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Efek vitamin D terhadap kadar IL-10, IFN-γ, dan histamin pada kultur PBMC pasien rinitis alergi Utama, Budi; Wibowo, Heri; Poerbonegoro, Niken Lestari
Oto Rhino Laryngologica Indonesiana Vol 47, No 2 (2017): Volume 47, No. 2 July - December 2017
Publisher : PERHATI-KL

Latar belakang: Rinitis alergi (RA) adalah penyakit inflamasi pada hidung, yang disebabkan oleh reaksi alergi pada pasien atopi. Tungau debu rumah merupakan aeroalergen yang tersering memicu reaksi alergi. Pada tahun 1988, reseptor vitamin D berhasil dilakukan klon. Reseptor vitamin D berlokasi di beberapa jaringan dan sel tubuh manusia, termasuk di sel-sel darah tepi berinti tunggal (peripheral blood mononuclear cells/PMBC). Tujuan: Mengidentifikasi pengaruh pemberian vitamin D pada sel-sel darah tepi berinti tunggal penderita rinitis alergi terhadap sel Th1, Th2, dan T Regulator, dengan cara melihat sekresi IFN-γ, IL-10, dan histamin. Metode: Sampel berupa darah segar (whole blood) penderita rinitis alergi yang telah dilakukan prick test, diolah dengan metode Ficoll untuk mengisolasi sel berinti tunggal. Kultur sel limfosit sebelum perlakuan dibagi menjadi kelompok yang diberi pendedahan dengan 1,25(OH)2D3 100 nM dan tanpa pendedahan, waktu inkubasi 7 hari, dengan penambahan phytohaemaglutinin dan alergen tungau pada hari ke-4. Kultur sel-sel darah tepi berinti tunggal dari pasien RA setelah perlakuan, selanjutnya pada hari ke-7 supernatannya diambil dan dibagi untuk diukur kadar sitokin IFN-γ, IL-10, dan histamin secara ELISA. Dilakukan uji secara statistik untuk melihat pola dari tiap parameter. Hasil: Pemberian alergen tungau tanpa vitamin D menyebabkan meningkatnya kadar histamin serta menurunkan kadar IL-10 dan IFN-γ. Pemberian vitamin D pada kultur sel darah tepi berinti tunggal yang telah diberi alergen tungau, dapat meningkatkan kadar IL-10 dan menurunkan kadar IFN-γ, serta histamin. Kesimpulan: Menurunnya kadar histamin dan IFN-γ terhadap stimulasi alergen tungau pada pasien rinitis alergi yang diberi vitamin D cenderung berhubungan dengan meningkatnya kadar IL-10. Kata kunci: Sel mast, rinitis alergi, tungau debu rumah, vitamin D ABSTRACT Background: Allergic rhinitis is an inflammatory disease of the nose, caused by an allergic reaction in atopic patients. House dust mites are the most common aeroalergen. In 1988, vitamin D receptor had been cloned successfully. Vitamin D receptors are located in various tissues and human body cells, including peripheral blood mononuclear cells (PBMCs). Purpose: To identify the effect of vitamin D on peripheral blood mononuclear cells culture of allergic rhinitis patients towards Th1, Th2, and T Regulator cell, by identifying IL-10, IFN-γ, and histamine secretion levels. Method: The sample were obtained from fresh blood (whole blood) of allergic rhinitis patients who had been prick tested, and isolated by Ficoll method. Pre-treated lymphocyte culture divided into groups treated with and without 1,25(OH)2D3 100 nM, and incubated for 7 days, with addition of phytohaemaglutinin and allergen mites on day 4. Cultures of PBMC cells after treatment were harvested on day 7, then the supernatant was dialyzed to measure the levels of IFN-γ IL-10 and histamine cytokines. Statistical test was performed to identify patterns of each parameter. Results: Treatment of allergen mites without vitamin D could increase levels of histamine and lower levels of IL-10 and IFN-γ. Provision of vitamin D in PBMC cell culture that had been given allergen mites could increase levels of IL-10 and decreased levels of IFN-γ and histamine. Conclusion: Lower levels of histamine and IFN-γ against allergen mite stimulation of allergic rhinitis patients who were given vitamin D tend to be associated with increased IL-10 levels. Keywords: Mast cell, allergic rhinitis, house dust mite, vitamin D

Dampak poliposis hidung terhadap fungsi ventilasi paru Poerbonegoro, Niken Lestari; Wardani, Retno Sulistyo; Dharmabakti, Umar Said; Rumende, Martin; Kusumayati, Agustin
Oto Rhino Laryngologica Indonesiana Vol 40, No 2 (2010): Volume 40, No. 2 July - December 2010
Publisher : PERHATI-KL

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.32637/orli.v40i2.4

Background: Correlation between upper and lower airway always been an interesting topic in thepast decades, showed by the emerging of “one airway one disease” concept. Nasal polyposis is a chronicinflammatory disease of the upper respiratory tract mucosa. How nasal polyposis affects or relates to thelower respiratory tract is still debatable. Purpose: to evaluate the impact of nasal polyposis on the lowerrespiratory function.Methods: This study was done in the ENT Department and Pulmonology - InternalMedicine Department Cipto Mangunkusumo Hospital from March to December 2003. It was a comparativecross-sectional study between polyposis group and non-polyposis group, with 29 subjects each. Subjectsunderwent skin prick test and spirometry examinations. Vital capacity (VC), forced expiratory volumeat the first one second (FEV1) and FEV1Dampak poliposis hidung terhadap fungsi ventilasi paru1/VC ratio values were gathered. Statistic calculations performed using independents t-test and Pearson chi-square.Results: Spirometry datas showed VC %prediction andFEV%prediction values in nasal polyposis group were lower than in non-polyposis group (68.33% and62.36% vs 78.66% and 70.65%, p < 0.05), but not significant for FEV1061 /VC ratio score (83.88 vs 83.18,p > 0.05). Patterns of lung ventilatory function, the percentage of lung ventilatory function disorderbetween the polyposis group and the control group is significantly different (58.7% vs 31%, p< 0.05).Using 2x2 table calculation, prevalence ratio was 1.9 (CI 95% 0.002-0.498).Conclusion: Polyposisgroup showed significant lower values of VC % prediction and FEV1 1% prediction. Percentage of lungventilatory function disorder in polyposis group is significantly higher than control.Keywords: nasal polyposis, lung ventilatory function, spirometry, VC, FEV Abstrak : Latar belakang: Beberapa dekade terakhir ini hubungan antara saluran napas atas dan bawah tetaphangat dibicarakan, ditandai dengan munculnya konsep “one airway one disease”. Poliposis hidungmerupakan keadaan inflamasi kronis mukosa saluran napas atas. Bagaimana kaitan poliposis hidungdengan saluran napas bawah sampai saat ini masih dipertanyakan. Tujuan: Mengetahui dampakpoliposis hidung terhadap fungsi ventilasi paru. Metode: Desain studi adalah potong lintang komparatifantara kelompok penderita poliposis hidung dan kelompok tanpa poliposis hidung. Jumlah percontohsetiap kelompok sebesar 29 orang. Dilakukan tes cukit kulit dan pemeriksaan spirometri untuk menilaifungsi ventilasi paru. Nilai persentase prediksi kapasitas vital paksa (KVP), volume ekspirasi paksa detikpertama (VEP1), dan rasio VEP/KVP dicatat. Perhitungan statistik dilakukan dengan uji t-independendan Pearson chi-square. Hasil: Hasil spirometri memperlihatkan nilai rerata % prediksi KVP dan nilairerata % prediksi VEP1 1 kelompok penderita poliposis hidung lebih rendah dari kelompok tanpa poliposishidung (68,33% dan 62,36% banding 78,66% dan 70,65%; p< 0,05). Nilai rasio VEP/KVP kelompokpasien poliposis hidung sedikit lebih tinggi dari kelompok tanpa poliposis hidung (83,88 banding 83,18;p>0,05). Data gambaran fungsi ventilasi paru memperlihatkan perbedaan yang bermakna pada proporsigangguan fungsi ventilasi paru antara kedua kelompok (58,7% dan 31%, p<0,05). Dengan perhitungantabel 2x2 didapatkan rasio prevalens sebesar 1,9 (IK 95% 0,002-0,498).Kesimpulan: kelompok denganpoliposis hidung memperlihatkan penurunan bermakna nilai % prediksi KVP dan % prediksi VEP, namunrasio VEP/KVP tidak menurun. Proporsi gangguan fungsi ventilasi paru pada kelompok poliposis hidunglebih besar daripada kelompok tanpa poliposis hidung.1Kata kunci: poliposis hidung, fungsi ventilasi paru, spirometri, KVP, VEP

Perubahan kualitas hidup, eosinofil mukosa hidung, dan interleukin-5 serum pasien rinitis alergi pasca terapi Arinda Putri Pitarini; Nina Irawati; Niken Lestari Poerbonegoro; Dewi Wulandari; Saptawati Badarsono
Oto Rhino Laryngologica Indonesiana Vol 45, No 2 (2015): Volume 45, No. 2 July - December 2015
Publisher : PERHATI-KL

Latar belakang: Rinitis alergi adalah suatu penyakit inflamasi pada hidung yang dimediasi oleh imunoglobulin-E, yang terjadi setelah mukosa hidung terpajan alergen. Sel dan mediator inflamasi yang berperan penting adalah eosinofil, histamin, dan sitokin produk Th2. Penyakit ini ditandai dengan gejala rinorea, bersin berulang, hidung tersumbat dan/atau hidung gatal. Selain dari gejala yang mengganggu, rinitis alergi berdampak buruk terhadap kualitas hidup penderita. Tatalaksana komprehensif, meliputi penghindaran alergen, farmakoterapi, imunoterapi dan edukasi, ditujukan untuk menghilangkan gejala dan memperbaiki kualitas hidup pasien. Tujuan: Mengetahui perubahan kualitas hidup, jumlah eosinofil mukosa hidung, dan kadar IL-5 serum pada pasien rinitis alergi setelah mendapat terapi farmaka sesuai panduan. Metode: Penelitian ini merupakan studi pre-eksperimental analitik dengan pengambilan data sebelum dan sesudah pemberian farmakoterapi. Hasil: Sebanyak 31 dari 33 subjek mengalami perubahan kualitas hidup yang bermakna (MID>0,7). Seluruh pasien, 33 subjek memperlihatkan perubahan yang responsif dari jumlah eosinofil mukosa hidung. Sebanyak 30 subjek dinyatakan responsif dan terdapat penurunan kadar IL-5. Tidak ada hubungan yang bermakna antara perubahan kualitas hidup dan kadar IL-5. Kesimpulan: Perubahan kualitas hidup, jumlah eosinofil mukosa hidung, dan kadar IL-5 serum dapat digunakan sebagai penanda objektif keberhasilan terapi rinitis alergi yang dapat dipakai dalam praktik klinis sehari-hari maupun kepentingan riset. Kata kunci: rinitis alergi, kualitas hidup, eosinofil, interleukin-5ABSTRACT Background: Allergic rhinitis defined as an inflammatory disease of the nose mediated by immunoglobulin-E, induced after nasal mucosa exposure to allergen. Important inflammatory cells and mediators are eosinophils, histamine, and Th2-related cytokines. Symptoms include rhinorrhea, repeated sneezing, nasal congestion and/or nasal itching. Aside from its bothersome symptoms, allergic rhinitis decreases patient’s quality of life (QOL). Comprehensive management consist of allergen avoidance, medication, immunotherapy, and education, aimed to diminish symptoms and improve the patient’s quality of life. Purpose: To evaluate changes in quality of life, nasal mucosal eosinophil count, and level of interleukin-5 in allergic rhinitis after medicamentous treatment. Methods: This was an analytic pre-experimental study with data taken before and after medicamentous treatment. Results: Thirty-one of 33 subjects showed significant changes of QOL (MID>0,7). All samples, 33 subjects, experienced responsive changes in nasal mucosal eosinophil count. Thirty subjects were responsive, which showed decrease of IL-5 level. There was no significant relation between changes of QOL and changes of IL-5 level. Conclusion: Changes in quality of life, nasal mucosal eosinophil count, and IL-5 level are objective markers of treatment efficacy in Allergic Rhinitis, which can be used in clinical practices and researches. Keywords: allergic rhinitis, quality of life, eosinophil, interleukin-5, intranasal steroid, antihistamine

Gambaran fungsi penghidu dengan Sniffin’ sticks pada pasien rinitis alergi Nurul Endah Ardianti; Nina Irawati; Niken Lestari Poerbonegoro; Saptawati Bardosono
Oto Rhino Laryngologica Indonesiana Vol 42, No 2 (2012): Volume 42, No. 2 July - December 2012
Publisher : PERHATI-KL

Background: Allergic rhinitis (AR) is defined as an inflammation of the lining mucosa of the nose induced by allergen exposure. The olfactory disturbance could affect around 21%-23% of AR patients.Purpose: To determine the olfactory performance of AR patients at the Allergy-Immunology outpatientclinic, ENT Department, Cipto Mangunkusumo Hospital. To find out the mean difference of olfactorythreshold, discrimination, and identification (TDI) score between intermittent AR group and persistent ARgroup, and also to determine the percentage of the AR patient who had olfactory disturbance. Method:Observational descriptive study with cross sectional method to assess the TDI in AR patients using theSniffin’ sticks extended test. Results: The olfactory performance characteristics of AR patients were:threshold score 0,25; discrimination score 7,00; identification score 10,10; TDI score 23,50. There wasno statistical difference of the TDI mean score between intermittent AR group and persistent AR group.In our study, 45% of all AR subjects were reported to have olfactory disturbance. Conclusion: The TDIresults which represent olfactory function of AR patients were lower compared to the healthy subjects. Key words: allergic rhinitis, olfactory function, Sniffin’ sticks Abstrak : Latar belakang: Rinitis alergi (RA) adalah penyakit inflamasi mukosa hidung akibat pajanan terhadap suatu alergen. Sekitar 21% sampai 23% pasien RA dapat mengalami gangguan penghidu. Tujuan: Mengetahui gambaran fungsi penghidu pada pasien rinitis alergi (RA). Menentukan perbedaan rerata nilai ambang, diskriminasi dan identifikasi (ADI) pada pasien RA intermiten dan persisten, dan mengetahui persentase pasien RA dengan gangguan fungsi penghidu di poliklinik Divisi Alergi-Imunologi, Departemen THT RSCM. Metode: Penelitian observasional dengan metode potong lintang untuk menilai ADI penghidu pada percontoh RA menggunakan pemeriksaan Sniffin’ sticks extended test. Hasil: Didapati karakteristik fungsi penghidu percontoh RA ambang 0,25; diskriminasi 7,00; identifikasi 10,10; nilai ADI 23,50. Tidak didapatkan perbedaan bermakna rerata nilai ADI antara kelompok rinitis alergi persisten dan intermiten. Diperoleh 45% dari seluruh percontoh RA mengalami gangguan fungsi penghidu. Kesimpulan: Nilai ADI yang merupakan fungsi penghidu pasien RA lebih rendah dibandingkan dengan subjek sehat. Kata kunci: rinitis alergi, fungsi penghidu, Sniffin’ sticks

Association between dust particulate and occupational rhinitis among basement parking lot workers in Jakarta Niken Lestari Poerbonegoro; Setyawati Budiningsih; Rina Metalapa
Oto Rhino Laryngologica Indonesiana Vol 48, No 2 (2018): Volume 48, No. 2 July - December 2018
Publisher : PERHATI-KL

Background: Jakarta municipal government estimates that at least 70% of Jakarta air pollution comes from traffic and vehicles. The prevalence of occupational rhinitis increases in such polluted environment. History of atopic disease and smoking habit might aggravate this condition. Purpose: To determine the association between dust particulate matter exposure and occupational rhinitis among basement parking lot workers in Jakarta. Methods: A cross-sectional study was performed on 57 workers from December 2014 until March 2015. Questionnaires on nasal symptoms and eosinophil counts by nasal mucosal scrapings were collected before and after working-hours to evaluate occupational rhinitis. Level of dust particulate matter was measured using high volume air sampler, and calculated by gravimetric method. Results: Three workers were diagnosed with occupational rhinitis (5.2%). Level of dust particulate matter was below permitted level in studied basement parking lots. There was no significant association between occupational rhinitis and working period (OR 0.5 [95% CI 0.43 to 5.85], p=1.000) and workplace (OR 435 [95%CI =0.37-51.37], p=0.255). Increased eosinophil level was associated with the history of atopic disease (OR 23.33 [95%CI=2.40-224.62], p=0.001but not associated with smoking habit (OR 0.13 [95%CI=0.22-7.71], p=0.575). Conclusion: There was no significant association between dust particulate matter exposure and occupational rhinitis among basement parking lot workers. Despite the low level of dust particulate matter exposure, occupational rhinitis did occur. Latar Belakang: Pemerintah DKI Jakarta memperkirakan sekitar 70% polusi udara di Jakarta berasal dari lalu lintas dan kendaraan bermotor. Prevalensi Rinitis Akibat Kerja (RAK) cenderung meningkat pada lingkungan berpolusi. Riwayat atopi dan kebiasaan merokok dapat memperberat penyakit tersebut. Tujuan: mengetahui hubungan pajanan partikulat debu terhadap RAK pada pekerja area parkir basement di Jakarta. Metode: Studi potong lintang dilakukan terhadap 57 pekerja dari Desember 2014 sampai Maret 2015. Pengisian kuesioner gejala hidung dan hitung jumlah eosinofil kerokan mukosa hidung dilakukan sebelum dan sesudah jam kerja untuk evaluasi RAK. Kadar partikulat debu diukur dengan High Volume Air Sampler lalu dikalkulasi dengan metode gravimetrik. Hasil: Didapatkan 3 orang pekerja dengan diagnosis RAK (5,2%). Kadar pajanan partikulat debu di lokasi studi dibawah nilai ambang batas yang diizinkan. Tidak terdapat hubungan bermakna antara RAK dengan lama bekerja (OR 0,5 [95% CI 0,43- 5,85], p=1,000) dan tempat kerja (OR 435 [95%CI=0,37-51,37], p=0,255). Terdapat hubungan yang bermakna antara peningkatan kadar eosinofil dan riwayat atopi (OR 23,33 [95%CI=2,40-224,62], p=0,001), tetapi hubungan tidak bermakna ditemukan antara peningkatan kadar eosinophil dan kebiasaan merokok (OR 0,13 [95% CI=0,22-7,71], p=0.575). Kesimpulan: Tidak terdapat hubungan bermakna antara pajanan partikulat debu dan RAK pada pekerja area parkir basement. Pada kadar partikulat debu rendah, ternyata ditemukan pekerja dengan RAK.

Accuracy of Centor scoring system in diagnosing group a-beta haemolytic streptococcal (GABHS) infection Niken Lestari Poerbonegoro; Joanna Erin Hanrahan; Indira Amelia; Viharsyah Aulia Akbar; Raditya Putra Djohan; Ika Dwi Mayangsari; Dini Widiarni Widodo
Oto Rhino Laryngologica Indonesiana Vol 52, No 1 (2022): VOLUME 52, NO. 1 JANUARY - JUNE 2022
Publisher : PERHATI-KL

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.32637/orli.v52i1.430

ABSTRACTBackground: At present, the standard examination for diagnosing streptococcal upper respiratory tract infection is throat culture. As throat culture is time-consuming and relatively expensive, efforts are made to develop certain criteria that will still lead to proper diagnosis and rational use of antibiotics, that is Centor score. Even so, the accuracy of Centor score is still debatable. Purpose: To provide evidence on the accuracy of Centor scoring system compared to throat culture in diagnosing GABHS upper respiratory tract infection. Case Report: A 25-years old male came to primary health care with primary complain of sore throat. Centor score was used to diagnose GABHS infection and as a guide to give antibiotics. Clinical question: “In patients with sore throat, how accurate is the Centor score compared to throat culture in diagnosing Group A Beta-Haemolytic Streptococcal (GABHS) Infection?” Methods: Literature searching was conducted through 4 databases. Critical appraisal based on the Centre of Evidence-Based Medicine (CEBM)-University of Oxford University, Diagnostic Critical Appraisal Sheet and Systematic Review Sheet. Results: All the selected studies were considered valid. They revealed a high specificity, low sensitivity, high negative predictive value (NPV), and low positive predictive value (PPV) in the importance aspect assessment. The Centor scoring system was applicable to our patient. It was available, affordable, and accurate in adult patients, yet less accurate in children. Conclusion: In conclusion,Patient with sore throat and suspicion of GABHS infection could be diagnosed with Centor scoring system as the first line diagnosis in primary care and as a guide to whether to give giving antibiotics or not.ABSTRAKLatar belakang: Saat ini, kultur tenggorok merupakan pemeriksaan baku emas yang digunakan untukmendiagnosis infeksi saluran napas atas yang disebabkan oleh bakteri Streptococcus. Namun, kulturtenggorok merupakan pemeriksaan yang mahal dan hasilnya memakan waktu yang lama, sehinggaberbagai kriteria dikeluarkan untuk dapat dipakai sebagai alat diagnostik dan sebagai panduanpenggunaan antibiotik yang rasional pada kasus infeksi saluran napas atas. Salah satunya yaitu Centorscore, tetapi akurasinya masih kontroversial. Tujuan: Menyediakan laporan kasus berbasis buktiterhadap akurasi dari Centor score sebagai alat diagnostik infeksi saluran napas atas yang disebabkanoleh bakteri Streptococcus dibandingkan dengan pemeriksaan kultur tenggorok. Laporan kasus: Seorang laki-laki berusia 25 tahun datang ke fasilitas kesehatan tingkat pertama dengan keluhan utama nyeri tenggorokan. Centor score digunakan untuk mendiagnosis pasien ini dan sebagai panduan pemberian antibiotik. Pertanyaan klinis: Pada pasien dengan radang tenggorok,seberapa akurat Centor score dibandingkan dengan kultur tenggorok dalam diagnosis GABHS? Metode: Pencarian literatur dilakukan melalui 4 database dan telaah kritis literatur menggunakan tilikan dari CEBM, University of Oxford University. Hasil: Seluruh studi yang ditelaah valid. Seluruh studi menunjukkan spesifisitas dan negative predictive value (NPV) yang tinggi, serta sensitivitas dan positive predictive value (PPV) yang rendah. Centor score dapat diaplikasikan untuk pasien pada skenario klinis karena bersifat mudah digunakan, biaya yang dikeluarkan terjangkau, dan akurat khususnya pada pasien dewasa. Kesimpulan: Pasien dengan nyeri tenggorok yang dicurigai memiliki infeksi saluran napas atas yang disebabkan oleh bakteri Streptococcus dapat ditegakkan diagnosisnya melalui penilaian Centor score di fasilitas layanan tingkat pertama, serta dapat menjadi panduan dalam pemberian antibiotik.

Comprehensive therapy in united airway disease: Evidence Based Case Report Nina Irawati; Elizabeth Vania; Niken Lestari Poerbonegoro; Raden Ayu Anatriera
Oto Rhino Laryngologica Indonesiana Vol 52, No 1 (2022): VOLUME 52, NO. 1 JANUARY - JUNE 2022
Publisher : PERHATI-KL

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.32637/orli.v52i1.548

ABSTRACTBackground: The concept of the united airway disease (UAD) recognises the association between allergic inflammation in the upper and lower airways. Patients with asthma and concomitant allergic rhinitis experience more asthma-related primary and secondary care visits. Purpose: To determine the best treatment option in the case of patients with asthma related allergic rhinitis, both in the control of nasal and pulmonary symptoms. Case report: A case case of 45 years old woman with asthma related to allergic rhinitis treated with combination of intranasal steroid and asthma therapy. Clinical question: In adult patient with allergic rhinitis related to asthma, does the combination of intranasal and inhaled steroids give better clinical improvement subjectively and objectively compared to monotherapy? Method: Literature search through two different databases (PubMed and Cochrane Library) and by searching the bibliography of articles to evaluate the outcome of combination therapy and monotherapy for the disease. Result: Two articles were found relevant with the topic fulfilled the requirements and relevant with the formulation or clinical question. Conclusion: Treating the inflammation associated with allergic rhinitis may have a true impact on the control of asthma, while the failure to treat rhinitis may impair asthma control.ABSTRAKLatar belakang: Konsep United Airway Disease (UAD) mengenali adanya hubungan antara inflamasi alergi pada saluran napas atas dan bawah. Pasien asma yang bersamaan dengan rinitis alergi melakukan lebih banyak kunjungan ke perawatan primer dan sekunder terkait asma. Tujuan: Menentukan pilihan pengobatan terbaik pada pasien dengan rinitis alergi terkait asma, baik dalam pengendalian keluhan hidung maupun paru. Laporan kasus: Satu kasus seorang wanita berusia 45 tahun dengan asma yang berhubungan dengan rinitis alergi. Metode: Mengumpulkan jurnal terkait dari dua database yang berbeda (PubMed dan Cochrane Library). Pencarian artikel juga dilakukan dengan mencari pada daftar pustaka artikel untuk mengevaluasi luaran dari terapi kombinasi dan terapi tunggal untuk penyakit ini. Pertanyaan klinis: Apakah terapi kombinasi dengan steroid intranasal dan steroid hirup dapat memberikan perbaikan lebih signifikan secara subjektif maupun objektif dibandingkan dengan terapi tunggal pada pasien dewasa dengan rinitis alergi dan asma? Hasil: Didapatkan dua artikel yang relevan dengan topik, sesuai dengan pertanyaan klinis serta memiliki penilaian kritis yang baik. Kesimpulan: Mengobati peradangan yang terkait dengan rinitis alergi dapat berdampak nyata pada pengendalian asma, sedangkan kegagalan untuk mengobati rinitis dapat mengganggu pengendalian asma.

Nasal and Sinus Diseases: Common Causes of Upper Airway Cough Syndrome Niken Lestari Poerbonegoro; Nina Irawati; Sonia Miyajima Anjani
eJournal Kedokteran Indonesia Vol 9, No. 3 - Desember 2021
Publisher : Faculty of Medicine Universitas Indonesia

Upper airway cough syndrome (UACS), previously known as post-nasal drip syndrome, is a persistent cough that lasts more than four weeks in children or more than eight weeks in adults, which is associated with nasal and sinus diseases, such as allergic rhinitis (AR), chronic rhinosinusitis (CRS), and adenoid hypertrophy (AH). UACS is one of the major causes of chronic cough. Several theories support the pathophysiology of chronic cough in UACS, namely post-nasal drip, airway inflammation, and sensory neural hypersensitivity theories. Persistent and excessive cough generates a deterioration in patient’s quality of life and social interaction. This review summarizes the knowledge on pathophysiology and underlying disease of UACS, aims to help clinicians identify and treat this syndrome.

Autonomic dysfunction in allergic rhinitis assessed by heart rate variability Irawati, Nina; Poerbonegoro, Niken Lestari; Azzahroh, Faiza; Hanrahan, Joanna Erin
Oto Rhino Laryngologica Indonesiana Vol. 55 No. 2 (2025): VOLUME 55, NO. 2 JULY - DECEMBER 2025
Publisher : PERHATI-KL

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.32637/orli.v55i2.745

Background: Allergic rhinitis is a chronic inflammatory condition of the nose mediated by IgE, characterized by symptoms such as nasal congestion, rhinorrhea, repeated sneezing, and nasal itching. Autonomic nervous system dysfunction is a significant factor in the pathophysiology of allergic rhinitis. Purpose: To evaluate autonomic nervous system dysfunction in allergic rhinitis patients using heart rate variability. Case report: A 28-year-old woman with allergic rhinitis who underwent heart rate variability testing, revealed increased parasympathetic nervous system activity. Method: The study involved a literature search through PubMed, EBSCO, Scopus, and ScienceDirect, with screening based on inclusion and exclusion criteria. The selected literatures were critically reviewed using the Oxford Centre for Evidence-based Medicine’s criteria for Etiology Studies. Result: Two cross-sectional studies were identified that matched the case report’s PICO and eligibility criteria. Those studies showed patterns of autonomic nervous system dysfunction, marked by increased parasympathetic and decreased sympathetic activity in allergic rhinitis patients. Conclusion: The findings suggested that autonomic nervous system dysfunction played a role in the pathophysiology of allergic rhinitis, as evidenced by changes in heart rate variability.

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