Medical Journal of Indonesia
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Role of regulatory T cells and T helper 17 cells in the pathogenesis of hypertension: a review
No full textThe discovery of autoantibodies in artery samples from cadavers with hypertension over 50 years ago suggested a potential link between the immune system and hypertension. Since then, research exploring the role of the immune system in hypertension has emerged. Animal studies have demonstrated a strong correlation between regulatory T cells (Tregs) and T helper 17 (Th17) cells in hypertension development, yet studies on human hypertension remain limited. Tregs produce inhibitory cytokines such as interleukin (IL)-10 and transforming growth factor-β to act as anti-inflammatory cells that protect against hypertension. In contrast, Th17 cells, by producing IL-17A, function as pro-inflammatory cells that promote hypertension. Recently, a subset of cells known as IL-17A+FOXP3+Treg cells have been identified, which can produce IL-17 and act as inflammatory cells under certain conditions. Understanding the basic mechanisms by which the immune system influences hypertension could lead to targeted immunotherapies for hypertension in the future. Thus, we highlighted the role of Tregs and Th17 cells in the development of hypertension and their potential as targets for therapy. Our findings confirmed the role of Tregs and Th17 cells in the pathogenesis of hypertension
Comparing anastomosis techniques on ischemia time in multi-arterial kidney grafts: a systematic review and meta-analysis
No full textBACKGROUND Kidney transplants with multiple renal arteries (MRAs) address donor shortages but carry higher vascular risks than single renal arteries. This study aimed to evaluate how different anastomosis techniques affect outcomes in kidney transplants with MRAs through meta-analysis and systematic review, concluding the continuous discussion about the best reconstructive strategy.
METHODS A comprehensive search across 5 databases (PubMed, ScienceDirect, Cochrane Library, Web of Science, and the Cumulative Index to Nursing and Allied Health Literature) was conducted until December 17, 2024, to find studies comparing anastomoses technique in MRA grafts. Meta-analysis was performed using Review Manager software version 5.4, generating pooled effect estimates for mean difference (MD) and risk ratio (RR), two-sided p-values, and 95% confidence intervals (CIs).
RESULTS Two retrospective cohort studies were included in the meta-analysis. There was no significant difference between end-to-side and side-to-side anastomosis in warm ischemia time (MD = 15.64, 95% CI: −6.82−38.10, p = 0.17) or cold ischemia time (MD = −16.74, 95% CI: −105.61−72.14, p = 0.71). The complication rate showed no significant variation between side-to-side and end-to-side anastomosis (RR = 2.38, 95% CI: 0.41−13.70, p = 0.33). Meta-analysis on graft function and rejection was impossible due to differences in measurements and the small number of studies.
CONCLUSIONS Different anastomosis techniques for MRA grafts did not result in longer ischemia times or higher complication rates. Graft function and rejection rates were comparable between side-to-side and end-to-side anastomosis, suggesting both were equally feasible for renal transplants with MRAs. Further studies are required to verify these findings
Predictors of syphilis infection among HIV pre-exposure prophylaxis users
No full textBACKGROUND Pre-exposure prophylaxis (PrEP) has revolutionized HIV prevention worldwide. However, research has shown a contradictory trend in which PrEP helps reduce HIV incidence, but increases sexually transmitted infections (STIs), especially in high-risk groups like men who have sex with men and female sex workers. This study aimed to examine the association between sex, age, occupational status, hepatitis B virus (HBV) infection, and hepatitis C virus (HCV) infection with syphilis infection among PrEP users.
METHODS The cross-sectional survey was conducted over 1 year, with 864 participants in Thu Duc City Hospital, Vietnam. The chi-square test was utilized for descriptive analysis. Binary logistic regression models estimated the association between sex, age, occupational status, HBV infection, and HCV infection with syphilis infection. Odds ratio (OR) and 95% confidence intervals (CIs) were calculated.
RESULTS Of 864 participants, 147 (18.2%) men and 68 (23.7%) employed individuals were tested positive for syphilis. The findings indicated that men (OR = 13.805; 95% CI = 1.886−101.024), employed individuals (OR = 1.838; 95% CI = 1.191−2.834), and HBV infection (OR = 2.076; 95% CI = 1.108−3.891) were significantly associated with an increased risk of syphilis infection.
CONCLUSIONS Men, employed individuals, and individuals infected with HBV face a higher risk of syphilis infection among PrEP users
Serum levels of IL-17A and cathelicidin antimicrobial peptide LL37 in females with breast cancer
No full textBACKGROUND Breast cancer (BC) is a leading cause of morbidity and mortality in women. Interleukin (IL)-17 and the antimicrobial peptide LL37 have been implicated in BC pathogenesis. This study aimed to assess their levels in women with BC and evaluate their correlation with molecular subclasses, clinical, and laboratory parameters.
METHODS This study included 69 BC females and 35 healthy controls. Patients were classified based on metastatic status and molecular indicators. Serum IL-17A and LL37 concentrations were estimated using ELISA and compared across patient subgroups. The area under the curve (AUC) was analyzed to determine cut-off values, sensitivity, and specificity for their diagnostic potential in BC.
RESULTS IL-17A and LL37 levels were notably higher in patients with BC than in controls (p<0.0001). LL37 levels were also higher in the metastatic than in the non-metastatic group and controls. IL-17A levels were considerably higher in patients with metastatic than in controls (p<0.0001), but did not differ significantly between metastatic and non-metastatic patients (p = 0.5573). Regarding diagnostic performance, LL37 showed an AUC of 0.989 (p<0.001) at the best cut-off value of 16.79 ng/ml, LL37 exhibited 95% sensitivity and 94% specificity, indicating diagnostic potential. IL-17A showed an AUC of 0.87 (p<0.001), with a best cut-off value of 15.11 pg/ml, 78.81% sensitivity, and 100% specificity. Both LL37 and IL-17A levels were correlated with each other (r = 0.284, p = 0.018).
CONCLUSIONS Patients with BC had increased serum levels of IL-17A and LL37. Their estimation is important for the follow-up of patients with metastatic
Hematologic profile of hemoglobin constant spring and its co-inheritance with hemoglobin C: a case report
No full textHemoglobin constant spring (Hb CS) is an alpha-globin variant characterized by an elongated alpha chain due to a mutation that leads to unstable hemoglobin (Hb) levels. Hemoglobin C (Hb C) is a beta-globin variant associated with mild hemolytic anemia. The co-inheritance of Hb CS and Hb C is uncommon and presents distinct hematologic features. We report the case of a 7-year-old Malaysian male who developed acute polyarthritis due to streptococcal infection. Routine blood tests revealed microcytic hypochromic anemia, suggestive of a thalassemia trait. Hb analysis via high-performance liquid chromatography and capillary electrophoresis detected low hemoglobin A levels with an additional peak in the Hb C zone. DNA analysis confirmed compound heterozygosity for Hb CS and Hb C. Family screening revealed that the mother is an Hb C carrier, and the father is an Hb CS carrier. This case report examined the hematological profile of a patient with this genetic combination
Estrogen receptor expression in type 1 endometrial cancer and its association with lymphovascular space invasion
No full textBACKGROUND Endometrial cancer (EC) ranks sixth in female genital malignancy and originates in the endometrial lining. Estrogen receptor (ER) expression is important in EC prognosis and recurrence, influenced by the presence of lymphovascular space invasion (LVSI). This study aimed to determine the association between ER expression and LVSI in type 1 EC.
METHODS A retrospective analysis was conducted on 135 patients with type 1 EC who underwent surgery at the Cipto Mangunkusumo Hospital, Jakarta, Indonesia, between January 2012 and December 2022. Immunohistochemistry (IHC) with ER antibodies was performed on all samples in April 2023. ER expression was evaluated using the Allred scoring system, and its association between ER expression (percentage and intensity stain) and LSVI was statistically analyzed.
RESULTS Of 135 samples, 44 (32.6%) were LVSI-positive. No significant association was found between IHC percentage stain and LVSI (p = 0.994). However, a significant association was found between IHC stain intensity and LVSI-positive in patients with type 1 EC (p = 0.022). ER intensity score 2 had a higher LVSI risk compared to score 1 and score 3 (from 51%, 26%, and 26%, respectively).
CONCLUSIONS ER expression is associated with LVSI of type 1 EC. While IHC stain percentage showed no correlation with LVSI, stain intensity was significantly linked to LVSI-positive in patients with type 1 EC. Regular assessment of ER expression can provide significant prognostic information, support hormonal therapy, and identifying clinical characteristics of tumors
Formulation of mice diet with low cholecalciferol content
No full textBACKGROUND Vitamin D deficiency has been linked to autoimmune diseases, cancer, and cardiovascular diseases. Although 1 study attempted to elucidate the ingredients required to make this diet, the process remained unclear. Hence, this study aimed to customize a low cholecalciferol diet with good tolerability in mice.
METHODS We customized a diet containing a normal cholecalciferol content (1 IU/g diet) and another with a low cholecalciferol content (0.05 IU/g diet). Samples from both diets were sent to an independent laboratory to ensure that the levels of cholecalciferol, phosphorus, and calcium present in the custom diets matched our calculations. 5 mice were fed the customized normal cholecalciferol diet for 1 week to assess tolerability. Tolerability was assessed by measuring the amount of food consumed, weight gained, and the presence of any adverse events.
RESULTS Cholecalciferol, phosphorous, and calcium levels in both diets satisfactorily matched our calculations. The diet was well tolerated without any adverse events or mortalities. The mice consumed an adequate amount of food (mean: 5.34 [0.08] g diet/day, 95% confidence interval [CI]: 5.12–5.56; 19.38 kcal, fat: 0.43 g, protein: 0.14 g, carbohydrates: 3.16 g, and cholecalciferol: 0.007 mg) and gained a slight amount of weight by the end of the experiment (mean: 1.86 [0.46] g, 95% CI: 0.58–3.14).
CONCLUSIONS This study successfully created 2 custom diets with quantified cholecalciferol contents. This animal model may prove valuable for studies involving vitamin D
Radiological and histological assessment of a novel interlocking three-dimensional miniplate for mandibular angle fractures: an animal study
No full textBACKGROUND Open reduction and internal fixation are considered the gold standard for managing mandibular fractures, as they effectively restore anatomical structure and functionality. Three-dimensional (3D) miniplates were developed to obtain a geometrically stable structure. However, the rigid structure of 3D miniplate may cause screw holes to be located within the fracture lines or directly above important anatomical structures. Hence, we have developed customizable interlocking 3D miniplates that allow for modifications in the configuration of the horizontal miniplates and vertical cross-struts to meet specific requirements.
METHODS This study included 24 goats divided into 2 groups: interlocking 3D miniplate and standard plate. Each group was further divided into subgroups sacrificed on Days 5, 28, and 56. Radiological assessments were performed to evaluate bone, muscle, peri-implant bone, and peri-implant muscle density. Histological assessments were performed using Masson's trichome (MT) for bone healing evaluation and hematoxylin and eosin (H&E) staining for biocompatibility.
RESULTS Radiological assessment indicated an increase in density across all measured parameters from Day 5 to 56. Histological evaluation from MT staining showed a significantly higher fibrocartilage in the interlocking 3D miniplate group (6.109%, IQR 1.453–10.828) compared to standard plate (1.311%, IQR 0.636–2.553; p = 0.001). Furthermore, H&E staining showed significantly higher inflammatory cell counts in the standard group on Days 28 and 56 compared to the interlocking 3D miniplate group (p = 0.027).
CONCLUSIONS This study concluded that the interlocking 3D miniplate showed better bone healing properties and biocompatibility than the standard plate
