Tri Wahju Astuti
Department of Pulmonology and Respiratory Medicine, Faculty of Medicine, Universitas Brawijaya, Malang, Indonesia.

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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.
Elevated Serum Levels of Isoprostane and Glutathione in Waste Landfill Workers Ari Irawan; Tri Wahju Astuti; Fitri Indah Sari; Rezki Tantular; Sastia Rakhma
Jurnal Respirasi Vol. 12 No. 2 (2026): May 2026
Publisher : Faculty of Medicine Universitas Airlangga

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.20473/jr.v12-I.2.2026.116-125

Abstract

Introduction: Waste landfill workers are frequently exposed to air pollutants, bioaerosols, and heavy metals, which may induce oxidative stress. Biomarkers such as isoprostanes and glutathione can be used to assess oxidative stress and antioxidant responses associated with landfill exposure. Methods: This cross-sectional study included 68 landfill workers, categorized by exposure duration into <5 years, 5-10 years, and >10 years. Isoprostane and glutathione levels were measured using an enzyme-linked immunosorbent assay (ELISA) test. A one-way analysis of variance (ANOVA) and Spearman’s correlation were used to compare biomarker levels across exposure groups and assess the relationship between biomarker levels and exposure groups. Results: Landfill workers averaged 596.01 pg/mL isoprostane. This figure is higher than the normal range of 35±6 pg/mL. The average serum glutathione level was also higher than the normal range (16.44±3.85 ng/mL). Meanwhile, the participants’ average serum glutathione level was 45.96 ng/mL. Compared to those exposed for <5 years (533.09 pg/mL), workers exposed for >10 years had higher isoprostane levels (643.94 pg/mL) (p=0.001). Thus, there was a positive correlation between exposure duration and isoprostane (r=0.331, p=0.006). Similarly, glutathione levels were higher in workers with >10 years of exposure (49.00 ng/mL) than in those with <5 years of exposure (41.20 ng/mL) (p=0.026) and showed a positive correlation (r=0.322, p=0.007). Conclusion: Long-term exposure to landfills is associated with higher serum levels of isoprostane and glutathione. It increases the risk of oxidative stress and adaptive antioxidant responses.
Urine Lipoarabinomannan and Serum C-Reactive Protein for Pulmonary Tuberculosis: A Cross-Sectional Diagnostic Accuracy Study in a Tertiary Referral Hospital Fahnida Nazliah; Yani Jane Sugiri; Tri Wahju Astuti
Jurnal Respirasi Vol. 12 No. 3 (2026): September 2026
Publisher : Faculty of Medicine Universitas Airlangga

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.20473/jr.v12-I.3.2026.212-220

Abstract

Background: Rapid molecular tests are central to pulmonary tuberculosis (TB) diagnosis, yet sputum scarcity, pre-analytic barriers, and operational delays sustain diagnostic uncertainty in referral hospitals. Urine lipoarabinomannan (LAM) and serum C-reactive protein (CRP) may provide adjunctive, point-of-care signals, but head-to-head evidence in routine care remains limited. Methods: We conducted a cross-sectional diagnostic accuracy study in a tertiary referral hospital in Indonesia and reported according to STARD principles. Adults with suspected pulmonary TB who had not started anti-tuberculosis treatment underwent urine LAM testing and serum CRP measurement (cut-off >5). The reference standard was bacteriological testing using a rapid molecular assay on respiratory specimens. We calculated sensitivity, specificity, predictive values, likelihood ratios, and receiver operating characteristic (ROC) area under the curve (AUC). Results: Fifty participants were included with complete index and reference test data. Urine LAM demonstrated sensitivity 78% and specificity 75%, with PPV 56.7% and NPV 75% (LR+ 3.12; LR− 0.29) and AUC 0.77. CRP showed sensitivity 75% and specificity 50%, with PPV 58.1% and NPV 68.4% (LR+ 1.50; LR− 0.50) and AUC 0.62. LAM and CRP distributions did not differ significantly between clinically diagnosed and bacteriologically confirmed TB groups (p=0.056 and p=0.072, respectively). Formal AUC comparison and subgroup analyses were not performed because of limited granularity and few HIV-positive participants. Conclusion: In this referral hospital cohort, urine LAM provided better overall discrimination and stronger rule-in support than CRP, while CRP appeared more suitable for triage-oriented use. Multicenter studies should validate these findings and test combined algorithms for implementation in practice.