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Immunosupressant Effect of the Extract of Tridax procumbens on Lymphocyte Cells Line from Patients with Systemic Lupus Erythematous: Immunoglobulin Gbiomarker Abdul Khairul Rizki Purba; Endang Mahati; Yolanda Dyah Kartika; Indwiani Astuti; Nyoman Kertia
Journal of Tropical Pharmacy and Chemistry Vol. 2 No. 2 (2013): J. Trop. Pharm. Chem.
Publisher : Faculty of Pharmacy, Universitas Mulawarman, Samarinda, Indonesia, 75117, Gedung Administrasi Fakultas Farmasi Jl. Penajam, Kampus UNMUL Gunung Kelua, Samarinda, Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.25026/jtpc.v2i2.50

Abstract

Systemic Lupus Erythematous (SLE) is one of the major autoimmune diseases that can cause severe damage to the tissues and organs in the body and lead to high mortality rates. The clinical manifestations are characterized by the production of autoantibody immunoglobulin G (Ig G) that fights component of the nucleus. The present scientific information issues about peculiar property of Tridax procumbens as immunosuppressant by inhibiting enzyme of cyclooxygenase-2 (COX-2) on surface of B cells. This study approved effect of the extract of Tridax procumbens on human lymphocytes cells line with SLE disease. The aim of this study was to approve effect of extract of Tridax procumbens in suppressing Ig G concentration from patient with stable SLE and patient with active SLE in vitro. This study was an in vitro experimental design on lymphocytes cell line that was isolated from whole blood patient with stable SLE and active SLE. Lymphocyte cells from healthy volunteer were also collected as control. American Rheumatism Association Diagnostic was used for inclusion criteria.Tridax procumbens was extracted with maceration method in solution of ethyl acetate. The extract was divided in several doses as immunosuppressant i.e.1000; 250; 62.5; 31.25; 15.13; and 3.91 µg/mL. Supernatant of the cultured cells was collected and examined for measuring Ig G concentration as secretion from activated B cells by ELISA. Ethical clearance had been completed before this study started. The extract of Tridax procumbens significantly suppressed Ig G secretion in patient with stable SLE at dose over 62.5 µg/mL, but Ig G concentration in patient with active SLE was significantly increased when compared with control. Furthermore from the analysis, effect of the Tridax procumbens extract on Ig G concentration followed dose dependent response. In in-vitro study, the extract of Tridax procumbens could significantly suppress Ig G secretion in healthy volunteer and patient with stable SLE. Otherwise, the extract does not suggest for patient with active SLE and it needs caution in use and investigation in-depth. Keywords: SLE, Tridax procumbens, immunoglobulin G ABSTRAK Penyakit Systemic Lupus Erythematous (SLE) merupakan salah satu penyakit autoimun yang sering menyebabkan kerusakan jaringan dan organ sehingga angka kematiannya tinggi. Karakteristik patognomonik penyakit SLE ditandai ada produksi auto antibody immunoglobulin G (Ig G) yang melawan komponen nukleosom tubuh sendiri. Penelitian ilmiah terbaru menunjukkan bahwa ekstrak Tridax procumbens memiliki efek imunosupresan melalui hambatan enzim cyclooxygenase-2 (COX-2) pada permukaan sel B. Pada studi ini menguji efek ekstrak Tridax procumbens pada cells line limfosit dari pasien SLE. Tujuan penelitian ini adalah mengetahui efek ekstrak Tridax procumbens dalam menekan konsentrasi Ig G pasien dengan SLE stabil dan pasien dengan SLE aktif secara in vitro. Penelitian ini merupakan penelitian eksperimen pada cell line limfosit yang diisolasi dari whole blood pasien dengan SLE stabil dan SLE aktif. Kelompok kontrol limfosit diambil dari sukarelawan sehat. Kriteria inklusi pasien yang mengikuti penelitian ini berdasarkan kriteria diagnostik American Rheumatism Association. Tridax procumbens diekstraksi dengan metode maserasi larutan etil asetat. Ekstrak dibagi menjadi beberapa dosis sebagai imunosupresan yaitu 1000; 250; 62,5; 31,25; 15,13; dan 3,91 µg/mL. Supernatan dari sel kultur dikoleksi dan diukur konsentrasi Ig G yang merupakan sekresi sel B dengan menggunakan metode ELISA. Persetujuan etik dilakukan sebelum penelitian dilakukan. Ekstrak Tridax procumbens menekan sekresi Ig G pasien dengan SLE stabil pada dosis diatas 62,5 µg/mL, namun konsentrasi Ig G dari pasien dengan SLE aktif meningkat secara signifikan dibandingkan dengan kontrol. Efek ekstrak Tridax procumbens pada konsentrasi Ig G mengikuti dose dependent response. Pada penelitian ini, ekstrak Tridax procumbens dapat menekan sekresi Ig G dari pasien dengan SLE stabil dan sukarelawan sehat. Pemberian ekstrak Tridax procumbens tidak dianjurkan pada pasien dengan SLE aktif, namun hal ini masih membutuhkan penelitian lebih mendalam. Keywords: SLE, Tridax procumbens, imunoglobulin G
The Impact of Starting Urate-Lowering Therapy (ULT) During A Gout Flare on The Ongoing Episode: A Systematic Review of Randomized Controlled Trials Yogiswara, Komang Satvika; Widhiarta, Putu Raka; Wiwekananda, Ketut Shri Satya; Paramaiswari, Ayu; Achadiono, Dedy Nurwachid; Kambayana, Gede; Kertia, Nyoman
Acta Interna The Journal of Internal Medicine Vol 13, No 1 (2024): Acta Interna The Journal of Internal Medicine
Publisher : Faculty of Medicine Universitas Gadjah Mada

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.22146/actainterna.101289

Abstract

Background. Gout is a prevalent form of arthritis caused by the accumulation of monosodium urate (MSU) crystals. Urate-lowering therapy (ULT) may be started once an acute flare has subsided to prevent the present episode from lasting longer. Nevertheless, ULT may be commenced during an acute flare-up in order to decrease the frequency of outpatient appointments and enhance patient adherence. The objective of this study was to conduct whether the commencement of urate-lowering therapy (ULT) during an acute gout flare is effective. Method. We performed a systematic review of articles published in MEDLINE, PubMed, Cochrane library, and EMBASE databases from 2018 to 2023. The search was limited to articles published in English, and RCTs in patients older than 18 years.Results and Discussions. Among 242 recorded studies, only four with 323 patients were eligible for this research. The treatment with Allopurinol began with a daily dose    of 100 mg for the initial 14 days, followed by an increase to a daily dose of 200 mg for     the subsequent 14 days. The reported time to resolution was 15.4 days for the group receiving allopurinol and 13.4 days for the group receiving the placebo. According to this review, the start of ULT (uric acid-lowering therapy) should be determined by sufficient anti-inflammatory measures. Commencing ULT during a gout flare has no impact on the intensity, duration, or likelihood of recurrence of the flare within the following 28 to 30 days.Conclusions. This study demonstrated that the commencement of urate-lowering therapy (ULT) during an acute gout flare did not result in a longer duration of the flare. Nevertheless, it is necessary to conduct a clinical  studies with a bigger sample size in order to validate this review.
Factors associated with health preparedness (istithaah) status among Hajj pilgrims in Indonesia: a cross-sectional study Sugeng, Sugeng; Setiyarini, Sri; Probosuseno, Probosuseno; Kertia, Nyoman
Jurnal Ners Vol. 20 No. 1 (2025): VOLUME 20 ISSUE 1 FEBRUARY 2025
Publisher : Universitas Airlangga

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.20473/jn.v20i1.58887

Abstract

Introduction: The Hajj pilgrimage presents unique health challenges due to the large gatherings, particularly affecting elderly participants with preexisting conditions. Health istithaah, referring to physical and mental readiness for Hajj participation, is crucial for ensuring the safety of pilgrims. This study aimed to identify the factors associated with health istithaah status among Indonesian Hajj pilgrims. Methods: This descriptive correlational study examined 1,305 pilgrims scheduled for the 2023 Hajj pilgrimage. The data collected included health istithaah status, age, gender, and medical diagnoses based on ICD-10. The analysis employed Chi-Square tests and multivariate logistic regression (p < 0.05). Results: Of the participants, 772 (59.2%) had unassisted health istithaah, while 533 (40.8%) required assistance. Diabetes mellitus showed the highest association with requiring assistance (PR = 4.938, 95% CI = 3.354–7.270, p = 0.001), followed by symptoms and signs not classified elsewhere (PR = 4.071, 95% CI: 3.091–5.362, p = 0.001) and essential hypertension (PR = 3.467, 95% CI = 2.565–4.685). Age and multiple diagnoses were significantly associated with health istithaah status (p = 0.001), while gender showed no significant association (p = 0.246). Conclusion: Age, multiple diagnoses, and chronic conditions, particularly diabetes, were key factors associated with requiring health istithaah assistance among Indonesian Hajj pilgrims. These findings emphasize the need for targeted health assessments and support for high-risk pilgrims.
Predictors of persistent high disease activity after methotrexate treatment in rheumatoid arthritis patients Paramaiswari, Ayu; Kertia, Nyoman; Achadiono, Deddy; Sinarta, Armin; Nugroho, Dhite
Universa Medicina Vol. 44 No. 2 (2025)
Publisher : Faculty of Medicine, Universitas Trisakti

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.18051/UnivMed.2025.v44.141-151

Abstract

Background Methotrexate (MTX) is the firstline therapy for rheumatoid arthritis (RA). However, 30–40% of RA patients exhibit poor response. Identifying early factors associated with persistent disease activity is critical to guide treatment. This study aimed to identify predictors of persistent high disease activity (DAS28-ESR >3.2) after six months of MTX therapy in RA patients. Methods A retrospective cohort study was conducted involving 204 RA patients who had completed six months of MTX therapy. The primary outcome was DAS28-ESR score at six months. Independent variables included baseline erythrocyte sedimentation rate (ESR), cumulative doses of MTX and low-dose methylprednisolone (LDM), and rheumatoid factor (RF) status. Simple and multiple logistic regression was used to analyze the data.  Results Significant differences in ESR and cumulative MTX dose were observed between low and high disease activity groups. Multivariate analysis identified four independent predictors of persistent high disease activity (DAS28-ESR >3.2) after six months of MTX therapy: disease duration >11 months (AOR =0.45; 95% CI 0.23–0.89; p=0.025); age at onset >50 years (AOR 0.48; 95% CI 0.24–0.94; p=0.038); cumulative MTX dose >85 mg (AOR 4.75; 95% CI 1.55–14.64; p=0.006); ESR >66 mm/hr (AOR 2.32; 95% CI 1.11–4.89; p=0.026).  Conclusion Greater cumulative methotrexate dose (>85 mg) was the most influential predictor of persistent high disease activity (DAS28-ESR >3.2) after six months of MTX therapy in RA patients. These findings may assist clinicians in identifying patients at risk for poor MTX response and support timely therapeutic adjustments.
Studi Pharmacovigilance Obat Herbal Di Puskesmas Kasihan II Bantul Mahdi, Nur; Perwitasari, Dyah Aryani; Kertia, Nyoman
Media Farmasi: Jurnal Ilmu Farmasi Vol. 13 No. 1: Maret 2016
Publisher : Universitas Ahmad Dahlan

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.12928/mf.v13i1.5744

Abstract

Kejadian Reaksi Obat yang Tidak Dikehendaki (ROTD) dari obat-obat herbal merupakan hal yang masih jarang diteliti di Indonesia. Gaya hidup kembali ke alam menjadi cukup popular saat ini, sehingga masyarakat kembali memanfaatkan berbagai bahan alam, termasuk pengobatan dengan tumbuhan obat atau herbal. Dengan meningkatnya penggunaan obat herbal di Indonesia, maka diperlukan pemantauan keamanan pada obat-obat herbal.  Tujuan penelitian ini adalah mengetahui gambaran kausalitas kejadian ROTD serta mengetahui kualitas hidup pasien yang mendapatkan resep obat herbal. Penelitian ini menggunakan rancangan observasional deskriptif, pengambilan data secara consecutive sampling secara prospektif. Pengambilan data selama dua bulan saat penelitian berlangsung, setelah itu dianalisis kejadian ROTD dan tanpa ROTD serta dinilai kualitas hidup pasien. Instrumen yang digunakan untuk menganalisis adalah algoritma Naranjo dan kuesioner SF-36. Hasil wawancara kepada 25 subyek penelitian pada pengamatan prospektif dan retrospektif, subyek yang melaporkan adanya kejadian ROTD sebanyak 3 subyek (12%). Sebanyak 2 subyek dengan kategori possible (mungkin) dan 1 subyek dengan kategori probable (cukup mungkin). ROTD yang muncul adalah gatal-gatal, nyeri pinggang, mual, ngantuk dan dada berdebar. Kesimpulan dari penelitian ini adalah terdapat kejadian ROTD pada pasien yang diberikan terapi herbal, gambaran kausalitas kejadian ROTD adalah kategori possible dan probable. Kata kunci: pharmacovigilance, reaksi obat yang tidak dikehendaki, obat herbal.
Acupressure for Pain of Osteoarthritis : A Systematic Review Mahanani, Srinalesti; Kertia, Nyoman; Madyaningrum, Ema; Lismidiati, Wiwin
Journal Of Nursing Practice Vol. 7 No. 1 (2023): October
Publisher : Universitas STRADA Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.30994/jnp.v7i1.341

Abstract

Background: Osteoarthritis can be defined as a disorder of movable joints characterized by deterioration of articular cartilage; osteophyte formation and bone remodeling; changes in periarticular tissues; and a low-grade, nonpurulent inflammation of variable degree. Acupressure is a traditional non-pharmacological intervention that promotes blood circulation and muscle activity. Purpose: This review aimed to investigate the efficacy of acupressure as a complementary therapy method for the pain of osteoarthritis. Methods: Four electronic databases were searched from PubMed, ProQuest, Scopus, and The Cochrane Library use PICO strategy. In studies comparing acupressure with sham acupuncture, no intervention, or conventional intervention was eligible for inclusion. Article study is published on 2012-2022, using English and design RCT and Quasi-experiment. Prisma analysis was used in selection process. The risk of bias in the included studies was assessed using the Joanna Briggs Institute Critical Appraisal Tools for Quasi-Experimental Studies and Randomized Controlled Trials. Results: There were 12 reports selected for review with the homogeny of knee Osteoarthritis. Outcomes were either objectively- or subjectively assessed improvements in specific pain parameters and safety for clinical use. Results showed more clinical trials with proper methodology are needed to confirm the effectiveness of acupressure for the pain of Osteoarthritis. The results of the review showed a positive effect in reducing pain level with acupressure intervention as either the main or complementary therapy. Conclusion: This systematic review shows that acupressure as a single or complementary intervention provides significant benefits in the management of Osteoarthritis. Further trials with a more rigorous design are needed to further validate and address the limitations of the current evidence.
Effects of Physalis angulata extracts on bleomycin-induced rat: analysis on lung inflammation and fibrosis Wibowo, Suryo Anggoro Kusumo; Rumende, Cleopas Martin; Isbagio, Harry; Setiyono, Agus; Setiabudy, Rianto; Rachmadi, Lisnawati; Kertia, Nyoman
Medical Journal of Indonesia Online First
Publisher : Faculty of Medicine Universitas Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.13181/mji.oa.257875

Abstract

BACKGROUND Scleroderma is an immune-mediated connective tissue disease, with interstitial lung disease as one of its manifestations. Physalis angulata (P. angulata) or ciplukan has shown potential in treating fibrosis, but its role in preventing lung inflammation and fibrosis remains unknown. This study aimed to evaluate the effect of P. angulata extract in a bleomycin (BLM)-induced scleroderma rat. METHODS Sprague-Dawley rats were divided into 6 groups. For lung inflammation prevention, 3 groups received: (1) BLM only, (2) BLM+50 mg/kgBW P. angulata, and (3) BLM+100 mg/kgBW P. angulata. After 14 days, rats were sacrificed and bronchoalveolar lavage (BAL) leukocyte count, interleukin-6 (IL-6) levels, and lung injury score were assessed. For fibrosis prevention, another 3 groups received the same interventions and were sacrificed after 51 days. Fibrosis score, fibrosis area, hydroxyproline, transforming growth factor-beta (TGF-β), and matrix metalloproteinase-13 (MMP-13) levels were analyzed. BLM was administered subcutaneously, while P. angulata was given orally for 14 days. IL-6, TGF-β, and MMP-13 were measured by ELISA and hydroxyproline by colorimetric method. Mean differences and p-values were calculated using appropriate statistical tests. RESULTS P. angulata extract did not prevent lung inflammation, as there were no differences in BAL leukocyte count (p = 0.126), IL-6 levels (p = 0.173), or lung injury scores (p = 0.397) between the BLM-only group and those receiving P. angulata. The extract also did not prevent lung fibrosis, with no differences in fibrosis scores (p = 0.173), fibrosis area (p = 0.359), hydroxyproline (p = 0.295), TGF-β (p = 0.374), or MMP-13 (p = 0.088) levels among groups. CONCLUSIONS P. angulata extract did not prevent the development of lung inflammation or fibrosis.
Co-Authors Abdul Khairul Rizki Purba Mustofa Indwiani Astuti Achadiono, Deddy Achadiono, Dedy Nurwachid Agus Setiyono Ahmad Husain Asdie Ahmad Husain Asdie Ahmad Husain Asdie Arif Nurrochmad Arif Prassetyo Arina Syarifa Fadlilah Asdie, Achmad Husain Ayu Paramaiswari Ayu Paramaiswari Baiq R Rhadianaa Bambang Udji Djoko Rianto Bambang Udji Djoko Riyanto, Bambang Udji Djoko Cleopas Martin Rumende Danang ., Danang Deddy Nur Wachid Deddy Nur Wachid Achadiono Deddy Nur Wachid Akhadiono Deddy Wachid Achadiyono Dewa Ayu G. N. Dewa Ayu G. N., Dewa Ayu Dyah Ariani Perwitasari Dyah Aryani Perwitasari Ema Madyaningrum Endang Mahati Eny Catur, Eny F, Melani Farah Nuriannisa Gede Kambayana Gunawan, I Made Alit Hangga Harinawantara Harry Isbagio Haslinda Haslinda Haslinda Haslinda, Haslinda Heru Yulianto I Dewa Putu Pramantara I Made Alit Gunawan I Made Alit Gunawan Ika Puspitaningrum Imono A.D., Imono Indwiani Astuti Irwan Supriyanto Kartyanto, Adhita Khasana, Tri Mei Krishnan, P N Lily Arsanti Lestari Lisnawati Rachmadi M. Marsetyawan Mae Sri Hartati Wahyuningsih Maria Caecilia Nanny Setiawati Maria Caecilia Setiawati Marsetyawan -, Marsetyawan Marsetyawan Marsetyawan Marsetyawan Marsetyawan Mohammad Robikhul Ikhsan Mufrod ., Mufrod Mustika Muthaharah mustika muthaharah Mustika Muthaharah muthaharah, mustika N. Setiawati, M. Caecilia Nastiti Hemas M. Nastiti Hemas M., Nastiti Hemas Nugroho, Dhite Nunu N Madjid Nur Arfian Nur Mahdi Nurrochmad, Arif P N Krishnan Poerwono Rahardjo Pratiwi, Woro Rukmi Probosuseno Probosuseno Probosuseno Probosuseno, Probosuseno Rianto Setiabudy Rochmach, Wasilah Ronny T Wirasto Sinarta, Armin SRI SETIYARINI, SRI Srinalesti Mahanani, Srinalesti Sugeng Sugeng Supanji, Supanji Susini R Sari Tri Mei Khasana W.N., Meika Wachid, Deddy Nur Wasilah Rochmah Wasilah Rochmah Wasilah Rochmah Wibowo, Suryo Anggoro Kusumo Widhiarta, Putu Raka Wiwekananda, Ketut Shri Satya Wiwin Lismidiati Yogiswara, Komang Satvika Yolanda Dyah Kartika Yuliani, Kartika Yulyani Werdhiningsih Z, Ikawati Zulies Ikawati