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Journal : Jurnal Respirasi (JR)

Volatile Organic Compounds (VOC) and Serum Leukotriene B4 between COPD Patients and COPD with Lung Cancer Patients Djajalaksana, Susanthy; Listyoko, Aditya Sri; Prasetyo, Kevin Wahyudy; Wardoyo, Arinto Yudi Ponco
Jurnal Respirasi Vol. 10 No. 3 (2024): September 2024
Publisher : Faculty of Medicine Universitas Airlangga

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.20473/jr.v10-I.3.2024.222-227

Abstract

Introduction: Chronic obstructive pulmonary disease (COPD) is estimated to become the third leading cause of death worldwide in 2030. COPD can affect the lungs and cause chronic systemic inflammation. Leukotriene B4 (LTB4) is involved in COPD and lung cancer pathogenesis. There has been the development of non-invasive methods for detecting lung disease in the last few decades, such as the examination of volatile organic compounds (VOC). This study aimed to analyze the serum LTB4 and the difference of VOCs in exhaled breath of stable COPD patients and COPD with lung cancer patients. Methods: This case-control study recruited 20 stable COPD patients and 20 patients with COPD and lung cancer. An exhaled breath sample was collected in Tedlar bags and analyzed using an arrayed sensor breath analyzer to check the concentration of VOCs. Meanwhile, a venous blood sample was collected to examine the level of LTB4 using an ELISA kit. Independent t-test and Mann-Whitney test were used to analyze the data. Results: The carbon dioxide (CO2), nitrogen dioxide (NO2), carbon monoxide (CO), benzene (C6H6), and propane (C3H8) levels were significantly different (p <0.05) in COPD-only patients compared to COPD with lung cancer patients. Serum LTB4 increased in both groups. Conclusion: CO2, CO, and C3H8 levels increased, but the NO2 level decreased in COPD patients with lung cancer compared to COPD-only patients. Serum LTB4 increased in COPD with lung cancer patients.
Prognosis of Tyrosine Kinase Inhibitor Therapy for Non-Small Cell Lung Cancer Santoso, Agus Andreas; Pratiwi, Suryanti Dwi; Sugiri, Yani Jane; Al Rasyid, Harun; Listyoko, Aditya Sri
Jurnal Respirasi Vol. 11 No. 2 (2025): May 2025
Publisher : Faculty of Medicine Universitas Airlangga

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.20473/jr.v11-I.2.2025.140-146

Abstract

Introduction: Non-small cell lung cancer (NSCLC) was the primary cause of death in lung cancer. Tyrosine kinase inhibitors (TKIs) were one of the management options for NSCLC. Meanwhile, serum carcinoembryonic antigen (CEA) plays a crucial role in the diagnosis and prognosis of NSCLC patients. This study aimed to determine the effectiveness of epidermal growth factor receptor (EGFR)-TKI based on progression-free survival (PFS) and overall survival (OS) in NSCLC patients with common EGFR mutations. Methods: This retrospective cohort study used a total sampling method. The serum CEA level was measured before the initial treatment. Tyrosine kinase inhibitors therapy was monitored with PFS and OS. Statistical analysis for comparing prognosis in NSCLC among TKI groups used Kruskal-Wallis, analysis of variance (ANOVA), Mann-Whitney, and Spearman’s rho tests. A significant analysis referred to a p-value of <0.05. Results: The participants were 189 patients, consisting of 106 on gefitinib, 43 on erlotinib, and 40 on afatinib. The average PFS values in the gefitinib, erlotinib, and afatinib groups were 9.9±5.25, 8.77±4.53, and 12.83±7.02 months, respectively (p=0.016). Furthermore, there were no significant OS among the gefitinib (14.91±7.61 months), erlotinib (14.54±7.64 months), and afatinib group (15.51±8.13 months, p=0.867). There was a significant correlation between CEA levels and PFS (r=0.146; p=0.046) and between CEA levels and OS (r=0.223; p=0.004). Conclusion: Although afatinib may prolong PFS compared with gefitinib and erlotinib, it did not significantly impact OS. Increased serum CEA levels before treatment significantly improved PFS and OS. However, elevated CEA levels are usually associated with a poor prognosis in NSCLC.
Significance Level of Pleural Fluid Tissue Inhibitor Metalloproteinase-1 (TIMP-1) and Glucose Levels as Biomarkers of Malignant Pleural Effusion Michaela, Cleine; Putra, Ngakan Putu Parsama; Djajalaksana, Susanthy; Setijowati, Nanik; Listyoko, Aditya Sri
Jurnal Respirasi Vol. 11 No. 3 (2025): September 2025
Publisher : Faculty of Medicine Universitas Airlangga

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.20473/jr.v11-I.3.2025.208-215

Abstract

Introduction: Distinguishing between malignant and non-malignant pleural effusions is often challenging due to overlapping biochemical profiles. Conventional diagnostic methods, including cytology and biopsy, are limited by their invasive nature, high costs, and potential complications. Emerging biomarkers, such as tissue inhibitor of metalloproteinase-1 (TIMP-1) and pleural fluid glucose levels, show promise as alternative diagnostic tools, but their clinical utility requires further validation. This study investigated the diagnostic value of TIMP-1 and pleural fluid glucose levels in differentiating malignant from non-malignant pleural effusions and explored their correlation in malignant cases. Methods: This cross-sectional analytical study included patients with exudative pleural effusion, categorized as malignant or non-malignant based on cytology and/or biopsy results. Biomarker levels of TIMP-1 and pleural fluid glucose were measured using enzyme-linked immunosorbent assay (ELISA) and biochemical analysis. Diagnostic thresholds for both biomarkers were determined using receiver operating characteristic (ROC) curve analysis. Results: Among 88 patients studied (33 malignant, 55 non-malignant), pleural fluid glucose levels were significantly lower in malignant cases (55.97 vs. 93.71 mg/dL; p=0.001), while TIMP-1 levels were notably higher (13.88 vs. 13.34 pg/mL; p<0.001). Tissue inhibitor of metalloproteinase-1 demonstrated superior diagnostic accuracy (86.5%) compared to glucose (70.6%) and the combined biomarker model (76.5%), with the sensitivity and specificity of 84.8% and 83.6%, respectively. Conclusion: Elevated TIMP-1 levels and reduced pleural fluid glucose levels are promising diagnostic biomarkers for malignant pleural effusion (MPE). Tissue inhibitor of metalloproteinase-1 exhibited the highest diagnostic accuracy, highlighting its potential as a non-invasive diagnostic tool in clinical practice.
Analysis of Urinary Midkine and Volatile Organic Compound (VOC) Levels Using a Breath Analyzer for Screening and Early Diagnosis of Lung Cancer Mafisah, Saidah; Setyawan, Ungky Agus; Tantular, Rezki; Permana, Deden; Djajalaksana, Susanthy; Wardoyo, Arinto Yudi Ponco; Listyoko, Aditya Sri
Jurnal Respirasi Vol. 11 No. 3 (2025): September 2025
Publisher : Faculty of Medicine Universitas Airlangga

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.20473/jr.v11-I.3.2025.223-231

Abstract

Introduction: Lung cancer is the leading cause of cancer-related mortality worldwide. Midkine, a heparin-binding growth factor, promotes proliferation, angiogenesis, and metastasis. Volatile organic compounds (VOCs) reflect cellular and molecular changes, aiding in cancer diagnosis. This study explored urinary midkine and VOC profiles as biomarkers for lung cancer screening and early diagnosis. Methods: A case-control, cross-sectional study was conducted on 20 controls (family members of lung cancer patients) and 20 lung cancer patients who had not received therapy. Volatile organic compounds breath analysis and urinary midkine measurements were performed. Volatile organic compounds, including total volatile organic compounds (TVOCs), ethanol (C2H5OH), formaldehyde (CH2O), toluene (C7H8), acetone (C3H6O), hexane (C6H14), and methane (CH4), were collected from exhaled breath using Tedlar bags and measured with a µβreath analyzer. Meanwhile, urinary midkine levels were determined using the Enzyme-Linked ImmunoSorbent Assay (ELISA) method. Statistical analyses included an independent t-test, Mann-Whitney U test, Spearman correlation, and diagnostic testing with receiver operating characteristic (ROC) analysis. Results: Urinary midkine levels were higher in lung cancer patients than in controls (330.56±120.50 vs. 282.18±146.28 pg/mL), although not significant (p>0.05). The independent t-test revealed that ethanol levels were significantly elevated in lung cancer patients (p < 0.001), whereas methane levels were not (p > 0.50). Receiver operating characteristic analysis demonstrated sensitivity and specificity: urinary midkine (60%, 60%), ethanol (75%, 75%), and methane (45%, 45%). Conclusion: Ethanol VOC appears to be a promising non-invasive biomarker for the early detection of lung cancer, whereas elevated urinary midkine levels did not demonstrate significant diagnostic value.
D-Dimer and Brixia Score to Mortality in COVID-19 Patients Falyani, Silvy Amalia; Pratiwi, Suryanti Dwi; Setyawan, Ungky Agus; Erawati, Dini Rachma; Djajalaksana, Susanthy; Listyoko, Aditya Sri
Jurnal Respirasi Vol. 10 No. 2 (2024): May 2024
Publisher : Faculty of Medicine Universitas Airlangga

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.20473/jr.v10-I.2.2024.99-106

Abstract

Introduction: Coronavirus disease 2019 (COVID-19) is a highly contagious severe and acute respiratory syndrome caused by the SARS-CoV-2 virus. A variety of factors can increase a patient's risk of death, including coagulopathy characterized by increased D-dimer levels. Brixia scores could be one of the determinants of COVID-19 severity, as assessed by chest radiographs. This study aimed to analyze chest radiographic severity based on the Brixia score at the degree of coagulation based on D-dimer in mortality of COVID-19 patients who were hospitalized. Methods: This cohort retrospective study was conducted at Dr. Saiful Anwar General Hospital, Malang, using an observational cross-sectional design. The study included 300 medical records of COVID-19 patients who passed away while hospitalized. The data were analyzed using the Wilcoxon test, and the results were also tested for Spearman correlation to determine the relationship between variables. Results: Significance results of median D-dimer were found by age and severity of COVID-19 (p-values 0.015 and 0.002), and median Brixia scores by age, gender, severity of COVID-19, and length of treatment (p-values 0.001, 0.001, 0.001, and 0.005). The results were also compared with normal values, which were significant (p = 0.000). Spearman correlation test results between the final D-dimer and the initial Brixia score (p = 0.005). Conclusion: The research results display a retrospective study of the correlation between D-dimer and Brixia score values "‹"‹and outcomes in COVID-19 patients. Higher D-dimer values"‹ "‹and Brixia scores on admission were shown to be associated with mortality.
Effects of Upper Arm and Breathing Exercise on Interleukin-6 in COVID-19 Patients Tarigan, Amira Permatasari; Listyoko, Aditya Sri; Pandia, Pandiaman; Pradana, Andika; Eyanoer, Putri Chairani; Sinaga, Sudirman Parningotan; Vera, Yeni; Firdaus, Ruby; Ramadhani, Adini Arifah
Jurnal Respirasi Vol. 10 No. 1 (2024): January 2024
Publisher : Faculty of Medicine Universitas Airlangga

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.20473/jr.v10-I.1.2024.36-41

Abstract

Introduction: COVID-19 disease has become a comprehensive world issue and has been declared a significant threat to global health. Interleukin-6 (IL-6) is an important inflammatory marker and one of the triggers of the cytokine storm in COVID-19, where increased levels can be an independent predictor of COVID-19 mortality. This study aimed to observe the effect of upper arm and breathing exercises on IL-6 levels in severe COVID-19 patients. Methods: The study design was quasi-experimental, with blood tests conducted before and after the examination. A total of 20 patients with confirmed COVID-19 were involved, divided into intervention and control groups. Results: Blood tests to determine baseline IL-6 levels were performed in all patients. Patients from the intervention group were given upper arm and breathing exercises for ten days, twice a day, via video tutorials on mobile phones, while patients from the control group did not receive any exercises. Patients from the intervention group obtained mean pre- and post-exercise IL-6 levels of 42.38 ± 48.48 and 16.78 ± 18.29, respectively (p = 0.005). Conclusion: Upper arm and breathing exercises showed significant changes in IL-6 levels in severe COVID-19 patients.