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Differences in the Expression of miRNA-126 and Interleukin (IL)-13 in Fully Controlled and Not Fully Controlled Asthma Patients Yulia Kartina; Susanthy Djajalaksana; Iin Noor Chozin; Harun Al Rasyid
Jurnal Respirologi Indonesia Vol 40, No 1 (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.v40i2.99

Abstract

Backgrounds: Important finding in the last decades in the field of biology and medicine are micro-RNA (miRNA), including miRNA-126 that are involved in the regulation of interleukin-13 (IL-13) and the T helper 2 cell (Th2) response, the key components of the asthmatic response. The aim of this study is to find the difference in the expression of miRNA-126 and IL-13 serum in fully controlled and not fully controlled groups of stable asthma patients and analyze the relationship between them. Methods: Case-control studies was conducted in 36 stable asthma patients who visited pulmonary outpatient clinic Saiful Anwar Hospital from September 2018 to March 2019. Subjects were divided into 2 groups, each group consisted of 18 fully controlled asthma and 18 not fully controlled asthma patients. The expression of miRNA-126 was measured by the quantitative polymerase chain reaction (q-PCR) and IL-13 using the enzyme-linked immunosorbent assay (ELISA) method. Results: The expression of miRNA-126 was higher in the control group (3.499±2.99) than case group (2.719±2.73), but the difference was not significant (P=0.273). The IL-13 levels were higher in the case group (17.285±9.37) than control group (11.681±5.22), and the difference was significant (P=0.009). However, there was no relationship between the expression of miRNA-126 and IL-13 levels in both groups. Conclusions: There were differences in IL-13 levels, but there were no differences in the expression of miRNA-126 in the two groups. There was no relationship between miRNA-126 expression and IL-13 levels in both groups. (J Respir Indo. 2020; 40(1): 24-32)
An evaluation of short-acting β2-agonist prescriptions and associated clinical outcomes in asthma management in Indonesia – the SABINA Indonesia study Wiwien Heru Wiyono; Muhammad Amin; Susanthy Djajalaksana; Amira Permatasari Tarigan; Febrina Susanti; Hisham Farouk; Helyanna Helyanna
Jurnal Respirologi Indonesia Vol 42, No 2 (2022)
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.v42i2.295

Abstract

Background: Asthma is a chronic inflammatory disease, therefore inhaled corticosteroid (ICS) should be as the cornerstone of asthma treatment. However patients tend to rely on short-acting β2-agonist (SABA) due to immediate symptom relief and underuse ICS, thereby undertreating the underlying inflammation. As part of the multi-country SABA use IN Asthma (SABINA) III study, we aimed to describe SABA prescription patterns and asthma-related clinical outcome in Indonesia.Methods: Cross-sectional study in asthma patients (> 12 years old) during August 2019 –  January 2020. Disease characteristic, prescribed asthma treatment in the 12 months before the study visit, and clinical outcomes, were recorded during a single visit and entered into an electronic case report form.Results: Of 219 patients recruited, the mean number of SABA canisters prescribed was 4 canisters per year. SABA over-prescription (≥ 3 canisters/year) seen in 37% patients, and was greater in moderate-to-severe vs mild asthma (40% vs 17.9%). 47.5% of patients had at least 1 severe exacerbation; and 7.3% of patients had ≥3 severe exacerbations, in the past 12 months. Almost half of the patients (40.2%) were prescribed oral corticosteroids (OCS). Overall, the well-, partly, and uncontrolled patients were 41.6%, 37.4%, and 21%, respectively.Conclusion: SABA over-prescription occurs in approximately one third of asthma patients, especially among moderate-to-severe patients and almost half of asthma patients experienced at least 1 severe exacerbation in the previous year. This highlights a public health concern and the need to improve asthma care by aligning with global recommendations including reducing SABA over-reliance in Indonesia
Effect of Giving Polyphytopharmaca on Improvement in The Degree of Asthma Control through Reduction of Eosinophils and Interleukin-13 Uncontrolled Asthma Patients Aditya Sri Listyoko; Iin Noor Chozin; Susanthy Djajalaksana
Jurnal Respirologi Indonesia Vol 40, No 3 (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.v40i3.109

Abstract

Backgrounds: Bronchial asthma is a heterogeneous disease characterized with chronic airway inflammation. The level of asthma control is an indicator of asthma management outcomes. It is influenced by a complex immunological mechanism, included the role of IL-13 as a key biomarker of inflammation. We investigate the effect of Poly-Phytopharm (Kleinhovia hospita 100 mg, Curcuma xanthorriza 75 mg, Nigella sativa 100 mg and Ophiocephalus striatus 100 mg) on the level of asthma control tests (ACT) score, blood eosinophils, and serum IL-13 on not fully controlled asthma stable patients. Methods: This study used quasi-experimental pre and post test methods, in 15 stable asthma patients who were not fully controlled at the pulmonary outpatient clinic of Dr. Saiful Anwar General Hospital, Malang. Assessment of ACT score, blood eosinophils, and serum IL-13 are carried out before and after supplementation of Poly-Phytopharm three times a day, two capsules respectively for 12 weeks. The ACT was scored by the investigator by direct questioning of patients, the blood eosinophil was measured with blood analysis, and the IL-13 in serum was detected with qPCR method. Results: There is significant increase of ACT score (18.07±2.57 to 22.06±1.83; P=0.001). In subject with baseline eosinophils ≥300 pg/mL (n=9), there were significant reduction in blood eosinophils (653.15±276.77/µL to 460.66±202.04/µL; P=0.038), and a decrease of serum IL-13 (17.69±9.901 pg/ml to 16.17±12.438 pg/ml; P=0.609). Conclusions: The administration of poly-phytopharm for 12 weeks improves ACT level, decreases blood eosinophils, and decrease serum IL-13 on not fully controlled asthma stable patients. (J Respir Indo. 2020; 40(3): 130-8)
The Effect of Ophiocephalus Striatus Extract on suPAR, Neutrophil Levels and Lung Diffusion Capacity (DLCO) in Stable Chronic Obstructive Pulmonary Disease (COPD) Patients with Muscle Wasting Sasongko Adhi Nugroho; Teguh Rahayu Sartono; Susanthy Djajalaksana; Harun Al Rasyid
Jurnal Respirologi Indonesia Vol 39, No 2 (2019)
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.v39i2.56

Abstract

Background: Muscle wasting is one of the extrapulmonary manifestation which influence quality of life in Chronic Obstructive Pulmonary Disease (COPD) patients. It caused by imbalance of protein metabolism in skeletal muscle. This study aimed to evaluate the effect of Ophiocephalus striatus extract on neutrophil count, soluble urokinase-type plasminogen activator (suPAR) level, diffusion capacity of lung for carbon monoxide (DLCO) and quality of life in stable COPD patients with muscle wasting. Methods: Clinical pre and post quasi experimental study was conducted to 32 stable muscle-wasted COPD patients from Pulmonary Outpatient Clinic Saiful Anwar Hospital Malang, determined by The Global Initiative for Chronic Obstructive Lung Disease (GOLD) 2016, Bioelectrical impedance analysis (BIA) dengan fat-free mass (FFM)
The Effect of Opiocephalus striatus Extract on Leptin, Adiponectin and COPD Assessment Test Scores on Stable COPD Patients Experiencing Muscle Wasting Komang Sri Rahayu Widiasari; Susanthy Djajalaksana; Harun Al Rasyid
Jurnal Respirologi Indonesia Vol 38, No 3 (2018)
Publisher : Perhimpunan Dokter Paru Indonesia (PDPI)/The Indonesian Society of Respirology (ISR)

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (789.57 KB) | DOI: 10.36497/jri.v38i3.5

Abstract

Background: Muscle wasting is one of extrapulmonary manifestations that occur in 20-40% of patients with COPD as a result of an imbalance of protein synthesis and degradation, where it is thought to be a consequence of chronic inflammation. One of the factor that affect muscle wasting is nutritional factor. The purpose of this study is to prove that nutrition therapy can improve inflammation (measured by levels of leptin, adiponectin) further improve muscle wasting and improve the quality of life of patients COPD with muscle wasting. Method: The clinical study design is pre and post auto control quasi experimental in stable COPD patients with comorbid muscle wasting. The experiment was conducted in Pulmonary Outpatient Clinic Dr. Saiful Anwar Hospital and Physiology Laboratory of Medical Faculty Brawijaya University. Chronic obstructive pulmonary disease was diagnosed based on 2014 GOLD criteria. Muscle wasting was diagnosed through examination of the BIA. Levels of leptin and adiponectin was measured using ELISA method, and quality of life was assessed using CAT score. We measured BIA, Leptin, Adiponectin and CAT in 32 COPD patients with muscle wasting, before and after 12 weeks supplementation of Opiocephalus striatus extract 3x1000mg/day. Results: There were significant increased of BMI (p = 0.046), no significant increase of FFMI (p = 0506), a significant decrease in leptin levels (p = 0.000) and a significant increase in adiponectin levels (p = 0.048) and improvement of quality of life (score CAT) (p = 0.000) ) after administration of opiocephalus striatus extract for 12 weeks. Conclusion: Suplementation of Opiocephalus striatus extract for 12 weeks can improve BMI, decrease levels of leptin and increase level of adiponectin resulting in improvement of quality of life in stable COPD patients with muscle wasting.
Poly-Phytopharm Increases Act Score and Serum miR-126 Relative Expressions, and Decreases Blood Eosinophil Levels in Asthma Patients I Dewa Putu Ardana; Susanthy Djajalaksana; Iin Noor Chozin; Alidha Nur Rakhmani
Jurnal Respirologi Indonesia Vol 39, No 4 (2019)
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.v39i4.77

Abstract

Background: The levels of asthma control is an indicator of asthma management outcomes. A complex immunological mechanism influences it. We aimed to investigate the effect of Poly-Phytopharm on the asthma control tests (ACT) score, blood eosinophil levels, and miR-126 relative expressions in asthma patients. Methods: Quasi experimental method is used in 15 stable asthma patients who were not fully controlled at the pulmonary outpatient clinic of Dr. Saiful Anwar General Hospital Malang. Assessment of ACT score, blood eosinophil levels, and miR-126 relative expressions are carried out before and after supplementation of Poly-Phytopharm that consist of Nigella sativa 100 mg, Kleinhovia hospita 100 mg, Curcuma xanthorrhiza 75 mg, and Ophiocephalus striatus 100 mg extract, three times a day, two capsules respectively for 12 weeks. The ACT was scored by the investigator by direct questioning of patients, the blood eosinophil level was measured with blood analysis, and the relative expressions of miR-126 was detected with qPCR. Results: There were significant increase of ACT score (18.07±2.57 to 22.06±1.83, P=0.001), decrease in blood eosinophil levels (653.15±276.15 pg/mL to 460.66±202.04 pg/mL, P=0.038), and enhancement of serum miR-126 relative expressions (1.83±1.89 to 5.89±1.34, P=0.038). Conclusion: The administration of Poly-Phytopharm increases ACT score, decreases blood eosinophil levels and increases serum miR-126 relative expressions in not fully controlled stable asthma patients. (J Respir Indo. 2019; 39(4): 231-7)
The Use of Mask in Respiratory Exercise in the Era of COVID-19 Pandemic Susanthy Djajalaksana; Aditya Sri Listyoko; Lucky Togihon Harjantho; Anthony Christanto; Silvy Amalia Falyani; Akira Yamasaki
Jurnal Respirasi Vol. 8 No. 2 (2022): May 2022
Publisher : Faculty of Medicine Universitas Airlangga

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (420.419 KB) | DOI: 10.20473/jr.v8-I.2.2022.69-74

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Introduction: The 2019 Coronavirus Disease (COVID-19) pandemic causes public health protocols to be strictly enforced. This study examined the effect of using masks on performing exercises, particularly respiratory exercises, in the era of COVID-19 pandemic. Methods: A total of 24 people participated in this study using randomization and cross-over techniques. The variables measured were respiratory rate, oxygen (O2) saturation, pulse rate, carbon monoxide (CO) levels, and fatigue scale using the Borg Breathless Score. The statistical test used independent t-test, Wilcoxon, and Mann-Whitney U with a different level of p < 0.05. Results: There was no significant difference between the observed parameters (heart rate, respiratory rate, peripheral O2 saturation, CO levels, and Borg scale) in the groups using masks and not using masks. Conclusion: The increase in pulse rate, respiratory rate, and Borg Scale in the aerobic phase of respiratory exercise is physiological and can improve significantly after the cooling phase.
ANALYSIS OF KNOWLEDGE ON CHRONIC OBSTRUCTIVE LUNG DISEASE Susanthy Djajalaksana; Aditya Sri Listyoko; Maria Kristiani; Tiar Oktavian Effendi; Magdalena Sirait
Journal of Community Health and Preventive Medicine Vol. 2 No. 1 (2022): JOCHAPM Vol. 2 No. 1 2022
Publisher : Universitas Brawijaya

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (839.527 KB) | DOI: 10.21776/ub.jochapm.2022.002.01.3

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ABSTRAKBackground : Chronic obstructive pulmonary disease (COPD) is a leading cause of morbidity, mortality and disability worldwide and represents a huge economical burden for the healthcare system. By knowing the level of public understanding of this disease, we were able to find out what education could be given to increase understanding about COPD. The aim of this study was to determine the level of knowledge of the non-medical and medical personnel about COPD.Methods : This is descriptive research. The research was conducted cross-sectionally with 200 respondents consisting of 100 medical subjects and 100 non-medical subjects. This research was carried out in the RSSA environment in November 2021. The data collection technique is that respondents filled out a Google Form.Results : The total score of the six categories showed that 73.875% of the medical group and 47.17% of the non-medical group already understood COPD. In all categories, the results of the analysis showing statistical significance (p<0.001).Conclusion : Our study shows significant knowledge about all knowledge of COPD between the general public and medical personnel.Suggestion : socialization to the public about COPD and the importance of the community getting to know COPD in preventive and treatment measures. Keywords: COPD, education, questionnaire 
Volatile Organic Compounds (VOCs) and Interleukin-23 Levels in Lung Cancer: A Future Biomarker Raden Dicky Wirawan Listiandoko; Ungky Agus Setyawan; Tri Wahju Astuti; Susanthy Djajalaksana; Aditya Sri Listyoko; Arinto Yudi Ponco
Jurnal Respirasi Vol. 9 No. 2 (2023): May 2023
Publisher : Faculty of Medicine Universitas Airlangga

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.20473/jr.v9-I.2.2023.80-86

Abstract

Introduction: Lung cancer (LC) is the world's second leading cause of death due to malignancy. In Indonesia, LC is one of the top three malignancies. Volatile organic compounds (VOCs) from the respiratory reflect changes in metabolism caused by disease and may be a biomarker of LC. Interleukin-23 (IL-23) has been known as a pro-inflammatory cytokine in the development and progression of cancer. This study aimed to identify levels of IL-23 and VOCs in LC patients. Methods: This study involved 40 LC patients and 42 controls. VOCs were taken by the subject exhaling their third deep breath into the sample bag, which was immediately analyzed using an E-nose-based device. As for the IL-23, the cytokine was taken from the blood serum and then analyzed using the ELISA method. Kolmogorov-Smirnov and Shapiro-Wilk tests were performed to test data normality. Mann-Whitney and Kruskal Wallis tests were conducted for variables. Spearman correlation and heat map were used to find the correlation between the observed gases and IL-23. Results: The concentration of ozone (p = 0.000), ethanol (p = 0.000), formaldehyde (p = 0.000), toluene (p = 0.000), acetone (p = 0.000), ammonia (p = 0.000), ammonium (p = 0.001), nitrogen (p = 0.001) and methane (p = 0.000) in LC group differed with controls. The same outcome was also observed in comparing LC patients and control groups of IL-23 (p = 0.000). Spearman correlation analysis revealed a positive correlation between serum IL-23 with formaldehyde (p = 0.029), toluene (p = 0.014), and ammonia (p = 0.028) and a negative correlation with nitrogen (p = 0.011). Compared to the control group, all types of LC were observed to have higher levels of IL-23. A weak positive correlation was found in formaldehyde (Cv = 0.23), toluene (Cv = 0.23), and ammonia (Cv = 0.13). A weak negative correlation was obtained in acetone (Cv = -0.12), ammonium (Cv = -0.11), and nitrogen dioxide (Cv = 0.23). Conclusion: Weak linear correlations were obtained between the cytokine and formaldehyde, toluene, ammonia, ammonium, and nitrogen dioxide. A higher IL-23 concentration was observed in the LC group than in the control group. The volatile concentration was significantly different between LC and control groups.