World Journal of
Pharmaceutical and Life Sciences

( An ISO 9001:2015 Certified International Journal )

An International Peer Reviewed Journal for Pharmaceutical and Life Sciences
An Official Publication of Society for Advance Healthcare Research (Reg. No. : 01/01/01/31674/16)
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Abstract

PROVISION OF LOW-DOSE PROPRANOLOL IN PATIENTS WITH ACUTE ISCHEMIC STROKE AGAINST THE LEVELS OF TNF-Α, IL-10, AND THE RATIO OF TNF-Α / IL-10 AT “ABDUL MOELOEK” GENERAL HOSPITAL, BANDAR LAMPUNG, INDONESIA

Roezwir Azhari, Ellyza Nasrul, Al Rasyid, Adnil Edwin and Endang Nurcahyani*

ABSTRACT

Brain and the immune system are linked through sympathetic, parasympathetic nervous system and HPA axis. Relationship between brain and immune system is thought to be through molecules secreted by the necrotic brain tissues. Immune system alterations in ischemic stroke can be seen with the presence of lymphopenia, immediate increment and followed by decrement of proinflammatory cytokines (TNF-?) and elevated anti-inflammatory cytokines (IL-10). According to animal study, this condition can be controlled by giving propranolol. The aim of this study was to demonstrate the effect of 2x10 mg propranolol on TNF-?, IL-10, and TNF-?/IL-10 ratio in acute ischemic stroke patients with lymphopenia. This is an experimental research with pretest-postest match control group study design. Samples used in this study were 40 ischemic stroke patients with lymphopenia. The study was conducted in “Abdul Moeloek” General Hospital, Bandar Lampung, Indonesia from July, 2016 to February, 2017. Patients were divided into 2 groups; ischemic stroke group without propranolol, and ischemic stroke group with propranolol. TNF-? and IL-10 levels were examined by ELISA. The results showed that reduction of in TNF-? levels in the group treated with propranolol was lower (p=0.221). IL-10 levels increased in the group without propranolol (p=0.547). TNF-?/IL-10 ratio in the group with propranolol was higher (p=0.053). Ischemic stroke affects the patient's immune system that show in alteration of TNF-?,IL-10 levels and ratio of TNF?/IL-10. Provision of propranolol 2x10 mg increase TNF-? level, decrease IL-10 level and inrease ratio TNF?/IL-10, but not significant statistically.

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