Effect of Sweet Purple Potato (Ipomoea batatas L.) Extract and Vitamin C on Endothelial Progenitor Cell Migration in Stable Coronary Disease Patient

Background: Number and function of Endothelial Progenitor Cells (EPC) are reduced incoronary artery disease (CAD) patient. EPC as progenitor of mature endothelial cell has important role for angiogenesis and neovasculogenesis. Dysfunctional EPC partly because of  oxidative stress. Decreasing oxidative stress with antioxidant especially with sweet purple potato extract and vitamin as easily found in Indonesia, may improve EPC migration to ischemic organ in stable CAD patient. Purpose : To analyze effect of sweet purple potato (Ipomoea batatas L.) extract and vitamin C on Endhotelial Progenitor Cell in Stable Coronary Disease patient. Method: This is experimental post-test control group study. Mononuclear cells (MNC) are isolated from peripheral blood of sample, and cultivated in medium for 3 days, immunofluorescence assay with CD34 as a marker for EPC. EPCs divided into sweet purple potato extract group (1 and 25 mcg/mL), vitamin C group (10 and 250 mcg/mL) and control, incubated for 2 days. 5x105 cell taken from each group and place in upper chamber of Transwell system. EPC migration was assessed in lower chamber of Transwell system after 24 hours using automated cell counters. Statistic testing using ANOVA. Results: EPC migration was increased significantly in sweet purple potato extract and vitamin C compared with control (3.03 ± 0.01, 2.15 ± 0.03 vs control 1.21 ± 0.04, p<0.01). Increased dose of sweet purple potato extract and vitamin C shows significantly increased of EPC migration (1.81 ± 0.02 vs1.47 ± 0.04 and 3.03 ± 0.01 vs 2.15 ± 0.03, p<0.01). There is significantly diferentiation between sweet potato purple extract and vitamin C (3.03 ± 0.01 vs 2.15 ± 0.03, p<0.01). Conclusion: Sweet purple potato extract and vitamin C increased EPC migration dose-dependently. Sweet purple potatao extract induces EPC migration better than vitamin C.                                                                                 Keywords: EPC migration, Stable CAD, sweet purple potato extract, vitamin C, antioxidant       &nbsp

EFFECT OF STATINS ON ENDOTHELIAL PROGENITOR CELL (EPC) MIGRATION FROM PERIPHERAL BLOOD OF STABLE CORONARY ARTERY DISEASE PATIENT

Penelitian Klinis ABSTRAK   Efek Pemberian Statin Terhadap Migrasi Endothelial Progenitor Cell (EPC) Pada Darah Tepi Penderita Penyakit Jantung Koroner Stabil Tyagita Verdena Rani Savitri, Yudi Her Oktaviono, Djoko Soemantri   Latar Belakang: Endothlelial progenitor cell (EPC) berpartisipasi dalam perbaikan endotel dan pertumbuhan pembuluh darah baru. Farmakoterapi kardiovaskular telah dibuktikan dapat memperbaiki jumlah dan fungsi EPC pada penderita dengan risiko kardiovaskular. Banyak studi melaporkan bahwa statin memiliki efek yang menguntungkan terhadap EPC dengan meningkatkan jumlah dan fungsi EPC, termasuk didalamnya adalah fungsi migrasi. Oleh karena itu, kami melakukan penelitian untuk menganalisis efek tiga statin yang berbeda terhadap migasi EPC. Tujuan: Untuk menganalisis efek pemberian statin terhadap migrasi EPC pada darah tepi penderita penyakit jantung koroner stabil. Metode: Penelitian ini kami lakukan secara in vitro true experimental post-test only control group design. Sel mononuklear diisolasi dari darah tepi penderita penyakit jantung koroner stabil dan dilakukan kultur dalam medium Stemline II Hematopoietic Stemcell Expansion Medium selama 3 hari. Kemudian sampel dibagi menjadi empat kelompok yaitu kelompok simvastatin 0.5 µmol/L,, atorvastatin 0.5 µmol/L, rosuvastatin 0.5 µmol/L dan kelompok kontrol kemudian diinkubasi selama 48 jam. Metode imunositokimia dilakukan untuk identifikasi EPC dengan mengevaluasi ekspresi CD34+. Pada hari ke-5 kultur, sel di pindahkan ke bagian atas transwell system sebanyak 5x105 sel per sumur perlakuan , kemudian di inkubasi selama 1 hari. Sel yang berpindah pada sumur transwell system bagian bawah dihitung dengan automatic cell counter dengan pewarnaan typhan blue. Data dianalisis dengan independent t test dan ANOVA. Hasil: Hasil independent t test terhadap hasil migrasi pada transwell system menunjukkan peningkatan bermakna terhadap migrasi EPC pada kelompok simvastatin, atorvastatin, dan rosuvastatin dibandingkan dengn kelompok kontrol (234000 ± 1290. 994, 265000 ± 1290. 994, 203000 ± 1290. 994 vs 174071.43 ± 1426. 785, p<0.05). Migrasi EPC juga berbeda antar kelompok statin, dimana efek tertinggi didapatkan pada kelompok atorvastatin. Migrasi EPC pada kelompok atorvastatin lebih tinggi daripada kelompok simvastatin (265000 ± 1290. 994 vs 234000 ± 1290. 994, p<0.05), dan simvastatin lebih tinggi daripada kelompok rosuvastatin (234000 ± 1290. 994 vs 203000 ± 1290. 994, p<0.05). Pemeriksaan imunositokimia menunjukkan ekspresi positif terhadap CD34+. Kesimpulan: Statin meningkatkan migrasi EPC pada darah tepi penderita penyakit jantung koroner stabil. Efek tertinggi tampak pada kelompok atorvastatin, diikuti kelompok simvastatin, dan rosuvastatin.   Kata kunci: Migrasi EPC, simvastatin, atorvastatin, rosuvastatin     Clinical Research   ABSTRACT   Effect of Statins on Endothelial Progenitor Cell (EPC) Migration from Peripheral Blood of Stable Coronary Artery Disease Patient   Tyagita Verdena Rani Savitri Yudi Her Oktaviono Djoko Soemantri     Background: Endothelial progenitor cell (EPC) participates in endothelial repair and new blood vessel growth. Cardiovascular pharmacotherapy has been shown to improve the amount and function of EPC in patients with cardiovascular risk. Many studies report that statins have a beneficial effect on EPC by increasing the number and function of EPC, including the migration function. Therefore, we conducted a study to analyze the effects of three different statins on EPC migration. Objective: To analyze the effect of statins on EPC migration from peripheral blood of stable coronary artery disease (SCAD) patient. Methods: This was an in vitro true experimental post-test only control group design. The MNCs were isolated from peripheral blood of SCAD patient and were cultured in Stemline II Hematopoietic Stemcell Expansion Medium in 3 days. Then samples were put into four groups, simvastatin 0.5 µmol/L, atorvastatin 0.5 µmol/L, rosuvastatin 0.5 µmol/L and control, then incubated for 48 hours. Immunocytochemical examination was performed to evaluate expression of CD34+. On the 5th day of culture, 5x105 cells per group were transferred to the upper chamber of the transwell system, then incubated for 1 day. Cells that migrated to the lower chamber of transwell system were calculated by automatic cell counter with typhan blue coloring. Data were analyzed by independent T-test and ANOVA. Results: The results of independent T-tests showed a significant increase in EPC migration in the simvastatin, atorvastatin, and rosuvastatin groups compared with the control group (234000 ± 1290.994, 265000 ± 1290.994, 203000 ± 1290. 994 vs 174071.43 ± 1426 785, p <0.05). EPC migration also differed between statin groups, where the highest effect was found in the atorvastatin group. EPC migration in the atorvastatin group was higher than the simvastatin group (265,000 ± 1290,994 vs 234,000 ± 1290,994, p <0.05), and simvastatin was higher than the rosuvastatin (234,000 ± 1290,994 vs 203000 ± 1290. 994, p < 0.05). Immunocytochemical examination showed a positive expression on CD34+. Conclusion: Statins increase EPC migration from peripheral blood of SCAD patient. Atorvastatin showed the highest EPC migration, followed by simvastatin, and rosuvastatin. Keywords: EPC migration, simvastatin, atorvastatin, rosuvastatin   &nbsp

Effects of Statins on Endothelial Progenitor Cell Proliferation from Peripheral Blood of Stable Coronary Artery Disease Patient

Background: Atherosclerotic lesions develop as the result of an inflammatory process initiated by endothelial damage. Endothelial progrenitor cells (EPCs), which is derived from bone marrow, participate in endothelial repair and new vessel growth. Cardiovascular pharmacotherapies have been shown to improve overall numbers and function of EPCs in patients with cardiovascular risk and cardiovascular disease. Studies have reported that statins exert beneficial effects on EPCs by enhancing EPC proliferation and differentiation. Thus, we require a research to analyze the effects of three different statins on EPC proliferation. The objective of this study is to analyze the effect of statins on EPC proliferation from peripheral blood of stable coronary artery disease patient. Methods: This is an in vitro true experimental post-test only control group design. The mononuclear cells (MNCs) were isolated from peripheral blood of stable coronary artery disease patient and were cultured in CFU-Hill medium for three days. Then samples were put into four groups, simvastatin experiment group, atorvastatin experiment group, rosuvastatin experiment group and control group. Each experiment group was divided into three subgroups with different doses, 0.1 ?mol/L, 0.5 ?mol/L, and 2.5 ?mol/L then incubated for 48 hours. EPC proliferation was evaluated afterwards with MTT cell proliferation assay. Immunocytochemistry method was performed for EPC identification to evaluate expression of CD34+. CFU-Hills were observed to confirm functional characteristics of EPC. Data were analyzed by independent T-test and ANOVA. Results: MTT cell proliferation assay showed a significant increase of EPC proliferation in simvastatin, atorvastatin, and rosuvastatin groups compared with control group (0.2370.007, 0.2480.01, 0.2310.008 vs 0.170.008, p<0.05). It also revealed significant difference in EPC proliferation between each experiment groups, which atorvastatin showed the highest effect. EPC proliferation in atorvastatin is higher than simvastatin group (0.2480.01 vs. 0.2370.007, p<0.05), and simvastatin is also higher than rosuvastatin group (0.2370.007 vs. 0.2310.008, p<0.05). CFU-Hill counts demonstrated highest number in rosuvastatin group, followed by atorvastatin, and simvastatin. Immunocytochemistry showed positive expression of CD34. Conclusion: Statins increase EPC proliferation from peripheral blood of stable coronary artery disease patient. Atorvastatin showed the highest EPC proliferation, followed by simvastatin, and rosuvastatin. Each statins increased EPC proliferation dose-dependently

Rosuvastatin is Superior Compared to Simvastatin and Atorvastatin to Induce Endothelial Progenitor Cells Migration

Introduction Statins have shown to improve Endothelial Progenitor Cells (EPCs) function, however no comparison has been done between various statins effectivity to induce EPCs migration. Aim This study compared simvastatin, atorvastatin and rosuvastatin treatment on impaired EPCs from Coronary Artery Disease (CAD) patients. Materials and Methods EPCs were isolated, cultivated and divided into untreated group (control), simvastatin (dose 0.1, 0.25, 0.5 mM), atorvastatin (0.1, 0.25, 0.5 mM), rosuvastatin (0.1, 0.25, 0.5 mM). EPCs migration was evaluated with boyden chamber assay. ANOVA, pearson correlation and linear regression test were done using SPSS 25.0. Results This research showed that simvastatin, atorvastatin, and rosuvastatin increased EPCs migration in dose dependent manner (p<0.05). Regression test showed that simvastatin treatment was responsible for 92.9% of EPCs migration, while atorvastatin was 75.5% and rosuvastatin was 65.6%. Rosuvastatin treatment dose 0.5 mM have the highest EPCs migration effect (195,750.00±5,809.48) compared to simvastatin (123,750.00±9,367.50, p≤0.001) and atorvastatin (156,375.00±12,392.03, p≤0.001) at the same dose. Conclusion Rosuvastatin treatment has higher EPCs migration effect compared to simvastatin and atorvastatin. This suggests that rosuvastatin might be preferable to improve EPCs migration in CAD patients

Rhinitis Leprosa : Laporan Sementara Penyelidikan dengan Cuci Hidung Secara Lokal

1. Telah dibahas 33 kasus Rhinitis Leprosa dari sejumlah 198 penderita Morbus Hansen dengan bermacam-macam tips balk dari po¬liklinik maupun Ruangan Penyakit Kulit dan Kelamin. 2. Diagnosa dini perlu ditegakkan untuk mencegah penularan dan deformitas hidung (saddle nose ). 3. Perlu dilakukan anamnesa yang teliti dan pemeriksaan hidung dengan Rhinoscepia anterior, karena sangat membantu dalam me¬negakkan diagnosa. 4. Kelainan lokal hidung yang terbanyak didapati (51,5%) yalah dalam stadium 3 atau stadium lanjut dari Rhinitis Leprosa be¬rupa atrophi mukosa dan crustac yang penuh pada cavum nasi. 5. Pemberian cuci hidung pada penderita Rhinitis Leprosa memberikan hasil yang baik sebagai terapi tambahan lokal disamping nasehat untuk menghindari tindakan yang traumatis pada hidung (oleh karena adanya mukosa anesthesia ) dan terapi, sistemik oleh Bagian Kulit. 6. Keuntungan lain pemberian cuci hidung. a. Harganya murah. b. Mudah dikerjakan sendiri dirumah. c. Kontrole hanya pada waktu-waktu tertentu saja. 7. Hasil penyelidikan ini merupakan laporan sementara, oleh kare¬na jumlah sample yang kecil

Hubungan Antara Ketebalan Intima Media Arteri Karotis (CIMT) dan Tekanan Sistolik Tungkai Lengan (ABI) pada Penderita dengan Faktor Risiko Penyakit Jantung Koroner Asimtomatis di Poloklinik Jantung RSUD Dr. Soetomo Surabaya

We studied associations between ankle-brachial index (ABI) and subclinical atherosclerosis using CIMT. Participats comparose 36 patients include 25 women (69,4%) and 11 men (30,6%) with an averadge age 59,4&plusmn;5,26 years who were asymptimatic and free of clinically eveident cardiovascular disease and have at least 2 risk factors of CVD. Measurements included ankle-brachial index (ABI), mean and maximum carotid intima-media thickness (CIMT) of common carotid artery, and cardiovascular risk factors that consist of age, hypertension, diabetes, smoking, dyslipidemia, and family history of premature CAD. ABI categories were defined : &lt;0.90 (abdnormal ABI or definite pepheral arterial disease (PAD)), 0.90-0.99 (borderline ABI), and 1.00-1.40 (normal ABI). Significantly higher common carotid artery intima-media thickness in both of mean and maximum CIMT were observed in patients with definite PAD and borderline ABI compared with that inpatients with normal ABI (p&lt;0,05). Analysis showed significantly weak correlation between mean CIMT and ABI (p=0,024; r=-0,376); and between maximum CIMT and ABI (p=0,039; r=-0,345). This study provide evidence that atherosclerosis process of the lower extremities arteries associated with subclinical atherosclerosis as reflected by increasing of CIMT of common carotid artery. This study also indicate patients with abnormal and borderline ABI have significantly greater degree of subclinical atherosclerosis and may imply increased risk of cardiovascular event

Whats New in Diabetes & CAD Management

Most patients with tlpe 2 diabetes have insulin resistance. Indeed, insulin resistance seems to predispose to both CVD and diabetes. Research suggests that insulin resistance is a multisystem disorder that induces multiple metabolic alterations. Factors that conribute to insulin resistance are genetics, obesity, physical inactivity, and advancing age. Patients with insulin resistance often have abdominal obesity. Metabolic risk factors that occur commonly in patients with insulin resistance are atherogenic dyslipidemi4 hypertension, glucose intolerance, and a prothrombotic state. Although monotherapies can, at least in theory, improve both metabolic defects underlying most cases of type 2 diabetes, monotherapies of all types gradually fail to correct hlperglycaernia as diabetes progresses. Such progressive treatment failures might be minimised by combining two separate agents, each highly effective in correcting one of two defects. There are a wide range possible combinations of sulphonylureas and metforrnin. Nevertheles , only glibenclamide and metformin are evidence-based, with several published clinical studies. These have shown that this combination provides enhanced glycaemic control in type 2 diabetes and cardiovascular protection, compared with ttnt offered by either monotherapy

Efek Angiotensin Coverting Enzyme Inhibitor (ACEI) Pada Proliferasi Endothelial Progenitor Cell (EPC) Penderita Angina Pektoris Stabil

Penelitian Pendanaan FK Unair 201

Angka kualitas hidup dan Gejala Depresi Pasien Gagal Jantung Kongestif di Poliklinik Jantung dan Vaskular RSUD Dr. Soetomo

Objective : to assess health related quality of life (QoL) and depressive disorder congestive heart of patients with failure (CHF); and to correlate the different aspect both of them. Background : morbidity and mortality are high in CHF. various studies approve reduced quality of rife and depression associated with worsening hean fairure itserf, increasing mortarity and readmission. Despite the obvious negative effects of depression and a reduced QoL on the course of CHF, these factors often go unrecognized and undertreated in ctinical practice. Method : we observed 55 Patients by purposive sampling. The inclusion criteria is all of out patients of CHF who classified to New York Heart Association (NYHA) functional class l, ll, and lll and the exclusion criteria is patients cHF with functional class IV who need incharge. Measurement was performed to NYHA functional class classification, quality of life and depression symptom and then we compare the associations between these variables. Both also compared to NYHA functional classes classification. Result : Quality of life short form-36 (Qol SF-36) score for NYHA Class I of physical component / physical summary score (PSS) = 73,30 +- 5.14 and mental component/mental summary score (MSS) = 80.83 +- 5.17; for NYHA class II, the PSS = 43.85 +- 6.39 and MSS = 53 +- 8.79; NYHA class III, the PSS = 24.67 +- 7.37 and MSS = 29.08 +- 9.08. significant correlation was found between NYHA functional classes and physical component and mental component of QoL. According to DSM-IV criteria the prevalence of Depressive Major Disorder was 24 patients (43,6%) significant correlation was found between NYHA functional classes and depressive symptoms PHQ-9 (r = 0.84; p< 0.01). patients with no depressive symptom have physical component (PSS) = 71.09 +- 8.05 and mental component (MSS) = 78,56 +- 8,52; mild depressive symptom have PSS = 55.00 +- 14.12 dan MSS = 65.62 +- 13.89; moderate depressive symptom have PSS = 38.17 +- 9,38 and MSS = 47.08 +- 8.34; moderatery severe have PSS = 31.43 +- 7.95 and MSS 36.71 +- 10,16; and = 31.43 +- 7.95 and MSS = 36,71 +- 10.16 severe have PSS = 21.20 +- 4.08 dan MSS =22.80 +- 6.30. significant correlation was found between Depressive symptom scale (pHQ-9) and both of physical Component,PSS (r = - 0.989, p < 0.01) and mental component, MSS (r = -0.939, p < 0.01) from Qol SF-36. Conclusion : Correlation between quality of life (SF-36) and depression scale (pHQ-9) was significant. All quality of life (SF-36) and depression scale (PHQ-9) was significant correlation with NYHA fun-ctional class