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All Journal Medical Journal of Indonesia Paediatrica Indonesiana Majalah Patologi Indonesia Narra J Makara Journal of Health Research Proceedings Book of International Conference and Exhibition on The Indonesian Medical Education and Research Institute
Lisnawati Rachmadi
Department Of Anatomical Pathology, Faculty Of Medicine, Universitas Indonesia, Cipto Mangunkusumo Hospital
Biochemistry, Genetics & Molecular Biology Health Professions Immunology & microbiology Medicine & Pharmacology Neuroscience Public Health

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Journal : Narra J

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Effect of the modified Atkins diet on NLRP3, caspase-1, IL-1β, and IL-10 in patients with tetralogy of Fallot undergoing open-heart surgery: A randomized controlled trial Yanuarso, Piprim B.; Djer, Mulyadi M.; Hendarto, Aryono; Pudjiadi, Antonius H.; Rachmadi, Lisnawati; Wibowo, Heri; Advani, Najib; Murni, Indah K.; Kekalih, Aria; Sukardi, Rubiana; Dilawar, Ismail; Susanti, Dhama S.; Supriatna, Novianti
Narra J Vol. 5 No. 1 (2025): April 2025
Publisher : Narra Sains Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.52225/narra.v5i1.2138

Abstract

Cardiopulmonary bypass in tetralogy of Fallot (TOF) corrective surgery induces hyperinflammation by activating NLRP3, caspase-1, and interleukin-1β (IL-1β), subsequently triggering an interleukin-10 (IL-10) response. Despite its known metabolic and anti-inflammatory effects, the impact of the modified Atkins diet (MAD) in pediatric cardiac surgery remains unexplored, with no studies on its use in TOF patients undergoing open-heart surgery. The aim of this study was to assess the effect of MAD on the expression of NLRP3, caspase-1, IL-1β, and IL-10, in TOF patients undergoing open-heart surgery. A double-arm, randomized-controlled trial was conducted with 44 TOF patients. The treatment group (n=22) received the MAD, a low-carbohydrate, high-fat regimen with unrestricted fat and protein intake for at least 14 days preoperatively, while the control group (n=22) followed a standard diet without carbohydrate restriction. Blood plasma and infundibulum heart tissues were collected for analysis. Whole blood samples were collected using a winged infusion needle before the intervention, an Abbocath infusion needle after 14 days of intervention, and a syringe without a needle connected to an arterial line in patients undergoing open-heart surgery at 6, 24, and 48 hours post-surgical correction. Infundibulum heart tissues were collected during the open-heart surgery. This study demonstrated significant differences in NLRP3 protein expression (p=0.015), caspase-1 protein expression (p=0.001), and IL-10 levels between before intervention and 6-, 24-, and 48-hours post-surgery in the MAD group compared to the control group. In contrast, no significant differences in IL-10 levels were observed in the control group between before intervention and 48 hours post-surgery (p=0.654). In conclusion, MAD may modulate perioperative inflammation in TOF patients undergoing open-heart surgery by downregulating NLRP3 and caspase-1 expression while sustaining IL-10 levels. Despite reduced NLRP3 and caspase-1 expression, unchanged IL-1β levels indicate alternative regulatory mechanisms.
Spectrum of rare EGFR mutations in Indonesian lung adenocarcinoma: Findings from an 8-year analysis of 4,778 cases highlighting the need for advanced targeted therapies Heriyanto, Didik S.; Trisnawati, Ika; Rachmadi, Lisnawati; Tenggara, Jeffry B.; Lau, Vincent; Gunawan, Andrew N.; Halim, Brigitta N.; Yuliani, Fara S.; Laiman, Vincent; Gondhowiardjo, Soehartati; Chuang, Hsiao-Chi
Narra J Vol. 5 No. 2 (2025): August 2025
Publisher : Narra Sains Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.52225/narra.v5i2.1721

Abstract

Lung cancer patients in Indonesia exhibit a high prevalence of epidermal growth factor receptor (EGFR) mutations, with a substantial proportion attributed to rare or uncommon variants. The clinical significance of rare EGFR mutations lies in their differential sensitivity to tyrosine kinase inhibitors (TKIs). While they are frequently resistant to first- and second- generation TKIs, they often respond to third-generation TKIs, necessitating tailored treatment options. The need for improving access to advanced targeted therapies in Indonesia also highlights the importance of conducting research on rare EGFR mutations. The aim of this study was to identify the spectrum and frequency of EGFR mutations in patients with lung adenocarcinoma in Indonesia. A cross-sectional observational study with total sampling was conducted from January 2016 to April 2024 to investigate EGFR mutation profiles in lung adenocarcinoma patients. Samples were acquired from patients with a confirmed anatomical pathology diagnosis from various healthcare centers across Indonesia. A total of 4,778 samples were analyzed using real-time quantitative polymerase chain reaction (RT-qPCR) on various specimen types to determine EGFR mutation prevalence and patterns. Associations between demographic data and EGFR mutation status were assessed. EGFR mutations were detected in 54.6% of samples, with common mutations (exon 19 deletions/insertions and point mutation L858R) comprising 76.2% of positive cases and rare mutations (exon 20 insertions, point mutation G719X, S768I, T790M, and L861Q) accounted for 20.3%. Significant associations were found between geographic origin, age, and sex with EGFR mutation status. This study confirms substantial genetic variability and geographical differences in EGFR mutations among Indonesian lung adenocarcinoma patients, emphasizing the urgent need for further research to prompt enhanced molecular diagnostics and targeted therapies in the region.
Co-Authors Abror Irsan Agus Setiyono Andi Yasmon Anna Rozaliyani Antonius H. Pudjiadi Aria Kekalih Aryono Hendarto Astrid E Greijer Billianti, Yayi Dwina Chuang, Hsiao-Chi Cleopas Martin Rumende David Sitinjak Diana Natalia Diana Natalia Dilawar, Ismail Djajadiman Gatot Djatikusumo, Ari Dwi Wulandari Effiana Effiana Effiana, Effiana Gede Wirya Kusuma Duarsa Gunawan, Andrew N. Halim, Brigitta N. Harry Isbagio Heri Wibowo Heriyanto, Didik S. I Bing Tan Ika Trisnawati, Ika Ikhwan Rinaldi Irfan Wahyudi Jaap M Middeldorp Junita Indarti Kusumowidagdo, Gladys Laiman, Vincent Lau, Vincent Linggodigdo, Michelle Lukman Edwar Mardhia, Mardhia Mardhia, Mardhia Mardianto, Umar Maria Mayella Vianney Marlinda Adham Mulyadi M. Djer Murni, Indah K. Najib Advani Namira Kesuma Jelita Nyoman Kertia Piprim B. Yanuarso, Piprim B. Ponco Birowo Raharja, Putu Angga Risky Rianto Setiabudy Rubiana Sukardi, Rubiana Sari Rahmayanti Sitinjak, David Soehartati Argadikoesoema Gondhowiardjo Soehartati Gondhowiardjo Supriatna, Novianti Susanti, Dhama S. Tenggara, Jeffry B. Tjahjani M. Sudiro Wibowo, Suryo Anggoro Kusumo Yayi Dwina Billianti Yudantha, Anggun R. Yuliani, Fara S.