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7/24/2019 Slide Presentasi Fucoidan 21 April 08
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NNatures Wayatures Wayfor Faster Peptic Ulcer Healingfor Faster Peptic Ulcer Healing
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PREVALENSIPREVALENSI
DISPEPSIADISPEPSIA
21%21%
DispepsiaFungsional
H. Pylori
50 60 %*
Hu!ungan H" pylori #an #ispepsia fungsional$ Etical Digest$ no"&'$ tn" (I$ April2'')
Helico!acter pylori Infection fro* +olecular to ,linical Practice$ Herno*o
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Prevalensi infeksi H. pyloridi negara maju 30-40% Prevalensi infeksi H. pyloridi negara erkemang !0-"0%
#0-$0% menjadi en&aki' gas'r(du(denal)
Peneliti Daera 0ua +eto#a
Diagnosis
Prealensi
3%4+anan ,H 5aarta Duo#eni ,67 1''
5ayapranata Sura!aya Duo#eni ,67 89"8
5ayapranata Sura!aya :aster ,67 )&";
Prealensi Hp pa#a Pasien 0ua Pepti #i In#onesia
Su*!er< .uu A=ar Il*u Penyait Dala*$ 5ili# I E#isi I($ 2''>
PREVALENSIPREVALENSI
U6-US PEP0I-U+DIIND7NESIA
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"0% ulkus gas'er meruakan ulkus kr(nik
Sumer* P+ Signa ,usada +./. Siene 1(r)
PREVALENSIPREVALENSI
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PA+.2ISI.L.IPA+.2ISI.L.I
Schwarst 1910Schwarst 1910
2ak'(r Asam Lamung2ak'(r Asam Lamung N( Aid N( 5ler N( Aid N( 5ler
Penga'uranPenga'uranSekresi Asam LamungSekresi Asam Lamung
ada Sel Parie'alada Sel Parie'al
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ARESI2ARESI2
6E2ENSI26E2ENSI2
#) End(gen
$) Eks(gen
7uk(sa gas'r(du(denal
PA+.2ISI.L.IPA+.2ISI.L.I
Shay and Sun : Balance Theory 1974Shay and Sun : Balance Theory 1974
angguan 8eseimangan an'araangguan 8eseimangan an'ara
2ak'(r Agresif dengan 2ak'(r 6efensif2ak'(r Agresif dengan 2ak'(r 6efensif
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EKSOGENEKSOGEN
ENDOGENENDOGEN
PEN/E9A9PEN/E9A9
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ARESI2ARESI2
WarrenWarren
andand
MarshallMarshall198198
Helyco!acter pyloriHelyco!acter pylori:,;:,;
N( , N( 5ler
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6E2ENSI26E2ENSI2Preei'elial 7ukus
9ikar(na'
Sur"ace acti#ephospholipids
Ei'elial $ellular resistance
%estitution
Growth factors,Growth factors,&rosta'landins
$ell proli"eration
Suei'elial $ellular resistance
%estitution (rowth "actors)
&rosta'landins
$ell proli"eration
Mikrosirkulasi
H+ Pepsin Lumen
, #-$
,1.3-
, =,1.3
-
Pr(s'aglandin
#)#) E2 :eidermal gr(>'? fa'(r;E2 :eidermal gr(>'? fa'(r;
$) +2 alfa :'ransf(rming gr(>'? fa'(r alfa;
3)3) 22 :fir(las' gr(>'? fa'(r;22 :fir(las' gr(>'? fa'(r;
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,595NAN,595NAN
H. pyloriH. pylori@ 5L85S PEP+I857@ 5L85S PEP+I857
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H. pylori
H. pylori
Ad?esin An'igen Sesifikasi
9a A Le 2u(se
Sa A sLe Siali aid
,595NAN,595NAN
H. pyloriH. pylori@ 5L85S PEP+I857@ 5L85S PEP+I857
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H. pylorisere'ed VaA
5ler
Ei'?elial er(si(n
H. pylori
VaA
VaA
VaA B Vau(la'ing &'('(in
,595NAN,595NAN
H. pyloriH. pylori@ 5L85S PEP+I857@ 5L85S PEP+I857
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CagAis translocated from the bacteria into gastric epithelialcell, and perturb mammalian signal transduction machineries
and modify cellular functions by physically interaction with a
host cell protein
,595NAN,595NAN
H. pyloriH. pylori@ 5L85S PEP+I857@ 5L85S PEP+I857
7u(sal
la&er
Ei'?elial ell
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+ERAPI+ERAPI
5L85S PEP+I85L85S PEP+I8
N.N 7E6I8A7EN+.SA
Is'ira?a' 6ie'
,indari .AINS dll
7E6I8A7EN+.SA
An'asida .a' enangkal kerusakan mukus
AR,$ PPI
An'ii('ika
+rile 6rug 1(mina'i(n
+ERAPI+ERAPI
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0erapi0erapi A6A+IAHA6A+IAHPen#a*ping PPIPen#a*ping PPIuntu +e*percepat Penye*!uanuntu +e*percepat Penye*!uanU6-US PEP0I-U+U6-US PEP0I-U+
IN7(A
SI
IN7(
ASI
.A?U.A?U
PPI @ Proton Pu*p Ini!itor 37*epraole$ 6ansopraole$ Pantopraole$ #ll4
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B.roCn SeaCee# 3:anggang colat4
BCladosiphon okamuranus
B0u*!u #i #aera 7inaCa 5epang
B+erupaan *aanan seariari pen#u#u sete*pat
Polisaari#a$ o*ponen uta*a K
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S) 7a'sum('( e' al) /akul' 1en'ral Ins'i'u'e f(r 7ir(i(l(g& Resear? +(k&( aan $004)
A" 0er=a#i penurunange=ala olitis ronisseperti turunnya !erat
!a#an$ #iare$ elainan#ara"
." ,olon le!i pan=angpa#a eCanperco!aan yang #i!eri#iet Cladosiphonfucoi#an #i!an#ingan#engan #iet stan#ar"
PENELI+IANPENELI+IAN
K+engurangi :e=ala -olitis -ronis K
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PENELI+IANPENELI+IAN
.A:AI+ANA DEN:AN U5I -6INIS
DI IND7NESIA
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+ER958+I E2E8+I2+ER958+I E2E8+I2
6I 3 RS 9ESAR 6I IN6.NESIA6I 3 RS 9ESAR 6I IN6.NESIADou!le !lin#$ *ulti center
PENELI+IAN 6IPENELI+IAN 6I
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+o" 5uLrie" Ina ?osalina$ Wayu Da*ayanti$ Ali D=u*ana$ Ariani$ Har=ono A*a#2''> Asia paciMc Digestie Cee *eeting in ,e!u PilippineDou!le !lin# stu#y$ four!locs ran#o* sa*ple
PENELI+IAN 6IPENELI+IAN 6I
IN6.NESIAIN6.NESIAKEfetiMtas 0era#ap Ulus 6a*!ung K
B !asien engan ispepsia se"iakn+a ala( "a'un"e#ak'i#
B !asien "iak (engkonsu(si o&a" an"i ulse#an ala( )&ulan "e#ak'i#
B Ulkus ipe#iksa engan (enggunakan enoskopi
B Dengan alasan e"is pasien i&e#ikan !!-
B !asien i&agi (en$ai ua g#oup Fucoian !!- an!lace&o !!-
B Se"ela' 4 (inggu enoskopi ke 7 an &iopsi
B Klasi8kasi &e#asa#kan S9K-29 an 1-:9
B G#oup Fucoian (ene#i(a )00 (g Fucoian+angieks"#ak a#i Okinawa Brown Seaweed
B Sela(a 4 (inggu keua kelo(pok ica"a" ge$alaklinisn+a
PENELI+IAN 6IPENELI+IAN 6I
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0ere Cas a signiMcant re#uction of a!#o*inal pain after & #ays in
te Fucoi#anPPI group co*pare# to te Place!oPPI group3p
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(o*iting ten#s to #ecrease in #ay > in Fucoi#an PPI group 3p
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Disten#e# Cas signiMcant #ecrease# in #ay 9 in te Fucoi#anPPI
group$ co*pare# to tat in te Place!oPPI group 3p
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2u(idan F PII mengurangi 6isesia menjadi2u(idan F PII mengurangi 6isesia menjadi4)3 %4)3 %dalamdalamG ?ariG ?ari
6iandingkan dengan PPI 'unggal6iandingkan dengan PPI 'unggal &ai'u #G)=% &ai'u #G)=%
PENELI+IAN 6IPENELI+IAN 6I
IN6.NESIAIN6.NESIA)*'PP'*A)*'PP'*A
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8lasifikasi 5lkus 9erdasarkan8lasifikasi 5lkus 9erdasarkan
Saki'a dan 7i>aSaki'a dan 7i>a'tadium'tadium 8eme8emera?anra?an
5lkus5lkusEdeEdemama
Li?enLi?enPerdaPerdara?anra?an
7uk(sa7uk(sa2(ld2(ld
Acti#e A H HHHH HH HH H
Aktif" A- H HHH H H
Healing H H HH HPenyembu
han"H- H H HH
'caring ' H HH
.aringanParut
'- HH +eruk'i 7en&emu?kan+eruk'i 7en&emu?kan
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,asil* +erjadi eraikan &ang signifikan ada gru 2u(idan
"4% diandingkan ada gru lae( ada deraja' keara?an
ulkus :* 0)00G;
B +o" 5uLrie$ Ina ?osalina$ Wayu Da*ayanti$ Ali D=u*ana$ Ariani$ Har=ono A*a#B 2''> Asia paciMc Digestie Cee *eeting in ,e!u Pilippine
B Dou!le !lin# stu#y$ four!locs ran#o* sa*plesB N@ 99 pasien ulus gaster$ 3fucoi#an 1'' *g$ 1; pasien place!o$ 1> pasien4 sela*a 9*inggu
B -e#ua grup #i!eri proton pu*p ini!itor untu alasan etia"
+eruk'i 7en&emu?kan+eruk'i 7en&emu?kan
5lkus Lamung5lkus Lamung
SE795,SE795,LE9I, 1EPA+LE9I, 1EPA+
6L76L7
3 7IN53 7IN5
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+erjadi eraikan deraja' ulkus &ang signifikan ada gru fu(idan
F PPI &ai'u "4% diandingkan dengan gru lae( F PPI &ai'u
3=)G%
5L85S PEP+I85L85S PEP+I8PER9AI8ANPER9AI8AN
LE9I, 1EPA+LE9I, 1EPA+
PENELI+IANPENELI+IAN
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Time /eeded for0astric 1lcer Healing
!!-
4 (inggu
O(ep#a=ole> (inggu
ansop#a=ole > (inggu
+eruk'i 7en&emu?kan+eruk'i 7en&emu?kan
5lkus Lamung5lkus Lamung
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Abdominal
Pain2omit )istended
kembung"
!!-
34 Less 54 3 4
!9E?O
!!-
more 5 4 more 54 more -34
+eruk'i Lei? 1ea'+eruk'i Lei? 1ea'
7eng?ilangkan ejala 6isesia7eng?ilangkan ejala 6isesia
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SUK@9F92SUK@9F92 @E?91-!-D@E?91-!-DEE
)%'*' 6 hr)%'*' 6 hr $ $
%nce )aily%nce )aily7$7$ 8$8$
'1M9:'1M9: ALAMALAM '*/TT*;'*/TT*; '*/TT*;'*/TT*;
*nteraksi*nteraksiobatobat
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ANI7AL +ES+
:7i'suis?i Safe'& Siene Ins'i'u'e;
S579ER ALA7IA,
Sanga' aman karena meruakan makananse?ari-?ari enduduk .kina>a
8EA7ANAN8EA7ANAN
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8ESI7P5LAN8ESI7P5LAN
KKNatures Way for Faster Peptic Ulcer HealingNatures Way for Faster Peptic Ulcer Healing KK
9ekerja ada lamung dengan Triple *ction#) 7enega? ad?esi dan k(l(nisasi ,)&l(ri
$) 7emeri efek si'(r('eksi ada daera? ulkus 'er?ada asam
lamung dan esin
3) 7eningka'kan r(duksi (rowth +actor ,-pideral (rowth
+actor/-(+ dan!asic +i!ro!last (rowth +actor/!+(+
7eng?ilangkan )*'PP'*A)*'PP'*A lei? ea' diandingkanPPI 'unggal :erandingan 'imuln&a gejala 2u(idan F
PPI vs Plase( F PPI B 4)3% vs #G)=%;
7en&emu?kan ulkus e'ikum lei? ea'diandingkan PPI 'unggal :2u(idan F PPI vs Plase(
F PPI B "4% vs 3=)G%;
Aman dan ?arga 'erjangkau 6(sis seder?ana .ne 6ail&
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A' aff(rdale rie
+?e m(s' valuale r(du'
A!!%
:)A9L+
A!!%
:)A9L+
2AL1A9L+
2AL1A9L+
8E5N5LAN
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=74
8>(54
.eneMt Fucoi#an 1'' yang =au le!i !esar
#i!an#ingan #engan cost
)era?at perbaikan ulkus
gaster
)alam 8 minggu
Time /eeded
for 0astric1lcer Healing Total Cost
!!-
4 (inggu
=533+@533"$-
hari
:p 8>@(333, (inggu
@533 $ 5B hari
:p 7>B(333, (inggu
=3>5 $ 5B hari
:p 53@(-33,