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All Journal Indonesian Journal of Medicine Narra J
Marwanta, Sri
Unknown Affiliation
Biochemistry, Genetics & Molecular Biology Health Professions Immunology & microbiology Medicine & Pharmacology 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.
Convalescent Plasma Treatment for Moderate to Critical Ill COVID-19 Patients – A Safe but Futile Treatment: A Non-Randomized Comparative Study Aphridasari, Jatu; Soetjahjo, Bintang; Joko, Agus; Sidharta, Rina; Harsini, Harsini; Arifin, Arifin; Permana, Septian Adi; Saraswati, Kunti; Adhiputri, Artrien; Marwanta, Sri; Laqif, Abdurahman; Danuaji, Rivan
Indonesian Journal of Medicine Vol. 8 No. 4 (2023)
Publisher : Masters Program in Public Health, Universitas Sebelas Maret, Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.26911/theijmed.2023.08.04.08

Abstract

Background: In a number of cases of viral infection, convalescent plasma therapy has been effective. Reportedly, the use of convalescent plasma as a therapy for COVID-19 patients with severe and life-threatening disorders is beneficial at this time. This study aims to assess the effectiveness and safety of convalescent plasma transfusions in hospitalized COVID-19 patients. Subjects and Method: This was a clinical trial employing a non-randomized comparative study. A historical control group (21 samples) and convalescent plasma transfusions (21 samples) was selected consecutively from hospitalized COVID-19 patients between May 6th, 2020, and May 6th, 2021 at Dr. Moewardi General Hospital. We assessed and quantified viral clearance in the laboratory. Statistical analysis is performed in SPSS version 20.0. Results: Plasma was taken from fifteen convalescent donors. In the plasma convalescent treatment group, there was a statistically significant difference between outcome and severity degree (p = 0.005). In addition, there was a substantial discrepancy between the result group and the control group (p 0.005). Significant differences in post-treatment NLR between the control and treatment groups (p 0.005). In addition, there were statistically significant differences between the control and treatment groups in post-treatment hsCRP levels (p 0.005). In addition, there were statistically significant differences (p 0.005) between all groups' inflammatory markers and outcomes. Conclusion: Using convalescent plasma to treat patients with COVID-19 is a rather safe practice. Our analysis demonstrated that the administration of convalescent plasma did not enhance survival or clinical outcomes for COVID-19 patients with moderate to severe disease. Keywords: COVID-19, convalescent therapy, critical ill
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, Universitas Sebelas Maret, Indonesia

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.
Co-Authors Adhiputri, Artrien Affandi, Andri Arief Nurudhin Arifin Arifin Arthareza, Adhelia Galuh Permatasari Ashma, Aisya Nailatul Damayani, Aritantri Gazali, Itqan Harioputro, Dhani Redhono Jatu Aphridasari Joko, Agus Laqif, Abdurahman Mochammad Imron Awalludin Muhammad, Faizal Permana, Septian Adi Prabowo, Nurhasan A. Rivan Danuaji Safitri, Ayu SI. Saraswati, Kunti Sidarta, Brigitte RA. Sidharta, Rina Soetjahjo, Bintang Sunarso, Indrayana Susilo, Satrio Budi Werdiningsih, Yulyani