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"Karsinoma hepatoselular memiliki prognosis yang buruk akibat keterbatasan terapi seperti terlambat diagnosis, kurangnya biomarker spesifik, dan ketidakpekaan terhadap agen tumor ini. Imunoterapi berbasis sel NK autologus dengan stimulasi eksosom menjadi modalitas pengembangan imunoterapi berbasis sel NK untuk pasien karsinoma hepatoseluler. Sel NK pasien karsinoma hepatoseluler diisolasi dari darah vena perifer dan eksosom diisolasi dari serum darah donor sehat. Karakterisasi eksosom dengan particle size analyzer dan flow cytometry. Stimulasi eksosom ke sel NK selama 24 jam kemudian evaluasi ekspresi reseptor NKp44, NKp46, NKp30, NKG2D, KIR2D, dan NKG2A serta ekspresi perforin dan granzyme B. Visualisasi interaksi sel NK dengan fraksi sel mononuklear lainnya (CD4, CD8, CD11c, dan CD19) dengan imunofluorens. Ukuran partikel < 100 nm, muatan listrik negatif dan CD63+CD81+ (positif ganda) hasil isolasi eksosom. Terjadi peningkatan ekspresi reseptor NKp44, NKp46, NKp30, NKG2D, penurunan ekspresi NKG2A, serta peningkatan ekspresi perforin dan granzyme B pada sel NK terinduksi eksosom. Tidak ada interaksi sel berupa sinapsis imun antara sel NK terstimulasi eksosom dengan fraksi sel mononuklear lain pasien karsinoma hepatoseluler. Stimulasi eksosom ke sel NK pasien karsinoma hepatoseluler memulihkan kemampuan sitotoksik sel NK.

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Hepatocellular carcinoma has a poor prognosis due to limitations of therapy such as late diagnosis, lack of specific biomarkers, and insensitivity to this tumor agent. Autologous NK cell-based immunotherapy with exosome stimulation is a modality for developing NK cell-based immunotherapy for hepatocellular carcinoma patients. NK cells from hepatocellular carcinoma patients were isolated from peripheral venous blood, and exosomes were isolated from the blood serum of healthy donors. Exosome characterization with a particle size analyzer and flow cytometry. Stimulation of exosomes on NK cells for 24 hours, then evaluation of expression of NKp44, NKp46, NKp30, NKG2D, KIR2D, and NKG2A receptors, as well as perforin and granzyme B expression. Visualization of interactions of NK cells with other mononuclear cell fractions (CD4, CD8, CD11c, and CD19) by immunofluorescence. Particle size < 100 nm, negative electric charge, and CD63+CD81+ (double positive) exosome isolated results. There was increased expression of receptors NKp44, NKp46, NKp30, NKG2D, decreased expression of NKG2A, and increased expression of perforin and granzyme B in exosome-induced NK cells. There was no cell interaction in the form of immune synapses between exosome-stimulated NK cells and other mononuclear cell fractions in hepatocellular carcinoma patients. Stimulation of exosomes into NK cells of hepatocellular carcinoma patients restores the cytotoxic ability of NK cells."

"Karsinoma hepatoseluler (KHS) adalah kanker primer liver dan penyebab kedua kematian akibat kanker. Eksosom pada lingkungan mikro KHS berfungsi untuk komunikasi antar sel dan bila endositosis ke sel NK dapat menyebabkan perubahan pada sel NK. Penelitian ini bertujuan menganalisis eksosom dari darah pasien KHS, perubahan fenotipe sel NK, dan uji pewarnaan histologi (peroksidase, toluidine blue) untuk mengamati perubahan granula azurofilik sel NK akibat endositosis eksosom. Metode penelitian meliputi isolasi sel NK dari donor sehat dan eksosom darah pasien KHS, karakterisasi eksosom dengan PSA, stimulasi sel NK dengan eksosom, flow cytometry reseptor pada sel NK dan CD81+ pada eksosom, imunofluoresens endositosis eksosom ke sel NK, pewarnaan toluidine blue dan peroksidase.Hasil menunjukkan eksosom berukuran 34,7 nm, bermuatan -4,33 mV dan positif CD81+. Perubahan reseptor sel NK sehat yang dipaparkan eksosom KHS tidak signifikan (P>0,05). Imunofluoresens memperlihatkan endositosis eksosom ke sel NK. Pewarnaan sel NK toluidine blue menunjukkan metakromasia dan peroksidase negatif. Sel NK+eksosom mengalami perubahan hasil pewarnaan. Peneliti menyimpulkan bahwa eksosom dari darah pasien KHS sesuai kriteria MISEV 2018.Tidak terjadi perubahan fenotipe sel NK sehat yang dipaparkan eksosom dari darah pasien KHS. Pewarnaan peroksidase dan toluidine blue dapat digunakan sebagai metode pengamatan endositosis eksosom ke sel NK.

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Hepatocellular carcinoma (HCC) is the primary liver cancer and the second leading cause of death from cancer. Exosomes in the HCC microenvironment function for communication between cells and when endocytosed to NK cells can cause changes in NK cells. This study aims to analyze exosomes from the blood of HCC patients, changes in NK cell phenotype, and histological staining tests (peroxidase, toluidine blue) to observe changes in NK cell azurophilic granules due to exosome endocytosis. NK cells from healthy donors and blood exosomes of KHS patients were isolated, exosomes characterized by PSA, stimulation of NK cells with exosomes, and flow cytometry of receptors on NK cells and CD81+ on exosomes were done. Endocytosis of exosomes onto NK cells were observed through immunofluorescence, then metacromasia and azurofilic granules of NK cells were observed after toluidine blue and peroxidase staining. Results showed The exosome is 34.7 nm in size, has a charge of -4.33 mV and is CD81+ positive. Changes in healthy NK cell receptors exposed to HCC exosomes were not significant (P>0.05). Immunofluorescence demonstrates exosome endocytosis in NK cells. Toluidine blue NK cell staining showed negative metachromasia and peroxidase. In NK cell+exosome there is a change in staining results. We concluded exosomes from the blood of HCC patients comply with MISEV 2018 criteria. There is no change in the phenotype of healthy NK cells exposed to exosomes from the blood of HCC patients. Peroxidase and toluidine blue staining can be used as a method of observing exosome endocytosis in NK cells."

"Tendinopati Achilles diabetes merupakan penyakit degeneratif akibat perubahan homeostasis jaringan tendon yang disebabkan oleh diabetes melitus tipe 2. Penyembuhan tendinopati Achilles diabetes sulit untuk dicapai karena terbatasnya kapasitas regenerasi tendon. Eksosom asal sel punca mesenkimal (SPM) sumsum tulang memiliki kemampuan dalam menghambat degenerasi jaringan sehingga berpotensi untuk mengatasi tendinopati Achilles diabetes. Efek eksosom SPM sumsum tulang terhadap tendon Achilles dapat diinvestigasi melalui perubahan ekspresi relatif gen a disintegrin and metalloproteinase domain 12 (ADAM12). Gen ADAM12 merupakan gen pendegradasi matriks yang terekspresi tinggi pada tendinopati Achilles diabetes. Penelitian ini bertujuan untuk mengetahui pengaruh injeksi 0,8 mL eksosom asal SPM sumsum tulang pada tendinopati Achilles tikus diabetes berdasarkan analisis histologi dan ekspresi gen ADAM12. Sebanyak 12 ekor tikus putih jantan galur Sprague Dawley dikelompokkan menjadi dua kelompok yang terdiri atas kelompok kontrol tendinopati (KK) dan kelompok eksosom (KE). Analisis histologi tendon Achilles posmortem hari ke-21 dilakukan dengan metode semikuantitatif skor Bonar dan histomorfometri kuantitatif luas area kolagen melalui pulasan Hematoksilin-Eosin, Alcian Blue, dan Masson’s Trichrome. Perubahan ekspresi gen ADAM12 diperiksa secara kuantitatif menggunakan qRT-PCR. Berdasarkan hasil penelitian, rata-rata skor Bonar KE (1,67 ± 1,282) ditemukan lebih rendah daripada KK (6,40 ± 2,195) secara signifikan (P = 0,001; P < 0,05). Analisis histomorfometri juga menunjukkan rata-rata luas area kolagen KE (85,15 ± 7,023) yang cenderung lebih tinggi dibandingkan KK (76,64 ± 9,237), tetapi tidak berbeda nyata (P = 0,103; P ≥ 0,05). Ekspresi gen ADAM12 KE mengalami perubahan sebesar 0,9 kali lipat lebih tinggi daripada KK, meskipun secara statistik tidak signifikan (P = 0,421; P ≥ 0,05). Dengan demikian, dapat disimpulkan bahwa injeksi 0,8 mL eksosom asal SPM sumsum tulang terbukti memiliki potensi dalam memicu perbaikan tendinopati Achilles diabetes pada hari ke-21.

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Diabetic Achilles tendinopathy is a degenerative disease resulting from changes in tendon tissue homeostasis caused by type 2 diabetes mellitus. The cure of diabetic Achilles tendinopathy is difficult to achieve due to the limited regeneration capacity of the tendon. Exosomes from bone marrow-derived mesenchymal stem cells (MSC) can inhibit tissue degeneration so they have the potential to treat diabetic Achilles tendinopathy. The effect of exosomes from bone marrow-derived MSC on the Achilles tendon can be investigated through changes in the relative expression of a disintegrin and metalloproteinase domain 12 (ADAM12) gene. The ADAM12 gene is a matrix-degrading gene that is highly expressed in diabetic Achilles tendinopathy. This study aims to determine the effect of injection of 0.8 mL of exosomes from bone marrow-derived MSC on Achilles tendinopathy in diabetic rats based on histology analysis and ADAM12 gene expression. A total of 12 male white Sprague Dawley rats were grouped into two groups consisting of the tendinopathy control group (KK) and the exosome group (KE). Postmortem Achilles tendon histology analysis on day 21 was carried out using the semiquantitative Bonar score method and quantitative histomorphometry of collagen area using Hematoxylin-Eosin, Alcian Blue, and Masson's Trichrome staining. Changes in ADAM12 gene expression were examined quantitatively using qRT-PCR. Based on the research results, the mean score of Bonar KE (1.67 ± 1.282) was found to be significantly lower than KK (6.40 ± 2.195) (P = 0.001; P < 0.05). The histomorphometric analysis also showed that the average collagen area of KE (85.15 ± 7.023) tended to be higher than KK (76.64 ± 9.237) but was not significantly different (P = 0.103; P ≥ 0.05). ADAM12 KE gene expression changed 0.9-fold higher than KK, although it was not statistically significant (P = 0.421; P ≥ 0.05). Thus, the injection of 0.8 mL of exosomes from bone marrow-derived MSC was proven to have the potential to trigger improvement in diabetic Achilles tendinopathy on day 21."