Wisnu Barlianto

The Effect of House Dust Mite Immunotherapy, Probiotic and Nigella sativa in The Number of Th17 Cell and Asthma Control Test Score

The Role of Th17 cells in the pathogenesis of asthma and immunotherapy is being a new concept and paradigm. Immunotherapy on asthma requires long periods of time, so administration of an adjuvant had been considered to improve its efficacy. The aims of this study was to evaluate the therapeutic efficacy of immunotherapy combined with probiotics and Nigella sativa in the number of Th17 cells and the improvement of clinical symptoms of asthma. A total of 31 children with mild asthma were evaluated and then randomized to receive immunotherapy or immunotherapy plus Nigella sativa or immunotherapy plus probiotic or immunotherapy plus Nigella sativa plus probiotic openly for 14 weeks. Statistical analysis found no significant difference in the mean number of Th17 cells pre and post test in all four treatment groups, however we found a significant differences asthma control test (ACT) score before and after the immunotherapy + Nigella sativa treatment (p = 0.001), before and after immunotherapy + probiotic treatment (p = 0.004), as well as before and after immunotherapy plus Nigella sativa plus probiotic treatment (p = 0.000). Correlation test found a significant association between the number of Th17 cells and ACT score in all groups. The combination immunotherapy with Nigella sativa and probiotics did not reduce the number of peripheral blood Th17 cells mild asthmatic children, but can improve the clinical symptom. Keywords - Immunotherapy, House dust mite, Probiotics, Nigella sativa, Th17 cell, Asthma Control test

Genistein modulates the estrogen receptor and suppresses angiogenesis and inflammation in the murine model of peritoneal endometriosis

The purpose of this study was to investigate the effect of genistein administration on the modulation of the estrogen receptor, inhibition of inflammation and angiogenesis in the murine model of peritoneal endometriosis. A total of thirty-six mice (Mus musculus) were divided into six groups (n = 6), including the control group, endometriosis group, endometriosis group treated with various doses of genistein (0.78; 1.04; 1.3 mg/day), and endometriosis group treated with leuprolide acetate (0.00975 mg/day every 5 days for 15 days). Analysis of estrogen receptor-α, estrogen receptor-β, TNF-α, IL-6, VEGF, and HIF-1α were performed immunohistochemically. Expression of estrogen receptor-α, estrogen receptor-β, TNF-α, IL-6, VEGF and HIF-1α increased significantly compared with the control group (p < 0.05). All doses of genistein decreased the expression of estrogen receptor-α, increased estrogen receptor-β, lowered VEGF and HIF-1α significantly compared with endometriosis group (p > 0.05). Genistein also decreased the expression of TNF-α and IL-6 (1.04 and 1.3 mg/day) compared with the endometriosis group, reaching level comparable to that of the control group (p > 0.05). It was concluded that genistein is able to modulate estrogen receptor-α and estrogen receptor-β and inhibit the development of inflammation and angiogenesis in the murine model of peritoneal endometriosis. Thus, genistein can be a candidate in the treatment of endometriosis.

The Effect of House Dust Mite Immunotherapy, Probiotic and Nigella sativa in The Number of CD4 + IL-4 + Cell, Total IgE level and Asthma Control Test (ACT) Score

Ashtma is a chronic inflammatory disorder of the airways dominated by Th2. Immunotherapy was beneficial for ashtma patients. Its long duration was oftenly caused patients to drop out treatment . Probiotic and Nigella sativa as immunomodulator for asthma expectantly could increase the efficacy of immunotherapy . The aims of this study was to evaluate the therapeutic efficacy of immunotherapy combined with probiotics and Nigella sativa in the number of CD4 + IL-4 + cells, Total IgE level and Asthma Scoring Test. A total of 31 children with mild asthma were evaluated and then randomized to receive immunotherapy or immunotherapy plus Nigella sativa or immunotherapy plus probiotic or immunotherapy plus Nigella sativa plus probiotic openly for 14 weeks. Statistical analysis found no significant difference in the mean number of CD4 + IL-4 + cells pre and posttest in all three treatment group. The Total IgE level was decreased significantly in the immunotherapy+ probiotic + Nigella sativa group (p = 0,022). The ACT score were increased in the immunotherapy + Nigella sativa group (p = 0.001), in the immunotherapy + probiotic group (p = 0.004), and immunotherapy + Nigella sativa + probiotic group (p = 0.000). Correlation test found a significant association between the number of CD4 + IL-4 + cells, Total IgE level and ACT score in all groups. The combination immunotherapy, Nigella sativa and probiotics could decrease the Total IgE level thus improve the clinical symptom. Keywords - Immunotherapy, House dust mite, Probiotics, Nigella sativa, CD4 + IL-4 + , Ig E, Asthma Control test

Improvement of Th17/Treg balance and Asthma Control Test score by Nigella sativa supplementation in asthmatic children: a new approach to managing asthma

Introduction: Th17 and Treg cells have important roles in the development and progression of the allergic diseases, such as asthma. Several studies reported that Nigella sativa could improve chronic airway inflammation, and inhibit airway remodeling by regulating the immune system. To examine the effect of Nigella sativa supplementation on Th17/ Treg cells, and asthma control test score in asthmatic children. Materials and Methods: Twenty-eight children with asthma meeting the inclusion criteria in Saiful Anwar Hospital, Indonesia, participated in this study. All subjects took the standard treatment based on asthma guidelines. Nigella sativa oil (NSO) is given as additional treatment at the dose of 15–30 mg/kg/day for eight weeks in a randomized, singleblind-controlled trial. Th17 and Treg in peripheral blood mononuclear cells were analyzed by flow cytometry tool. Improvement of asthma control was accessed by ACT (Asthma Control Test) Score. Results: There was a significant decrease of Th17, and an increase of Treg percentages in NSO treatment group. Th17/ Treg ratio was lower in NSO group compared to the standard treatment group (1.06±0.33 vs. 2.30±1.08, p=0.001). The ACT score improvement was significantly higher in NSO compared to that in the standard treatment group (3.71±1.634 vs. 1.86±0.864, p=0.033). However, there was no significant correlation between Th17/Treg ratio and ACT score in preand post-treatment (p=0.552, p=0.344 respectively). Conclusion: NSO supplementation improves Th17/Treg balance and clinical symptoms in asthmatic children.

Effect of cowpea (Vigna unguiculata) extract on leptin serum levels, weight of visceral fat and visceral fat levels of MDA in Rattus norvegicus treated with DMPA

The purpose of this study was to show the effect of extracts of cowpea on leptin serum levels, fat weight and visceral fat levels of MDA in Rattus norvegicus exposed to DMPA. This study used a true experimental design approach using a post test only control group design. The animals used were Wistar Rattus norvegicus with measurements of serum leptin using the Elisa test technique. The fat was weighed and used for examinations of the MDA level in visceral fat. The measurement method of visceral fat MDA-586 was done using a kit bioassay. There were significant differences in the mean levels of leptin and fat loss as a result of cowpea extract in Treatment 2 and Treatment 3. There were significant differences in fat MDA as a consequence of cowpea extract in each treatment group. The extract of cowpea had also some influence on serum leptin level decrease, on the weight of visceral fat and the visceral fat levels of MDA in Rattus norvegicus treated with DMPA.

Perbedaan Skor ACT, CD4+CD25+Foxp3treg, CD4+IFN-γ pada Pemberian Imunoterapi, Probiotik dan Nigella Sativa

Probiotik dan Nigella sativa memiliki efek imunomodulator dan telah banyak banyak dikaji penggunaannya dalam kombinasi dengan imunoterapi asma. Imunoterapi dapat merubah perjalanan alamiah asma yang melibatkan perubahan respon imun Th2 menjadi Th1 dengan peningkatan IFN-γ. Proses tersebut juga berhubungan dengan pembentukan Tregulator, tetapi belum jelas mekanisme mana yang lebih dominan. Penelitian dilakukan untuk mengetahui perbedaan skor ACT serta jumlah sel CD4+CD25+FoxP3Treg dan CD4+IFN-γ pada anak asma ringan yang mendapat imunoterapi, probiotik dan Nigella sativa. Penelitian dilakukan dengan desain randomized clinical trial posttest only with control pada 32 subjek penelitian yang memenuhi kriteria inklusi dalam 4 kelompok yaitu kelompok A (imunoterapi+plasebo), kelompok B (imunoterapi+Nigella sativa), kelompok C (imunoterapi+probiotik), dan kelompok D (imunoterapi+Nigella sativa+probiotik). Perlakuan diberikan selama 56 minggu (imunoterapi fase induksi 14 minggu dan fase rumatan 42 minggu). Imunoterapi berupa ekstrak house dust mite diberikan subkutan, probiotik berupa Lactobacillus acidophilus dan Bifidobacterium lactis, dengan penilaian skoring asma menggunakan Asthma Control Test (ACT). Jumlah sel CD4+CD25+FoxP3+Treg dan CD4+IFN-γ diukur menggunakan flowcytometry. Hasil menunjukkan skor ACT kelompok C lebih tinggi bermakna dibandingkan kelompok A (p=0,04). Jumlah CD4+CD25+FoxP3+Treg paling tinggi pada kelompok D (15,966±9,720) , sedangkan jumlah CD4+IFN-γ paling tinggi pada kelompok C (17,506±11,576), tetapi tidak didapatkan perbedaan bermakna pada jumlah CD4+CD25+FoxP3+Treg (p=0,278) dan CD4+IFN-γ (p=0,367) antar semua kelompok. Dapat disimpulkan bahwa Imunoterapi+probiotik dapat meningkatkan skor ACT lebih baik dibandingkan imunoterapi saja. Imunoterapi, Nigella sativa, dan probiotik tidak memberikan perbedaan bermakna pada jumlah CD4+CD25+FoxP3 Treg dan CD4+IFN-γ.Kata Kunci: Asthma Control Test, CD4+CD25+FoxP3+Treg, CD4+IFN-γ, imunoterapi, Nigella sativa, probiotik