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"Latar belakang: Prediabetes didefinisikan sebagai keadaan hiperglikemia dengan kadar glukosa di atas normal dan dapat berkembang menjadi keadaan diabetes. Beberapa studi membuktikan keadaan defisiensi vitamin D berhubungan dengan keadaan resistensi insulin. Penelitian ini bertujuan untuk menganalisis efek modulasi suplementasi vitamin D terhadap mekanisme molekular pada kondisi resistensi insulin melaluli regulasi persinyalan jalur inflamasi dan mikrobiota usus pada tikus prediabetes.Metode: Penelitian ini dilakukan pada tahun 2019-2021 di Fakultas Kedokteran Universitas Indonesia dan Medica Satwa Laboratory Bogor. Eksperimen dilakukan pada tikus Wistar jantan berumur 4 minggu. Tikus akan dibagi secara acak, yaitu tikus yang menerima diet normal dan diet tinggi lemak dan tinggi glukosa (DTL-G)yang dikombinasi dengan dosis rendah injeksi streptozotocin 30 mg/kgBB intraperitoneal pada minggu ketiga. Setelah itu dilakukan tes toleransi glukosa oral (TTGO) dengan dosis 2 gram/kgBB pada tikus. Jika telah terjadi resistensi insulin (model tikus prediabetes) maka tikus prediabetes dibagi dalam tiga kelompok secara acak yaitu: (1) kelompok yang tidak diberi terapi, (2) kelompok yang diterapi vitamin D3 dosis 100 IU/kg/hari, (3) kelompok yang diterapi vitamin D3 dosis 1000 IU/kgBB/hari bersamaan dengan induksi DTL-G 12 minggu. Setelah itu akan dilakukan pengukuran kadar glukosa darah puasa (GDP), kadar glukosa darah 2 jam pasca-bebas glukosa, nilai HOMA-IR, kadar Glycated albumin, profil hematologi, kadar 25(OH)D3,pengamatan histopatologi pankreas, kadar TNF-alpha, IL-6, IL-10, NF-κB, TLR2, TLR4, PPARg, IRS1, dan komposisi mikrobiota usus.Hasil: Pada tikus prediabetes terjadi peningkatan nilai glukosa darah puasa, kadar glukosa darah 2 jam pasca-bebas glukosa, nilai HOMA-IR, kadar Glycated albumin, serta perubahan profil hematologi. Pemberian vitamin D 1000 IU mampu menurunkan nilai GDP, TTGO, Glycated albumin, HOMA-IR, serta mampu mengurangi degenerasi pada pulau Langerhans. Vitamin D 1000 IU mampu meningkatan sitokin anti-inflamasi IL-10, menurunkan ekspresi TLR2 dan TLR4, mengembalikan ekspresi IRS seperti kelompok normal, serta dapat meningkatkan keragaman mikrobiota. Suplementasi vitamin D berkorelasi dengan kadar PPARg, IRS1, TLR2, TLR4, dan sel beta pankreas.Kesimpulan: Pemberian vitamin D 1000 IU bersamaan dengan DTL-G pada tikus prediabetes dapat memberikan perbaikan kondisi resistensi insulin, meningkatkan sitokin anti-inflamasi, mengembalikan nilai ekspresi PPARg, meningkatkan ekspresi protein IRS1 kembali seperti kelompok normal, serta meningkatkan keragaman mikrobiota yang berkorelasi dengan regulasi persinyalan sitokin inflamasi.

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Introduction: Prediabetes is defined as a state of intermediate hyperglycemia and can lead to type 2 diabetes. Several studies have shown that vitamin D deficiency is associated with insulin resistance. This study aimed to analyze the modulating effect of vitamin D supplementation on the molecular mechanisms of insulin resistance through signaling regulation pathways of inflammation and gut microbiota in prediabetic rats.

Methods: The study was conducted during 2019-2021 at the Faculty of Medicine, Universitas Indonesia and Medica Satwa Laboratory Bogor. The experiments was conducted on male Wistar rats of 4 weeks. Rats were divided randomly into control and a high-fat and high-glucose (HFD-G) diet combined with 30 mg/kg intraperitoneal injection of streptozotocin in the third week. Oral glucose tolerance test (OGTT) was performed at 2 grams/kgBW gluocose. If insulin resistance has occurred (prediabetic rat model) then rats were randomly divided into three groups, namely: (1) the group that was not given therapy, (2) the group with vitamin D3 at a dose of 100 IU/kgBW/day, (3) the group with vitamin D3 at a dose of 1000 IU/kgBW/day together with HFD-G in 12 weeks. Fasting blood glucose (FBG) levels, OGTT, HOMA-IR, Glycated albumin levels, hematological profiles, 25(OH)D3 levels, pancreatic histopathological observations, TNF-alpha, IL-6, IL-10, NF-B, TLR2, TLR4, PPARg, IRS1, and gut microbiota composition was evaluated.

Results: In prediabetic rats there was an increase in FBG, OGTT, HOMA-IR, Glycated albumin levels, and changes in hematological profiles. The administration of vitamin D 1000 IU could reduce the levels of FBG, OGTT, Glycated albumin, HOMA-IR, and could reduce degeneration of the islets of Langerhans. Vitamin D 1000 IU increased the anti-inflammatory cytokine IL-10, decreased the expression of TLR2 and TLR4, increased IRS1 expression like the normal group, and increased the diversity of gut microbiota. Vitamin D supplementation correlated with levels of PPARg, IRS1, TLR2, TLR4, and pancreatic beta cells.

Conclusion: Vitamin D 1000 IU vitamin D together with HFD-G in prediabetic rat could reduce insulin resistance, increased anti-inflammatory cytokines, increased PPARg expression level, increased IRS1 protein expression, and increased diversity of gut microbiota which correlates with signaling regulation of Inflammatory Pathways."

"Hematotoksisitas pada leukemia limfoblastik akut (LLA) anak selama terapi fase pemeliharaan, merupakan hal penting, karena dapat menyebabkan kondisi mengancam jiwa dan penghentian dini terapi, yang dapat meningkatkan risiko relaps. Untuk menghindari hematotoksisitas, American Society for Clinical Pharmacology and Therapeutics merekomendasikan penyesuaian dosis awal merkaptopurin (6MP) berdasarkan genotip enzim pemetabolisme 6MP yaitu thiopurine S-methyl transferase (TPMT), berdasarkan studi-studi sebelumnya polimorfisme enzim tersebut memengaruhi kadar metabolit aktif 6MP dan hematotoksisitas. Penelitian ini bertujuan untuk mengetahui prevalensi hematotoksisitas dan melihat hubungannya dengan genotip TPMT, fenotip TPMT, dan karakteristik pada pasien LLA anak di Indonesia. Studi potong lintang dilakukan di RS Cipto Mangunkusumo dan RS Kanker Dharmais pada bulan Juni 2017–Oktober 2018 terhadap 106 pasien LLA anak yang sedang mendapatkan 6MP minimal 1 bulan pada terapi fase pemeliharaan. Prevalensi hematotoksisitas pada fase pemeliharaan pasien LLA anak di Indonesia 71,7%, dengan neutropenia 51,9%, anemia 44,3%, dan trombositopenia 6,6%. Neutropenia tingkat 3–4 sebesar 9,4%. Alel mutan yang ditemukan hanya TPMT*3C dengan frekuensi 0,95%. Kadar 6TGN, 6MeMP dan rasio kadar 6MeMP/6TGN sangat bervariasi, yaitu 6–234,04 pmol/8x10⁸ eritrosit, 3,5–3167,01 pmol/8x10⁸ eritrosit, dan 0,06–100,64 pmol/8x10⁸ eritrosit, secara berurutan. Sebesar 76,4% pasien berusia antara 1–10 tahun dan > 95% pasien memiliki status gizi dan kadar albumin normal. Proporsi pasien berdasarkan stratifikasi risiko dan dosis harian 6MP sebanding. Tidak terdapat hubungan antara hematotoksisitas dengan genotip TPMT, usia, status gizi, kadar albumin, stratifikasi risiko, cara pemberian dosis harian 6MP, dan pemberian bersama kotrimoksazol. Faktor yang berhubungan dengan hematotoksisitas adalah fenotip TPMT: kadar 6MeMP (p = 0,004) dan rasio kadar 6MeMP/6TGN (p = 0,010). IMT ≤ 16,6 kg/m2 berhubungan dengan anemia dan kadar albumin serum ≤ 4,2 g/dL berhubungan dengan trombositopenia. Tidak terdapat hubungan antara genotip dengan fenotip TPMT pada pasien LLA anak di Indonesia. Kesimpulan: Hematotoksisitas tidak berhubungan dengan genotip TPMT dan karakteristik pasien. Fenotip TPMT berhubungan dengan hematotoksisitas, namun kurang kuat untuk memprediksi hematotoksisitas.

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Hematotoxicity in acute lymphoblastic leukemia (ALL) children during maintenance phase therapy is important, because it can cause life-threatening conditions and it is the major cause of drug discontinuation, which can increase the risk of relapse. To reduce hematotoxicity, American Society for Clinical Pharmacology and Therapeutics recommended to adjust starting dose of mercaptopurine (6MP) based on patient's genotype of thiopurine S-methyl transferase (TPMT), that affected 6MP active metabolite levels and hematotoxicity.

The aim of the study was to determine the prevalence of hematotoxicity and factors that affecting hematotoxicity, focus on genotype and phenotype of TPMT. A cross-sectional study was conducted at Cipto Mangunkusumo Hospital and Dharmais Cancer Hospital in June 2017–October 2018 for 106 LLA patients who were receiving at least 1 month of 6MP during maintenance therapy.

The prevalence of neutropenia, anemia, and thrombocytopenia were 51.9%, 44.3%, and 6.6%, respectively. We found only TPMT *3C with a frequency of 0.95%. Erythrocyte levels of 6TGN, 6MeMP, and ratio of 6MeMP/6TGN levels vary greatly, 6–234,04 pmol/8x10⁸ RBC, 3,5–3167,01 pmol/8x10⁸ RBC, and 0,06–100,64 pmol/8x10⁸ RBC. About 76.4% of patients aged 1–10 years, and > 95% of patients had normal nutritional status and serum albumin levels. The proportion of patients based on risk stratification and daily dose of 6MP were comparable. There was no association between hematotoxicity and genotype TPMT, age, nutritional status, serum albumin levels, risk stratification, daily dose of 6MP, and co-administration of cotrimoxazole. The factor associated with hematotoxicity was the TPMT phenotype: 6MeMP levels (p = 0.004) and the ratio of 6MeMP/6TGN levels (p = 0.010). BMI ≤ 16.6 kg/m2 was associated with anemia and serum albumin level ≤ 4.2 g/dL was associated with thrombocytopenia. There was no relationship between genotype and the TPMT phenotype in pediatric LLA patients in Indonesia.

Conclusion: Hematotoxicity is not associated with TPMT genotype and patient characteristics. The TPMT phenotype is associated with hematotoxicity but is not strong enough at predicting hematotoxicity."

"Latar belakang: Terapi farmakologi kanker payudara triple negative (KPTN)terbatas pada obat sitostatika seperti doksorubisin. Namun, resistensi doksorubisinsulit dihindari. Salah satu jalur pensinyalan yang penting pada resistensiKPTN terhadap doksorubisn adalah TGF-β. TMEPAI (transmembran prostatandrogen-induced protein), regulator negatif sekaligus gen target pada jalur TGF-β diduga merupakan salah satu kunci dalam resistensi KPTN terhadapdoksorubisin.Metode: Teknik CRISPR-Cas9 digunakan untuk menghilangkan TMEPAI padagalur sel KPTN, BT549. Sel diberi perlakuan TGF-β 2 ng / mL dan doksorubisinselama 24 jam. Pengukuran konsentrasi sitotoksik doksorubisin pada 50%populasi sel (CC50) dilakukan terhadap sel KPTN wildtype (WT) dan knock out(KO). Setelah itu, sel dipanen dan dihitung. Rantai Polimerase Waktu NyataReaction (RT-PCR) dan western blot (WB) digunakan untuk mengukur tingkatekspresi penande proliferasi, apoptosis, EMT, dan transporter. Selain itu, SMADyang terfosforilasi dan aktivitas PI3K / Akt juga belajar.Hasil: Galur sel yang tidak memiliki TMEPAI (KO) berhasil diperoleh dari selKPTN, BT549. Sel WT terbukti lebih resistan terhadap doksorubisindibandingkan sel KO yang ditunjukkan dengan peningkatan CC50 dan Ki-67.TMEPAI menurunkan efek apoptosis doksorubisin dengan memodulasi ekspresibcl-2 dan kaspase-3, namun tidak kaspase-9 dan bax. Efek TMEPAI mengurangidoksorubisin dengan menekan fosforilasi SMAD. Namun TMEPAI meningkatkanpenghambatan PI3K / Akt oleh doksorubisin. TMEPAI juga meningkatkan EMTdan transporter efluks yang diinduksi oleh doksorubisin.Kesimpulan: TMEPAI terhadap pertarungan dalam resistensi sel KPTNdoksorubisin melalui aktivasi jalur sinyal TGF-β non-canonical beserta proteindan gen targetnya.Background: Triple negative breast cancer (KPTN) pharmacological therapylimited to cytostatic drugs such as doxorubicin. However, doxorubicin resistancehard to avoid. One of the important signaling pathways of resistanceKPTN against doxorubisn is TGF-β. TMEPAI (transmembrane prostateandrogen-induced protein), a negative regulator as well as a target gene in the TGF-β is thought to be one of the keys in the resistance of KPTN todoxorubicin.Method: The CRISPR-Cas9 technique was used to remove TMEPAI onKPTN cell lines, BT549. Cells were treated with TGF-β 2 ng / mL and doxorubicinfor 24 hours. Measurement of the cytotoxic concentration of doxorubicin at 50%cell population (CC50) was carried out against wildtype KPTN (WT) cells and knockout(KO). After that, cells are harvested and counted. Real Time Polymerase ChainReaction (RT-PCR) and western blot (WB) were used to measure levelsexpression markers of proliferation, apoptosis, EMT, and transporters. Apart from that, SMADthe phosphorylated and PI3K / Akt activities also learn.Results: Cell lines that did not have TMEPAI (KO) were obtained from the cellsKPTN, BT549. WT cells have been shown to be more resistant to doxorubicincompared to cell knockout shown with increased CC50 and Ki-67.TMEPAI decreases the apoptotic effect of doxorubicin by modulating expressionbcl-2 and caspase-3, but not caspase-9 and bax. TMEPAI reducing effectsdoxorubicin by suppressing SMAD phosphorylation. However TMEPAI is improvingPI3K / Akt inhibition by doxorubicin. TMEPAI also increases EMTand doxorubicin-induced efflux transporters.Conclusion: TMEPAI against the fight against KPTN cell resistancedoxorubicin via activation of the non-canonical TGF-β signaling pathway along with proteinsand its target genes."

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Latar belakang: Kurkumin memiliki aktivitas antikanker yang poten, namun profil farmakokinetik dan ketersediaan kurkumin di organ target sangat rendah. Nanopartikel kurkumin dibuat untuk meningkatkan aktivitas kurkumin sehingga dapat meningkatkan efek obat pada proses angiogenesis dan proliferasi sel pada tikus model kanker ovarium.

Metode: Nanopartikel kurkumin dibuat dengan metode gelasi ionik menggunakan kitosan sebagai polimer. Profil farmakokinetika kurkumin dan nanokurkumin dilakukan pada tikus dengan pemberian dosis oral sebesar 100 mg/kgBB. Sampel darah diambil pada sembilan  waktu dan konsentrasi kurkumin dalam plasma dianalisis menggunakan UPLC-MS/MS. Pengujian nanokurkumin sebagai ko-kemoterapi secara in vivo pada kanker ovarium dilakukan pada tikus model kanker ovarium dengan induksi DMBA. Tikus model kanker ovarium diberikan terapi cisplatin atau kombinasi cisplatin dan kurkumin, atau kombinasi cisplatin dan nanokurkumin. Efek antikanker dilihat dari pengukuran marker antiproliferasi (Ki67), marker apoptosis serta jalur sinyal TGF-b/PI3K/Akt dan IL-6/JAK/STAT3.

Hasil: Diperoleh ukuran partikel nanokurkumin sebesar 19,43±11,24 nm, dengan efisiensi penjerapan 99,97%, dan loading capacity 11,34%. Sifat mukoadhesif nanokurkumin lebih baik dibandingkan dengan kurkumin. Evaluasi profil farmakokinetik pada tikus diperoleh bahwa nanokurkumin meningkatkan AUC, Cmax, Tmax dan menurunkan klirens. Pada uji aktivitas in vivo,  pemberian cisplatin dan ko-kemoterapi nanokurkumin menyebabkan penurunan yang signifikan pada volume dan berat ovarium. Penemuan ini sesuai dengan penurunan ekspresi protein TGF-β, PI3K dan p-Akt/Akt. Efek ko-kemoterapi nanokurkumin juga dapat dapat menurunkan ekspresi protein IL-6, JAK, dan p-STAT3/STAT3. Pemberian cisplatin dan nanokurkumin juga menyebabkan peningkatan marker apoptosis yang signifikan seperti Bax, kaspase-9 dan kaspase-3 serta menurunkan ekspresi Bcl-2.

Kesimpulan: Nanokurkumin dapat memperbaiki profil farmakokinetika kurkumin, sehingga dapat diaplikasikan pada strategi ko-kemoterapi kanker ovarium dengan menghambat proliferasi melalui penghambatan jalur sinyal PI3K/Akt, JAK/STAT3, peningkatan apoptosis marker Bax, kaspase-3 dan kaspase-9 serta menurunkan ekspresi Bcl-2.

Kata kunci: kurkumin, kitosan, nanopartikel, kanker ovarium, PI3K/Akt, JAK/STAT

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Background: Curcumin has a potent anticancer activity. However, its systemic bioavailability and its concentration in organ is extremely low. The modification of curcumin to curcumin nanoparticles was expected to increase the activity of curcumin on angiogenesis and cell proliferation process in rat ovarian cancer.

Methods: Nanocurcumin were made using ionic gelation methods. The pharmacokinetic profiles of curcumin particles and nanoparticles were then assessed in rats by administering a single oral dose of 100 mg/kg BW. Blood samples were taken from nine predetermined time points, and curcumin plasma concentrations were then analyzed using UPLC-MS/MS. Nanocurcumin was tested as a co-chemotherapy in vivo and was carried out on ovarian cancer animal models, induced with 7,12-dimethylbenz(a)anthracene (DMBA). The ovarian cancer animal models were then treated with cisplatin, or cisplatin and curcumin, or combination of cisplatin with nanocurcumin. The anticancer effect of nanocurcumin as co-chemotherapy was investigated with the measurement of antiproliferation marker (Ki67), apoptotic markers as well as the expression of TGF-b/PI3K/Akt dan IL-6/JAK/STAT3.

Result: The particle size of the curcumin nanoparticles obtained were 19,43±11,24 nm. Entrapment efficiency (EE) of curcumin nanoparticles were exceeding 99.97%, and drug loading capacity (DLC) was 11.34%. The mucoadhesive properties of the nanoparticles were superior to that of curcumin particles. Pharmacokinetic evaluation in rats revealed that curcumin nanoparticles resulted in an increase of AUC, Cmax, Tmax, and lower Cl. The administration of cisplatin and nanocurcumin co-chemotherapy caused a significant reduction in ovarian volume and weight. These findings followed with decreased protein expression of TGF-β, PI3K and p-Akt/Akt. The co-chemotherapy effect nanocurcumin is also investigated as a mechanism of action via IL-6, JAK, p-STAT3/STAT3 expressions.  Treatments of cisplatin and nanocurcumin resulted in a significant increase in apoptotic markers such as Bax, caspase-9, and caspase-3 expressions and decreased Bcl-2 expression.

Conclusion: Nanocurcumin is an effective formulation to improve pharmacokinetics profile. Nanocurcumin as a co-chemotherapy  can be considered as a potential co-chemotherapy in ovarian cancer. The improved mechanism of actions are shown by the proliferation inhibition, downregulation of PI3K/Akt, JAK/STAT3 signaling pathways, and Bcl-2 expression and increasing apoptosis through the expression of Bax, caspase-9 and caspase-3.

Keywords: curcumin, chitosan, nanoparticles, ovarian cancer, PI3K/Akt, JAK/STAT

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"Penelitian ini bertujuan untuk menganalisis peran mutasi gen FLT3 dalam resistensi terapi induksi D3A7 pada pasien LMA, melalui pengamatan perubahan struktur protein reseptor FLT3, aktivitas jalur persinyalan downstream FLT3 yaitu PI3K/AKT, menggunakan persentasi jumlah sel yang berapoptosis dan proliferasi sebagai indikator dalam mekanisme multidrug resistance terhadap terapi induksi D3A7. Selain itu dilakukan juga analasis peran sub populasi sel punca leukemia CD34+CD38-CD123+ dan marka ALDH dalam resistensi terapi Induksi D3A7, untuk mengetahui hubungannya denagn resistensi terapi induksi D3A7. Metode Deteksi mutasi gen FLT3 dilakukan dengan PCR-sekuensing dari sampel darah sumsum tulang pasien LMA de novo yang telah selesai diberikan terapi induksi D3A7. Sikuens gen yang termutasi kemudian dianalisis menggunakan studi in silico untuk menilai dampak dari mutasi gen terhadap perubahan struktur dan aktivitas pengikatan protein terhadap regimen sitarabin. Analisis aktivitas fosforilasi protein PI3K dan AKT dilakukan dengan metode sandwich ELISA. Penghitungan persentasi jumlah sel yang mengalami apoptosis dan proliferasi, serta deteksi sel punca leukemia dengan penanda CD34+, CD38-, CD123+, dan ALDH menggunakan Flowcitometry. Hasil Ditemukan mutasi baru Ins_572G573 (Insersi-G) pada domain juxtamembran dari protein reseptor FLT3 dengan frekuensi sebesar 30% dari total 20 pasien LMA yang direkrut, sementara frekuensi mutasi FLT3-ITD yang diperoleh sebesar 20%. Kelompok pasien dengan mutasi gen FLT3 mengalami peningkatan fosforilasi protein PI3K dan AKT yang bermakna secara statistik, mengalami peningkatan rerata persentasi jumlah proliferasi sel dan penurunan rerata jumlah apoptosis sel dibandingkan kelompok tanpa mutasi. Kelompok pasien dengan outcome terapi resistensi juga mengalami peningkatan fosforilasi protein PI3K dan AKT, penurunan rerata jumlah sel yang mengalami apoptosis dan peningkatan rerata jumlah sel yang berproliferasi. Penanda sel punca leukemia CD34+, CD38-, CD123+, dan ALDH memiliki hubungan tidak bermakna dengan resistensi terapi induksi D3A7. Kesimpulan Penelitian ini menunjukkan bahwa mutasi gen FLT3 tidak berhubungan lansung pada resistensi terapi D3A7. Namun perubahan struktur protein akibat mutasi berperan penting dalam mekanisme resistensi melalui aktivasi jalur pro-proliferasi dan anti papoptosis dari persinyalan PI3K/AKT. Salain itu, penanda sel punca leukemia tidak berhubungan dengan resistensi terapi induksi D3A7.

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Introduction This study aims to analyze the role of FLT3 gene mutations in the resistance of AML therapy induction with D3A7 in patients, through observing changes in FLT3 receptor protein structure, the activity of downstream FLT3 signaling pathways such as PI3K/AKT, and using the percentage of apoptotic and proliferative cells as indicators in the mechanism of multidrug resistance against D3A7 induction therapy. Additionally, the study also analyzes the role of leukemia stem cell subpopulations CD34+CD38-CD123+ and ALDH markers in resistance to D3A7 induction therapy, to understand their relationship with resistance to D3A7 induction therapy. Method Detection of FLT3 gene mutations was performed by PCR-sequencing from bone marrow blood samples of de novo AML patients who had completed D3A7 induction therapy. Sequences of the mutated genes were then analyzed using in silico studies to assess the impact of gene mutations on structural changes and protein binding activity with cytarabine regimens. Analysis of PI3K and AKT protein phosphorylation activity was conducted using sandwich ELISA. Calculation of the percentage of cells undergoing apoptosis and proliferation, as well as detection of leukemia stem cells marked by CD34+, CD38-, CD123+, and ALDH, was performed using Flow cytometry. Results A novel mutation, Ins_572G573 (Insertion-G), was found in the juxtamembrane domain of the FLT3 receptor protein with a frequency of 30% among a total of 20 recruited AML patients. Meanwhile, FLT3-ITD mutation frequency was obtained at 20%. Patients with FLT3 gene mutations showed statistically significant increases in PI3K and AKT protein phosphorylation, as well as higher average percentages of proliferating cells and lower average percentages of apoptotic cells compared to the non-mutation group. Patients in the therapy-resistant outcome group also exhibited increased PI3K and AKT protein phosphorylation, decreased average percentages of apoptotic cells, and increased average percentages of proliferating cells. However, leukemia stem cell markers CD34+, CD38-, CD123+, and ALDH did not show statistically significant associations with resistance to D3A7 induction therapy. Conclusion This study indicates that FLT3 gene mutations do not directly correlate with resistance to D3A7 therapy. However, structural changes in proteins due to mutations play a crucial role in resistance mechanisms through the activation of pro-proliferation and anti-apoptosis pathways via PI3K/AKT signaling. Additionally, leukemia stem cell markers are not associated with resistance to D3A7 induction therapy."

"Latar Belakang :Malnutrisi selama kehamilan dan 1.000 hari pertama kehidupan dapat mempengaruhi pertumbuhan fisik, fungsi otak dan perkembangan hipokampus. Moringa oleifera (MO), telah digunakan sebagai suplemen makanan pada malnutrisi. Penelitian ini bertujuan untuk menguji efektifitas kandungan protein dari ekstrak etanol daun MO (EEMO) dalam mengatasi defisiensi protein pada anakan tikus dari induk defisiensi protein.Metode :Daun MO asal kabupaten Kupang, propinsi NTT diektraksi dengan metode UAE dalam etanol dan dikarakterisasi (EEMO). Anakan tikus Sprangue dawley usia 3 minggu dari induk yang mendapat diet protein rendah (9% protein) diberikan terapi EEMO 400 atau 800 mg/kg BB atau protein normal (KP) selama 5 minggu. Kelompok pembanding adalah anakan dari induk yang diberikan diet protein normal (18% protein) yang tidak diberikan terapi atau diberikan EEMO 800 mg/kg BB selama 5 minggu. Pada akhir pengujian, dilakukan pemeriksaan antropometri, fungsi spasial memori (Y-test), profil biokimia darah dan asam amino darah, analisis histopatologi pada jaringan hati dan hipokampus, serta mikrobiota usus pada feces kolon.Hasil:EEMO yang dihasilkan pada penelitian ini mengandung protein sebesar 45,5% dan senyawa fitokimia utamanya adalah golongan kaempferol. Pemberian EEMO tidak memberikan perbaikan pada profil antropometrik dibandingkan dengan kelompok KP. Pemberian EEMO 400, 800 mg/kg BB dan KP dapat menormalkan spasial memori, yang diikuti dengan penurunan rasio sel pada daerah CA1-4 hipokampus. Hasil analisis histopatologi jaringan hati menunjukkan bahwa EEMO 800 mg/kg BB memperbaiki perlemakan hati lebih baik vs. EEMO 400 mg/kg BB dan KP. EEMO meningkatkan kadar albumin, Hb, BUN dan menurunkan kadar glukosa mendekati kelompok normal, namun belum dapat menetralkan bilirubin, SGPT, SGOT dan kreatinin. Terdapat tendensi perbaikan pada total asam amino esensial dan BCAA pada plasma darah setelah pemberian EEMO dan KP. Selain itu, EEMO dapat memperbaiki relative abundance mikrobiota di usus. Perbaikan pada spasial memori berkorelasi negatif dengan total asam amino non esensial, asam amino alifatik sederhana, asam amino hidroksi alifatik dan berkorelasi negatif dengan kelimpahan famili Peptostreptococcaceae, Erysipelotrichacea dan Staphylococcaceae.Kesimpulan:Penelitian ini menunjukkan bahwa induk dengan diet rendah protein selama kehamilan akan melahirkan keturunan dengan karakteristik defisiensi protein (DP), termasuk berat badan lahir rendah (BBLR), BMI di bawah 0,45 g/cm², kenaikan berat badan yang lambat, anemia, hypoalbuminemia, rendahnya kadar BUN, penurunan asam amino darah dan gangguan enzim hati. Hasil penelitian kami menunjukkan bahwa pemberian EEMO pada anak tikus sampai dengan usia 8 minggu tidak memperbaiki antropometri anakan, namun dapat menormalkan spasial memori, memperbaiki kerusakan sel hipokampus dan meminimalkan perlemakan hati anak tikus DP. Perbaikan tersebut diikuti dengan perbaikan kelimpahan mikrobiota usus di tingkat filum.

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Background:

Malnutrition during pregnancy and the first 1,000 days of life can affect physical growth, brain function, and hippocampal development. Moringa oleifera (MO) has been used as a food supplement in malnutrition. This study aims to evaluate the effectiveness of the protein content of an ethanolic extract of MO leaves (EEMO) in overcoming protein deficiency in rat offspring of protein-deficient rats.

Methods:

Moringa oleifera leaves from the Kupang district, Nusa Tenggara Timur province were extracted using the UAE method in ethanol and then characterized. Offsping of Sprague Dawley rats, aged 3 weeks from mothers on a low protein diet (9% protein) were given 400 or 800 mg/kg BW EEMO or normal protein (KP) for 5 weeks. The comparison groups were offspring from rats given a normal protein diet (18% protein) without therapy or given 800 mg/kg BW EEMO for 5 weeks. At the end of the study, various assessments were conducted, including anthropometric examinations, spatial memory function using the Y-maze test, analysis of blood biochemical and blood amino acid profiles, histopathological analysis of liver and hippocampal tissue, and assessment of intestinal microbiota in colonic faeces.

Results:

In this research, the EEMO contained 45.5% protein, with the main phytochemical compound being the kaempferol group. The administration of EEMO did not improve anthropometric profiles compared to the KP group. However, the administration of 400 and 800 mg/kg BW EEMO, as well as KP, normalized spatial memory and decreased the damaged cell ratio in the CA1-4 area of the hippocampus. Histopathological analysis of liver tissue revealed that EEMO 800 mg/kg BW was more effective in improving fatty liver than EEMO 400 mg/kg BW and KP. In addition, EEMO increased albumin Hb and BUN levels and reduced glucose levels, bringing them close to the normal group. However, it could not neutralize bilirubin, SGPT, SGOT, and creatinine levels. There was a tendency for improvement in total essential amino acids and BCAA’s in blood plasma after the administration of EEMO and KP. Furthermore, EEMO improved the relative abundance of microbiota in the intestine. Notably, improvements in spatial memory were negatively correlated with total non-essential amino acids, simple aliphatic amino acids, aliphatic-hydroxy amino acids, and the abundance of the Peptostreptococcaceae, Erysipelotrichacea, and Staphylococcaceae families.

Conclusions:

This research showed that rats with a low protein diet during pregnancy gave birth to offspring with characteristics of protein deficiency (PD), including low birth weight (LBW), BMI below 0.45 g/cm², slow weight gain, anaemia, hypoalbuminemia, low BUN levels, decreased blood amino acids and liver enzyme disorders. The results also showed that administering EEMO to rats' offspring up to 8 weeks of age did not improve the anthropometric measurement but did normalize spatial memory, repair hippocampal cell damage, and minimize fatty liver in PD rats offspring. Additionally, a positive impact of EEMO was observed in the abundance of gut microbiota at the pylum level."