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Macrophages are essential components of the immune system, with significant roles in inflammation modulation. They can be activated into pro-inflammatory M1 or anti-inflammatory M2 phenotypes, depending on their micro-environment. Molecular factors that modulate macrophage polarization are hot targets for therapeutic strategies to counter chronic inflammatory pathological conditions.The current study aimed to elucidate the molecular mechanisms by which Retinoic acid (RA), a potent immunomodulator, suppresses LPS-induced inflammatory response in macrophages.RAW 264.7 macrophages were treated with RA and/or LPS, and analyzed for inflammatory genes and miR-21 by PCR. The roles of miR-21 and NF-ĸB signaling pathway were also assessed by knock-down experiments, immunofluorescence, and ChIP assays.Pretreatment with RA quenched the LPS-induced inflammatory responses, including phagocytosis, ROS generation, and NO production. RA shifted the polarization away from the M1 state by negative regulation of IKKα/β, p65, and miR-21. RA hindered the phosphorylation of IKKα/β, translocation of p65 into the nucleus, and the subsequent upregulation of miR-21. Knock-in and knock-down experiments showed that miR-21 is central for the polarization shift toward the pro-inflammatory M1 state.miR-21 is involved in the LPS-induced pro-inflammatory profile of macrophages and that RA negatively regulates the inflammatory response by targeting NF-ĸB/miR-21 signaling. Our data exposes RA's potential as a pharmacological agent to manipulate miR-21 and counteract hyper-inflammatory response.

MicroRNAs can regulate inflammatory responses by modulating macrophage polarization. Although microRNA miR-21 is linked to crucial processes involved in inflammatory responses, its precise role in macrophage polarization is controversial. In this study, we investigated the functional relevance of endogenous miRNA-21 and the role of exosomes. RAW 264.7 macrophages were transfected with miR-21 plasmid, and the inflammatory response was evaluated by flow cytometry, phagocytosis, and real-time PCR analysis of inflammatory cytokines. To understand the signaling pathways' role, the cells were treated with inhibitors specific for PI3K or NFĸB. Exosomes from transfected cells were used to study the paracrine action of miR-21 on naive macrophages. Overexpression of miR-21 resulted in significant upregulation of pro-inflammatory cytokines, pushing the cells towards a pro-inflammatory phenotype, with partial involvement of PI3K and NFĸB signal pathways. The cells also secreted miR-21 rich exosomes, which, on delivery to naive macrophages, caused them to exhibit pro-inflammatory activity. The presence of miR-21 inhibitor quenched the inflammatory response. This study validates the pro-inflammatory property of miR-21 with a tendency to foster an inflammatory milieu. Our findings also reinforce the dual importance of exosomal miR-21 as a biomarker and therapeutic target in inflammatory conditions.

Tuberculosis (TB) in Indonesia is at the third level in the world. The effectiveness of TB vaccine in lung TB. prevention varies, thus,this has motivated the researcher to explore based material of vaccine with a higher effectivity. One of the alternate vaccines that hasdeveloped, is the sub unit one made from adhesin protein. The aim of this study was to know the kind of oral administration of 38 kDaadhesin protein of M. tuberculosis in determining so that it can increase the level of macrophage in lungs of BALB/c mice. This study wasan experimental work using BALB/c male mice that were immunized with 38 kDa adhesin protein of Mycobacterium tuberculosis orally.The samples were chosen at random and divided into six (6) groups that consisted of: "100 μg protein +adjuvant ImmunostimulatingComplex (ISCOM)” group (n=5), "50 μg + adjuvant ISCOM” group (n=5), "100 μg” group (n=5), "50 μg” group (n=5), "ISCOM” group(n=5) and "negative control” group (n=5). The measurement of the variable in this study was the number of macrophages . The resultsshowed that the increasing number of macrophage had significant differences between each group. ANOVA test showed a significant levelat p

Background. The prevalence of diabetes mellitus has been epidemically increasing throughout all the world population, and diabetic polyneuropathy (PNP-DM) is one of the most common neurologic manifestation of this disease. Clinical research has proved that effective bedside screening of PNP-DM can significantly reduce the incidence of foot ulcer and limb amputation. Objective. To measure the diagnostic test of polyneuropathy scoring, monofilament 10-g SemmesWeinstein test, and 128 Hz tuning fork test as an early detection measure for PNP-DM. Methods. This research was conducted using a cross sectional approach from Januari 2016 to Juli 2017. Results. Among the total study population of 43 (23 men and 20 woman), Modified Toronto Score has the highest sensitivity (100%), PPV (93%) and accuracy (93%). Toronto score has the highest NPV (9%). Conclusion. Modified Toronto Score has good diagnostic value as screening tool in PNP-DM.

Background:Motor neuropathy is an extremely rare herpes complication, with a mere prevalence of 0.5–5%. The case of segmental zoster paresis of limbs, resulting from motor radiculopathy, is especially limited, with cervical and thoracic segments being the least frequent.Setting:Neurology outpatient clinic. CaseDescription:We report a case of a 16-year-old female who presented sudden-onset right upper extremity weakness, a week after her herpes zoster lesions first appeared. As she was diagnosed with systemic lupus erythematosus (SLE) 4 months prior, she routinely consumed steroids and azathioprine. Initial examinations revealed multiple vesicles along right C5-C6 roots dermatome accompanied by upper right extremity weakness (manual muscle test [MMT] 3) corresponding to the myotome of C5-C6 roots. An electromyography assessment uncovered results relevant to motor root neuritis in C5-C6. Magnetic resonance imaging of the cervical radix with contrast showed no abnormality. Thus, she received acyclovir, gabapentin and physiotherapy.Results:A follow-up visit after 2 weeks revealed an improvement of the weakness along C5-C6 myotome (MMT 4). A month later, all motor functions were restored with hypoesthesia and hypoalgesia sensory sequelae along C5-C6 dermatome.Conclusion:Herpes zoster radiculopathy, though rare, can occur after the onset of characteristic rash. Since cellular-mediated immunity holds crucial roles in varicella zoster virus activation, SLE and immunosuppression therapy is pertinent to this rare motoric complication of herpes. The prognosis is good. Acyclovir, gabapentin and physiotherapy treatments resulted in satisfactory recovery.