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"ABSTRAKDalam beberapa tahun terakhir, kasus Parkinson rsquo;s disease telah bertambah banyak, dengan teori patologis yang turut berkembang. Salah satu teori patologis yang paling dikenal adalah teori inflamasi yang melibatkan aktivasi mikroglia dan ekspresi sitokin proinflamatori. Studi sebelumnya telah mengkonfirmasi efek andrografolida terhadap karakter anti-inflamatorinya. Sangatlah penting untuk mendapatkan pemahaman yang lebih baik tentang efek andrografolida dalam berbagai dosis sebagai agen neuroprotektif pada model Parkinson yang disebabkan oleh MPTP. 5 jenis perlakuan diberlakukan terhadap 5 kelompok tikus C57bl/6. Perlakuan yang dimaksud adalah 1 kontrol normal, 2 positif MPTP, 3 positif MPTP dan selegiline, 4 positif andrografolida pada dosis 5 mg/kgbb, dan 5 positif andrografolida pada dosis 50 mg/kgbb. Analisis imunohistokimia digunakan untuk menentukan level TNF?. Analisa statistik menghasilkan perbedaan level TNF? yang tidak signifikan antara kelompok andrografolida dan kelompok kontrol. level TNF? adalah 10.0000 3.50999 pada kelompok normal, 8.3600 2.89275 pada kelompok selegilin, 12.8000 7.78203 pada kelompok MPTP, 5.4000 2.43311 pada kelompok andrografolida 50 mg/kgbb, dan 5.8000 1.61864 pada kelompok andrografolida 5 mg/kgbb . Hasil studi ini menunjukkan bahwa tidak ada pengurangan TNF? yang signifikan setelah diberikan andrografolida pada dosis 5 dan 50 mg/kgbb pada model Parkinson yang telat diberikan MPTP. Maka tidak disimpulkan adanya efek neuroprotektif dari andrografolida.

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ABSTRACTParkinson rsquo s disease has overgrown cases in the last few years, with emerging pathological theories have also been developing. One of the most acknowledged pathological theories is the neuroinflammation theory involving microglial activation and proinflammatory cytokines expression. Previous studies have confirmed andrographolide effect on anti inflammatory characteristics. It is important to acquire better understanding on the effect of andrographolide as a neuroprotective agent in MPTP induced Parkinsonism model in several dose. 5 types of treatment were enacted on 5 groups of C57bl 6 mice. Treatments include 1 normal control, 2 MPTP treated, 3 MPTP and selegiline treated, 4 Andrographolide treated at 5 mg kgbw, and 5 Andrographolide treated at 50 mg kgbw. Immunohistochemical analysis was used to determine TNF level. Statistical analysis result showed no significant differences of TNF level between the groups treated with andrographolide and the control groups. TNF level was 10.0000 3.50999 for normal group, 8.3600 2.89275 for selegiline treated group, 12.8000 7.78203 for MPTP treated group, 5.4000 2.43311 for andrographolide treated group at 50mg kgbw, and 5.8000 1.61864 for andrographolide treated group at 5 mg kgbw . This study suggests that there is no significant reduction of TNF level after treated with andrographolide at doses of 5 and 50 mg kgbw in MPTP treated Parkinsonism model, thus showing no neuroprotective effect of andrographolide. "

"Nama : Fazria NasriatiProgram studi : Ilmu Penyakit DalamJudul : Korelasi Antara Kadar Tumor Necrosis Factor-?, Kadar Free Fatty Acid, dan Kadar Vascular Cellular Adhesion Molecule-1 Pada Pasien Artritis Reumatoid Latar Belakang: Mortalitas Artritis Reumatoid cukup tinggi, dimana sebagian besar disebabkan oleh komplikasi kardiovaskular yang disebabkan oleh proses disfungsi endotel. Salah satu mediator inflamasi penting yang berperan terhadap kerusakan sendi pasien AR yaitu TNF-?, juga terbukti berperan dalam proses disfungsi endotel serta berperan meningkatkan lipolisis intraselular sehingga meningkatkan kadar FFA yang bersirkulasi.Tujuan: Mengetahui korelasi antara kadar TNF-? dengan kadar VCAM-1, korelasi kadar TNF-? dengan kadar FFA, serta korelasi kadar FFA dengan kadar VCAM-1.Metode: Penelitian desain cross sectional dan retrospektif terhadap pasien AR dewasa yang berobat di Poliklinik Reumatologi Rumah Sakit Cipto Mangunkusumo RSCM , tanpa gangguan metabolik, infeksi akut, gangguan kardiovaskular, maupun penyakit autoimun lain. Pengumpulan data cross sectional dilakukan pada rentang bulan Oktober hingga November 2017, sedangkan sampel retrospektif telah dikumpulkan sejak Agustus 2016. Kadar TNF-?, VCAM-1, dan FFA dinilai melalui pemeriksaan darah serum dengan metode ELISA. Analisis korelasi dilakukan dengan analisis Pearson bila sebaran data normal dan dengan analisis Spearman bila sebaran data tidak normal.Hasil Penelitian: Sebanyak 35 orang subjek diikutsertakan dalam penelitian ini. Sebagian besar 97,1 merupakan perempuan dengan rerata usia 45,29 tahun, median lama sakit 48 bulan, dan sebagian besar memiliki derajat aktifitas penyakit sedang 65,7 . Tidak didapatkan adanya korelasi antara kadar TNF-? dengan kadar VCAM-1 p = 0,677; r = 0,073 . Korelasi antara kadar FFA dengan kadar VCAM-1 memperlihatkan adanya korelasi yang bermakna dengan arah korelasi negatif dan kekuatan korelasi lemah p = 0,036; r = - 0,355 . Korelasi antara kadar TNF-? dan kadar FFA memiliki arah negatif dan kekuatan korelasi yang lemah dengan hubungan yang tidak bermakna p = 0,227; r = - 0,21 .Kesimpulan: 1 Belum terdapat korelasi antara kadar TNF-? dengan kadar VCAM-1 pada pasien AR; 2 Belum terdapat korelasi antara kadar TNF-? dengan kadar FFA pada pasien AR; 3 Terdapat korelasi negatif antara kadar FFA dengan kadar VCAM-1 pada pasien AR. Kata Kunci : Tumor Necrosis Factor-?, Free Fatty Acids, Vascular Cell Adhesion Molecule-1, Artritis Reumatoid.

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Name Fazria NasriatiStudy Program Internal MedicineTitle Correlation Between Tumor Necrosis Factor levels, Free Fatty Acid Levels, and soluble Vascular Cell Adhesion Molecule 1 Levels in Rheumatoid Arthritis Patients. Backgrounds The mortality of Rheumatoid arthritis RA is quite high, which is largely due to cardiovascular complications caused by endothelial dysfunction. One of the important inflammatory mediators that contribute to AR joints arthritis of TNF , also proven to play a role in endothelial dysfunction and play a role in increasing intracellular lipolysis, thus increasing circulating FFA levels.Objectives To determine the correlation between TNF levels with VCAM 1 levels, correlation of TNF levels with FFA levels, and correlation of FFA levelswith VCAM 1 levels.Methods Cross sectional and retrospective design studies of adult AR patients treated at Cipto Mangunkusumo Hospital RSCM , without metabolic disturbances, acute infection, cardiovascular disorders, or other autoimmune diseases. The cross sectional data was collected from October to November 2017, while retrospective samples were collected since August 2016. TNF , VCAM 1, and FFA levels were assessed by serum blood test by ELISA method. Correlation analysis is done by Pearson analysis when the data distribution is normal and with Spearman analysis when the data distribution is not normal.Results A total of 35 subjects were enrolled in the study. Most 97.1 were women with an average age of 45.29 years, median duration of 48 months, and most had moderate disease status 65.7 . No correlation was found between TNF levels and VCAM 1 levels p 0.677 r 0.073 . The correlation between FFA and VCAM 1 levels showed significant correlation with negative correlation and weak correlation p 0.036 r 0.355 . The correlations between TNF levels and FFA levels had negative direction and weak correlation strength with non significant associations p 0.227 r 0.21 .Conclusions 1 There was no correlation between TNF levels and VCAM 1 levels in AR patients 2 There was no correlation between TNF levels and FFA levels in AR patients 3 There was a negative correlation between FFA levels and VCAM 1 levels in AR patients.Keywords Tumor Necrosis Factor , Free Fatty Acids, Vascular Cell Adhesion Molecule 1, Rheumatoid Arthritis."

"ABSTRAKObesitas masih menjadi masalah di dunia dengan lebih dari 650 juta pendudukmengalami obesitas. Diet memiliki peranan penting dalam penatalaksanaanobesitas, selain memberikan restriksi kalori dengan komposisi seimbang perludipertimbangkan pemilihan makanan sustainable terkait isu ketahanan pangan,keanekaragaman hayati dan kelestarian ekologi. Manajemen diet melalui aplikasitelepon pintar dapat menjadi solusi alternatif untuk meningkatkan efektivitastatalaksana obesitas. Oleh sebab itu, penelitian ini bertujuan menilai efek dari dietrestriksi kalori seimbang-sustainable dibandingkan dengan diet restriksi kaloriseimbang yang diberikan melalui aplikasi EatsUp terhadap perubahan lingkar Kesimpulan : Intervensi diet restriksi kalori seimbang-sustainable yang diberikanmelalui aplikasi selama 8 minggu dapat menurunkan lingkar pinggangdibandingkan dengan diet restriksi kalori seimbang, namun tidak dapatmenurunkan inflamasi yang ditandai dengan kadar TNF-α serum. Promosikesehatan mengenai diet seimbang-sustainable diperlukan untuk mencegahkonsekuensi obesitas lebih lanjut. Penelitian lebih lanjut diharapkan dapatdilakukan pada subjek dengan karakteristik yang berbeda dalam penerapan dietseimbang-sustainable."

"Cedera otak pada perdarahan intraserebral spontan (PIS) terdiri dari cedera primer kerusakan struktural karena proses mekanis dan cedera sekunder akibat respons patofisiologis subklinis mencakup inflamasi, stress oksidatif dan sitotoksik terhadap komponen serta produk degradasi darah. Proses subklinis PIS yang sedang berlangsung tersebut masih belum terpantau secara lengkap, sehingga penelitian ini ditujukan untuk mengidentifikasi perjalanan proses subklinis cedera otak sekunder perdarahan intraserebral spontan dan pengaruhnya terhadap perubahan luaran respons klinis kasus (LRK) PIS pasca-intervensi bedah saraf. Penelitian ini menggunakan desain observasional prospektif, mulai Agustus 2016-April 2018 terhadap 20 subjek yang baru pertama kali mengalami perdarahan intraserebral spontan yang disertai perdarahan intraventricular dan menjalani intervensi bedah saraf external ventricular drainage (EVD). Data tercatat mencakup skor Full Outline of UnResponsiveness (SF), TIK, dan kadar hari ke-1 dan hari ke-7 Tumor Necrosis Factor alpha (TNFα), Superoxide Dismutase (SOD) dan zat besi dalam LSS. Analisis bivariat menggunakan uji Ttak berpasangan atau uji Mann-Whitney. Data skala kategorik diuji dengan Chisquare atau Fisher's exact test, dan untuk data kategorik berpasangan dengan uji McNemar.TIK pasca-intervensi semua subjek menurun secara gradual menjadi normal dan ada lima subjek yang tidak mengalami perbaikan LRK SF hari 1-7. Semua subjek kelompok 'tanpa perbaikan' mempunyai kadar TNFα LSS hari ke-1 tinggi, sebaliknya yang kadarnya normal mengalami perbaikan LRK (P=0,003). Selisih nilai peningkatan TNFα hari 1-7 juga lebih besar bermakna pada yang 'tanpa perbaikan' (P=0,005). Kadar SOD LSS hari ke-1 dan perubahannya tidak terbukti berbeda bermakna antara kedua kelompok. Pengamatan klinis memperlihatkan 80% subjek 'perbaikan', mempunyai kadar zat besi LSS hari ke-1 normal dalam status saturasi transferin < 50%. Semua subjek yang mempunyai kadar zat besi hari ke-1 tinggi dalam status saturasi transferin ≥ 50% mengalami LRK 'tanpa perbaikan'. Terdapat perbedaan bermakna dari selisih peningkatan status saturasi transferin antara kedua kelompok subjek. (P=0,05). Penelitian ini menyimpulkan bahwa subjek PIS dengan kadar TNFα LSS hari ke-1 tinggi dan/atau zat besi LSS tinggi dalam status saturasi transferin ≥ 50%, mempunyai LRK 'tanpa perbaikan'. Semakin besar peningkatan kadar TNFα LSS pada hari ke-7 dan/atau kadar zat besi yang disertai peningkatan saturasi transferrin, mempunyai LRK 'tanpa perbaikan'. Kadar SOD hari ke-1 dan perubahan kadar hari 1-7 belum dapat dimanfaatkan sebagai penanda prognosis dan proses subklinis PIS.

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Brain injury of spontaneous intracerebral hemorrhage caused by primary injury of structural damage due to mechanical processes and secondary injuries resulting from subclinical pathophysiological responses of inflammation, oxidative stress and cytotoxicity to components and blood degradation products including iron. The subclinical pathophysiology processes still cannot be monitored explicitly. This study is aimed at identifying the course of ICH subclinical secondary brain injury process and finding its relations with the days 1-7 trend of clinical response outcomes after neurosurgical intervention. This study is a prospective observational designed study done from August 2016 until April 2018. Twenty subjects were diagnosed as spontaneous intracerebral hemorrhage and underwent neurosurgical intervention external ventricular drainage (EVD). Recorded data consist of everyday Full Outline of UnResponsiveness (FOUR) score, intracranial pressure, and cerebro-spinal fluid (CSF) Tumor Necrosis Factor alpha (TNFα), Superoxide Dismutase (SOD), iron and transferrin saturation at day-1 and day-7. Bivariate analysis performed with unpaired T-test or Mann-Whitney test. Unpaired categorical scale data tested by Chi-square or Fisher's exact test, and McNemar test for paired categorical data.All 'unimproved' subjects had high levels of day-1 CSF TNFα, whereas all subjects with normal TNFα have clinical improvement response (P=0.003). Subsequently those subjects had significantly greater increasing levels (P=0.005). No significant difference of CSF SOD between of 'unimproved' and 'improved' group. Clinical observation clearly showed that 80% of 'improved' subjects have normal day-1 iron levels in controlled by transferrin saturation < 50%. There will be no improvement of those high iron levels with transferrin saturation ≥ 50%. A significant difference results were also noted of increasing transferrin saturation status (P=0,05). This study concluded that SICH with high level of day-1 CSF TNFα and/or high CSF iron with transferrin saturation ≥ 50%, would have an 'unimproved' trend of clinical response outcome. Greater increasing level of those biomarkers in days 1-7, tend to have an unimproved outcome. CSF SOD could not to be use as a significant clinical prognostic and process biomarker."

"ABSTRAKPajanan particulate matter 2.5 kepada manusia dapat menyebabkan terjadinya inflamasi akut dan kronik hingga menimbulkan terjadinya perubahan sel yang abnormal. Inflamasi terjadi akibat adanya respon tubuh terhadap dengan melepaskan Tumor Necrosis Factor ? Alpha sebagai protein stimulus inflamasi di dalam tubuh. Penelitian ini bertujuan untuk menganalisis hubungan dengan kadar di Pusat Pengujian Kendaraan Bermotor (PKB) Ujung Menteng dan Pulogadung, penelitian ini juga menganalisis status merokok, kategori obesitas, dan umur pada pekerja, dengan menggunakan Uji ? T independen (T ? test). Sampel penelitian sejumlah 42 pekerja di PKB Ujung Menteng dan Pulogadung sebagai kelompok terpajan dan 27 pekerja Fakultas Kesehatan Masyarakat Universitas Indonesia (FKM UI) sebagai kelompok kontrol. Analisis nilai kadar dalam darah dilakukan di laboratorium dengan teknik quantitative sandwich enzyme immune assay / ELISA dengan Human / TNFSF1A HS (R&D Systems). Jenis penelitian ini menggunakan metode analitik kuantitatif dengan membandingkan nilai kadar pada variabel kelompok terpajan dengan kelompok kontrol. Hasil penelitian menunjukkan bahwa pajanan berhubungan dengan nilai kadar dalam darah karakteristik pekerja yang merokok dan obesitas tidak berhubungan nilai kadar dalam darah Selain itu, hubungan umur dengan nilai kadar berhubungan sangat lemah Pajanan pada pekerja secara kronis menimbulkan inflamasi kronik dengan menghasilkan dalam darah melalui proses oxidative stress di dalam tubuh hingga menimbulkan gangguan pada sistem pernapasan dan sistem kardiovaskuler di dalam tubuh.

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ABSTRAKThe exposure of particulate matter 2.5 (PM25) to human can provoke the occurrence of acute and chronic inflammatory that can potentially lead to abnormal cell change. Inflammation occurs due to body response to PM25 by discharging Tumor Necrosis Factor ? Alpha ) as protein inflammatory stimulus inside the body. This research aims to analyze the correlation between PM2.5 exposure concentration with level at Pengujian Kendaraan Bermotor (PKB) center Ujung Menteng and Pulogadung, also to analyze smoking status, obese category, and age of workers, by using independent T ? Test. Research samples of 42 workers at PKB Ujung Menteng and Pulogadung as exposed group and 27 workers of Faculty of Public Health Universitas Indonesia (FKM UI) as control group. Analysis of level in the blood is conducted at laboratory with quantitative sandwich enzyme immune assay / ELISA technique with Human / TNFSF1A HS (R&D Systems). This research is performed with quantitative analytical method by comparing level score on exposed group variable and control group variable. The research result showed that exposure correlated with level score in the blood characteristics on workers who smoke and obese are not correlated with level score in the blood. Other than that, the correlation between workers? age and level score is proven weak exposure on workers chronically inflicts chronic inflammatory by producing in the blood through oxidative stress process in the body causing disruption of respiratory and cardiovascular system in the body."

"Peningkatan konsentrasi kristal monosodium urea pada sendi dan jaringan menunjukkan adanya keradangan Gout artritis (GA). Angka insiden dan prevalensi GA tersebar di negara berkembang sebesar 2?15%. Di Indonesia, prevalensi GA sekitar 29% dan sering terjadi pada suku Minahasa, Toraja dan Batak. Penelitian ini bertujuan untuk menganalisis aplikasi minyak atsiri kunyit sebagai anti-radang pada penderita GA dengan diet tinggi purin serta mengukur mediatorseluler tumor necrosis factor-α (TNF-α). Desain penelitian adalah randomized pretest-posttest control group design dengan pemberian secara single blind. Tes GCMS dilakukan untuk mengetahui komponen aktif minyak atsiri. Sampel penelitian ini adalah pasien baru GA di RS Haji Surabaya. Selama tujuh hari, kelompok perlakuan diberi minyak atsiri kunyit dengan dosis 25 mg/kg BB, sedangkan kelompok kontrol diberi indometasin dengan dosis 150 mg/kg BB. Sampel darah diambil sebelum dan sesudah perlakuan. Minyak atsiri kunyit mempunyai empat fraksi komponen aktif. Terdapat penurunan kadar urea darah pada kelompok perlakuan (p = 0,001) dan kelompok kontrol (p = 0,007). Terdapat penurunan konsentrasi pelepasan TNF-α, tetapi penurunan ini tidak berbeda secara signifikan pada kelompok kontrol dan perlakuan.Increased concentrations of crystal monosodium urea at joint and soft tissue represent induced of inflammation at gout arthritis (GA). Incidence and prevalence GA disseminate wide in developed countries in Asian range from 2-15% and In Indonesia, GA prevalence was 29% and mostly found in Minahasa, Toraja, and Batak ethnics. This research was aimed to analyse application of curcuma domestica volatile oil as anti inflammation agent on gout arthritis patient who has high purin diet and to assess specific cellular mediator Tumor Necrosis Factor-α (TNF-α). The design of the study was randomized pretest-posttest control group design with single blind treatment. The GCMS test was performed to identify active component in volatile oil. The sample was the new gout arthritis patient in Haji Public Hospital Surabaya. For a week, treatment group was assigned with volatile oil with dose 25 mg/kg body weight and the control group was given indometasin 150 mg/kg body weight. Blood samples were taken before and after treatment. Volatile oil of curcuma domestica (Curcuma domestica, val) has four fraction of active component. There wasdecreasing in blood urea level in treatment group (p = 0.001) and control group (p = 0.007). Both in control and treatment group, there was also decreasing in TNF-α, however it was not statistically significant. "

"Latar Belakang: Produksi TNF-α yang berlebihan pada mukosa kolon menyebabkan gangguan homeostasis sehingga timbul reaksi peradangan kronik. Inflammatory Bowel Diseases (IBD) merupakan kondisi klinis akibat reaksi peradangan kronik. Angka kejadian kedua penyakit tersebut sangat tinggi baik secara global. Belum ada obat yang efektif menginduksi serta mempertahankan remisi IBD dengan efek samping minimal. Penelitian ini bertujuan untuk mengetahui apakah pengemasan ekstrak daun mahkota dewa dalam nanopartikel kitosan mampu menekan ekspresi TNF-α.Metode: Penelitian ini menggunakan 30 sampel jaringan kolon tersimpan dari penelitian sebelumnya yang diwarnai dengan pewarnaan imunohistokimia (IHK). Mencit dibagi dalam 6 kelompok perlakuan yaitu kelompok normal yang tidak diberikan perlakuan (N), Kelompok kontrol negatif yang hanya diberikan larutan DSS 2% b/v, ada dua Kelompok yang diberikan larutan DSS 2% b/v diikuti dengan pemberian ekstrak daun mahkota dewa dengan dosis masing-masing 25 dan 12,5 mg dalam air minumnya (EMD 25 dan EMD 12,5 mg), dan dua kelompok yang diberikan larutan DSS 2% b/v diikuti dengan pemberian ekstrak daun mahkota dewa yang terenkapsulasi dalam nanopartikel kitosan dengan dosis masing-masing 12,5 dan 6,25 mg (NPMD 12,5 dan NPMD 6,25 mg).Hasil: Indeks ekspresi TNF-α kelompok NPMD 12,5 mg dan NPMD 6,25 mg menunjukan penurunan signifikan terhadap kelompok kontrol (p<0,05), Sedangkan kelompok EMD 25 mg dan EMD 12,5 mg tidak signifikan (p>0,05) dibandingkan kelompok kontrol.Kesimpulan: Ekstrak daun mahkota dewa yang dikemas dalam nanopartikel kitosan dengan dosis 12,5 mg dan 6,25 mg dapat menekan ekspresi TNF-α pada jaringan kolon mencit yang diinduksi dengan Dextran Sodium Sulfat.

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Background: Excessive TNF-α production in colon mucosa is known to cause homeostasis disturbance, which then lead to chronic inflammation reaction. Inflammatory Bowel Diseases (IBD) is a clinical condition caused by the chronic inflammation reaction. The diseases incidence is high globally. To date, effective drug that maintain IBD remission with mild adverse effect has yet to be found. This study aims to determine whether encapsulation of mahkota dewa leaf extract in chitosan nanoparticles can suppress TNF-α expression.Methods: This study involves 30 samples colon tissue mice from previous study that has been stained using immunohistochemistry (IHC). Included mice were divided into 6 intervention groups: a group without intervention (N); a negative control group which were only given DSS 2% b/v; two groups which were given DSS 2% b/v followed by mahkota dewa leaves extract administration, with dosages of 25 and 12.5 mg (EMD 25 and 12,5mg), and two groups which were given DSS 2% b/v followed by chitosan nanoparticle-encapsulated mahkota dewa leaves extract with dosages of 12.5 and 6.25mg (NPMD 12,5 and 6,25mg).Results: TNF-α expression index of groups treated with NPMD 12.5 mg and NPMD 6.25 mg shows significant reduction (p<0.05), while the reduction in groups treated with EMD 25 mg and EMD 12.5 mg is not significant (p>0.05), both compared to control group.Conclusion: Mahkota dewa extract loaded in chitosan nanoparticles with dosage 12,5 mg and 6,25 mg can suppress TNF-α expression on colon tissue of Dextran Sodium Sulfate-Induced mice."

"Obstructive: jaundice represents the most common complication of biliary tract Malignancy. Obstructive jaundice causes releases of proinflammatory cytokine. There has been controversy about effect of biliary drainage on the change in proinflammatory cytokine level in pancreatobiliary cancer patients. The present study was designed to determine levels of tumor necrosis factor alpha (TNF-alfa) and interleukin 6 (IL-6) in preprocedure of either endoscopic retrograde cholangio pancreatography (ERCP) or percutaneous transhepatic biliary drainage (PTBD) and postprocedure of them in obstructive jaundice patient caused by pancreatobiliary cancer.Method: The study method was before-and-after case study design with consecutive sampling. Blood was collected five days prior to either endoscopic retrograde cholangio pancreatography (ERCP) procedure or percutaneus transhepatic biliary drainage (PTBD) procedure and five days after either of them. Enzyme linked immunosorbed assay (ELISA) was used to determine TNF-alfa and IL-6.Results: Forty subjects were included in this study which consisted of 22 men and 18 women. The age was 55.3 (SD 13.7) years old. According to the results of imaging and endoscopy procedure, twenty-two people were diagnosed cholangicarcinoma, ten people were diagnosed ampulla vateri and eigth people were diagnosed pancreatic tumor. In preprocedure, the TNF-alfa concentration was 4.81 (SD 2.91) pg/mL, the IL-6 concentration was 7.79 (SD 1.57) pg/mL and the bilirubin concentration was 15.5 (SD 6,9) mg%. In postprocedure, the TNF-alfa concentration was 8.05 (SD 6.7) pg/mL, there was a significant increase in TNF-alfa concentration (p = 0.02). However, IL-6 concentration was 7.75 (SD 1.76) pg/mL, there was not any significant chance in IL-6 concentration (p = 0.52). The bilirubin concentration was 11.3 (SD 6,5) mg%.Conclusion: There was a significant increase in mean concentration value of TNF-alfa after biliary drainage procedure. On the other hand there was not any significant decrease in the mean concentration value of IL-6 after biliary drainage procedure"