Inflammatory factors that could possibly be involved in genesis of OA structural changes. Osteoarthritis chondrocyte Increase functions - Type II collagen and aggrecan synthesis (early OA) - Cell proliferation - Catabolic cytokine production - MMPs, TPA / plasmin - IL-I receptor type 1, NOS / NO, Cox-2 / PGE2 - Apoptosis chondrocyte metabolism catabolism anabo
Inflammatory factors that could possibly be involved in genesis of OA structural changes. Osteoarthritis chondrocyte Increase functions - Type II collagen and aggrecan synthesis (early OA) - Cell proliferation - Catabolic cytokine production - MMPs, TPA / plasmin - IL-I receptor type 1, NOS / NO, Cox-2 / PGE2 - Apoptosis chondrocyte metabolism catabolism anabo
Inflammatory factors that could possibly be involved in genesis of OA structural changes. Osteoarthritis chondrocyte Increase functions - Type II collagen and aggrecan synthesis (early OA) - Cell proliferation - Catabolic cytokine production - MMPs, TPA / plasmin - IL-I receptor type 1, NOS / NO, Cox-2 / PGE2 - Apoptosis chondrocyte metabolism catabolism anabo
JABATAN : Guru Besar Divisi Reumatologi Dep. Ilmu Penyakit Dalam FKUI/RSUPN Ciptomangunkusumo Jakarta
PENDIDIKAN : Tamat Dokter 1972 FKUI Brevet Spesialis Penyakit Dalam 1979 FKUI Brevet Subspesialis Reumatologi 1986 FKUI Brevet Subspesialis Geriatri 1996 FKUI Doktor 2004 FKUI Guru Besar 2005 FKUI
ORGANISASI : Ketua Umum, Ikatan Reumatologi Indonesia, 1994 2005 President , Rheumatology Association of ASEAN 2001 2006 Ketua Bidang Sp Konsultan, Kolegium Ilmu Penyakit Dalam (KIPD), 2006- 2012 The Role Diacerein in the Management of Osteoathrosis Harry Isbagio Pathogenesis of OA Wear and tear ? It is not necessarily age related It is asymmetrically distribution/ localized It is progress steadily The sign & symptoms of inflammation Role of inflammation in OA, what is the evidence ? What are inflammatory factors that could possibly be involved in genesis of OA structural changes? Osteoarthritis chondrocyte Increase functions Type II collagen and aggrecan synthesis (early OA) Cell proliferation Catabolic cytokine production MMPs, TPA/plasmin IL-I receptor type 1, NOS/NO, Cox-2/PGE2 Apoptosis, Decrease functions Type II collagen and aggrecan synthesis (late OA) IL-1 receptor antagonist Response to IGF-1 Chondrocyte metabolism Catabolism Anabolism Chondrocyte Stimulation IGFs, TGF-beta, PDGF, EGF Bone morphogenic protein Cartilage derived morphogenic protein Growth factor Stimulation Gamma- Interferon TNF-alpha Prostaglandins Oxygen radicals, NO IL-1, TNF-alpha, IL-17, FGFs, gamma interferon Leukemia inhibitory factor Glucocorticoid Pro-collagen fragments Inhibition TIMP, Plasminogen activator inhibitor Calicrein Inhibition Chondrocytes Pro-MMPs Active-MMPs Extra-cellular matrix degradation Cytokines IL-1, TNF + Growth factors IGF, TGF-b + PKC, NF-KB, Kinase inhibitors PA, plasmin + + Thiol, serine proteases, MT-MMPs + TIMPs - Heavy metal chelators (Ca, Zn) - Modified from Pelletier JP, Arthritis Rheum 2001;44:1237 NO NO + + + + Management of Osteoarthritis Non-pharmacological therapy Pharmacological therapy Surgery OA KNEE Cell membrane IL-1 Intracellular signalling COX NOS Plasmin PGs NO Activation of MMPs Stromelysin Degrades cartilage Collagenase Degrades cartilage TGF-B IGF-1 Collagen II Aggrecans Hyaluronic acid Mechanism of action of diacerein Diacerein Conclusion Non-pharmacological therapy is as important as pharmacological therapy, and should be used in all cases There are some evidences that SYSADOAs, eg. diacerein is effective in osteoarthritis, and when used for a long term period they might be able to modify cartilage structure (disease modifying osteoarthritis drugs: DMOADs). Diacerein is as effective as NSAIDs in osteoarthritis, and is well tolerate. Thank You
Machine Learning Predicts 5-Chloro-1 - (2 - Phenylethyl) - 1h-Indole-2,3-Dione As A Drug Target For Fructose Bisphosphate Aldolase in Plasmodium Falciparum
International Journal of Innovative Science and Research Technology