The Indonesian Biomedical Journal

194-221

Authors: Anna Meiliana, Andi Wijaya

BACKGROUND: Statins have been used for around three decades as the primary way to lower cholesterol and reduce the risk of atherosclerosis, but in some groups, statin resistance is common, and the danger of atherosclerosis is still high. CONTENT: Atherosclerosis was once believed to be caused by cholesterol and thrombotic material passively accumulating in the walls of arteries. However, current knowledge shows that the immune cells and inflammatory processes are essential in the formation, progression, and consequences of atherosclerotic lesions, characterized by a persistent inflammatory response, including thrombotic complications. Study of genetic, creating risk score for atherosclerosis, add more information to create more new therapies targeting low density lipoprotein cholesterol (LDL-C) receptor, and shows prospect. SUMMARY: Over time, atherosclerosis theories and treatment strategies have changed. While statins were widely used, they have now been supplanted by alternative options like the proprotein convertase subtilisin/kexin type 9 (PSCK9) inhibitor that manage atherosclerosis more effectively and comprehensive.

231-9

Authors: Aiman Al-Maathadi, Fardous Karawya, Said Al-Dalaen, Ahmed Aljabali, Anas Satari

BACKGROUND: Titanium dioxide nanoparticles (TiO2 NPs) uptake may primarily cause adverse effects by inducing oxidative stress, resulting in cell damage, genotoxicity, inflammation, and immune response. To date, there are limited studies investigating the adverse effect of TiO2 NPs on liver health and no studies found a naturally occurring compound able to ameliorate such effect. Thus, this study investigated alpha lipoic acid (ALA) potential for reversing the biochemical and histopathological changes that TiO2 NPs exposure causes in rat liver. METHODS: Thirty adult male albino rats were divided into: control rats received distilled water, control rats treated with 50 mg/kg ALA, rats intoxicated with TiO2 NPs, and TiO2 NPs-intoxicated rats treated 50 mg/kg ALA. Rats were sacrificed before blood samples were collected to assess the liver function using parameters of alanine aminotransferase (ALT), aspartate aminotransferase (AST), total bilirubin, albumin and total protein. Liver tissue homogenates were prepared to assess hepatic antioxidant and oxidative stress using parameters of superoxide dismutase (SOD), catalase (CAT), glutathione (GSH), and malondialdehyde (MDA). Liver tissue sections were used for histopathological analysis and caspase-3 immunohistochemical analysis. RESULTS: TiO2 NPs produced deleterious effects on rat liver tissue, as confirmed through biochemical results, caspase-3 immunohistochemistry, and histological alterations. TiO2 NPs intoxication induced hepatocyte vacuolation, blood vessels congestion, biliary proliferation, apoptosis, and fibrosis. However, ALA treatment of TiO2 NPs-intoxicated rats significantly alleviated deleterious impact on the liver. CONCLUSION: Administration of 600 mg/kg TiO2 NPs to rats resulted in hepatic degenerative lesions, depletion of GSH, oxidative stress, and apoptosis. However, these changes were mitigated by ALA administration. Therefore, ALA offers protection against deleterious effects of TiO2 NPs intoxication.

247-52

Authors: Rahmad Mulyadi, Joedo Prihartono, Em Yunir, Dian Anindita Lubis, Reyhan Eddy Yunus

BACKGROUND: One type of thalassemia known as transfusion-dependent thalassemia (TDT) requires a lifelong blood transfusion. Iron overload from prolonged blood transfusions causes nutritional disorders and several organs impairment, including the testicles. In contrast to an orchidometer, ultrasound shows more details of the testicles. This study aimed to compare testicular volumes based on ultrasound and orchidometer measurements and correlate testicular volume with nutritional status in TDT patients. METHODS: A cross-sectional study including 27 male thalassemia subjects who underwent routine check-ups was conducted. Measurements of testicular volume using an orchidometer and ultrasound, and body mass index (BMI) was performed. Ultrasound measurement of testicular volume was calculated using the Lambert Formula, while the orchidometer was performed by matching the bead next to the testicle. RESULTS: Most subjects were underweight (63%) or normal weight (37%). However, no significant correlation between BMI and testicular volume was found. As measured using an orchidometer, the mean volume of the right and left testes were 9.22±4.92 mL and 8.67±4.45 mL, respectively. Ultrasound measurement showed the mean values of the right and left testicles were 7.68±3.96 mL and 7.09±4.03 mL, respectively. Testicular measurements obtained using ultrasound showed a significant difference (p<0.05) when compared with the orchidometer. The testicle measured by ultrasound was smaller, which was more accurate. However, the comparison between the right and the left testicular volumes showed no significance. CONCLUSION: Thalassemia patients are mainly underweight, and their nutritional status have no relationship with testicular volume. Ultrasound, as compared to an orchidometer, is better for measuring testicular volume.

262-8

Authors: Muhammad Javedh Iqbal, Diah Rumekti Hadiati, Didik Setyo Heriyanto

BACKGROUND: Early-onset preeclampsia is characterized by higher oxidative stress and apoptosis level than late-onset one. Studies comparing the expression of the Bcl-2 family protein in early and late-onset preeclampsia are still lacking and show inconclusive evidence. This study aimed to compare the expression of Bax and Bcl-2 messenger RNA (mRNA) as a biomarker of placental apoptosis between early-onset and late-onset preeclampsia. METHODS: A cross-sectional study was conducted using formalin-fixed, paraffin-embedded preeclamptic placental samples and dividing them into early-onset and late-onset preeclampsia groups. Bax and Bcl-2 mRNA expressions were assessed using the quantitative real-time polymerase chain reaction method. Apoptosis was assessed through DNA fragmentation examination by the ligation-mediated real-time polymerase chain reaction method. RESULTS: Thirty early-onset and 30 late-onset preeclamptic placental samples were included. The mean fold change Bax mRNA in early-onset was higher than in late-onset preeclampsia (6.02±3.59 vs. 2.82±1.97; p=0.00). The mean fold change Bcl-2 mRNA early-onset was not different from late-onset preeclampsia (31.20±17.94 vs. 31.01±27.60; p=0.98). The mean DNA fragmentation cycle threshold in early-onset preeclampsia was lower than in late-onset preeclampsia (28.07±0.64 vs. 30.63±0.96; p=0.00). A weak negative correlation exists between fold change Bax mRNA and DNA fragmentation cycle threshold (r=-0.30; p=0.02). CONCLUSION: Bax mRNA showed significant correlation in DNA fragmentation compared to Bcl-2 mRNA; hence, might show more role in apoptotic pathway. Early-onset preeclampsia has higher Bax mRNA relative expression and apoptosis than late-onset preeclampsia. Therefore, Bax mRNA can be potential biomarker in early-onset preeclampsia.

277-86

Authors: Oentarini Tjandra, Shirly Gunawan, Johan Johan, Fia Fia Lie, Marcella Erwina Rumawas, Agus Limarta

BACKGROUND: Available medication for pain and joint stiffness release in osteoarthritis (OA) often gives considerable side effects. Undenatured type II collagen (UC-II) has been considered as a treatment for OA for its ability to prevent the progress of articular cartilage damage. Hence, this study aimed to evaluate the efficacy and safety of UC-II in modulating knee joint function. METHODS: This was a randomized, double-blind, placebo-controlled study involving 102 OA subjects. Subjects were randomized into two groups: receiving an oral daily dose of 40 mg/day UC-II or placebo containing microcrystalline cellulose for 90 days. Efficacy was evaluated by using the Western Ontario McMaster Osteoarthritis Index (WOMAC), Lequesne’s Functional Index (LFI), and Visual Analogue Scale (VAS) score on day-1, -7, -30, -60, and -90. Safety was evaluated by assessing the adverse events (AEs) and abnormal laboratory findings. RESULTS: The WOMAC total score showed a significant difference between the UC-II group vs. the placebo group from day-7 (p<0.05) to day-90 (p<0.01). UC-II was more effective in reducing the WOMAC total scores by 81.6% compared to 19.2% in the placebo group after 90 days. The total LFI and VAS score was significantly reduced in subjects supplemented with UC-II compared to the placebo group (75.8% vs. 7.8%; 67.9% vs. 12.2%, respectively). No significant changes were observed in vital signs and clinical laboratory tests compared to the placebo. The UC-II had a good safety profile with no serious adverse events among participants. CONCLUSION: UC-II significantly improved the knee pain, stiffness, and functional mobility of OA patients and was well-tolerated.