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Triwahju Astuti
Bagian Paru Fakultas Kedokteran Universitas Brawijaya / Rumah Sakit Umum Dr. Saiful Anwar Malang
Biochemistry, Genetics & Molecular Biology Dentistry Education Health Professions Immunology & microbiology Medicine & Pharmacology Nursing Public Health Other

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PROFIL KADAR SOLUBLE UROKINASE PLASMINOGEN ACTIVATOR RECEPTOR (suPAR) PADA SERUM PENDERITA TUBERKULOSIS PARU (SEBAGAI MONITORING TERAPI) Astuti, Triwahju; MR, Tri Yudani; Riawan, Wibi; Muktiati, Nunuk Sri; Widjajanto, Edy
Jurnal Kedokteran Brawijaya Vol 24, No 1 (2008)
Publisher : Fakultas Kedokteran Universitas Brawijaya

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (136.873 KB) | DOI: 10.21776/ub.jkb.2008.024.01.4

Abstract

Dutch study shows that Upar expression content is significantly higher in tubercolusis patient’s psiphsy monosit compared to those in the healthy control group. So far, there is no biologic marker used whichcan accurately observe response improvement in the treatment of lung tubercolusis. The aim of this research is to investigate whether the serum level of soluble utokinase plasminogen activator receptor (suPAR) carries information in monitoring TB treatment for Lung Tuberculosis patients. suPAR was measured by ELISA in 21 individuals at the time of enrolment into observational cross sectional based on active tuberculosis  and 5 individuals as healthy control. There were 3 groups, 1). patients who had not started treatment (n=7),2). patients who had been treated for 2 months (n=7),  3). patients who had been treated for 6 months (n=7). Among groups, there were no difference in mean of body mass index, erythrocyte sedimentation rate and monocyte count. Patients positive for TB on direct  microscopy were 29% ( 6 from 21 patients) , 2 patients each groups. The suPAR levels were elevated in patients with active TB compared to healthy control (P<0,001). suPAR levels were highest in patients positive for TB on direct microscopy ( mean suPAR 4.455 ng/ml).
Efek Pemberian Protein Rekombinan Fusi ESAT6-CFP10 Mycobacterium tuberculosis terhadap Persentase IL2 dan IL10 yang Dipresentasikan Sel T CD8 pada Kultur PBMC Christianto, David; Raras, Tri Yudani Mardining; Sumarno, Sumarno; Arthamin, Maimun Zulhaidah; Astuti, Triwahju; Sardjono, Teguh Wahyu; S, Noorhamdani A
Jurnal Kedokteran Brawijaya Vol 30, No 3 (2019)
Publisher : Fakultas Kedokteran Universitas Brawijaya

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.21776/ub.jkb.2019.030.03.7

Abstract

Keberhasilan vaksin BCG dalam memberikan perlindungan terhadap tuberkulosis (TB) pada orang dewasa di Indonesia belum optimal (37%) sehingga diperlukan vaksin alternatif yang lebih efektif. Protein rekombinan fusi ESAT6-CFP10 merupakan kandidat vaksin yang potensial. Penelitian dilakukan untuk menguji efektifitas protein rekombinan fusi ESAT6-CFP10 dalam meningkatkan ekspresi IL2 dan IL10 sel T CD8 yang memainkan peran penting dalam respon imun melawan TB. Pengujian kandidat vaksin dilakukan secara in vitro pada peripheral blood mononuclear cell (PBMC) dari kelompok sehat endemik TB, kelompok kontak TB, dan kelompok pasien TB dengan melihat persentase IL2 dan IL10 CD8. Setiap kelompok diberi perlakuan tanpa antigen, PPD, dan protein rekombinan fusi ESAT6-CFP10. Persentase IL2 meningkat secara signifikan dari kelompok sehat, kontak TB, hingga Pasien TB. Sebaliknya peningkatan persentase IL2 antar kelompok yang dipaparkan PPD tidak signifikan secara statistik (p=0,396). Persentase IL10 tidak menunjukkan perbedaan yang signifikan antar kelompoknya baik tanpa paparan antigen (p=0,617), PPD (p=0,351), maupun protein rekombinan fusi ESAT6-CFP10 (p=0,257). Didapatkan persentase IL2 yang tidak berbeda secara signifikan antar perlakuan pada kelompok sehat (p=0,309), kelompok kontak TB (p=0,318), dan kelompok pasien TB (p=0,424). Demikian juga dengan persentase IL10 yang tidak berbeda secara signifikan antar perlakuan pada kelompok sehat (p=0,908), kelompok kontak TB (p=0,352), dan kelompok pasien TB (p=0,776). Hal ini menunjukkan bahwa protein fusi rekombinan ESAT6-CFP10 dapat meningkatkan persentase IL2 tetapi tidak dengan IL10 meskipun secara statistik tidak signifikan.
Distribusi M. Tuberculosis Genotipe Beijing pada Pasien Tuberkulosis Paru di Malang MR, Tri Yudani; Astuti, Triwahju
Jurnal Kedokteran Brawijaya Vol 26, No 2 (2010)
Publisher : Fakultas Kedokteran Universitas Brawijaya

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (656.868 KB) | DOI: 10.21776/ub.jkb.2010.026.02.3

Abstract

ABSTRAKPenelusuran  penyebaran  genetis  Mycobacterium  tuberculosis  merupakan  salah  satu  faktor  penting  dalam mengendalikan infeksi Mycobacterium tuberculosis. Studi mengenai distribusi Mycobacterium tuberculosis galur Beijing pada TB paru BTA (+) pasien di RSU dr. Saiful Anwar rumah sakit ini   dilaksanakan dengan metode spoligotyping. Dahak dikumpulkan dari total 41 pasien, dicuci dengan salin normal dan ditanam pada medium LJ. DNA dari bakteri yang tumbuh kemudian diisolasi dan mengalami spoligotyping. Sembilan belas spoligotype (65,5%) ditemukan dari total dua puluh sembilan sampel yang berkembang, sedangkan sepuluh sampel (34,5%) adalah non-Mycobacterium tuberculosis. Dari spoligotype sembilan belas, sembilan sampel merupakan Beijing strain (31%) dan sepuluh sampel (34,5%) menunjukkan strain non Beijing. Proporsi pasien TB yang terinfeksi, menunjukkan bahwa persentase pasien terinfeksi dengan strain Beijing hampir sama antara wanita dan pria. Ditemukan bahwa prevalensi tertinggi strain Beijing pada pasien dengan usia berkisar antara 31-40 tahun (51%). Oleh karena itu dapat disimpulkan bahwa strain Beijing mendominasi distribusi M. tuberculosis pada pasien TB paru di Malang.Kata Kunci: Beijing strain, M. tuberculosis, Spoligotyping
Pola Bakteri dari Isolat Sputum dan Kepekaannya terhadap berbagai antibiotik di RSU dr. Saiful Anwar Malang Periode Januari-Juni 2003 Astuti, Triwahju
Jurnal Kedokteran Brawijaya Vol 19, No 1 (2003)
Publisher : Fakultas Kedokteran Universitas Brawijaya

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (1840.02 KB)

Abstract

Informasi mengenai kemampuan suatu antibiotika dalam mengatasi kelompok pathogen yang mungkin menjadi penyebab infeksi saluran nafas akan sangat membantu klinisi dalam menentukan antibiotika empiris sebelum hasil pemeriksaan mikrobiologi diperoleh. Telah dilakukan penelitian pola bakteri dan kepekaannya terhadap antibiotik. Data sekunder diperoleh dari Laboratorium Mikrobiologi RSU dr. Saiful Anwar Malang. Diperoleh hasil 5 jenis bakteri peringkat pertama adalah Klebsiella pneumoniae (20,2%), Acinetobacter anitrartus (16,5%), Staphylococcus koagulase negatif (12,5%), Pseudomonas aeruginosa (8,4%), Staphylococcus koagulase positif (6,9%). Antibiotik yang sensitif untuk seluruh bakteri isolat sputum adalah: Amikacin, Fosfomycin, Netilmycin, Gentamycin, Ciprofloxacin.
PERBEDAAN KADAR HEMOGLOBIN DAN PARAMETER ERITROSIT PADA PENDERITA PENYAKIT PARU OBSTRUKTIF KRONIK POPULASI D YANG TIDAK DAN YANG MENDAPAT TERAPI INHALASI KOMBINASI LONG ACTING B2 AGONIST–KORTIKOSTEROID Astuti, Triwahju; Karima, Karima; Iskandar, Agustin
Majalah Kesehatan FKUB Vol 6, No 3 (2019): Majalah Kesehatan
Publisher : Faculty of Medicine Universitas Brawijaya

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (560.684 KB) | DOI: 10.21776/ub.majalahkesehatan.2019.006.03.3

Abstract

Penyakit Paru Obstruktif Kronik (PPOK) merupakan penyakit paru yang didasari salah satunya oleh reaksi inflamasi yang meningkat sehingga menimbulkan hambatan aliran udara dan perusakan pada eritrosit, sehingga terjadi resistensi hormon eritropoietin. Populasi D merupakan pasien PPOK yang memiliki risiko eksaserbasi tertinggi dan gejala yang paling berat di antara populasi lainnya. Terapi lini pertama untuk pasien PPOK populasi D yang direkomendasikan GOLD adalah terapi LABACS (long acting beta2 agonist and corticosteroid). Penelitian ini dilakukan untuk mengetahui perbedaan kadar hemoglobin dan parameter eritrosit berupa jumlah eritrosit, nilai red blod cell distribution width dan indeks eritrosit penderita PPOK populasi D yang mendapat dan tidak mendapat LABACS. Penelitian ini menggunakan metode observational cross sectional dengan melihat rekam medis pasien PPOK pada bulan Juni sampai November 2015. Hasilnya pada terapi LABACS didapatkan kadar hemoglobin yang lebih tinggi dibandingkan dengan tanpa terapi, jumlah eritrosit, nilai MCV, MCH, MCHC lebih rendah dibandingkan dengan tanpa terapi, dan nilai RDW lebih tinggi dibandingkan dengan tanpa terapi LABACS. Selain itu, persentase pasien PPOK yang terkena anemia pada kelompok yang mendapat terapi LABACS lebih rendah dibanding dengan yang tidak mendapat terapi. Kadar hemoglobin, jumlah eritrosit, indeks eritrosit, dan RDW dievaluasi dengan program SPSS 16.0. Tidak didapatkan perbedaan yang signifikan pada semua parameter. Kesimpulannya, tidak terdapat perbedaan kadar hemogolobin dan parameter eritrosit antara pasien PPOK populasi D yang mendapat dan tidak mendapatkan terapi LABACS. 
Gambaran Infeksi Nontuberculous Mycobacteria (NTM) pada Penderita Suspek TB Paru Menggunakan Multiplex PCR (MPCR)-Universal Lateral Flow Assay (ULFA) Kit Putri Wulan Akbar; Agustin Iskandar; Tri Wahju Astuti; Kristin Indriana
Jurnal Kesehatan Andalas Vol 9, No 3 (2020): Online September 2020
Publisher : Fakultas Kedokteran, Universitas Andalas

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.25077/jka.v9i3.1394

Abstract

Infeksi paru akibat Nontuberculous Mycobacteria (NTM) dan Mycobacterium tuberculosis (MTB) dapat memberikan gambaran klinis yang serupa sehingga berpotensi menyebabkan kesalahan diagnosis dan terapi. Pemeriksaan Multiplex PCR (MPCR)-Universal Lateral Flow Assay (ULFA) merupakan pemeriksaan berbasis molekuler untuk mendeteksi gen rpoB, IS1660 dan mtp40 yang dapat digunakan untuk membedakan infeksi NTM dari infeksi TB. Tujuan:  Mendapatkan gambaran infeksi NTM menggunakan MPCR-ULFA pada penderita terduga TB paru. Metode: Penelitian ini merupakan studi deskriptif dengan pendekatan potong lintang yang dilaksanakan sejak April sampai Juli 2019. Sebanyak 39 sampel sputum dari pasien terduga TB paru dari RSUD Kanjuruhan Kepanjen, Kabupaten Malang diperiksakan apusan BTA, GeneXpert dan MPCR-ULFA. Hasil: Sebanyak 5 sampel (12,8%) sputum dari pasien terduga TB paru terdeteksi sebagai NTM positif menggunakan pemeriksaan MPCR-ULFA. Empat dari lima sampel (80%) tersebut memiliki kesesuaian dengan hasil GeneXpert dan apusan BTA, yakni MTB negatif.  Pemeriksaan molekuler baik GeneXpert maupun MPCR-ULFA keduanya mendeteksi keberadaan gen rpoB dari Mycobacterium. Metode MPCR-ULFA mengamplifikasi 3 gen target sekaligus (IS1660, mtp40 dan rpoB) sehingga dapat mendeteksi infeksi NTM atau MTB. Simpulan: Prevalensi NTM pada pasien terduga TB paru di RSUD Kanjuruhan Kepanjen menggunakan MPCR-ULFA mencapai 12,8%. Sebanyak 80% dari NTM positif memiliki hasil pemeriksaan GeneXpert dan apusan BTA negatif.Kata kunci: GeneXpert, MPCR-ULFA, NTM, suspek TB paru
Increased Serum KL-6/MUC1 Level, Neutrophils and Lymphocytes Sputum in Malang Splendid Bird Market Workers Zam Zam Firmansyah; Tri Wahju Astuti; Garinda Alma Duta
Jurnal Respirologi Indonesia Vol 40, No 2 (2020)
Publisher : Perhimpunan Dokter Paru Indonesia (PDPI)/The Indonesian Society of Respirology (ISR)

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.36497/jri.v40i2.103

Abstract

Backgrounds: People who work in the bird market have a high exposure risk of air pollution in large numbers, particulate pollutans including organic dust, loose feathers, insects or ticks, food aerosol particles, bird’s excreta (amonia) and various of gram bacteria, fungal and virus. Exposure to particles will stimulate the immune system against harmful pathogens in the form of an inflammatory response. An infection or injury will stimulate secretion of KL-6/MUC1 (Krebs von den Lungen-6 is a high molecular weight, mucin-like glycoprotein in human (MUC1)) by AEC type II and bronchial epithelial cells in response to cell damage and regeneration. Methods: This was an observational analytic cross-sectional study on 35 subjects, which examined and analyzed the characteristics of workers, percentage count of neutrophils, lymphocytes in induced sputum and KL-6/MUC1 serum levels using ELISA sandwich. Results: Mean KL-6/MUC1 serum levels in the bird market workers increased (1152.67+583.92 U/ml) from normal levels (105.3-401.2 U/ml). There was a significant positive correlation between the length of exposure and KL-6/MUC1 serum levels (r=0.624; P
Preliminary Study: Increased Profile of PAI-1 in Lung Cancer Patients Receiving Chemotherapy Ria Siska Myrnasari; Triwahju Astuti; Suryanti Dwi Pratiwi
Jurnal Respirologi Indonesia Vol 38, No 1 (2018)
Publisher : Perhimpunan Dokter Paru Indonesia (PDPI)/The Indonesian Society of Respirology (ISR)

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.36497/jri.v38i1.139

Abstract

Background: Lung cancer has the highest mortality rate in the world. Lung cancer management requires biomarkers to evaluate the chemotherapy response. Levels of Plasminogen Activator Inhibitor-1 (PAI-1) in malignancy >14 ng/ml shows poor prognosis. Increased levels of PAI-1 are associated with stage, metastasis, and prognosis of lung cancer. The chemotherapy is thought to decrease PAI-1 levels. The aim this study is analyze the profile of PAI-1 levels before and after 3rd and 6th chemotherapy cycle and their changes by type of lung cancer and Response Evaluation Criteria in Solid Tumors (RECIST). Methods: This research was conducted from December 2016 to December 2017 at RSSA Malang. The study design was a cohort of 18 lung cancer patients. PAI-1 levels were measured by ELISA in 18 lung cancer stage III or IV patients before (PAI-1(1)) and after 3rd chemotherapy cycle (PAI-1(2)), and 9 patients after 6th chemotherapy cycle (PAI-1(3)). Average PAI-1 levels are presented in tables and graphs. Result: PAI-1(1) 2,151±0,564 ng/ml, PAI-1(2) 1,951±0,534 ng/ml, and PAI-1(3) 1,647±0,495 ng/ml. PAI-1 levels in non-small cell lung carcinoma (NSCLC) were 1.658±0.562 ng/ml and small cell lung carcinoma (SCLC) were 1.609±0.244 ng/ml. Levels of PAI-1(2) in partial response 1.784 ± 0.363 ng/ml, stable disease 1.980 ± 0.304 ng/ml, and progressive disease 2.020±0.635 ng/ml. Levels of PAI-1(3) in the partial response 1.427 ± 0.324 ng/ml and in progressive disease 2.085±0.532 ng/ml. Conclusions: PAI-1 levels in patients with stage III and IV lung cancer after chemotherapy were lower than before chemotherapy, and showed changes corresponding to the response according to RECIST. PAI-1 levels in NSCLC are higher than SCLC. (J Respir Indo 2018; 38(1): 48-56)
Immunogenicity Test of ESAT-6/CFP-10 Mycobacterium tuberculosis (Indonesian Strain) Recombinant Protein Fusion: TNF-α, IL-17 and CD4+ T Cells Expression in PBMC Culture Eko Prasetyo; Triwahju Astuti; Nunuk Sri Muktiati; Maimun Z Arthamin
Jurnal Respirologi Indonesia Vol 39, No 3 (2019)
Publisher : Perhimpunan Dokter Paru Indonesia (PDPI)/The Indonesian Society of Respirology (ISR)

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (1250.041 KB) | DOI: 10.36497/jri.v39i3.64

Abstract

Background: Bascillus Calmette Guѐrin vaccination has not provided protection against TB in adults. ESAT-6/CFP-10 Mtb recombinant protein fusion as a vaccine candidate can stimulate the body's immune response. Interleukin-17, TNF-α and CD4+ play a major role against TB. This study aims to determine that the recombinant protein fusion ESAT-6/CFP-10 Mtb can stimulate TNF-α, IL-17 and CD4+ T cells expression in PBMC culture. Methods: Design of this study is experimental study. Number of research sample per group of 8 subjects. The subjects: healthy, TB contact and TB patients were taken their peripheral blood sample and treated with ESAT-6/CFP-10 Mtb recombinant protein fusion. TNF-α CD4+ T cells were measured by ELISA. Flow cytometry is used to measure IL-17 and CD4+ Tcells. As standard protocol research on tuberculosis vaccine, each subject also treated without antigen and with PPD. Results: There was no significant increase in the administration of ESAT-6/CFP-10 Mtb fusion compared without antigen on TNF-α expression of CD4+ (P=0.202), expression of IL-17 CD4+ (P=0.994) and percentage of CD4+ T cells (P=0.183). ESAT-6/CFP-10 Mtb Fusion was able to stimulate expression of TNF-α CD4+ in healthy subjects (29.91±1.23pg/ml), TB contact (32.21±4.02pg/ml) and TB patients (33.35±8.41 pg/ml). Expression IL-17 CD4+ in healthy subjects (33.24 ± 39.01%), TB contact (23.88 ± 21%) and TB patients (51.93 ± 36%). CD4+ T cell expression in healthy subjects 30.64 ± 7.63%, TB contact 24.58 ± 5.24% and TB patients (40.73±2.63%). Conclusions: ESAT-6/CFP-10 Mtb recombinant proteins fusion may stimulate the production of TNF-α, IL-17 CD4+ and CD4+ T cells in all subject. Expression of TNF-α, IL-17 CD4+ and CD4+ T cells in the healthy group, indicated that the ESAT-6/CFP-10 recombinant protein fusion has the potential as vaccine candidate. (J Respir Indo. 2019; 39(3):160-8)
The Differences in Urokinase Plasminogen Activator System in Lung Cancer Patients Before and After Chemotherapy Tri Wahju Astuti; Agustin Iskandar; Mufidatun Hasanah; Lindayanti Sumali; Dian Nugrahenny
Jurnal Respirologi Indonesia Vol 41, No 4 (2021)
Publisher : Perhimpunan Dokter Paru Indonesia (PDPI)/The Indonesian Society of Respirology (ISR)

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.36497/jri.v41i4.214

Abstract

Background: Lung cancer is still the leading cause of death for malignancies worldwide. Urokinase plasminogen activator (uPA), its soluble receptor (suPAR), and its inhibitor (PAI-1) play an important role in tumor invasion and metastasis. This study aimed to evaluate the differences in the urokinase plasminogen activator system (uPA, suPAR, and PAI-1) in lung cancer patients before and after chemotherapy.Methods: This research was an observational analytical study with a cross-sectional design. The subjects were 30, consisting of 17 lung cancer patients before chemotherapy and 13 lung cancer patients after chemotherapy for 4 or 6 cycles. The levels of serum uPA, suPAR, and PAI-1 were measured by enzyme-linked immunosorbent assay (ELISA). Results: In lung cancer patients before chemotherapy, there were no significant (p>0.05) differences in levels of serum uPA, suPAR, and PAI-1 between patients with stage III and IV. The highest serum uPA and suPAR levels were found in adenocarcinoma cell types and the highest serum PAI-1 level in adenoepidermoid cell types. After chemotherapy, serum suPAR and PAI-1 were significantly (p < 0.05) decreased in lung cancer patients. However, there were no significant (p>0.05) differences in the levels of serum uPA, suPAR, and PAI-1 between patients with chemotherapy responses for stable and progressive diseases. Conclusion: This study revealed that suPAR and PAI-1 levels were decreased in lung cancer patients who had received chemotherapy. This can occur due to decreased tumor cells activity. 
Co-Authors Agustin Iskandar Anung Sri Handayani David Christianto Dian Nugrahenny Djajalaksana, Susanthy Duta, Garinda Alma Edy Widjajanto Eko Prasetyo Erawati, Dini Rachma Febriawati, Juwita Fransisca Srioetami Tanoerahardjo Garinda Alma Duta Gede Sasmika Suwandi Harun Al Rasyid Karima, Karima Kristin Indriana Lindayanti Sumali Listyoko, Aditya Sri Maimun Z Arthamin Maimun Zulhaidah Arthamin Maimun Zulhaidah Arthamin, Maimun Zulhaidah Mufidatun Hasanah Munthe, Indra Nunuk Sri Muktiati Nunuk Sri Muktiati Putri Wulan Akbar Rahmad Budianto Ria Siska Myrnasari S, Noorhamdani A Sardjono, Teguh Wahyu Sartono, Teguh Rahayu Sumarno . Suryanti Dwi Pratiwi Teguh Rahayu Sartono Tjahyadi, Rizal Muldani Tri Yudani Mardining Raras Tri Yudani MR Trimurtini, Asih Wibi Riawan Yani Jane Sugiri Yudhanto, Hendy Setyo Zam Zam Firmansyah