The Indonesian Biomedical Journal

3-11

Authors: Yani Lina, Andi Wijaya

BACKGROUND: Mesenchymal stromal cells are multipotent cells considered to be of great promise for use in regenerative medicine. However, the cell dose may be a critical factor in many clinical conditions and the yield resulting from the ex vivo expansion of mesenchymal stromal cells derived from bone marrow may be insufficient. Thus, alternative sources of mesenchymal stromal cells need to be explored. CONTENT: There are multiple extra-embryonic tissues emerging during gestation including umbilical cord blood (UCB), amniotic fluid (AF), Wharton’s jelly, the amniotic membrane and the placenta, which are all discarded following birth. Fetal stem cells from these sources actually represent a new class of stem cells developmentally and operationally located between the state of embryonic stem cells and adult stem cells, sharing and exhibiting features of pluripotency and multipotency, without necessarily implying that they can generate every type of tissue. SUMMARY: Fetal stem cells have been recently isolated from several tissues (amniotic fluid, umbilical cord, Wharton’s jelly, amnion and placenta). They are derived either from the fetus proper or from the supportive extra-embryonic structures. They represent ideal sources for regenerative medicine since they are easily accessible, exhibit high proliferation rates, do not form teratomas and present no ethical reservations like embryonic stem cells (ESC). Their functional features indicate that they actually represent intermediates between ESC and adult stem cells.

17-23

Authors: Imelda Novianti, Andi Wijaya, Marsetio Donosepoetro

BACKGROUND: Central obesity is the accumulation of visceral (intra-abdominal) fat and is strongly known to be associated with insulin resistance and type 2 diabetes mellitus (T2DM). Obesity can cause adipocyte hypertrophy that results in dysregulation of adipokine expression. The abnormal function of adipocytes may play an important role in the development of a chronic low-grade proinflammatory state associated with obesity. Adiponectin, RETINOL binding protein (RBP)-4 and fetuin-A play a role in the pathophysiology of insulin resistance. Expression of fetuin-A is increased due to fat accumulation in the liver. Elevated concentration of fetuin-A in the circulation can impair insulin signaling in muscle and liver as well as suppress adiponectin secretion, although its molecular mechanism is still unclear. The aim of this study was to identify the relationship of fetuin-A, adiponectin, RBP-4 and hsCRP with insulin resistance in obese non diabetic men. METHODS: This was an observational study with a cross-sectional design. The study subjects were 64 men with non diabetic abdominal obesity, characterized by waist circumference of 98.47 ± 5.88 cm and fasting blood glucose of 85.75±8.36 mg/dL. RESULTS: This study showed that fetuin-A was positively correlated with HOMA-IR in obese non diabetic men with insulin resistance (r = 0.128; p = 0.570), although not significant. Fetuin-A was found to be correlated with adiponectin, RBP-4 and hsCRP (r=0.150; p=0.233; r=0.050; p=0.711; r=-0.04; p=0.445), although not significant. CONCLUSIONS: The concentration of fetuin-A showed a tendency to be positively correlated with HOMA-IR and with RBP-4 in obese non diabetic men, although statistically not significant. The concentration of fetuin-A showed a tendency to be negatively correlated with adiponectin and hsCRP although statistically not significant. There was no interrelationship between fetuin-A, adiponectin, RBP-4, hsCRP and HOMA-IR. Elevated concentrations of fetuin-A were noted in obese subjects, which in turn might impair insulin signaling. This finding might suggest that fetuin-A may represent a new target for the prevention of insulin resistance. Further studies might be needed on obese population with fatty liver.

29-34

Authors: Diah Kumalasari, Andi Wijaya, Anwar Santoso

BACKGROUND: Myocardial infarction is one of the coronary artery diseases caused by plaque rupture, plaque erosion or calcified nodules, with the occurence of thrombus formation and artery occlusion. YKL-40 has a functional role in plaque fibrous formation because of its high expression during fibrosis development, vascular smooth muscle cells differentiation, elevated matrix turnover and tissue remodelling in old myocardial infarction, whereas CD40 ligand, which is stored in the cytoplasm of resting platelets, rapidly presents on the surface. After cleavage, a soluble functional CD40 ligand (sCD4OL) is generated. The aim of this study was to assess the association between YKL-40 and sCD4OL in old myocardial infarction. METHODS: This study used the cross sectional study design. Fifty six patients with old myocardial infarction were selected based on their electrocardiographical results. Among these patients, 23 subjects had hypertension and 15 subjects had hsCRP >3-l0 mg/L. YKL-40 and sCD40L were measured by ELISA method. RESULTS: There was no significant correlation between YKL-40 and sCD40L (r=0.078; p=0.569) in old myocardial infarction and in subjects with hsCRP >3-10 mg/L (r=0.524; p=0.045). However, significant positive correlations Were found in subjects with hypertension (r=0.447; p=0.029). CONCLUSIONS: Our findings showed that YKL 40 correlated significantly with sCD4OL in subjects with hypertension.

43-9

Authors: Bayu Winata Putera, Cynthia Retna Sartika, Andi Wijaya

BACKGROUND: Obesity is a major health problem in the world today. Obesity is closely associated with insulin resistance and type 2 diabetes. Epidemiological studies have shown that obese persons are in a state of insulin resistance, however, most of them do not progress to type 2 diabetes. This occurs because the beta cell function is still good enough for maintaining normal glucose level. Obestatin and visfatin are cytokines that are known to have a role in beta cell function. The aim of this study was to assess the relationship between visfatin and obestatin and Homeostasis Model Assessment of beta cell function (HOMA-β) and Homeostasis Model Assessment of insulin resistance (HOMA-IR). METHODS: This was a cross-sectional study involving 80 central obesity men with waist circumference >90 cm, age 30-65 years old. Visfatin and obestatin were measured by ELISA method. Beta pancreas cell dysfunction and insulin resistance were calculated by HOMA model. RESULTS: Our study showed a correlation between visfatin and HOMA-β (r=0.244 and p = 0.029) and visfatin with HOMA-IR (r=0.287 and p=0.001) and no correlation was found between obestatin with HOMA-β (r=0.010 and p=0.990) and obestatin with HOMA-IR (r=0.080 and p=0.480). We also found visfatin and obestatin concentrations were fluctuative depending on the measurements of the waist circumferences. CONCLUSIONS: High visfatin and low obestatin concentration were independently associated with increased beta pancreas cell dysfunction and insulin resistance.