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All Journal Indonesian Journal of Medicine Jurnal Riset Kesehatan Poltekkes Depkes Bandung Narra J Jurnal Info Kesehatan
Marwanta, Sri
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Biochemistry, Genetics & Molecular Biology Chemistry Dentistry Health Professions Immunology & microbiology Medicine & Pharmacology Nursing Public Health

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Umbilical cord mesenchymal stem cell-derived secretome as a potential treatment for systemic lupus erythematosus: A double-blind randomized controlled trial Nurudhin, Arief; Werdiningsih, Yulyani; Sunarso, Indrayana; Marwanta, Sri; Damayani, Aritantri; Prabowo, Nurhasan A.; Affandi, Andri; Gazali, Itqan; Safitri, Ayu SI.; Sidarta, Brigitte RA.
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.v5i1.1799

Abstract

Umbilical cord mesenchymal stem cell-derived (UCMSC-derived) secretome is anti-apoptotic, anti-inflammatory, antifibrotic, angiogenic, and tissue-regenerating. Thus, it may treat systemic lupus erythematosus (SLE). The aim of this study was to investigate the impact of the UCMSC-derived secretome on SLE patients' disease activity, using Mexican systemic lupus erythematosus disease activity index (MEX-SLEDAI) score, complement (C3 and C4) levels, tumor necrosis factor-alpha (TNF-α), anti-double-stranded DNA (anti-dsDNA), and interleukin-6 (IL-6) levels. This double-blind randomized controlled trial investigated the efficacy and safety of UCMSC-derived secretome in SLE patients with moderate disease activity. A total of 29 female patients were randomized into two groups to receive weekly 1.5 cc intramuscular injections of UCMSC-derived secretome or placebo (0.9% NaCl) for six weeks. Disease activity was assessed using the MEX-SLEDAI score, C3 and C4 levels, pro-inflammatory cytokines (IL-6 and TNF-α), and anti-dsDNA antibodies at baseline, Day 22, and Day 43. Results showed a significant reduction in MEX-SLEDAI scores in the secretome group compared to the placebo group (p<0.05). Complement C3 levels significantly increased in the secretome group on Day 43, indicating improved immune homeostasis, while C4 levels did not show significant differences between groups. IL-6 and TNF-α levels showed decreasing trends in the secretome group. Anti-dsDNA levels exhibited a decreasing trend in the secretome group, though not statistically significant. Importantly, no severe adverse events were observed, underscoring the safety of the intervention. UCMSC-derived secretome demonstrated immunomodulatory and anti-inflammatory effects, reducing disease activity in SLE patients. These findings suggest its potential as a safe and effective adjunct therapy for SLE, although further studies with larger sample sizes and extended follow-up periods are needed to validate these results.
A Rare Case of Newly Acquired Hemophilia Following Diabetic Ketoacidosis in A Male Patient with IL-2 (Rs2069762) Polymorphism Muhammad, Faizal; Arthareza, Adhelia Galuh Permatasari; Marwanta, Sri
Indonesian Journal of Medicine Vol. 10 No. 3 (2025)
Publisher : Masters Program in Public Health, Sebelas Maret University

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.26911/theijmed.2025.10.3.832

Abstract

Background: Diabetes is commonly linked to autoimmune processes, but acquired hemophilia A (AH)—a rare bleeding disorder due to factor VIII (FVIII) inhibitors—remains uncommon, particularly during diabetic ketoacidosis (DKA). Recent studies have suggested a role of IL-2 (rs2069762) polymorphism in FVIII inhibitor development. This study aims to highlight a rare case of newly acquired hemophilia coinciding with DKA and the presence of IL-2 gene polymorphism. Case Presentation: A 40-year-old male presented with dyspnea, abdominal pain, and signs of DKA. He had a history of drug-induced rash due to sulfasalazine. Initial management with IV fluids and insulin resolved the metabolic crisis. However, on day two, he developed spontaneous bruising and gross hematuria. Laboratory tests revealed a low FVIII inhibitor titer (1.2 BU) and positive insulin antibodies. Genetic testing showed TT homozygous polymorphism of IL-2 (rs2069762), potentially contributing to FVIII inhibitor formation. Results: The patient was treated with low-dose cyclophosphamide and methylprednisolone, followed by rituximab due to poor initial response. Intensive insulin therapy was also administered. After five weeks, clinical remission of AH was achieved, although the patient remains at risk for relapse due to the IL-2 polymorphism. Conclusion: This case illustrates a rare interplay between DKA and acquired hemophilia, potentially mediated by IL-2 (rs2069762) polymorphism. Prompt diagnosis and individualized immunosuppressive therapy are essential. The findings support further investigation into genetic predispositions in AH pathogenesis during autoimmune or metabolic stress events like DKA.
Neutrophil-lymphocyte Ratio and Platelet-lymphocyte Ratio as Early Sign Plasma Leakage Process in Dengue Infection Ashma, Aisya Nailatul; Susilo, Satrio Budi; Marwanta, Sri; Harioputro, Dhani Redhono
JURNAL INFO KESEHATAN Vol 21 No 4 (2023): JURNAL INFO KESEHATAN
Publisher : Research and Community Service Unit, Poltekkes Kemenkes Kupang

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.31965/infokes.Vol21.Iss4.1382

Abstract

Dengue hemorrhagic fever remains a global health concern, especially in tropical and subtropical regions, such as Indonesia. Plasma leakage is the main symptom of Dengue infection which be seen through a hemoconcentration. NLR and PLR are cost-effective and easily measurable indexes that help to predict signs of infection. This study aims to analyze the correlation of NLR and PLR as early sign on hemoconcentration in Dengue infection. This study was an analytical observational method with a cross-sectional design. The study was conducted at the inpatient infectious disease wards of Dr. Moewardi General Hospital and Sebelas Maret University Hospital. The data was statistically analyzed using bivariate and multivariate analysis. There were seventy subject which of male was more than female. The result of bivariate analysis showed a statistically significant correlation for NLR (p = 0,008; r = 0,314) and non-significant for PLR (p = 0,150; r = 0,174). Both NLR and PLR were positively correlated with hemoconcentration. The effect of NLR on hemoconcentration was significant. There was a positive correlation significant between NLR and hemoconcentration in Dengue infection.
Pengaruh Skor ALBI terhadap Kadar NT-proBNP dan disfungsi diastolik pada sirosis hati Pratama, Randy; Yuli Pramana, Triyanta; Sulastomo, Heru; Marwanta, Sri; Pamungkasari, Eti Poncorini
JURNAL RISET KESEHATAN POLTEKKES DEPKES BANDUNG, Online ISSN 2579-8103 Vol 18 No 1 (2026): Jurnal Riset Kesehatan Poltekkes Depkes Bandung
Publisher : Poltekkes Kemenkes Bandung

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.34011/juriskesbdg.v18i1.2996

Abstract

Latar Belakang: Skor Albumin–Bilirubin (ALBI) dan N-Terminal pro b-type natriuretic peptide (NT-proBNP) merupakan parameter penting untuk mendeteksi disfungsi ventrikel kiri asimtomatik dan memprediksi prognosis pada gagal jantung. Sirosis hepatis Child-Pugh C menunjukkan kerusakan hati berat dengan risiko tinggi komplikasi kardiovaskular, termasuk disfungsi diastolik.   Tujuan: Penelitian ini bertujuan untuk menganalisis pengaruh skor ALBI terhadap kadar NT-proBNP dan derajat disfungsi diastolik pada pasien sirosis hepatis Child-Pugh C. Metode: Penelitian analitik observasional dengan pendekatan cross-sectional ini melibatkan 54 pasien sirosis hepatis Child-Pugh C yang menjalani rawat jalan dan rawat inap di RSUD Dr. Moewardi Surakarta. Sampel dipilih menggunakan teknik consecutive sampling dan dibagi menjadi kelompok kontrol (ALBI Grade I–II, n=27) dan kelompok intervensi (ALBI Grade III, n=27). Kadar NT-proBNP diukur menggunakan metode enzyme immunoassay, sedangkan fungsi diastolik dinilai melalui parameter ekokardiografi meliputi rasio E/A, E/e′, deceleration time (DT), kecepatan tricuspid regurgitation (TR), dan left atrial volume index (LAVI). Hasil: Rerata kadar NT-proBNP pada kelompok intervensi lebih tinggi secara signifikan dibandingkan kelompok kontrol (1926 ± 468 pg/mL vs. 1184 ± 351 pg/mL; p=0,032). Namun, tidak terdapat perbedaan bermakna pada derajat disfungsi diastolik antara kedua kelompok (p=0,234). Disfungsi diastolik derajat II ditemukan pada 48,1% pasien dengan ALBI Grade III dan 37,0% pada ALBI Grade I–II. Kesimpulan: Skor ALBI berpengaruh signifikan terhadap kadar NT-proBNP, tetapi tidak terhadap derajat disfungsi diastolik. Penilaian kombinasi skor ALBI dan NT-proBNP dapat membantu deteksi dini disfungsi jantung pada sirosis hepatis lanjut.
Co-Authors Affandi, Andri Arief Nurudhin Arthareza, Adhelia Galuh Permatasari Ashma, Aisya Nailatul Damayani, Aritantri Eti Poncorini Pamungkasari Gazali, Itqan Harioputro, Dhani Redhono Muhammad, Faizal Prabowo, Nurhasan A. Pratama, Randy Safitri, Ayu SI. Sidarta, Brigitte RA. Sulastomo, Heru Sunarso, Indrayana Susilo, Satrio Budi Werdiningsih, Yulyani Yuli Pramana, Triyanta