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Potential of Emodin as Effective Therapy Overcoming COVID-19 Through Inhibition of the SARS-CoV-2 Spike Protein Interaction on ACE2 Receptors Ilham, Ahmad Fadhil; Handayani, Diah
Jurnal Respirologi Indonesia Vol 44, No 4 (2024)
Publisher : Perhimpunan Dokter Paru Indonesia (PDPI)/The Indonesian Society of Respirology (ISR)

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.36497/jri.v44i4.355

Background: The coronavirus disease 2019 (COVID-19) once became a major pandemic in the history of human health. Patients in severe to critical conditions, especially with comorbidities, are more likely to have complications such as ARDS, cytokine storm, higher mortality rates, and require more effective treatments. Emodin is a candidate regimen that has the potential benefit for COVID-19.Method: This literature review was synthesized with literature searches on journal databases such as PubMed, ScienceDirect, EMBASE, and the Google Scholar search engine. As a result, three main articles and 36 supporting articles were used to synthesize this literature review.Results: The pathogenesis of SARS-CoV-2 infection was similar to SARS-CoV infection, as demonstrated by Hoffmann et al, namely through the interaction of viral spike (S) protein with ACE2 receptors in the human body, so the inhibition of this interaction would be one of the therapeutic targets. Ho et al proved that emodin can inhibit the binding of the SARS-CoV S protein to ACE2 in vitro. The direct inhibition of S protein may also support the ACE2 cardioprotective function in patients with cardiovascular comorbidities. Emodin is also superior because it has various other benefits such as anti-inflammatory and immunosuppressive activity. Based on the research of Dong et al, emodin can be given orally but in combination with inhibitors of glucuronidation, metabolism can increase the bioavailability of this drug.Conclusion: Emodin has the potential to be developed for the effective therapy of COVID-19.

Non-Genetic Risk Factors for First-Line Anti-Tuberculosis Drug-Induced Liver Injury in Active Pulmonary Tuberculosis Patients: A Systematic Review and Meta-Analysis Ilham, Ahmad Fadhil; Felim, Ris Raihan; Akbar, Fadhian; Burhan, Erlina
Jurnal Respirologi Indonesia Vol 45 No 3 (2025)
Publisher : Perhimpunan Dokter Paru Indonesia (PDPI)/The Indonesian Society of Respirology (ISR)

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.36497/jri.v45i3.693

Background: Tuberculosis is still one of the leading causes of poor health and death worldwide. Drug-induced liver injury (DILI) is an important and serious side effect of anti-tuberculosis treatment and can cause non-adherence of patients to the treatment. To reduce the possibility of patients developing DILI, the risk factors must be identified. Methods: This systematic review was conducted based on the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) 2020 statement. Inclusion and exclusion criteria were used to screen and filter the articles that were obtained from literature searching performed through several journal databases. The extracted data were analyzed qualitatively and quantitatively. The quality of each study was also assessed using the modified Newcastle Ottawa Scale (NOS). The protocol for this systematic review has been registered with PROSPERO CRD42022384892. Results: The results showed that, of the 13 studies analyzed qualitatively, 11 studies with a total of 4,920 patients were selected for quantitative analysis. The factors analyzed and the results were female gender (OR=1.10; 95% CI=0.72-1.67; P=0.65), age over 40 years (OR=1.60; 95% CI=1.04-2.46; P=0.03), body mass index less than 18.5 kg/m2 (OR=0.96; 95% CI=0.52-1.79; P=0.9), active smoking (OR=0.71; 95% CI=0.34-1.49; P=0.36), frequent alcohol intake (OR=1.44; 95% CI=0.61-3.42; P=0.41), hepatitis B (OR=3.42; 95% CI=1.72-6.79; P<0.001]), and hepatitis C (OR=12.87; 95% CI=6.67-24.86; P<0.00001]). Conclusion: In conclusion, the evidence from this review suggests that older age, hepatitis B, and hepatitis C are significant risk factors thought to increase the incidence of DILI in active pulmonary tuberculosis patients taking first-line anti-tuberculosis regimens.

Chronic Obstructive Pulmonary Disease Exacerbation Complicated with Pneumonia and Lung Cancer: An Evidence-based Case Report of Erdosteine Role in the Management of Complex COPD Ilham, Ahmad Fadhil; Rakasiwi, Muhammad Ilham Dhiya; Felim, Ris Raihan; Arfan, Ahmad; Burhan, Erlina
Malang Respiratory Journal Vol. 6 No. 2 (2024): September 2024
Publisher : Universitaas Brawijaya

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.21776/ub.mrj.2024.006.02.05

Background: Acute exacerbations of chronic obstructive pulmonary disease (COPD) are strongly associated with poor health status and morbidity. Erdosteine is a mucolytic agent that also has anti-inflammatory, antioxidant and antibacterial effects. This case report aims to evaluate the role of erdosteine in the prevention and treatment of acute exacerbations of complex COPD case. Case: A 73-year-old male arrived at the emergency department with an increased difficulty in breathing that had deteriorated over the previous 5 days, and had a history of heavy smoking for more than 40 years. Following a thorough examination, he was diagnosed with acute exacerbation of COPD (Anthonisen criteria type 2) in clinical group E, pneumonia, along with stage IIIA right lung tumor (T4N1Mx), and received erdosteine inhalation as part of his treatment. Discussion: A comprehensive search of journal databases (PubMed, EMBASE, CENTRAL, EBSCO Medline, Scopus, and ProQuest) was conducted using specific keywords, critical appraisal based on the Oxford Center for Evidence-Based Medicine. Article selection resulted in 1 systematic review article for the prevention of acute exacerbations and 1 systematic review article for the management of acute exacerbations of COPD. In patients with stable COPD, administration of erdosteine in the standard COPD regimen significantly reduced the risk of exacerbations (RR=0.65; p=0.01), while in patients with acute exacerbations of COPD, erdosteine increased treatment success (OR=3.2; p<0.0001). Conclusion: Erdosteine may serve as a therapeutic choice for COPD patients in preventing or managing acute exacerbations.

Potential of Emodin as Effective Therapy Overcoming COVID-19 Through Inhibition of the SARS-CoV-2 Spike Protein Interaction on ACE2 Receptors Ilham, Ahmad Fadhil; Handayani, Diah
Jurnal Respirologi Indonesia Vol 44 No 4 (2024)
Publisher : Perhimpunan Dokter Paru Indonesia (PDPI)/The Indonesian Society of Respirology (ISR)

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.36497/jri.v44i4.355

Background: The coronavirus disease 2019 (COVID-19) once became a major pandemic in the history of human health. Patients in severe to critical conditions, especially with comorbidities, are more likely to have complications such as ARDS, cytokine storm, higher mortality rates, and require more effective treatments. Emodin is a candidate regimen that has the potential benefit for COVID-19.Method: This literature review was synthesized with literature searches on journal databases such as PubMed, ScienceDirect, EMBASE, and the Google Scholar search engine. As a result, three main articles and 36 supporting articles were used to synthesize this literature review.Results: The pathogenesis of SARS-CoV-2 infection was similar to SARS-CoV infection, as demonstrated by Hoffmann et al, namely through the interaction of viral spike (S) protein with ACE2 receptors in the human body, so the inhibition of this interaction would be one of the therapeutic targets. Ho et al proved that emodin can inhibit the binding of the SARS-CoV S protein to ACE2 in vitro. The direct inhibition of S protein may also support the ACE2 cardioprotective function in patients with cardiovascular comorbidities. Emodin is also superior because it has various other benefits such as anti-inflammatory and immunosuppressive activity. Based on the research of Dong et al, emodin can be given orally but in combination with inhibitors of glucuronidation, metabolism can increase the bioavailability of this drug.Conclusion: Emodin has the potential to be developed for the effective therapy of COVID-19.

Diagnostic Accuracy and Clinical Utility of InaTB-Rif, Locally Developed Molecular Test for Tuberculosis, in Comparison with Xpert MTB/RIF in Indonesia Handayani, Diah; Haryanto, Budi; Adyasiwi, Galoeh; Dahlan, Muhammad Sopiyudin; Agustin, Heidi; Wardoyo, Muhammad Prasetio; Ilham, Ahmad Fadhil; Burhan, Erlina
Jurnal Respirologi Indonesia Vol 45 No 2 (2025)
Publisher : Perhimpunan Dokter Paru Indonesia (PDPI)/The Indonesian Society of Respirology (ISR)

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.36497/jri.v45i2.907

Background: Tuberculosis (TB) remains a significant public health issue in Indonesia. Early and accurate diagnosis and drug susceptibility testing are essential for TB management. This study compared the diagnostic accuracy of the locally developed InaTB-Rif molecular test and Xpert MTB/RIF, using Mycobacterium Growth Indicator Tube (MGIT) culture as the reference standard. Methods: A cross-sectional study was conducted at Persahabatan Hospital, Jakarta, from February to August 2023. Presumptive pulmonary TB patients were recruited and tested using Xpert MTB/RIF, InaTB-Rif, and MGIT culture. The study assessed the sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and agreement between InaTB-Rif and Xpert MTB/RIF for Mycobacterium tuberculosis (MTB) detection and rifampicin resistance. Diagnostic accuracy was compared using receiver operating characteristic (ROC) curves. Results: MGIT culture identified 29 TB-positive and 26 TB-negative cases. InaTB-RIF showed a sensitivity of 93.1% (95% CI=0.77-0.99), specificity of 76.9% (95% CI=0.56-0.91), PPV of 81.8% (95% CI=0.64-0.93), and NPV of 90.9% (95% CI=0.70-0.98). Xpert MTB/RIF had a sensitivity of 89.7% (95% CI=0.726-0.978), specificity of 80.8% (95% CI=0.606-0.93), PPV of 83.9% (95% CI=0.66-0.94), and NPV of 87.5% (95% CI=0.67-0.97). The area under the curve (AUC) was 0.8501 for InaTB-RIF and 0.8521 for Xpert MTB/RIF, with no significant difference in accuracy (P=0.965). The kappa value for MTB detection was 0.776, indicating substantial agreement, while the kappa value for rifampicin resistance detection was 0.517, indicating moderate agreement. Conclusions: InaTB-RIF demonstrates comparable diagnostic accuracy to Xpert MTB/RIF with good diagnostic performance and agreement for detecting MTB and moderate agreement for rifampicin resistance detection.

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