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All Journal Jurnal Respirologi Indonesia Jurnal Respirasi (JR) Respiratory Science Jurnal Farmasi Indonesia
Imaniar, Rania
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Health Professions Medicine & Pharmacology Public Health

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Exploring Epigenetic Landscapes in COPD: Therapeutic Implications and Recent Insights Wirawan, Aditya; Kinasih, Tutug; Imaniar, Rania; Baskoro, Hario; Antariksa, Budhi; Matsumoto, Naohisa
Respiratory Science Vol. 5 No. 2 (2025): Respiratory Science
Publisher : Indonesian Society of Respirology (ISR)

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.36497/respirsci.v5i2.166

Abstract

Chronic Obstructive Pulmonary Disease (COPD) is a leading cause of global mortality, primarily driven by an abnormal inflammatory response to harmful particles and gases. This review explores the epigenetic mechanisms underlying COPD pathogenesis and their therapeutic implications. A comprehensive literature review was conducted, analyzing recent findings on DNA methylation, histone modifications, and noncoding RNAs (ncRNAs) in COPD. Key studies highlighting the impact of these epigenetic changes on inflammation, cellular responses, and disease progression were evaluated. Our review highlights that epigenetic modifications, such as DNA methylation and histone modifications, significantly impact gene expression without altering the DNA sequence. Cigarette smoking has been shown to influence both DNA methylation and histone acetylation, leading to inflammatory responses and the the exacerbation of COPD. These modifications contribute to chronic inflammation and disease progression, with alterations in histone acetylation, methylation, and phosphorylation playing critical roles in COPD pathogenesis. The interplay between epigenetic changes and environmental factors, particularly tobacco smoke, reveals a complex mechanism driving COPD progression. Aberrant gene expression linked to these epigenetic modifications suggests potential disease severity and progression biomarkers. Targeting these alterations offers novel therapeutic strategies. Emerging treatments, such as quercetin and theophylline, promise to restore normal cellular functions and effectively manage COPD. Future research should focus on elucidating these mechanisms further and developing targeted therapies to mitigate the impact of epigenetic modifications on COPD.
Pengaruh Faktor Risiko terhadap Kejadian Peningkatan Kadar Enzim Transaminase pada Pasien Covid-19 dengan Terapi Tocilizumab Nasution, Izza Aulia Rizqika; Andrajati, Retnosari; Syafhan, Nadia Farhanah; Imaniar, Rania
JFIOnline | Print ISSN 1412-1107 | e-ISSN 2355-696X Vol. 15 No. 1 (2023): Jurnal Farmasi Indonesia
Publisher : Pengurus Pusat Ikatan Apoteker Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (398.476 KB) | DOI: 10.35617/jfionline.v15i1.137

Abstract

Abstract: Tocilizumab is an anti-IL-6 which is recommended as cytokine release syndrome therapy in the treatment of Covid-19. One of the side effects of tocilizumab that can occur is hepatotoxicity, from mild elevated transaminases to severe drug-induced liver injury (DILI). Currently, research related to tocilizumab hepatotoxicity and the risk factors affecting Covid-19 patients is limited and still needs to conduct. This research is an observational study with cross-sectional design. Data collection was carried out retrospectively using secondary data obtained from medical records department, patients with Covid-19 at Universitas Indonesia Hospital in 2020-2021. Patients confirmed with positive Covid-19 receiving Tocilizumab therapy in medical record were included in this study. Patient demographics, clinical diagnoses, laboratory examinations, history of others medication were also reviewed. Patients with less than 18 years old, incomplete medical record data, and referred to other hospitals were excluded. The sampling technique used was total sampling, namely all patients who met the inclusion criteria were taken as subject in this research. Chi-square test was used to analyze the relationship between each risk factors and the incidence of elevated transaminases. The results of Chi-square test showed that several risk factors significantly increased the incidence of elevated transaminases in patients given tocilizumab therapy, including age, obesity, diabetes mellitus, and ceftriaxone as antibiotic therapy.
Zinc Intake and Appetite in Patients with Post-Tuberculosis Lung Disease at Persahabatan National Respiratory Referral Hospital, Jakarta Mahardhika, Linda; Nurwidya, Fariz; Singal, Anna Maurina; Sutanto, Krisadelfa; Imaniar, Rania; Syam, Shaogi
Jurnal Respirasi Vol. 11 No. 3 (2025): September 2025
Publisher : Faculty of Medicine Universitas Airlangga

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.20473/jr.v11-I.3.2025.232-240

Abstract

Introduction: After completion of pulmonary tuberculosis (TB) treatment, some people may continue to experience respiratory issues that can progress into post-TB lung disease (PTLD). Individuals with PTLD exhibit suboptimal nutritional status. The loss of appetite is a significant factor influencing nutritional status. Zinc plays a role in hunger control.  Lack of zinc reduces taste sensitivity and food intake. This study examined the relationship between zinc intake and appetite in patients with PTLD at Persahabatan National Respiratory Referral Hospital, Jakarta. Methods: This cross-sectional study was conducted at Persahabatan National Respiratory Referral Hospital, Jakarta, from November 2024 to March 2025. Eighty-five adult patients with PTLD were included. Zinc intake was assessed by a semi-quantitative food frequency questionnaire (SQ-FFQ) and analyzed by NutriSurvey software. Appetite was measured using the visual analog scale (VAS) for appetite. Results: A total of 85 subjects participated in the study, comprising 78.8% males and 21.2% females. The average daily zinc intake was 4.4 mg/day, and 92.9% of the subjects had zinc intake below the recommended dietary allowance (RDA). The average VAS appetite score was 70 mm. A significant positive correlation was found between zinc intake and appetite, indicating that a decrease in zinc intake might result in a reduced appetite (r=0.266, p=0.014). Conclusion: Zinc intake is positively associated with appetite in patients with PTLD. Therefore, zinc intake monitoring is essential for supporting nutritional recovery and lung function in PTLD.
Clinical, Immunological, and Microbiological Aspects of Nontuberculous Mycobacterium (NTM) Nurfitri, Rina Diana; Isbaniah, Fathiyah; Nurwidya, Fariz; Imaniar, Rania; Hatim, Faiza; Dharmawan, Ibrahim Nur Insan Putra
Jurnal Respirologi Indonesia Vol 46 No 1 (2026)
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.v46i1.1084

Abstract

Nontuberculous mycobacteria (NTM) refer to all mycobacterial species except Mycobacterium tuberculosis (M. tuberculosis) complex and M. leprae complex. These bacteria are acid-fast. The bacteria are environmental bacteria that act opportunistically in humans. The infection can lead to disease, primarily affecting the lungs in susceptible hosts. Risk factors for NTM infection include defects in the body's defence mechanisms, changes in lung structure, and immune system abnormalities, which can be congenital or acquired. The bacteria possess pathogen-associated molecular patterns (PAMPs) and cell wall components that differ from those of M. tuberculosis, one of which is the glycopeptidolipid (GPL) component. Different species have distinct cell wall components, enabling them to modulate the immune system in various ways by interacting with multiple pathogen recognition receptors, including toll-like receptors and fibronectin. The cell-mediated immune response plays a role in the response to NTM infection. Alveolar macrophages, as the first line of defence, release interleukin (IL)-12, activating the T-helper-1 (Th1) axis and natural killer (NK) cells, followed by the release of tumour necrosis factor- α (TNF-α), interferon (IFN)-γ, and IL-17. The clinical symptoms of NTM lung disease (NTM-LD) are similar to those of M. tuberculosis. Two radiological findings are commonly observed: fibro-cavitary lesions and nodular bronchiectasis. Diagnosis must meet clinical, radiological, and microbiological criteria. The decision to start therapy should consider host factors, clinical conditions, and species type. The treatment approach involves multi-drug therapy and long-term administration, depending on species, disease extent, drug susceptibility testing results, and comorbidities.
Co-Authors Aditya Wirawan, Aditya Baskoro, Hario Budhi Antariksa Dharmawan, Ibrahim Nur Insan Putra Fariz, Nurwidya Hatim, Faiza Isbaniah, Fathiyah Kinasih, Tutug Mahardhika, Linda Matsumoto, Naohisa Nadia Farhanah Syafhan Nasution, Izza Aulia Rizqika Nurfitri, Rina Diana Retnosari Andrajati Singal, Anna Maurina Sutanto, Krisadelfa Syam, Shaogi