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The effects of duration of mesenteric artery ligation to the ratio of TNF-α/IL-10 in a rat model of acute mesenteric ischemia (AMI)

Journal of the Medical Sciences (Berkala Ilmu Kedokteran) Vol 49, No 4 (2017)
Publisher : Journal of the Medical Sciences (Berkala Ilmu Kedokteran)

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Abstract

The mortality rate of acute mesenteric ischemia (AMI) is high due to the delay in diagnosis.Determination of potent biomarker for early AMI is the key in reducing the mortality. As aproinflammatory cytokine, the level of TNF-α might be affected during the ischemia andreperfusion, with the prediction duration of 60-120 min. High TNF-α level may stimulatethe upregulation of IL-10 as an inhibitor of TNF-α. This provides a new opportunity forearly diagnosis of AMI by measuring the ratio between those two cytokines. The purposeof this study was to investigate the effect of duration of the mesenteric artery to theratio of TNF-α/IL-10 in a AMI rat model. This was an experimental study using Wistarrat. We performed mesenteric artery in 28 male rats to produce an AMI model, withligation duration of 0, 30, 60, 90, 120, 150, and 180 minutes. At the end of ligation,blood samples were taken for measurement of TNF-α and IL-10 level using ELISA. For themicroscopic examination of tissue necrosis, intestinal organ samples were taken and madeinto paraffin blocks and stained using Haematoxylin-Eosin. TNF-α increased in minute 120compared to other treatment groups (p<0.05). IL-10 increased in minute 180 comparedto control group (p<0.05). Microscopic examination showed that the duration of ligationaffects the structure and morphology of intestinal mucosa characterized by discolorationof organs along with increasing the ligation duration. Ligation of the superior mesentericartery was found to be significantly increased the TNF-α level and to be compensated byincreasing IL-10. It is assumed that when the IL-10 level, that has protective effect as aninhibitor, higher than TNF-α level as a proinflammatory cytokine on duration 150 minutes,it means no more inflammatory or cells is dead. Therefore TNF-α/IL-10 ratio can be usedas a biomarker candidate of prognosic factor management of AMI.

Correlation between alkaline phosphatase, g-glutamyl transpeptidase, and bilirubin with interleukin-1b level in dogs with obstructive jaundice

Journal of the Medical Sciences (Berkala Ilmu Kedokteran) Vol 47, No 4 (2015)
Publisher : Journal of the Medical Sciences (Berkala Ilmu Kedokteran)

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Abstract

Surgical management in obstructive jaundice still contributes to significant morbidity and mortality. One of complications following surgery in obstructive jaundice is sepsis. This complication is caused by the toxic effects of bilirubin and bile salts, endotoxins, bacterial translocation, modulation of the immune-inflammatory cascade, decreased cellular immunity and/or nutritional status. Many studies have shown the elevated inflammatory response indicator, interleukin-1 (IL-1b), in patients with obstructive jaundice. However, only a few report described the association between the indicators of obstructive jaundice (alkaline phosphatase [ALP], g-glutamyl transpeptidase [GGT], and bilirubin)and the indicator of inflammatory response (interleukin-1b [IL-1b]). This study aimed to investigate the association between the indicator of obstructive jaundice (ALP, GGT, and bilirubin) and the level of interleukin-1b (IL-1b) in dogs as the animal model. We performed ligation on distal common bile ducts (CBD) to produce a model of obstructive jaundice. Every three days within a month, the blood samples from ten dogs were extracted to determine the ALP, GGT, direct and total bilirubin, and IL-1b levels. We found a significant correlation between the ALP and GGT with IL-1b level with p-value of 0.036 (r=0.626) and 0.003 (r=0.826). However, there was no association between the increased directbilirubin with the IL-1b level (p=0.068; r=0.537). Moreover, the increased level of ALP and GGT had a strong correlation with the increased level of direct bilirubin with p-value of 0.004 (r=0.810) and p=0.011 (r=0.746). In conclusion, the increased level of GGT was the strongest indicator for inflammatory response in dogs with obstructive jaundice. Furthermore, the increased levels of GGT and ALP might imply the development of obstructive jaundice in dogs.