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Dismantling Immunosuppression in Colorectal Cancer: A Systematic Review and Meta-Analysis on Phyllanthus niruri as a Potent Antagonist of the IL-10 Axis in the Tumor Microenvironment Jeffrey Eka Wijaya; Albertus Ari Adrianto; Awal Prasetyo
Bioscientia Medicina : Journal of Biomedicine and Translational Research Vol. 9 No. 10 (2025): Bioscientia Medicina: Journal of Biomedicine & Translational Research
Publisher : HM Publisher

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37275/bsm.v9i10.1404

Abstract

Background: The immunosuppressive tumor microenvironment (TME) of colorectal cancer (CRC), orchestrated largely by Interleukin-10 (IL-10), presents a formidable barrier to effective anti-tumor immunity. Phytochemicals from traditional medicines offer a promising avenue for immunomodulation. Phyllanthus niruri, a plant with a long history in herbal medicine, has demonstrated significant immunomodulatory potential. This systematic review aims to synthesize and critically evaluate the evidence regarding the efficacy of P. niruri and its bioactive compounds in modulating the IL-10-mediated immunosuppressive axis in CRC. Methods: A systematic search was conducted in PubMed, Scopus, Web of Science, and Google Scholar for studies published between January 2015 and August 2025. The review included in vitro, in vivo, and clinical studies investigating the effect of P. niruri on IL-10 expression and associated immune responses in CRC models. The PRISMA guidelines were followed. Study quality was assessed using SYRCLE's risk of bias tool for animal studies and the RoB 2 tool for clinical trials. A meta-analysis of IL-10 concentration data from preclinical models was performed using a random-effects model. Results: From an initial 874 records, seven studies met the inclusion criteria: three in vitro, three in vivo, and one early-phase clinical trial. The selected studies consistently demonstrated that P. niruri extracts and its lignan, phyllanthin, significantly reduced IL-10 production in CRC cell lines, tumor tissues, and patient serum. Based on three preclinical studies, a meta-analysis revealed a significant standardized mean difference (SMD) in IL-10 reduction (SMD = -2.45; 95% CI: -3.10, -1.80; p < 0.00001). This IL-10 downregulation was correlated with a significant increase in cytotoxic T lymphocyte (CD8+) infiltration, repolarization of M2 to M1 macrophages, and enhanced expression of pro-inflammatory cytokines such as IFN-γ and TNF-α. Mechanistically, P. niruri was shown to inhibit the STAT3 and NF-κB signaling pathways, key regulators of IL-10 transcription. Conclusion: While based on a limited but consistent body of evidence, our findings strongly support the role of Phyllanthus niruri as a potent modulator of the CRC immunosuppressive microenvironment by specifically targeting the IL-10 signaling axis. By reducing IL-10 production, P. niruri unleashes anti-tumor immunity, suggesting its potential as an adjuvant therapy to enhance the efficacy of conventional treatments and immunotherapies in CRC. Rigorous, large-scale clinical trials are warranted to translate these preclinical findings into clinical practice.
Effectiveness of Spiritual-Based Interventions in Enhancing Quality of Life Among Breast Cancer Patients: A Systematic Review Su, Hansen Maikel; Ismail, Suhartini; Prasetyo, Awal
Journal of Health and Nutrition Research Vol. 4 No. 2 (2025)
Publisher : Media Publikasi Cendekia Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.56303/jhnresearch.v4i2.406

Abstract

Breast cancer is the most prevalent cancer among women and significantly affects patients' quality of life. Beyond physical symptoms, patients often experience emotional and social burdens that deteriorate their overall well-being. While medical and psychosocial interventions are widely applied, spiritual aspects are often underemphasized. Therefore, spiritual-based interventions are needed to support recovery by fostering hope, emotional stability, and a sense of life meaning.To explore the effectiveness of spiritual-based interventions in improving the quality of life of breast cancer patients. This study employed a systematic review design. Articles were retrieved from three databases CINAHL, PubMed, and Scopus using the main keywords: “breast cancer,” “quality of life,” “spiritual care,” and “spiritual intervention.” Inclusion criteria were original research articles, written in English, published between 2011 and 2025, and involving breast cancer patients. Data were extracted using structured tables and analyzed descriptively using qualitative synthesis. Seven eligible studies demonstrated that spiritual-based interventions, such as prayer, group therapy, meditation, and religious counseling, positively affect the quality of life of breast cancer patients. Key outcomes included enhanced hope, reduced pain, improved emotional, physical, and social well-being, stronger spiritual resilience, better coping mechanisms, and increased social support through group-based activities. Spiritual-based interventions significantly improve the quality of life of breast cancer patients through a holistic approach, integrating physical, emotional, social, and spiritual dimensions.
Masker Herbal Nephrolephis Exaltata Menghambat Pemanjangan Waktu Transpor Mukosilier Hidung Pekerja Industri Tekstil Nurhayadi, Tommy; Prasetyo, Awal; Miranti, Ika Pawitra
Jurnal Biomedika dan Kesehatan Vol 6 No 1 (2023)
Publisher : Fakultas Kedokteran Universitas Trisakti

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.18051/JBiomedKes.2023.v6.51-61

Abstract

Background Herbal masks are made from lamination-spraying of Nephrolepis exaltata (NE) extract on regular medical masks, which may absorb Volatile Organic compounds (VOC) in the occupational exposure of the textile industry'sindustry's dyeing area. Therefore, clinically, the effect on nasal mucociliary transport time (TMSH) needed to be tested and compared with ordinary cloth-mask teens used by textile industry workers as their daily personal protective equipment. Methods Pre- and post-test randomized control trials on 30 textile-dyeing areas of textile industry workers in Bawean Indonesia, divided into two groups; 1) users of NE herbal masks (N=17) as the treatment group and 2) regular cloth mask users (N=13) as control-group, for eight weeks. First, the TMSH time (seconds) was carried out before and after treatment using the saccharin test by an ENT specialist, followed by a different test on delta. Results The TMSH-time of NE herbal mask users before vs after treatment was 1169.60 ± 644.55 seconds vs 1075.75 ± 677.36 (p = 0.102). On subjects wearing regular cloth masks was 1113.75 ± 479.43 vs 1187.40 ± 544.96 (p = 0.003). The mean delta'sdelta's difference before and after treatment was 25.5 seconds, with a significant difference in mean delta TMSH-time between the treatment and control groups (p = 0.048). Conclusions Textile-industry workers who wear NE herbal masks have better TMSH times than regular cloth mask wearer
Biosmart and safe bus : new approach implementing epidemiologic triangle to reduce pathogen transmission on public transportation Mentari, Alfitra Akbar Bara Mentari; Antari, Arlita Leniseptaria; Saraswati, Indah; Firmanti, Stefani Candra; Subagio, Agus; Prasetyo, Awal; Taufiq, Heydar Ruffa; Rowi, Khasan; Gufron, Ahmad
BKM Public Health and Community Medicine The 12th UGM Public Health Symposium
Publisher : Universitas Gadjah Mada

Show Abstract | Download Original | Original Source | Check in Google Scholar

Abstract

Background: Indirect pathogen transmission is one of the factors that cause the transmission of infectious problems from human to human. Surface cabine bus is one of the places that probably can be an intermediary of indirect pathogen transmission. Biosmart and Safe Bus is the concept of implementing an epidemiologic triangle, one of the innovations in Biosmart and Safe Bus is implementing silver nanoparticles as a coating in the cabine to decrease the bacterial load on the surface. Objective: To determine the effectiveness of coating silver nanoparticles in decreasing the bacterial surface load on the Biosmart and Safe Bus concept. Methods: This research used a post-test-only design with a control group. The sampling technique in this research is using surface swab sampling with a total of 18 samples in each Biosmart and Safe Bus and conventional bus that turn to Jakarta and Batu from Semarang. The data were analyzed by using the Mann-Whitney test, the Kruskal-Wallis test, and pairwise comparison Kruskal-Wallis test. Results: The results showed a significant difference between bacterial surface load on Biosmart and Safe Bus and conventional bus (p = 0.015). Along with it, the implementation of coating silver nanoparticles has a considerable effect (cohen effect size = 1.0324) in decreasing the bacterial surface load on the cabin of Biosmart and Safe Bus. The use of silver nanoparticles as a coating on the surface of Biosmart and Safe Bus is effective in being a surface antibacterial agent. This is in line with another research conducted in the United Kingdom with the result that the use of Ag antimicrobial BioCote as coating can reduce 95% surface bacteria. Conclusion: This research proved that coating silver nanoparticles is effective in decreasing the bacterial surface load on Biosmart and Safe Bus compared to a conventional bus.
Nuclear β-Catenin Accumulation Correlates with Poor Survival in Undifferentiated Nasopharyngeal Carcinoma: A Retrospective Cohort Study in an Endemic Region Ayu Aksara; Awal Prasetyo; Devia Eka Listiana
Bioscientia Medicina : Journal of Biomedicine and Translational Research Vol. 10 No. 2 (2026): Bioscientia Medicina: Journal of Biomedicine & Translational Research
Publisher : HM Publisher

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37275/bsm.v10i2.1503

Abstract

Background: Nasopharyngeal carcinoma (NPC) is highly endemic in Indonesia, characterized by a prevalence of undifferentiated subtypes and late-stage presentation. While the Epstein-Barr virus (EBV) is a primary driver, the limitations of TNM staging in predicting individual outcomes necessitate the identification of molecular biomarkers. This study investigates the prognostic utility of aberrant Wnt/β-catenin signaling, specifically nuclear accumulation, in predicting overall survival (OS). Methods: A retrospective cohort study was conducted on 44 patients diagnosed with undifferentiated NPC at Dr. Kariadi General Hospital, Indonesia, between 2020 and 2024. Immunohistochemistry (IHC) for β-catenin was performed, with scoring specifically targeting nuclear and cytoplasmic reactivity (excluding physiological membranous staining) using the Allred system. Clinicopathological variables, including TNM staging (AJCC 8th edition), were analyzed. Survival analysis utilized Kaplan-Meier curves and multivariate Cox Proportional Hazards regression. Results: The cohort exhibited advanced disease, with 81.8% of patients presenting at Stage III or IV. Nuclear β-catenin overexpression (moderate-to-strong) was observed in 97.7% of cases. Strong nuclear expression was significantly associated with advanced T-stage (p=0.032) and distant metastasis (p=0.045). Kaplan-Meier analysis revealed a significant reduction in 5-year overall survival for the strong expression group (0%) compared to the weak/moderate group (p < 0.001). In multivariate analysis adjusted for age and TNM stage, strong β-catenin expression remained a significant predictor of mortality (Hazard Ratio: 2.15; 95% CI: 1.05–4.42; p=0.036), alongside Stage IV disease. Conclusion: Nuclear accumulation of β-catenin is a prevalent molecular event in Indonesian NPC and serves as a significant prognostic biomarker independent of tumor stage. These findings suggest potential utility for risk stratification and targeted Wnt-inhibitor therapies.
Nuclear β-Catenin Accumulation Correlates with Poor Survival in Undifferentiated Nasopharyngeal Carcinoma: A Retrospective Cohort Study in an Endemic Region Ayu Aksara; Awal Prasetyo; Devia Eka Listiana
Bioscientia Medicina : Journal of Biomedicine and Translational Research Vol. 10 No. 2 (2026): Bioscientia Medicina: Journal of Biomedicine & Translational Research
Publisher : HM Publisher

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37275/bsm.v10i2.1503

Abstract

Background: Nasopharyngeal carcinoma (NPC) is highly endemic in Indonesia, characterized by a prevalence of undifferentiated subtypes and late-stage presentation. While the Epstein-Barr virus (EBV) is a primary driver, the limitations of TNM staging in predicting individual outcomes necessitate the identification of molecular biomarkers. This study investigates the prognostic utility of aberrant Wnt/β-catenin signaling, specifically nuclear accumulation, in predicting overall survival (OS). Methods: A retrospective cohort study was conducted on 44 patients diagnosed with undifferentiated NPC at Dr. Kariadi General Hospital, Indonesia, between 2020 and 2024. Immunohistochemistry (IHC) for β-catenin was performed, with scoring specifically targeting nuclear and cytoplasmic reactivity (excluding physiological membranous staining) using the Allred system. Clinicopathological variables, including TNM staging (AJCC 8th edition), were analyzed. Survival analysis utilized Kaplan-Meier curves and multivariate Cox Proportional Hazards regression. Results: The cohort exhibited advanced disease, with 81.8% of patients presenting at Stage III or IV. Nuclear β-catenin overexpression (moderate-to-strong) was observed in 97.7% of cases. Strong nuclear expression was significantly associated with advanced T-stage (p=0.032) and distant metastasis (p=0.045). Kaplan-Meier analysis revealed a significant reduction in 5-year overall survival for the strong expression group (0%) compared to the weak/moderate group (p < 0.001). In multivariate analysis adjusted for age and TNM stage, strong β-catenin expression remained a significant predictor of mortality (Hazard Ratio: 2.15; 95% CI: 1.05–4.42; p=0.036), alongside Stage IV disease. Conclusion: Nuclear accumulation of β-catenin is a prevalent molecular event in Indonesian NPC and serves as a significant prognostic biomarker independent of tumor stage. These findings suggest potential utility for risk stratification and targeted Wnt-inhibitor therapies.
Platelet-Rich Plasma (PRP) Allogenic: A Potential Challenge for Decreasing Random Blood Glucose, Uric Acid, and Cholesterol Levels in A Preliminary Pre and Post Test Study on Adult Subjects Diah Hastuti; Awal Prasetyo; Anzhari, Della Hashfi; Resti Ariani; Mutia Syafira; Anna Kartika Yuli Astuti; Rina Puspita
EKSAKTA: Berkala Ilmiah Bidang MIPA Vol. 27 No. 01 (2026): Eksakta : Berkala Ilmiah Bidang MIPA (E-ISSN : 2549-7464)
Publisher : Faculty of Mathematics and Natural Sciences (FMIPA), Universitas Negeri Padang, Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24036/eksakta/vol27-iss01/643

Abstract

Ideally, metabolic homeostasis is maintained through stable glucose regulation, balanced lipid metabolism, and effective uric acid clearance under conditions of minimal systemic inflammation. In real clinical conditions, aging and persistent low-grade inflammation frequently disrupt this balance, leading to hyperglycemia, dyslipidemia, and elevated uric acid levels. Current pharmacological management mainly emphasizes metabolic control and may not sufficiently address underlying tissue dysfunction or inflammatory processes. Platelet-rich plasma (PRP) is a blood-derived bioregenerative product containing growth factors with anti-inflammatory and regenerative properties, offering a potential supportive approach for metabolic regulation. Nevertheless, PRP administration has predominantly relied on invasive delivery methods. Nebulization provides a non-invasive pulmonary route that enables rapid systemic absorption, representing an alternative delivery strategy. Despite its potential advantages, clinical evidence regarding the metabolic effects of PRP delivered via nebulization remains limited, creating an urgent need for preliminary clinical evaluation. Therefore, this pre–post test study aimed to assess the effects of allogeneic PRP nebulization on random blood glucose, uric acid, and total cholesterol levels. Fourteen adult subjects received PRP nebulization for five consecutive days. The intervention resulted in a significant reduction in random blood glucose levels and mild decreasing trends in uric acid and total cholesterol without serious adverse events.
The Effects of Kretek Cigarettes and Ascorbic Acid-based Vape on IL-6, TNF-α Levels, and Pulmonary Histopathology: An Experimental Study on White Rats (Rattus novergicus) on Inflammatory Response and Pulmonary Histopathology Maftikhati, Dora; Prasetyo, Awal; Sadhana, Udadi; Istiadi, Hermawan
Diponegoro International Medical Journal Vol 6, No 2 (2025): December 2025
Publisher : Faculty of Medicine, Diponegoro University

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.14710/dimj.v6i2.29825

Abstract

Background: Smoking habits remain difficult to break, with 991 million smokers worldwide in 2020. Many have switched to vaping, which is regarded as safer than clove cigarettes. Exposure to cigarette smoke can increase pro-inflammatory cytokines and damage lung tissue.Objective: This study compared the effects of kretek cigarette smoke and ascorbic acid-based vape smoke on inflammatory response and lung tissue in male white rats (Rattus norvegicus).Methods: Twenty-one 8-week-old rats were randomized into three groups: control, exposed to kretek cigarette smoke, and exposed to ascorbic acid-based vape. The kretek cigarette group was exposed to smoke from 3 cigarettes/day, while the vape group received 0.5 ml/day of vape smoke, for 12 weeks. Interleukin-6 (IL-6) and Tumor Necrosis Factor-alpha (TNF-α) levels were analyzed using ELISA. The perimeter length of the alveolus, the degree of alveolar wall damage, and the extent of inflammatory cell distribution were also examined. Statistical analyses were accomplished using the ANOVA One-Way test, chi square test, and Kruskal-Wallis test.Results: Cigarette exposure significantly increased IL-6 levels (control: 8.43 ± 0.88 pg/ml; kretek cigarette: 11.45 ± 1.17 pg/ml; ascorbic acid vape: 11.83 ± 1.56 pg/ml; p = 0.000), the degree of alveolar damage (mean rank control: 6.21; kretek cigarette: 14.17; ascorbic acid vape: 11.64; p = 0.001), and the extent of inflammatory cell distribution (mean rank control: 4.00; kretek cigarette: 15.25; ascorbic acid vape: 12.93; p = 0.012). TNF-α levels increased in the kretek cigarette group, while the alveolar perimeter length increased in the ascorbic acid vape group; however, neither parameter was statistically significant (p > 0.05).Conclusion: Both kretek cigarette smoke and ascorbic acid-based vape smoke induced pulmonary inflammation and structural changes, with significant effects observed in IL-6 levels and histopathological damage, but not in TNF-α levels or alveolar perimeter length. There is a need for better regulation and increased public awareness about the dangers of smoking.
The Development of Wellness Tourism in Curug Wadas Malang, Mangkang, Semarang Hendro Prabowo; Awal Prasetyo; Yovhandra Ockta
Jurnal Penelitian Pendidikan IPA Vol 10 No SpecialIssue (2024): Science Education, Ecotourism, Health Science
Publisher : Postgraduate, University of Mataram

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.29303/jppipa.v10iSpecialIssue.9089

Abstract

The research aims to develop Curug Wadas Malang in Mangkang as a wellness tourism destination within Semarang City. Utilizing field research, the study involved direct observation and interaction with individuals in their natural environment, as outlined by Sugiyono (2018). Observations were conducted in the Curug Wadas Malang forest area, alongside interviews with forest rangers, local residents, and Indonesian Red Cross (PMI) officers. This dual approach of simultaneous observations and interviews facilitated comprehensive data collection.In addition to fieldwork, a thorough literature review was undertaken to explore existing health tourism examples that incorporate natural elements such as forests, rivers, and waterfalls. The data gathered from both the literature and field research were thematically analyzed following the methodology proposed by Braun, Clarke & Hayfield (2022). The analysis revealed four key themes: the potential for wellness tourism at Curug Wadas Malang, the advantages of integrating forest, river, and waterfall elements in wellness tourism, a case study of Hoshinoya Karuizawa in Japan, and another case study from Kaua'i in Hawaii.The findings indicate that Curug Wadas Malang possesses significant natural resources and social capital through Community-Based Disaster Preparedness (CBDP) initiatives led by local communities. Therefore, a community-based tourism approach is recommended. This strategy emphasizes involving local populations in planning and implementing health tourism initiatives, enhancing disaster preparedness efforts while promoting sustainable tourism that benefits the community economically and socially
Co-Authors - Anggorowati Adhi Setradian Anto Maria Aditya Purnama Agus Subagio Ahmad Hamim Sadewa Albertus Ari Adrianto Alendra Chakramurty Alfin Ihza Trimahendra Amira Naufal Andreas Arie Setiawan, Andreas Arie Anisa Ell Raharyani Anna Jumatul Laely Anna Kartika Yuli Astuti Antari, Arlita Leniseptaria Anzhari, Della Hashfi Apriana, Ledisda Ariani, Resti Arthur Lelono Arum Kartikadewi Asri, Hairul Astika Widy Utomo Astuti, Meira Dewi Kusuma Ayu Aksara Bagus Ropyanto, Chandra Bambang Endro Putranto Bambang Hariwiyanto Cahyono Hadi Cahyono Hadi Chandra Bagus Ropyanto Dadi Hamdani Darryl Samuel Salim Devia Eka Listiana Devia Eka Listiana, Devia Eka Dewi Kartikawati Paramita Diah Hastuti Dik Puspasari Dik Puspasari Dik Puspasari, Dik Djaswadi Dasuki Djaswadi Dasuki Em Sutrisna Eriawan Agung Nugroho Gufron, Ahmad Halim, Fenny Hendro Prabowo Hermawan Istiadi Hermawan Istiadi Heru Suwardianto Hidayat Sulistyo Hidayat Sulistyo Ika Pawitra Miranti Ika Pawitra Miranti Indah Saraswati Indwiani Astuti Indwiani Astuti Jeffrey Eka Wijaya Jessica Christanti Jumatul Laely, Anna K. Heri Nugroho HS, K. Heri Karlowee, Vega Kenty Wantri Anita, Kenty Wantri Khasan Rowi Kurniawan, Eirin Yovita Kusmiyati Tjahjono Kusmiyati Tjahjono Lisyani Budipradigdo Maftikhati, Dora Meira Dewi Kusuma Astuti Mentari, Alfitra Akbar Bara Mentari Mochamad Ali Sobirin Mohammad Hakimi Muniroh, Muflihatul Mutia Syafira Muzakar Isa Nani Maharani Neni Susilaningsih Nur, Rizki Widya Nurhayadi, Tommy Nurjaya Adinugroho Nurkholis, Fathur Puspita`, Rina Putra, Dominikus Evano Rahajeng, Herera Redyaksa Drestanta Ariandoko Reni Sulung Utami Resti Ariani Rina Puspita Sarinti Sarinti Sarinti, Sarinti Selvia David Richard Siahaan, Johanna Soenarto Sastrowijoto Sony Noegroho Sri Jumini Stefani Candra Firmanti Su, Hansen Maikel Sugiri, Sugiri Suhartini Ismail, Suhartini Taufiq R Nasihun Taufiq, Heydar Ruffa Tjahjono Tjahjono Tjahjono Tri Nur Kristina Udadi Sadhana Udadi Sadhana, Udadi Vega Karlowee Veni, Rizka Wahyu Haris Prabowo Wahyuningsih, Indah S Wiratno Wiratno Yovhandra Ockta Yuriz Bakhtiar Yusuf, Franky