Recent Updates on Epigenetic-Based Pharmacotherapy for Atherosclerosis.

Atherosclerosis is one of the most dominant pathological processes responsible in cardiovascular diseases (CVD) caused by cholesterol accumulation accompanied by inflammation in the arteries which will subsequently lead to further complications, including myocardial infarction and stroke. Although the incidence of atherosclerosis is decreasing in some countries, it is still considered the leading cause of death worldwide. Atherosclerosis is a vascular pathological process that is chronically inflammatory and is characterized by the invasion of inflammatory cells and cytokines. Many reports have unraveled the pivotal roles of epigenetics such as DNA methylation, post-translational histone modifications, and non-coding RNAs (ncRNAs) in atherogenesis, which regulate the expression of numerous genes related to various responsible pathways. Many studies have been conducted to develop new therapeutical approaches based on epigenetic changes for combating atherosclerosis. This review elaborates on recent updates on the development of new atherosclerosis drugs whose mechanism of action is associated with the modulation of DNA methylation, posttranslational histone modifications, and ncRNA-based gene regulation.

Strong Association of Metabolic Parameters with ADMA and VCAM-1 in Normo-Weight Subjects with Metabolic Syndrome.

Background: Metabolic syndrome (MetS) is a risk factor for cardiovascular disease and is linked to obesity. Subjects with MetS who have normo-weight potentially show higher mortality and morbidity. Purpose: This study aims to reveal the critical essential metabolic parameters associated with endothelial dysfunction in MetS subjects with normo-weight compared to obese. Patients and Methods: The study was designed using a case-control approach. Ninety-nine MetS subjects (34 Normo-weight and 65 obese) from the urban population were enrolled in this study. The components of MetS are based on NCEP/ATP III criteria. Asymmetric dimethylarginine (ADMA) and vascular cell adhesion molecule 1 (VCAM-1) as markers for endothelial dysfunction were measured in both groups. Results: Fasting blood glucose (FBG) levels were higher in the normo-weight group (143.38 ± 79.8 mg/dL) compared to the obese group (120.89 ± 46.5 mg/dL). High-density lipoprotein cholesterol (HDL-c) levels in the normo-weight group were lower (42.82 ± 10.1 mg/dL) compared to obesity (45.74 ± 9.3 mg/dL), while triacylglycerol (TAG) levels were higher in the obese (197.25 ± 110.5 mg/dL) compared to the normo-weight group (167.03 ± 98.4 mg/dL), although the differences were statistically not significant (all p > 0.05). The difference between ADMA and VCAM-1 levels was statistically not significant in both groups. Correlation between MetS components with endothelial dysfunction parameters shows that metabolic parameters correlate strongly. Interestingly, a stronger correlation between FBG and ADMA was observed in normo-weight (r = 0.519) compared to obese groups (r = 0.445). In addition, TAG consistently shows a significant correlation with ADMA and VCAM-1 in normo-weight groups. Conclusion: Metabolic parameters, especially FBG and TAG, correlate strongly with endothelial dysfunction parameters in normo-weight subjects with metabolic syndrome.

Non-monotonic dose-response of di-(2-ethylhexyl) phthalate isolated from Penicillium citrinum XT6 on adipogenesis and expression of PPARγ and GLUT4 in 3T3-L1 adipocytes.

OBJECTIVES: Adipogenesis is the fat cell formation process regulated by peroxisome proliferator-activated receptors (PPARγ). The insulin-responsive glucose transporter 4 (GLUT4) has a major role in glucose uptake and metabolism in insulin target tissues (i.e., adipose and muscle cells). The interplay between PPARγ and GLUT4 is essential for proper glucose homeostasis. This study aimed to isolate, elucidate, and investigate the effect of an isolated compound from Penicillium citrinum XT6 on adipogenesis, PPARγ, and GLUT4 expression in 3T3-L1 adipocytes. METHODS: The isolated compound was determined by analyzing spectroscopic data (LC-MS, FT-IR, Spectrophotometry UV-Vis, and NMR). The adipogenesis activity of the isolated compound in 3T3-L1 cells was determined by the Oil Red O staining method. RT-PCR was used to analyze the gene expression of PPARγ and GLUT4. RESULTS: Di-(2-ethylhexyl)-phthalate (DEHP) was the isolated compound from P.citrinum XT6. The results revealed adipogenesis stimulation and inhibition, as well as PPARγ and GLUT4 expressions. CONCLUSIONS: DEHP showed a non-monotonic dose-response (NMDR) effect on adipogenesis and PPARγ and GLUT4 expression. It is the first study that reveals DEHP's NMDR effects on lipid and glucose metabolism in adipocytes.

Anthocyanin-Containing Purple Sweet Potato (Ipomoea batatas L.) Synbiotic Yogurt Inhibited 3T3-L1 Adipogenesis by Suppressing White Adipocyte-Specific Genes.

Purpose: We unravel the effect of anthocyanin-containing purple sweet potato synbiotic yogurt (PSPY) on 3T3-L1 adipocyte differentiation and its fundamental molecular mechanisms. Methods: Molecular docking simulation was performed to observe and identify the affinity and interaction between bioactive compounds and targeted proteins. MDI (isobutylmethylxanthine, dexamethasone, and insulin)-containing medium, a cocktail that stimulates adipogenesis, was used in this study. The toxic effect possibility of the yogurt product was evaluated using 3-[4, 5-dimethylthiazol-2-yl]-2.5 diphenyl tetrazolium bromide (MTT) assay. A 0.25%, 0.5%, 1%, and 5% (v/v) plain or purple sweet potato yogurt supernatant was given to 3T3-L1 preadipocyte culture medium from 24 h after seeding until day 11 of MDI-induced differentiation. The mRNA expression and lipid accumulation were analyzed using RT-qPCR and Oil red O staining, respectively, on day 11 after differentiation induction. Results: In silico study suggested that anthocyanin-derived compounds have the potential to inhibit peroxisome proliferator activated receptor gamma (PPAR-γ), a master regulator for white adipogenesis. Anthocyanin-containing PSPY significantly suppressed the expression of Pparg, Adipoq, Slc2a4, and Pgc1a. PSPY significantly suppressed Pparg with 1% and 5% concentrations, while with a concentration of 0.25%, PSPY significantly suppressed Adipoq expression as compared to control. Significant inhibition of Slc2a4 and Pgc1a was observed starting from a 0.25% concentration of PSPY. The suppression of adipogenic genes was also observed with the treatment of plain yogurt; however, the effects were relatively lower than the PSPY. The group treated with 1% and 5% of PSPY also showed inhibition effects on lipid accumulation. Conclusion: This study demonstrated PSPY inhibition effect on white adipocyte differentiation through suppression of Pparg and its downstream genes, Adipoq and Slc2a4, indicating the potential of this yogurt as a functional food for obesity management and prevention.

Effect of Resveratrol in Melinjo Seed (Gnetum gnemon L.) Extract on Type 2 Diabetes Mellitus Patients and its Possible Mechanism: A Review.

BACKGROUND AND OBJECTIVE: Diabetes mellitus is the third leading cause of death in Indonesia (6.7 %), followed by stroke (21.1 %) and coronary heart disease (12.9 %). The prevalence of diabetes worldwide continues to increase on a yearly basis, including in Indonesia. Diabetes is a significant burden for many countries due to the high costs of treatment and reduced productivity of diabetes patients. Comprehensive strategies to prevent and treat diabetes are therefore mandatory. Oral hypoglycemic drugs are the first-line therapy for diabetes mellitus patients; however, these oral drugs still have several side effects. Therefore, it is necessary to conduct studies on medicinal plants with hypoglycemic effects to identify substances that have an anti-diabetic potential resembling physiological processes in the body. Indonesian people often use herbal medicines empirically, but the benefits have not been scientifically documented. Melinjo (Gnetum gnemon L.) is a native Indonesian gymnosperm plant, and the seeds are often processed into food. Melinjo seeds extract contains many polyphenols, including trans-resveratrol. CONCLUSION: Studies on the health benefits of resveratrol are widely available, including antidiabetes and blood sugar control in patients with type 2 diabetes.

The Ethyl Acetate Fraction of Marine Sponge Stylissa carteri Induces Breast Cancer Cell Death via Upregulation of Mcl-1S: an In vitro Study.

OBJECTIVE: To evaluate the potency of the fraction of marine sponge Stylissa carteri in inducing cell death, inhibiting spheroid growth, and its impact on pro-apoptotic protein Mcl-1S in breast cancer cells. METHODS: Stylissa carteri were collected from Pramuka Island followed by ethanol extraction and ethyl acetate fractionation. To evaluate the cytotoxic effect of fraction, the HCC-1954, MDA MB 231, and MCF-7 cells were treated with the fraction of Stylissa carteri and MTT assay was then performed. The effect on spheroid growth was evaluated in HCC-1954 cells. The combined effect of the ethyl acetate fraction and paclitaxel were analyzed using combination index (CI) and immunoblotting on the pro-apoptotic protein Mcl-1S. Furthermore, compounds in this fraction were identified using GC-MS. RESULTS: Data showed that both the MDA MB 231 and HCC-1954 cells were interestingly more sensitive to the fraction as compared with MCF-7 cells. The IC50 of the ethyl acetate fraction on HCC-1954, MDA MB 231 and MCF-7 were 4.1 µg/ml, 3.9 µg/ml, and 123.8 µg/ml, respectively. In addition, the fraction triggered spheroid destruction within 10 days. The CI of paclitaxel and ethyl acetate fraction of Stylissa carteri were less than 0.52. Moreover, this combination induced upregulation of the Mcl-1S protein. Furthermore, some fatty acid-based structures were predicted as the major compounds in this fraction. CONCLUSION: The ethyl acetate fraction of Stylissa carteri induces cell death and spheroid destruction in aggressive breast cancer cells. It has a synergistic cytotoxic effect with paclitaxel on MDA MB 231 cell death and upregulates Mcl-1S protein.

A Literature Review: The History of Psychological Impact of Illness amongst People with Leprosy (PwL) in Countries across the Globe.

BACKGROUND: Leprosy is a chronic infectious disease for which effective therapy has been long since invented. Thus, the morbidity has been decreased as technology has advanced, but the permanent disability has continuously generated stigma for centuries. The stigma causes the emergence of a poor psychological impact on people with leprosy (PwL). These impacts make new PwL reluctant to get appropriate therapy for their initial symptoms and are, thus, troublesome in accomplishing the goals of the leprosy elimination program. The aim of this review is to provide the history of psychological impact amongst PwL in countries across the globe. METHODS: This is a literature review study. A keyword-based search was conducted in digital libraries. Articles reporting on PwL's psychology and related issues, such as quality of life, opportunity of building a marriage, and getting hired, were included. The data were presented based on a leprosy history timeline with cutoff points, namely, the invention of promin (1941) and multidrug treatment (1970). RESULTS: In total, 38 studies were included in this review. These studies showed that PwL's knowledge towards leprosy has been increasing; nevertheless, their attitude is still lacking. The emotional response was described by various negative feelings that had persistently occurred. These poor psychological impacts were followed by poor treatment-seeking behavior and resulted in low quality of life. CONCLUSIONS: From year to year, the PwL's knowledge about leprosy has been getting better; nevertheless, their attitude towards the disease is still poor. The emotional response, social participation, and quality of life of PwL are persistently poor due to the persistent stigma.

The Ethanol Extract of Marine Sponge Aaptos suberitoides Suppress Cell Viability, Cell Proliferation and Cell Migration in HER2-Positive Breast Cancer Cell Line.

OBJECTIVE: This study aimed to investigate the cytotoxicity, anti-proliferation and anti-migration effect of the ethanol extract of Aaptos suberitoides on trastuzumab-resistant HER2+ breast cancer cell line. METHODS: Aaptos suberitoides was collected from Tinjil Island, Banten, Indonesia, and was processed with maceration and ethanol extraction. HCC-1954 cells were treated with the ethanol extract and then followed by 3- [4, 5-dimethylthiazol-2-yl] -2.5 diphenyl tetrazolium bromide (MTT) assay to assess cytotoxicity, clonogenic assay and three-dimensional (3D) spheroid assay to evaluate anti-proliferative effect in two-dimensional and 3D model, respectively, and wound healing assay to determine anti-cell migration effect. Four parametric regression was used to analyse the IC50. RESULTS: This study revealed that the ethanol extract of Aaptos suberitoides suppressed cell viability in correlation with cell death induction. The IC50 values of the ethanol extract of Aaptos suberitoides using MTT assay and clonogenic assay were 12.0 ppm and 4.36 ppm, respectively. The extract demonstrated an inhibition effect on spheroid growth. In low concentration, the extract of Aaptos suberitoides inhibited cell migration. Furthermore, MS analysis showed that the most abundant compounds in this extract has molecular weight m/z 229.81 [M+H]+. CONCLUSION: This study revealed that the ethanol extract of Aaptos suberitoides demonstrates cytotoxicity, anti-proliferation and anti-migration effect as well as inhibition effect on three-dimensional spheroid growth in trastuzumab-resistant HER2+ breast cancer cell line.
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Temporal association between serious bleeding and immunization: vitamin K deficiency as main causative factor.

BACKGROUND: Bleeding as an adverse event following immunization (AEFI) that is rarely reported in children, although it can be a parental concern. Bleeding episodes ranging in severity from mild to severe and defined as any external and/or internal bleeding can be caused by acquired or hereditary disorders. This study analyzes whether bleeding episodes in children that were recorded as AEFIs are causally associated with immunization and elaborates their etiology. METHODS: A cross-sectional study of 388 AEFI cases in children from West Java Provincial Committee in Indonesia confirmed by case findings from 2000 until 2017. RESULTS: Of the total number of cases studied, 55 (14%) involved children aged 5 days to 12 years who presented with bleeding and were referred to a provincial hospital. Analysis revealed that 32 cases were most likely caused by acquired prothrombin complex deficiency (APCD) and 30 of these APCD cases were strongly suspected to be manifestations of vitamin K deficiency bleeding (VKDB). All VKDB subjects were aged 5 days to 3 months without a history of administration of prophylactic vitamin K. When a World Health Organization classification was used, most bleeding cases in this study became coincidental events with a temporal association with immunization. A causality assessment suggested that these cases were causally unrelated. CONCLUSION: Most cases of bleeding reported as an AEFI were found to be VKDB, which is considered a coincidental event following immunization with a temporal association, and an unrelated category based on the results of a causality assessment. Vitamin K should be administered to all newborns as a prophylactic and AEFI surveillance should be improved based on the low numbers of AEFI reported in Indonesia.

Determinants of adolescent shortness in Tanjungsari, West Java, Indonesia.

BACKGROUND AND OBJECTIVES: Health status during adolescence may predetermine that during adulthood. Being short because of nutritional and health adversity, where stunting is indicative, is a global health concern, possibly in adolescence. This study assessed the prevalence of shortness (defined by HAZ <-2 SD) at age 12 and its determinants. STUDY DESIGN: This Tanjungsari birth cohort of 1988/1989 was revisited in 2001-2002 with 3093 participating children, their parents and households. The cohort was tracked from birth, to ages 2 and 12 with anthropometry, with birth weight, then weight and height-for-age at 2 and 12, dietary history at age 2, health patterns at age 2 and 12, and environmental exposures. RESULTS: The prevalence of adolescent shortness, presumed 'stunting', was 48.8% for which predictor Odds Ratios (OR) were low birth weight 1.64 (95% CI: 1.28-2.09), short height for age at 2-years 1.54 (95% CI: 1.33-1.80), limited maternal education 1.19 (95% CI: 1.01-1.41), unimproved source of drinking water 1.27 (95% CI: 1.08-1.49), unimproved latrine 1.18 (95% CI: 1.01-1.39) and presence of atopic disease at 12 years of age 1.29 (95% CI: 1.01-1.65). Smoking exposure, not breastfed, formula milk consumption and infectious disease at age 2 were not associated with shortness at age 12 on multivariable analysis. CONCLUSIONS: Adolescent shortness was found in almost half of this rural Javanese cohort followed from birth. It was associated with birth weight, and several individual, maternal and environmental factors evident at age 2, along with an atopic disposition at age 12. However, stature itself may not constitute a health risk over and above the associated socio-environmental conditions.