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All Journal The Indonesian Biomedical Journal Majalah Kedokteran Andalas
Suswita, Rini
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Biochemistry, Genetics & Molecular Biology Health Professions Medicine & Pharmacology Public Health

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Role Of Endoscopy To Reduce Extreme Hyperbilirubinemia In Lemmel Syndrome : A Case Report Suswita, Rini
Majalah Kedokteran Andalas Vol. 46 No. 3 (2023): Online Juli 2023
Publisher : Faculty of Medicine, Universitas Andalas

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.25077/mka.v46.i4.p730-735.2023

Abstract

Duodenal diverticulum is a false diverticulum which is generally asymptomatic, frequently founded incidentally at endoscopy and 22% at autopsy. One to five percent of duodenal diverticulum have complications such as bilio-pancreatic complications. Lemmel syndrome is a complication of bilio-pancreatic characterized by jaundice, increased levels of bilirubin, liver and pancreatic enzymes. Reported a male patient, 72 years old, he complained abdominal pain in the right upper quadrant, yellow eyes and body, and dark tea-colored urine. Abdominal pain with Visual Analog Scale (VAS) value between 6 to 7. Blood test resulted prolonged APTT 37", PT 17.7", INR 1.66, increased in total bilirubin 26.0 mg/dL with a ratio of direct and indirect bilirubin was 15.0 mg/dL and 11.0 mg/dL consecutively, hyponatremia 133 mmol/L, and hypokalemia 5.2 mmol/L. Abdominal CT scan examination showed compression of the distal bile duct (common bile duct) and dilatation of the proximal bile duct, both intra and extra-hepatic bile ducts. ERCP with endoscopic sphincterotomy and biliary stent placement can be an option for drainage and decompression of the biliary tract to prevent further complications to severe hyperbilirubinemia and the effects of biliary tract obstruction.
Exploring the Therapeutic Landscape: A Systematic Review on the Anti-inflammatory Effects of Probiotics in Colitis-associated Colorectal Cancer Suswita, Rini; Alvarino; Eryati Darwin; Jamsari
Majalah Kedokteran Andalas Vol. 47 No. 3 (2024): MKA July 2024
Publisher : Faculty of Medicine, Universitas Andalas

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.25077/mka.v47.i3.p341-361.2024

Abstract

Background: Colorectal cancer is closely linked to chronic inflammation; long-standing colitis confers a 2–3-fold higher risk. Modulating the gut–immune axis with probiotics may attenuate the inflammatory microenvironment of colitis-associated colorectal cancer (CAC). Objective:To evaluate the anti-inflammatory effects of probiotics in CAC animal models. Methods: We searched PubMed, ScienceDirect, and Wiley Online Library; 248 records were screened and 9 studies met inclusion. Risk of bias was appraised using SYRCLE RoB. Results: Probiotic treatment consistently reduced clinical severity, down-regulated inflammatory markers, and modulated key signaling pathways in CAC models. Nonetheless, evidence was heterogeneous, sample sizes were small, and dosing, strains, and formulations varied; safety reporting was limited. Conclusions: Probiotics show promise as anti-inflammatory adjuncts in CAC based on animal studies. Rigorous, standardized preclinical work and well-designed trials are needed to define optimal strains, dosing, and formulations, and to confirm efficacy and safety for translation.
Lactococcus lactis D4 Has Potential Effect to Alleviate Inflammation and Reverse Dysbiosis in Colitis Rat Model Suswita, Rini; Alvarino, Alvarino; Darwin, Eryati; Jamsari, Jamsari
The Indonesian Biomedical Journal Vol 16, No 2 (2024)
Publisher : The Prodia Education and Research Institute (PERI)

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.18585/inabj.v16i2.2970

Abstract

BACKGROUND: Inflammatory bowel disease (IBD) is a prevalent chronic inflammatory disorder of the gastrointestinal tract that may lead to colorectal cancer if untreated. Several medications for IBD have adverse side effects. Thus, there are high interest for searching alternative treatment to treat IBD. Lactococcus lactis D4 isolated from dadih, a traditional fermented buffalo milk product, was investigated for the effect on gut inflammation and microbial composition in the colitis rat model.METHODS: Eighteen male Sprague-Dawley rats were divided into three groups; control rats, colitis-induced rats, and colitis-induced rats treated with L. lactis D4 isolate. The control group received water, while the colitis-induced rats were given azoxymethane (AOM) and dextran sodium sulphate (DSS). Rats’ feces were collected for the analysis of gut microbiota diversity by next-generation sequencing and for the measurement of transforming growth factor (TGF)-β, nuclear factor kappa-B (NF-κB), interleukin (IL)-6, and tumor necrosis factor (TNF)-α colonic expression using reverse transcription-quantitative polymerase chain reaction (RT-qPCR).RESULTS: L. lactis D4 administration was able to reduce inflammation in colitis by decreasing IL-6 expression (0.87 vs. 0.73), while expression of TGF-β, NF-κB, and TNF-α were increased compared to the model group, suggesting a complex immunomodulatory effect. Gut microbiota sequencing revealed a similarity between the control and treatment groups, suggesting L. lactis D4 has great potential to ameliorate gut microbiota dysbiosis in colitis rats.CONCLUSION: L. lactis D4 has a beneficial effect in decreasing pro-inflammatory cytokines and is able to reserve dysbiosis in colitis rat model. Thus, L. lactis D4 might be used as a therapeutic agent for IBD.KEYWORDS: colitis, gut microbiota, inflammation, inflammatory bowel disease, Lactococcus lactis D4, probiotic, proinflammatory cytokines
Lactococcus lactis D4 Restores Gut Microbiota Balance in Azoxymethane and Dextran Sulfate Sodium-induced Colorectal Cancer Rat Model Suswita, Rini; Rivai, Muhammad Iqbal; Iqbal, Muhammad; Irwan, Irwan; Suchitra, Avit
The Indonesian Biomedical Journal Vol 16, No 6 (2024)
Publisher : The Prodia Education and Research Institute (PERI)

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.18585/inabj.v16i6.3311

Abstract

BACKGROUND: Gut microbiota plays a crucial role in the initiation and progression of colorectal cancer (CRC), with various bacterial species including Lactococcus lactis implicated in this process. However, there is a lack of studies reporting the specific effects of L. lactis on microbiota balance in the context of CRC, especially strain D4. Therefore, this study was conducted to evaluate the effect of L. lactis D4 administration on gut microbiota balance in a rat model of CRC.METHODS: This experimental study involved Sprague Dawley rats that were separated into untreated control (CO group), CRC-induced (CA group), and L. lactis D4-treated CRC-induced (LLD group). The CRC induction was performed by giving azoxymethane (AOM) and dextran sulfate sodium (DDS). Gut microbiota profile was analyzed using next generation sequencing (NGS), and microbial community dynamics were assessed through alpha and beta diversity metrics.RESULTS: L. lactis D4 restored gut microbiota balance by regulating Firmicutes/Bacteroidota ratio, and changing the microbiota composition by increasing the number of bacteria from the phylum Actinobacteria and decreasing bacteria from the phylum Bacteroidota and Proteobacteria. Alpha diversity was reduced in the LLD group, suggesting a decreased bacterial diversity post-treatment, but more closely aligned with the CO group than the CA group. Beta diversity analysis showed that the microbial composition of the treated group was similar to the CO group, while the CA group exhibited a distinct microbiota profile, characterized by higher abundance of pathogenic bacteria and reducing beneficial microbial species.CONCLUSION: L. lactis D4 administration effectively modulates gut microbiota in CRC model, enhancing the presence of beneficial bacteria from the Firmicutes and Bacteroidota phylum while suppressing pathogenic species from the Proteobacteria phylum.KEYWORDS: colorectal cancer, gut microbiota, next generation sequencing, Lactococcus lactis D4 
Co-Authors Alvarino Alvarino Alvarino Eryati Darwin Eryati Darwin Irwan Irwan Jamsari Jamsari Muhammad Iqbal Rivai, Muhammad Iqbal Suchitra, Avit