (95% CI 2.47–10.15, p < 0.001) for participants aged 40–49 years and 72.19 (95% CI 36.32–143.51, p < 0.001) for participants aged 70 years or over, compared to participants under 40 years. Knee OA was higher among female participants (aOR = 1.91; 95% CI 1.53–2.39, p < 0.001). Married and divorced participants had higher odds of having knee OA compared to those who never married (aORs 2.56 (95% CI 1.37–4.77, p = 0.003) and 2.40 (95% CI 1.23–4.68, p < 0.010), respectively). Knee OA is less likely found among participants with elementary school education background (aOR 0.37; 95% CI 0.22–0.64, p < 0.001) and those with senior high school (aOR 0.49; 95% CI 0.29–0.83, p = 0.007). The total WOMAC score was 25.9 ± 18.7 from all participants, indicating moderate impairment in QoL. Conclusion The prevalence of knee OA in several urban districts in Indonesia was 15.0%, with most patients having moderate impairment in QoL. Several sociodemographic factors were associated with the odds of having knee OA.
