The Indonesian Biomedical Journal

106-13

Authors: Yudi Her Oktaviono, Suryo Ardi Hutomo, Kevin Luke

BACKGROUND: Coronary artery disease (CAD) remains as the world number one cause of morbidity and mortality. Endothelial progenitor cells (EPCs) are known to be involved in vascular biology. Current review briefly summarizes the basics of EPCs and its clinical use in CAD. CONTENT: EPCs were firstly isolated in 1997 and involved in neovascularization. Further evidence defined EPCs into two distinguishable groups, namely: myeloid angiogenic cells (MACs) and endothelial colony forming cells (ECFCs). Common cardiovascular drugs, statin, angiotensin-converting enzyme (ACE) inhibitor, and their combinations, showed beneficial effects on EPCs. Likewise, the incorporation of EPCs upon CAD intervention management had been recently studied. Intramyocardial EPCs implementation and anti-CD34 antibody-coated stents could provide a promising option for refractory symptoms in CAD. SUMMARY: Association between EPCs and CAD is very dynamic and complex. EPCs could serve as both therapeutic target and agent in CAD patients. Subsequently, a universal definition of EPCs is needed for greater research in the future.

140-6

Authors: Desy Thayyil Menambath, Durga Rao Yella, Ashok Prabhu Khandige, Sudha Kuthethur, Nandini Mangalore

BACKGROUND: Diabetes mellitus is a common disease worldwide which affects renal function. Cardiovascular morbidity and mortality in diabetes patients can be accelerated by dyslipidemia. Small dense lowdensity lipoprotein-cholesterol (sdLDL-C) is atherogenic and its predominance has been known as a cardiovascular risk factor. The study aimed to assess the validity of calculated sdLDL-C using three different formulae and its association with other clinical variables in diabetic patients with and without nephropathy, and also to determine the best suited formula to measure sdLDL-C. METHODS: The study subjects were divided into two groups based on the amount of albumin excreted in the urine. Group I or the control group consisted of diabetic subjects without microalbuminuria, while group II consisted of diabetic subjects with microalbuminuria. Blood glucose, glycated haemoglobin (HbA1c), creatinine, total cholesterol (TC), triglyceride (TG), high-density lipoprotein-cholesterol (HDL-C), LDL-C and apoB were estimated. Three formulae used for the validation of calculated sdLDL-C were TG/HDL, sdLDL (mg/dL) = 0.580 (nonHDL) + 0.407 (direct-LDL-C) – 0.719 (calculated-LDL-C) – 12.05, and LDL-C/LDL apoB. RESULTS: There was no significant difference in sdLDL-C levels of diabetic subjects with and without nephropathy. The sdLDL-C had strong correlation with TC, TG, LDL-C, very-low-density lipoprotein (VLDL), non-HDL and apoB in both study groups. ROC curve showed that LDL-C/LDL apoB derived sdLDL-C had better sensitivity (85%) and specificity (69%) compared to other two measures. CONCLUSION: Though the calculated sdLDL-C do not predict the occurrence of nephropathy in diabetes subjects, it may still be used in conjunction with the traditional markers since it is cost effective. The LDL-C/LDL apoB formula is the best predictor of sdLDL-C among the three equations.

155-62

Authors: Yanuarita Tursinawati, Arum Kartikadewi, Ari Yuniastuti, R Susanti

BACKGROUND: One of the hormones that plays a role in glucose metabolism of Type 2 Diabetes Mellitus (T2DM) is melatonin. Its genetic variation is believed to play a significant role in the pathophysiology of obese and non-obese T2DM. The role of MTNR1B (melatonin receptor coding gene) and SLC2A1 (Glucose transporter 1/GLUT 1 transporter coding gene) on the risk of obese and non-obese T2DM patients is controversial. This study aims to analyze the association between the rs10830963 MTNR1B and rs841853 SLC2A1 polymorphism to the risk of Javanese obese T2DM. METHODS: This was a cross-sectional study that involved 107 Javanese T2DM patients from primary heath care in Semarang. Furthermore, obese T2DM was defined by a body mass index (BMI) more than 25 kg/m2. The genetic variations examined were rs10830963 MTNR1B and rs841853 SLC2A1 polymorphism by PCR-RFLP methods. Blood biochemistry parameters were also examined. Allele and genotype frequencies of rs10830963 MTNR1B and rs841853 SLC2A1 polymorphisms were analyzed using the x2 test with p≤0.05 and 95% CI. RESULTS: There was a significant association between rs10830963 MTNR1B polymorphisms in obese and nonobese T2DM (p=0.044) and the CG genotype increased the risk of obese T2DM. Furthermore, the allele and genotype frequency of rs841853 SLC2A1 polymorphism in both group had no significant difference, with a p=0.756 and p=0.802, respectively. There was also no significant difference in the biochemical parameters' in both groups of the two genetic variants studied. CONCLUSION: The rs10830963 MTNR1B polymorphism is associated with the risk of obesity in Javanese T2DM patients but not for the rs841853 SLC2A1 polymorphism.

170-7

Authors: Ronald Winardi Kartika, Idrus Alwi, Franciscus Dhyanagiri Suyatna, Em Yunir, Sarwono Waspadji, Suzanna Immanuel, Todung Silalahi, Saleha Sungkar, Jusuf Rachmat, Saptawati Bardosono, Mirta Hediyati Reksodiputro

BACKGROUND: Diabetic foot ulcer (DFU) is the most common and threatening complication of Diabetes Mellitus (DM). Ideal wound dressing for DFU management should relieve symptoms, provide wound protection, and encourage healing. Advanced-Platelet Rich Fibrin (A-PRF) and Hyaluronic Acid (HA) have been proven to improve wound healing process. This study was aimed to demonstrate the ability of combination of A-PRF and HA in reducing inflammation and improving DFU tissue healing. METHODS: Twenty DFU subjects were involved in this study, and divided into two groups based on the topical fibrin gel treatment: A-PRF + HA group and A-PRF only group. A-PRF was obtained by peripheral blood centrifugation. A-PRF + HA was prepared by homogening A-PRF and AH with a ratio of 1:0.6. Interleukin-6 (IL-6) level, granulation index (GI), numeric pain score (NPS), and inflammation clinical symptoms (ICS) were assessed on day-0, 3, 7 and 14. RESULTS: Wound swabs’ IL-6 level on day-7 was found to be significantly lower in A-PRF + HA compared to A-PRF alone (p=0.041). The IL-6 level reduction also found to be significant higher either in wound swabs (day 0-7, p=0.015) or fibrin gel (day 0-3, p=0.049; day 0-7, p=0.034). A-PRF + HA treatment significantly increased the GI even since day-3 (p=0.043), with lower NPS (p<0.001), and ICS score. CONCLUSION: The combination of A-PRF and HA increases the GI in DFU healing by reducing the inflammation state which will induce the angiogenesis process, as well as reducing pain in DFU subjects better than A-PRF alone.

186-91

Authors: Frisma Sagara Brilliyanto, Gatut Suhendro, Indri Wahyuni, Maftucah Rochmanti, Windhu Pramono

BACKGROUND: Posterior capsule opacification (PCO) often occurs after cataract surgery. Metformin has been known to have an ability to inhibit fibrosis. This study aimed to investigate the effects of metformin on cell contractility, collagen deposition and degradation in human lens epithelial cells (HLEC) of cataract patients. METHODS: HLEC were isolated from the anterior lens capsule of patients undergoing cataract surgery. The HLEC culture was carried out using explant culture technique. The in vitro PCO model was created by scratching technique on HLEC cultures. The treatment groups were given 0.1, 0.5 and 1 mM metformin, respectively, while the control group were given 10% fetal bovine serum (FBS). On the 7th day after scratching technique, the collagen deposition, collagen degradation and cell contractility were evaluated. RESULTS: Collagen deposition in HLEC was significantly reduced after given 0.1 mM, 0.5 mM and 1 mM metformin (17.92±6.16 mg/mL, 12.92±4.31 mg/mL, 11.25±5.30 mg/mL, respectively), compared to the control group (31.46±7.52 μg/mL, p=0.002). Collagen degradation significantly was increased in the 0.1 mM, 0.5 mM and 1 mM metformin groups (4.77±9.27 mg/mL, 6.59±1.16 mg/mL, 6.35±1.90 mg/mL, respectively) compared to the control group (2.21±2.78 μg/mL, p=0.002). While, collagen contractility in HLEC was significantly reduced in 0.1mM, 0.5mM and 1 mM metformin groups (16.39±3.89%, 13.89±2.59%, 11.93±2.44%, respectively), compared to the control group (44.25±4.95%, p=0.000). CONCLUSION: Metformin reduced collagen deposition and contractility, but increased collagen degradation in HLEC of cataract patients through mechanism of extracellular matrix remodeling.

201-7

Authors: Yenny Kandarini, Gede Wira Mahadita, Sianny Herawati, Anak Agung Wiradewi Lestari, Ketut Suega, I Gde Raka Widiana

BACKGROUND: Monitoring of iron status in chronic kidney disease patients is important, however inflammation may hinder its monitoring. Soluble transferrin receptor (sTfR) is an alternative parameter to overcome this issue, whereas ferritin play a part in the inflammation process. Hence, the correlation between the sTfR ratio and the sTfR/log ferritin ratio with conventional iron status parameters in regular hemodialysis patients is necessary to be evaluated. METHODS: A cross-sectional was conducted in the current study. As many as 5 mL of blood (2 mL for sTfR and 3 mL for serum iron and ferritin levels) was collected. sTfR level was the blood-soluble transferrin receptor level measured by the enzyme-linked immunosorbent assay (ELISA). The amount of ferritin and serum iron was determined using the immunochemiluminescent process. To evaluate the correlation, the Pearson correlation test was used. RESULTS: A total of 80 subjects was included in this study. The mean of hemoglobin was 10.25±1.66 g/dL, serum iron was 58.19±26.56 g/dL, and the median ferritin was 520.4 (49.9-3606) ng/mL. The sTfR was significantly associated only with serum iron levels with a correlation coefficient of r=-0.242; p=0.031. The sTfR/log ferritin was significantly associated with serum iron l evels (InSI)(r=-0.255, p=0.022); and transferrin saturation (r=-0.295; p=0.008). CONCLUSION: sTfR/log ferritin has a negative and significant correlation with serum iron levels and transferrin saturation, while sTfR negatively correlated with serum iron levels. sTfR and sTfR/log ferritin may be considered as an alternative iron marker in inflammation setting such as CKD.

216-20

Authors: Yessy Ariesanti, Ferry Sandra, Bianda Claresta, Livia Alvita

BACKGROUND: Wound healing is an essential biological process that consists of sequential steps aimed at restoring the architecture and function of damaged cells and tissues. There are empirical evidences of using pure coffee bean powder as an alternative medicine in treating various types of wounds. However, there is limited data on coffee-induced wound healing, especially migration of cells. Therefore, current study was conducted to investigate the role of coffee extract in cell migration, especially fibroblast which is important for wound healing. METHODS: Coffea canephora beans were prepared, extracted and added in the NIH3T3 cell culture in final concentration of 2.5% and 5%. Then cytotoxicity test was performed using Na,30-[(phenylamino)-carbonyl]-3,4-tetrazolium]-bis(4-methoxy-6-nitro) benzenesulfonic acid hydrate (XTT) assay. Meanwhile, cell migration test was performed with scratch assay. All results were statistically analyzed. RESULTS: The 2.5% or 5% Coffea canephora beans extract (CCBE)-treated NIH3T3 cell numbers were almost similar with the numbers of NIH3T3 cells in starvation medium merely. Meanwhile, 2.5% and 5% CCBE showed significant decrease of the widths of scratched areas compared to starvation medium merely (ANOVA with LSD Post-hoc, p=0.000). After 24 h and 48 h, the average widths of 2.5% and 5% CCBE-treated scratched areas were 235.68±22.79, 50.36±5.29, 229.95±23.01, 27.68±2.83, respectively. CONCLUSION: Since both 2.5% and 5% CCBE are potential in inducing migration of fibroblast (NIH3T3 cell) and do not induce cytotoxicity, the CCBE could be potential as an agent for wound healing.