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"Gastropathy refers to the damage of the epithelial cells of the gastric mucosa and disturbance of epithelial cell regeneration unaccompanied by inflammation. Gastropathy occurs due to irritation by chemical agents (such as non-steroidal anti inflammatory drugs - NSAIDs and alcohol), bile reflux, hypovolemic conditions, and chronic obstruction.NSAIDs in general are chemical agents that cause irritation of the upper gastrointestinal tract through direct and indirect topical effects and by inhibiting prostaglandin synthesis through inhibition of COX-1 and COX-2. There are many data that demonstrates that the anti-inflammatory function of NSAIDs is mainly through inhibition of COX-2, while many of their side effects are due to inhibition of COX-1.In general, there is a correlation between the influence of NSAID and the administered dose. The higher the dose, the higher the risk for upper gastrointestinal tract disorder. NSAID users who frequently switch drugs have a risk twice higher than those only receiving one kind of NSAID. Those who use NSAID with corticosteroids have 15 times the risk. Use ofNSAID simultaneously with anticoagulants increases the risk of bleeding from ulcer 13 times compared to control subjects. NSAID use in a patient with history of bleeding from the gastrointestinal tract is 17.2 times non-users. Smoking also increases the percentage of gastroduodenal ulcer due to NSAID.Clinical symptoms ofNSAID gastropathy are often only dyspepsia syndrome. There is no correlation between symptoms and endoscopic findings.The first step in the therapy ofNSAID gastropathy is termination ofNSAID administration. To treat and prevent risks of gastropathy due to NSAID, mucosal protection agents may be used. Out of the various kinds of medicine available, proton-pump inhibitors turn out to be more effective compared to H2 receptor antagonists or cytoprotectiveagents."

"ABSTRAKPasien kanker umumnya mengalami penurunan berat badan terkait kaheksia. Patofisiologi kaheksia kanker multifaktorial, termasuk efek sitokin pro inflamasi dan inflamasi sistemik. Profil asam amino plasma pada pasien kanker mengalami perubahan. Deplesi protein dapat terjadi akibat asupan yang menurun atau efek langsung dari tumor. Penelitian ini bertujuan untuk mengetahui profil dan hubungan antara asam amino serum, status nutrisi dan sitokin-sitokin pro-anti inflamasi, serta sel T helper 17 pada pasien kaheksia kanker paru. Penelitian potong lintang dengan consecutive sampling pada pasien kanker paru dengan kaheksia ini mengambil subjek berusia lebih dari 18 tahun dan belum diterapi atau sudah selesai terapi lebih dari 2 bulan di Rumah Sakit Kanker Dharmais. Analisis asupan dilakukan dengan food frequency questionnaire semikuantitatif dan 24-hours food recall. Pemeriksaan asam amino serum dengan metode spektofotometri, Sel T helper-17 dengan metode flowcytometry, dan C-reactive protein dengan metode latex agglutination, serta kadar IL 17, IL 6 dan TNFα dengan metode ELISA. Data yg didapat kemudian di analisis dengan uji T atau Mann Whitney untuk melihat hubungan dan untuk menganalisis hubungan dalam tabel digunakan uji Chi-Square atau Fischer Exact, sedangkan untuk korelasi digunakan uji Pearson atau Spearman. Asam amino triptofan, asparagin, glutamin, valin, lisin dan sistein berkorelasi positif dengan sitokin anti-inflamasi dan status nutrisi, sebaliknya negatif dengan sitokin pro inflamasi. Asam amino fenilalanin, treonin, dan glutamat berkorelasi positif dengan sitokin pro-inflamasi dan berkorelasi negatif dengan status nutrisi dan sitokin anti inflamasi. Khusus aspartat, selain berkorelasi positif dengan sitokin pro inflamasi, juga berkorelasi positif dengan indeks massa tubuh, tetapi menunjukkan korelasi negatif dengan penurunan berat badan. Beberapa asam amino serum terbukti berhubungan dengan status sitokin dan status nutrisi pada subjek kanker paru dengan kaheksia, sehingga perlu menjadi perhatian dalam terapi nutrisi pasien kankerKata kunci: asam amino serum, status nutrisi, sitokin, kaheksia kanker

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ABSTRACTCancer patients generally experience weight loss associated with cancer cachexia. The pathophysiology of cancer cachexia is multifactorial, including the effects of pro inflammatory cytokines and systemic inflammation.. The plasma amino acid profile was found to significantly undergo changes in cancer patients. Protein depletion can occur due to decreased intake or direct effects of tumors on protein metabolism. This study aimed to determine the profile and relationship between serum amino acids, nutritional status and pro-anti-inflammatory cytokines, and T helper 17 cells in lung cancer cachexia patients. This cross-sectional study with consecutive sampling in lung cancer patients with cachexia took subjects over the age of 18 years and who had not been treated or who had finished therapy for more than 2 months at the Dharmais Cancer Hospital. Dietary intake analyses were carried out with semiquantitative food frequency questionnaire and 24-hour food recalls. Blood tests were carried out in the form of serum amino acids, cytokines, C-reactive protein and T helper 17 cells. Data obtained were then analyzed by the T or Mann Whitney test to see the relationship and to analyze relationships in the table used chi-square or Fischer Exact, while for correlation used Pearson or Spearman test. The amino acids tryptophan, asparagine, glutamine, valine, lysine and cysteine were positively correlated with anti-inflammatory cytokines and nutritional status, and negatively correlated with pro-inflammatory cytokines. Phenylalanine, threonine and glutamate amino acids were positively correlated with pro-inflammatory cytokines and negatively correlated with nutritional status and anti-inflammatory cytokines. Aspartate showed a positive correlation pro inflammatory cytokines and body mass index, but a negative correlation with weight loss. Some serum amino acids have been shown to be related to cytokines and nutritional status in lung cancer cachexia patients, so it should be a concern in nutritional therapy for cancer patients"

"Non-steroidal anti-inflammatory drugs (NSAIDs) is a group of drugs used to treat pain, inflammation, and fever. High consumption of NSAIDs associated with high gastrointestinal side effects. Common complaint from patients, which ranging from mild heartburn to the onset of gastrointestinal bleeding, often complicates the adequate administration of NSAIDs. Various methods have been developed to reduce the likelihood of gastroenteropathy complication. Early diagnosis, appropriate prompt treatment, as well as adequate monitoring will reduce morbidity and mortality from complications due to NSAIDs. This paper will discuss the diagnosis and management of gastro-enteropathy NSAID through approaching the underlying pathophysiology."

"Latar Belakang: Hilangnya mikroorganisme komensal yang menjadi building block dari maturasi sistem imun dapat menyebabkan ketidakseimbangan sitokin proinflamasi dan antiinflamasi. Disregulasi dari sistem imun memiliki implikasi pada predisposisi penyakit. Tujuan: Mengetahui hubungan antara status permukiman sebagai proksi dari pajanan mikroorganisme dengan keseimbangan sitokin proinflamasi dan antiinflamasi. Metode: Penelitian dengan desain studi potong lintang analitik ini menggunakan data sekunder dari disertasi berjudul “Regulasi Respons Imun Subyek di Permukiman Kumuh: Studi Imunitas Seluler pada Kultur Sel Darah yang Distimulasi Malaria, Vaksin BCG, dan LDL” di mana sampel kelompok kumuh diambil dari masyarakat yang bermukim di sekitar TPST Bantar Gebang (n=10), sedangkan sampel kelompok nonkumuh diambil dari mahasiswa Universitas YARSI (n=8). Pada penelitian tersebut sampel darah kelompok kumuh dan nonkumuh dikultur dengan metode PBMC dan distimulasi dengan LPS. Kadar TNF-alfa dan IL-10 diukur menggunakan luminex assay pada kondisi basal, pascastimulasi, dan kedua data tersebut dibandingkan menjadi suatu nilai rasio stimulasi:basal yang menggambarkan besarnya peningkatan produksi setelah terpajan stimulus dari keadaan basal. Hasil: Pada keadaan basal, kadar TNF-alfa lebih tinggi pada kelompok kumuh, namun tidak bermakna secara statistik (p=0,202). Kadar IL-10 pada keadaan basal lebih tinggi pada kelompok nonkumuh, namun juga tidak bermakna (p=0,108). Kadar TNF-alfa pascastimulasi LPS dan dalam bentuk rasio stimulasi:basal lebih tinggi secara bermakna pada kelompok kumuh (masing-masing p=0,000 dan p=0,005), sementara kadar IL-10 pascastimulasi LPS maupun dalam bentuk rasio stimulasi:basal lebih tinggi pada kelompok kumuh, namun tidak bermakna secara statistik (masing-masing p=0,893 dan p=0,423). Korelasi antara kadar TNF-alfa dan IL-10 sangat kuat dan signifikan pada kelompok kumuh (r=0,881, p=0,000), sementara korelasi yang lebih lemah da tidak signifikan diamati pada kelompok nonkumuh (r=0,611, p=0,054). Kesimpulan: Penduduk permukiman kumuh memiliki potensi produksi sitokin proinflamasi TNF-alfa yang lebih besar, namun potensi tersebut diimbangi dengan produksi sitokin antiinflamasi IL-10 secara seimbang. Hal ini tidak diamati pada penduduk permukiman nonkumuh.

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Introduction: Reduced exposure to commensal microorganisms—one of the building blocks/inputs needed for immune system maturation—can lead to aberation on the balance between pro- and anti-inflammatory cytokine. This kind of immune dysregulation has an implication on disease predisposition. Objective: To determine the association between residential status—a proxy for microorganism exposure—and the balance of pro- and anti-inflammatory cytokine production. Method: This is an analytic cross-sectional study and secondary data was obtained from a parent study titled "Regulation of Immune Response to People Living in The Slum Area: A Study of Cellular Immunity on Whole Blood Cultures Stimulated Malaria, BCG, and LDL". Subjects for the rural group were sampled from Bantar Gebang landfill (n=10) while subjects for the urban group were sampled from YARSI University students (n=8). Blood sampled from the subjects was cultured using PBMC method and stimulated using Lipopolysaccharide. The measurement for the concentration of TNF-alpha and IL-10 was undertaken using luminex assay in basal and after stimulation condition. Both data were then made into a ratio (stimulated:basal) that represents the amount of cytokine production increment from basal. Result: At the basal condition, TNF-alpha concentration was higher in rural group, but the association was not significant (p=0,202). Meanwhile, IL-10 concentration at the basal condition was higher in urban group, but the association was not significant as well (p=0,108). The concentration of TNF-alpha after stimulation and the stimulated:basal ratio were significantly higher for rural group (p=0,000 and p=0,005, respectively), while the concentration of IL-10 after stimulation and the stimulated:basal ratio were higher for rural group, but the mean differences were statistically insignificant (p=0,893 dan p=0,423, respectively). Correlation between the concentration of TNF-alpha and IL-10 was very strong and statistically significant for rural group (r=0,881, p=0,000), while a weaker insignificant correlation was observed for urban group (r=0,611, p=0,054). Conclusion: Rural population have a greater potential to produce pro-inflammatory cytokine TNF-alpha but this potential was followed and balanced by the production of anti-inflammatory cytokine IL-10. This relationship was not observed in the urban population.

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