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PROCEEDING

International Seminar and Workshop 8TH BASIC MOLECULAR BIOLOGY

COURSE ON STEM CELL “Treatment by using Stem Cells“

Malang, 22nd-23rd May 20106th Floor Faculty of Medicine, Brawijaya University

Organised by

Basic Molecular Biology Course 2010 – Faculty of Medicine, Brawijaya University, Malang

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Table of Contents

Acknowledgements Welcome Address Congress Organizing Committee Invited Speakers Congress Information for All Attendees Information for speakers and presenters Detail Scientific Program Listing Abstract of Invited Lectures

May 22, SaturdayMay 23, Sunday

WorkshopAbstract of Poster Presentation

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ACKNOWLEDGEMENTS

The Organizing Committee of the BMBC International Seminar and Workshop would like to extend our great gratitude to the following organizations and companies who generously contribute and support to the success of the congress.

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WELCOME ADDRESSFrom president of the 8th Basic Molecular Bioogy Course

Dear Colleagues,

It is both my privilege and pleasure to welcome you all to the 8th Basic Molecular Biology Course (BMBC) 2010, International Seminar and Workshop of Stem Cell Therapy, held on 22nd – 23rd May 2010 at Brawijaya University, Malang, Indonesia. Since its first Course, BMBC has been one of the most important courses in Brawijaya University over the past years. It is truly a great pleasure that this year Medical School Brawijaya University collaborates with Saiful Anwar General Hospital, and Pathobiology Association Malang host this Course. On behalf of the Organizing Committee and myself personally, I would like to express our highest appreciation to all the invited speakers, from abroad and local, who have flown here and generously will share their expertise and experience with us in this two day BMBC Seminar.

We are delighted to announce that more than 150 delegates from all over Indonesia attend this Seminar. We are sure that this Seminar will be a suitable platform for exchanging and sharing ideas, as well as, contribute to a great extent to the promotion of diseases control. With your participation, fruitful discussion and success of the BMBC are very much expected.

The 8th BMBC comprises informative scientific sessions, plenary lectures, poster presentations and workshop. This BMBC educational program is designed to provide updates for clinicians, researchers, and allied health professionals on basic science of stem cells and its clinical application for diagnosis and management of disorders. As in previous meetings, we believe that BMBC 2010 will be just as rewarding to attendees

Seminars sessions will highlight research and therapeutic use of stem cell in the field of metabolic diseases: diabetes and cardiovascular, obesity, neurology, cancer and tendon regenerative engineering. These will be delivered by experts and clinicians from Belgium, Canada, Singapore and from research centers in Indonesia. Afternoon workshops focused on in vitro culture of stem cells will be offered at Laboratory of Biomedical and Physiology, Faculty of Medicine, Brawijaya University which have successfully cultured endothelial and cancer progenitor cells. Also, a Dinner Symposium discussing the recent advances in cardiovascular therapy will present experts and clinicians from Belgium and Indonesia.

In addition to the scientific program, we are pleased to introduce you to Malang, our beautiful town in the eastern part of Java. We hope that all participants will take the opportunity to enjoy, experience the warm hospitality of our people and embrace our rich culture. Spare some of your time to see “Malang Kembali” (Malang Returns): which is now on display along our landmark Ijen Boulevard.

Once again, thank you very much for participating in this Seminar and Workshop, and we hope that your journey in Malang will be gratifying scientifically and personally and may result in long-lasting collaboration among us.

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Sincerely yours,Professor DR. Djanggan Sargowo, MD, Cardiologist FACC.FESC.FCAPC.FASCC.FIHA

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WELCOME ADDRESSFrom Rector of Brawijaya University

Good morning, ladies and gentlemen. As Rector of Brawijaya University, I'd like to offer a warm welcome to all of you in this special occasion. I am honored to be here with such a distinguished gathering of academics and clinicians, also the world renowned researchers, and directors of research centers and hospital. We at Brawijaya University are very grateful to you, and to all of our guest speakers, for coming all the way here. I would also like to thank the BMBC team and Faculty of Medicine Brawijaya University for organizing this seminar and workshop of the 8th Basic Molecular Biology Course (BMBC) 2010, International Seminar and Workshop of Stem Cell Therapy, concurrently with Guest Lectures for medical students. I believe that the theme chosen by the BMBC team, is one of keen interest in medicine, as I have informed that the number of participants registered for this event is more than 150, the highest in BMBC history so far.

Dear guestsStem cell is one of the most important areas in medical research and therapy around the world today. Share knowledge, expertise and work together with different institutions, such as universities, heath care institutions, biotech and pharmaceutical companies is very important to speed the translation of knowledge to answer problems at society, because a good discovery today may well take twenty-five years before it is an accepted as technical practice and.

Ladies and gentleman,Our scientists at Brawijaya University are doing stem cell research here and networking with colleagues around the world including Japan and Korea in taking part to transform these stem cell knowledge into truly useful treatments. We will devote ourselves to development for the future in terms of science and technology. In this situation, we are very happy that experts in this field are attending here. I wish, among other things, one of the outcomes of this BMBC is a collaborative research and education among us, benefited us the academic practitioner and clinicians as well as patients and society at large. I am confident that you will, along with the rest of us, benefit greatly from this opportunity to share ideas, exchange information and work toward our common goal.

Finally, herewith I will officially open this Internatinal Seminar and workshopof BMBC and I would like to ask all of you to please yourselves at this event, and..thank you very much for your attention.

Professor DR. Ir. Yogi SugitoRector, Brawijaya University

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CONGRESS ORGANIZING COMMITTEEInitiatorBasic Molecular Biology Course Team

Conference HostFaculty of Medicine, Brawijaya University, MalangSaiful Anwar Hospital, Malang

BMBC Organizing CommitteePatron Dean of Faculty of Medicine Brawijaya University

Director of Saiful Anwar Hospital, MalangChairman of Indonesian Society of Pathobiology

BMBC President Prof. DR. Dr. Djanggan Sargowo, SpPD, SpJP(K) FIHA FESC FACCBMBC Vice President DR. Dr. PWM Olly Indrayani SpPDSecretary DR. Dr. Pudji Rahayu, SpTHT-KL(K)Vice Secretary Anna Satyana K, SP MPTreasurer DR. Dr. Emmy Endang sulastri, SpS

Erni SulastriScientific Program Chairperson Diana Lyrawati, Apt. MS. PhD

Prof. Dr. M Aris Widodo, SpFK. PhDDr. John Prihadi, Cardiologist-RehabilitationDR. Dr. Ketut Muliartha, SpPADR. Dr. Tinny E Hernowati, SpPK MKesDR. Dra. Sri Winarsih MKes Apt. MKesDR. Dr. Achmad Rudiyanto SpPD

Workshop DR. Drg. Nur Permatasari, MSSatuman, MKes

Fund Raising DR. Dr. Sugiharta Tandya SpPKAccomodation and Transportation Safira Sahra SPsi

Prodia TeamHospitality Dian

Erni SulastriHagus Ismunir SPiDesi Kafa NillaFaculty of Medicine, Brawijaya University TeamProdia Team

Secretariat Ruang CVCU RS Dr. Saiful Anwar MalangJl. Jaksa Agung Suprapto, Malang, IndonesiaTel./Fax: +62 341 346818Email: [email protected]

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INVITED SPEAKERSBelgiumStefan JanssensJan Staessen Koen TheuniessenFrans Van De Werf

CanadaChristian Drapeau

IndonesiaM Sasmito DjatiM Rasjad IndraPWM Olly IndrayaniDiana LyrawatiSofia MubarikaFerry SandraDjanggan SargowoSatumanBoenjamin SetiawanAli SulaimanHeri SurotoM Aris WidodoAndi Wijaya

SingaporePatrick Tan

(*alphabetical order of the countries/regions and last name)

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INFORMATION FOR ALL ATTENDEES(in alphabetical order)

BadgesAt the registration time, each registered participant receives a colour-code name badge. Badgesshould be worn at all times and clearly exhibited during BMBC events, not only as a courtesy to other registrants, but as an indication that registration has been completed.

Name badges are required for entry into the exhibit hall and all sessions during the congress. If you are not wearing your name badge, you may be refused entry or exclude participation in any congress activity.

BMBC Seminar and Workshop PoliciesThe 8th BMBC reserves the right to deny registration or entrance to any attendee or prospectiveattendees, and to cancel an existing registration, if it determines that a registration or an attendee is notthe best interest of the BMBC Seminar and Workshop.Lost badges cannot be replaced. If you lose your badge, you must register again at the regular rates toobtain a new badge. Lost Dinner Symposium vouchers will not be replaced.

BMBC Seminar KitBMBC seminar kit contains a CD of final program, proceedings, name badge/banquet ticket, official receipt and pen. You may obtain the kit when you check in at the Registration Desk. A specially designed congress bag is a free gift to each participant.

BMBC WebsiteFor up-to-date information on the BMBC including scientific program, please visit the Website at:http://ppsub.brawijaya.ac.id/bmbc/

CateringSnack for coffee-break and lunch-box will be provided for registered participants. All participants and exhibitors will have the possibility to purchase snacks and refreshments at the congress venue or at locations close by.

Dinner SymposiumDinner symposium sessions are free of charge and open to full-registered participants.

Duplication/ RecordingUnauthorized photography, audio taping, video recording, digital taping or any other form of duplication isprohibited in congress sessions.

Internet and Wireless AccessParticipants will be able to access the web wirelessly within the BMBC venue at Faculty of Medicine, Brawijaya University. It includes basic web access only.

Insurance and LiabilityThe congress organizer cannot accept liability for personal injury, loss of or damage to belongings of

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http://ppsub.brawijaya.ac.id/bmbc/


participants, either during or as a result of the BMBC. Please check the validity of your own insurance.

Mobile PhonesAs a courtesy to other delegates and speakers, please ensure your mobile phone is switched off or turned to silent when conference sessions are in progress.

Official LanguageThe official language of the BMBC is English.

PhotographyDuring the Seminar and Workshop, and all related activities and events, photographs may be taken of delegates. The BMBC organizers reserves the right to use all images that photographers takes during the course forpublication and promotion of future BMBC events. If you have any concerns regarding this, or do not wish your photo to be published in any way, please see staff at the BMBC information desk.

Program ChangesThe organizers cannot assume liability for any changes in the program due to external or unforeseencircumstances. The organizers reserve the right to cancel, postpone, relocate or change any of the sessions or to add new sessions.

ParkingDay parking is available at Brawijaya University parking structures at the rate IDR2,000.

Registration Desk HoursOn-site, advance, accompanying person registration and general information are located at the 6th Floor of Faculty of Medicine Building, Brawijaya University. The registration desk will operate from 8am to 5pm.

Smoking PolicySmoking is not allowed in the areas of the BMBC Venue.

Verification of AttendanceVertification of Attendance for participants will be provided on-site upon request. Registrants may presenttheir congress name badge at the Registration Desk to receive a letter of verifying attendance. Verification of Attendance may be collected at the registration desk on May 23rd.

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INFORMATION FOR SPEAKERS AND PRESENTERSInformation for Oral PresentersKeynote Lecture, Plenary Sessions, Mini Symposium, Free Paper SessionsAll presentations are in English.It is very important that your Power Point Presentation NOT contain any audio (sound or music), video,movie or any unusual files.Presentation slides should be use Power Points (Windows XP-Microsoft Office 2003 or 2007) oncomputers connected to a multimedia projector.Presenters will not be allowed to use their own computers because of the time it takes to switchbetween computers during the session and the potential for crashing the onsite system.Presenters are requested to submit their presentation either in a USB flash drive or CD-ROM at theSpeakers’ Preparation Room at least 2 hours prior to their presentation. If there is any technical problem with your file, this arrangement gives you still enough time to solve it.The presentation file will be transferred to the session room prior the session. Once, transferred,speakers are request to preview their own presentation.Please note that the Speakers’ Preparation Room does not provide editing facilities.If due to unforeseen circumstance the presenting author cannot attend, please notify the BMBC Staffsat the Speakers’ Preparation Room.

Information for Poster PresentersPoster will be displayed in the designated locations. Please visit the information desk to find out wherethe location. Poster presenters are suggested to stand by their poster during the breaks.Mounting materials (double sided tape) will be provided.Authors who wish to keep their posters should remove them after the presentation. The organizer shalldispose all posters left on May 23rd after 17:30.

Poster Area & Poster SessionsPosters have to be mounted between 08:30 to 09:00 on the day of BMBC sessions. The Poster Area will be located in foyer at the congress venue.

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BEST POSTER AWARDPurpose:The award will be given to the best posters presented at the BMBC. The awards are to be givento acknowledge the quality and thoroughness of the candidate’s work, originality and independence of thecandidate’s contributions, significance and timeliness of research results and depth of understanding of theresearch topic and its relationship to the fields of interest to pediatrics. All displayed posters will be automatically entered into a competition for the “Best Poster Award”

Selection Process:Selection will be made in two stages during poster session on 22nd and 23rd May. The review committee will select best papers according to the following criteria:1) Novelty2) Clarity of the poster without oral explanation (State of the arts)3) Potential application4) Overall contribution to medicine After judgments, the winners will be announced and will receive this special honor on the closing ceremony of the BMBC.

Requirements:If the first author will not be present at the closing ceremony and has no valid reason, he/she will receiveonly Award Certificate. In that case, the decision to accept or reject the author’s reasons will be of BMBCOrganizing Committee.

Other Matters:By their participation, the candidates accept the general conditions of the award. All matters not expresslycovered in the present regulation are subjected to the decision of the BMBC Organizing Committee, whichshall be finalized.

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DETAIL SCENTIFIC PROGRAM LISTDay 1, Saturday, 22 May 201008.30 – 08.45 Welcome Addresses and Opening of the 8th BMBC08.45 – 09.00 Keynote Speech:

The Use of Stem Cell in MedicineProf.Dr.Sofia Mubarika, M.Sc.,Ph.D (Gajah Mada University)

09.00 – 09.20 Coffee break

Basic Stem CellModerators: Prof. DR. Dr. M. Istiadjid E Santoso, SpS SpBS; DR. Dr. Pudji Rahayu, SpTHT-KL(K)09.30 – 09.50 The Effects of Xenobiotic, Endogenous

Substances and Oxidative Stress on Endothelial Cell and Endothelial Progenitor Cell Function

Prof.Dr.M. Aris Widodo, SpFK, Ph.D(Brawijaya University)

09.50 – 10.10 Identification of Stem Cells from Different Tissues for Regenerative Medicine

DR .M Sasmito Djati,MS(Brawijaya University)

10.10 – 10.30 Stem Cells in the Future and Regenerative Medicine

Drs. Andi Wijaya. Ph.D. (Prodia Indonesia)

10.30 – 11.00 DISCUSSION11.00 – 12.30 LUNCH

Experiences of Stem Cell ApplicationModerators: Diana Lyrawati, Apt. MS. PhD; DR. Sri Winarsih, Apt. MSi12.30 – 12.50 Role of Stem Cell Microenvironment in

Biomedical Science Prof. Ferry Sandra PhD(Stem Cell and Cancer Institute, Kalbe Farma Indonesia)

12.50 – 13.10 The Therapeutic Potential of Endogenous Bone Marrow Mobilization

Christian Drapeau, MSc-Neurophysiologist(STEMtech Health Sciences Inc.; Canada)

13.10 – 13.30 Autologous Haematopoietic Stem Cell Transplant for Acute Myeloid Leukemia

Prof. Patrick Tan, MD(Haematology and Stem Cell Transplant Centre, Mt. Elizabeth Hospital, Singapore)

13.30 – 14.00 DISCUSSION14.00 – 14.30 Coffee Break14.30 – 17.00 WORK SHOP In vitro culture of stem cells

Dinner Symposium Cardiology (Hotel Tugu, Jl. Tugu 3, Malang, 65119)Moderators: Dr. John Prihadi Cardiologist Rehabilitation; DR. Dr. Robert Arjuna, SpPK18.00 – 18.15 Opening18.15 – 18.30 Effectiveness of Statin in LDL Goal

AttainmentDR.Dr.PWM. Olly Indrayani, SpPD(Brawijaya University)

18.30 – 18.45 Statin Update to Conquer Atherosclerosis Progression

Prof.DR.Dr.H. Djanggan Sargowo, SpPD.,SpJP (K) FACC.FESC.FCAPC.FASCC.FIHA (Brawijaya University)

18.45 – 19.15 DISCUSSION19.15 – 19.30 Arts Performance (Dance)19.50 – 20.10 Importance of Blood Pressure Control to

Prevent Cardiovascular EventProf. Jan Staessen (University of Leuven, Belgium)

20.10 – 20.40 Therapy for Acute Coronary Syndrome Prof. Frans Van de Werf (University of Leuven, Belgium)

20.40 – 21.00 DISCUSSION

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Day 2, Sunday 23 May 2010

Stem Cell Clinical ApplicationModerators: Prof DR. Dr. Retty Ratnawaty, MSc ; DR. Dr. Tinny E Hernowati, MKes SpPK 08.30 – 08.50 Stem Cell Application in Hepatocellular

CancerProf.DR.Dr. Ali Sulaiman, SpPD-KGEH(University of Indonesia)

08.50 – 09.10 Clinical Application of Adults Stem Cell in Regenerative Treatment

Dr. Boenjamin Setiawan, Ph.D(Kalbe Farma)

09.10 – 09.30 Stem Cell in Haematology Prof. Koen Theunissen(University of Leuven, Belgium)

09.30 – 09.50 Stem and Progenitor Cells for Myocardial Repair

Prof. Stefan Janssens/Prof.Frans Van de Werf(University of Leuven, Belgium)

09.50 – 10.30 DISCUSSION10.30-10.45 Coffee break

Research Progress in Stem CellsModerators: Prof. DR. Dr. Edi Widjajanto, MS SpPK ; Dr. M. Saifurrohman, PhD. SpJP. 10.45 – 11.05 Progenitor Cell Myf5 for Obesity

ManagementProf.DR.Dr. M. Rasyad Indra, MS(Brawijaya University)

11.05 – 11.25 Neuronal Stem Cell Dra. Diana Lyrawati, Apt. MS. Ph.D(Brawijaya University)

11.25 – 11.45 Quercetin, a Natural Product as Chemical Treatment for Breast Cancer Stem Cells

Drs. Satuman, M.Kes(Brawijaya University)

11.45 – 12.05 Freeze Dried Tendon Allograft and Mesenchymal Stem Cell for Tendon Tissue Engineering

Dr. Heri Suroto, SpOT(Airlangga University)

12.05 – 12.25 DISCUSSION12.25 –13.25 LUNCH 13.25 – 16.00 WORK SHOP

In vitro culture of stem cells16.00 – 16.30 CLOSING

WORKSHOPSaturday May 2214.30-15.15 Introduction to cell culture Nur Permatasari (Meeting Room)15.15-15.30 Introduction to workshop M Rasjad Indra (Meeting Room)15.30-17.30 Isolation of peripheral mononuclear cell Team 1 (Lab 1 & 2)

EPCs culture: angiogenic assaySun May 2313.30-14.15 Introduction to cell culture Nur Permatasari (Meeting Room)14.15-14.30 Introduction to workshop M Rasjad Indra (Meeting Room)14.30-16.30 Isolation of peripheral mononuclear cell Team 1 (Lab 1 & 2)

EPCs culture: angiogenic assay

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ABSTRACT OF INVITED LECTURES Thursday 15 April Friday 16 AprilSaturday, 22 May

KEYNOTE SPEECH

THE USE OF STEM CELLS IN MEDICINE

Professor Sofia Mubarika, Gadjah Mada UniversityYogyakarta, Indonesia

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Saturday, 22 May

THE EFFECTS OF XENOBIOTIC, ENDOGENOUS SUBSTANCES AND OXYDATIVE STRESS ON ENDOTHELIAL CELL AND ENDOTHELIAL PROGENITOR CELL FUNCTION

M Aris Widodo1, Nur Permatasari2

1Professor, Faculty of Medicine; 2Laboratory of Pharmacology, Faculty of Medicine Brawijaya UniversityMalang, Indonesia

Endothelial cells are important in the cellular biology of blood vessels . Indeed, the intima of the blood vessel is composed of a singular layer of endothelial cells embedded in an extracellular matrix. Three major functions are attributed to the endothelium: a metabolically active secretory tissue, an anticoagulant antithrombotic surface, and a barrier for blood constituents for blood vessel walls. Oxidative stress , shear stress, xenobiotic and bacterial and viral infection may affect directly to the endothelial cell leading to endothelial dysfunction, apoptosis and necrosis.The regenerative system of our body can replace the dysfunction, apoptotic or necrotic endothelial cell by edothelial progenitor cell an adult stem cell derived from bone marrow. However, endothelal progenitor cell in the bone marrow and when there are mobilized in to circulatory, will be affected by environmental condition of those cells such as xenobiotic, drug, pollutant, heavy metals oxidative stress such as diabetes and probably shear stress of the blood Because the location and structure of both group of cell are differ the effects of xenobiotics in both group of the cell may be not similar. The implication of these are, different effect of xenobiotic and others on EPC function which can affects their function in regenerative process in vascular diseases.

Key words : xenobiotics endothelial progenitor cell, endothelial cell

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Saturday, 22 May

IDENTIFICATION STEM CELLS FROM DIFFERENT TISSUE FOR RENERATIVE MEDICINE

M Sasmito DjatiLaboratory of Animal Cell and tissues Culture, Division Animal Physiology, Department of Biology, Faculty of Science Brawijaya University. Jl. Veteran Malang, Indonesia. 65145.

Research in regenerative medicine is developing at a significantly quick pace. Cell-based replacement is an evolving therapy aiming at the treatment of patients who suffer from damaged tissues and various degenerative-related disorders. Stem cells are undifferentiated cells with the capability to regenerate into one or more committed cell lineages. Stem cells isolated from multiple sources have been finding widespread use to advance the field of tissue repair. The present review gives a comprehensive overview of the developments in stem cells originating from different tissues and suggests future prospects for functional bone and cartilage tissue regeneration. A stem cell is defined as a cell with the properties of being clonogenic, self-renewing, and multipotent. In response to intercellular signaling or environmental stimuli, stem cell derived from three primary germs layer that are as follow: ectoderm, endoderm, mesoderm, a powerful advantage for regenerative therapies. Stem cells can be classified into three categories: (1) Adult stem cells, (2) Cancer Stem cells, (3) Embryonic Stem Cells, (4) Induced pluripotential stem cells. Adult stem cells have been indentified in numerous organs and tissues in adult including bone marrow, skeletal muscle, adipose tissues, and as was recently discover the heart or cardiac stem cells. Cancer stem cells (CSC) have a variety of biological properties with normal somatic stem cells in term of self renewal, the propagation of differentiated progeny, the expression of specific cell markers and stem cells genes, and the utilization of common signaling pathways and stem cells niche, however CSC differ from normal stem cells in the tumorigenic activity, embryonic stem cells are derived from the inner cells mass of blastocyts stage of the developing embryo. Finally trough transcriptional re-programming, somatic cells, such as fibroblast, can be converted into induced pluripotential cells that resemble embryonic stem cells. Almost all of kinds of stem cells have been demonstrated in many laboratories world-wide to explore their potency and lead to progress in regenerative medicine.

Key words: Adult stem cells, Cancer stem Cells, Embryonic stem cells and Induced pluripotential stem cells.

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Saturday, 22 May

STEM CELL IN THE FUTURE

Andi WijayaClinical Laboratory of ProdiaBandung, Indonesia

Regenerative medicine aims to repair diseased or damaged tissues by replacing the affected cells with healthy, functional cells of the same type.-The prospects of this discipline have been boosted by the promise of ES cells, which are pluripotent (they can differentiate into any cell type) & which can be maintained in culture to “self-renewal” indefinitely.- Although at a nascent stage, stem cell research & therapies is a rapidly growing field in regenerative medicine.-The global market for stem cell therapy is expected to be worth around US$ 20 billion by 2010.- Concurent research to develop a bioartificial pancreas led to a variety of biohybrid organ projects incl. Amcyte’s & Novocell’s Phase I/II trials of microencapsulated allogenic islet cells.-The world’s first allogenic bioengineered product (FDA approved), Apligraf, marketed as a living skin equivalent.- Thus regenerative medicine in this day & age incorporates both the transplantation of cells or synthesised material into the body, as well as aiding the body’s natural regenerative capacity.-The prospect of ex vivo cell, tissue & organ genesis is conceivable.-

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Saturday, 22 May

ROLE OF STEM CELL MICROENVIRONTMENT IN BIOMEDICAL SCIENCE

Ferry SandraProfessor, Stem Cell and Cancer InstituteJl. Ahmad Yani No 2Jakarta, Indonesia

Somatic stem cells are maintained and regulated by their surrounding microenvironment (niche). A tissue‐specific niche is a restricted locale that supports self‐renewing division of stem cells. Stem cell niche is a phrase loosely used in the scientific community to describe the microenvironment in which stem cells are found, which interacts with stem cells to regulate stem cell fate. Adult stem cells and their more committed skin, progenitor cells, are prized by medical researchers for their ability to produce different types of specialized cells. The potential of using these cells to repair or replace damaged tissue holds great promise for regenerative medicine.

Previous studies on how microenvironments affect the development of adult human stem or progenitor cells have been based on the behavior of these cells in culture (in vitro) where they are exposed to a single molecular agent. However, when these cells are in an actual human being (in vivo) they are surrounded by a multitude of other cells plus a supporting network of fibrous and globular proteins called the extracellular matrix (ECM), as well as many other nearby molecules, all of which may be simultaneously sending them instructional signals.

In our current research, we tried to modify the stem cell microenvironment by adding some of potential agents that resulted in an increasing phenomenon of stem cell growth. Our current results have shown that microenvironment could affect in the proliferation of fibroblast. Hence, in this short communication we could conclude an early suggestion of the importance of stem cell microenvironment.

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Saturday, 22 May

THE THERAPEUTIC POTENTIAL OF ENDOGENOUS BONE MARROW MOBILIZATION

Christian DrapeauCo-Founder and Chief Scientist, STEMTech and HealthSciences Inc.Canada

Bone marrow stem cells (BMSC) are self-renewing undifferentiated cells that have been traditionally considered as precursors to blood cells. However, many recent studies have established that the ability of BMSC to differentiate into other types of cells goes far beyond blood cells; when put in presence of various tissues, BMSC can differentiate in functional cells of that tissue, including brain, liver, pancreatic, lung, and muscle tissues. In fact, BMSC constitute the natural repair system of the body. Whenever the body is subjected to an injury or a degenerative process, the affected area secretes compounds such a Granulocyte-Colony Stimulating Factor (G-CSF), which is a well known mobilizer of BMSC. The affected tissue also secretes Stromal Derived Factor-1 (SDF-1), a compound that specifically binds to CXCR4 on the surface of circulating stem cells, triggering the process of migration in the affected tissue. As they migrate in a tissue, stem cells proliferate and then differentiate into cells of that tissue. This presentation will briefly review the various technologies developed around the use of both embryonic stem cells and adult stem cells, focusing on a novel approach referred to as Endogenous Stem Cell Mobilization (ESCM). Simply stimulating the release of stem cells from the bone marrow, therefore increasing the number of circulating stem cells available to migrate in various tissues, has been shown to be a promising therapeutic approach tapping into the potential of adult stem cells. For example, BMSC have been shown to have the ability to migrate on their own into the pancreas and differentiate into functional insulin-producing cells, while triggering the release of BMSC has been shown to rescue streptozotocin-induced diabetes in mice. Likewise, G-SCF-induced BMSC mobilization has been shown to enhance recovery after experimental stroke and acute myocardial infarction in mice. Aside from a purely therapeutic approach, the recent discoveries in the field of stem cell research points into an entirely new direction in our understanding of the aging process. The development of many diseases such as cardiomyopathy, diabetes, arthritis, kidney failure, pulmonary diseases, muscular dystrophy and even erectile dysfunction have been linked to a lower number of circulating stem cells. Any treatment or lifestyle strategy shown to increase the number of circulating stem cells should be studied as potential anti-aging modalities.

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Saturday, 22 MayAUTOLOGOUS HAEMATOPOIETIC STEM CELL TRANSPLANT FOR ACUTE MYELOID LEUKEMIA

Patrick TanProfessor, Medical Director, Haematology and Stem Cell Transplant Centre, Mt Elizabeth Hospital Singapore

Acute myeloid Leukemia is a life threatening condition which becomes fatal within 2- 3 months if untreated. Chemotherapy has been the mainstay of treatment for the condition and outcome of treatment has improved over the last few years. Currently, combination chemotherapy using an anthracycline (Idarubicin or daunorubicin) and Cytarabine is the standard of care for patients with AML In general, chance of achieving complete remission is about 60% after 1 round of chemotherapy and 85% after 2 rounds of chemotherapy.Most patients will be given 2 – 3 rounds consolidation chemotherapy in the form of high dose cytarabine after achieving complete remission. However, despite this, the chance of relapse remain high (70-90%); most of the relapses occurring within 1 year but some may happen as far out as 3 years post first remission.Autologous haematopoeitic stem cell transplant allowing the use high doses of chemotherapy to treat resistant tumour clones have been found to be useful for AML patients who have achieved complete remission. In general, it is a low risk procedure with fatality rate of less than 3% worldwide. In our centre, we have not encountered any fatality in our autologous stem cell transplants for AML, myeloma and lymphoma (N=50) over the last 6 years Overall long term survival after autologous transplants for AML ranged from 40% -65% in many large centres worldwide. Unlike allogeneic transplant, autologous transplant is fairly safe in the elderly patients. In our centre, more than half of our patients receiving autologous transplants for AML are above 60 years old. I hereby report our experiences and results of autologous stem cell transplants done for patients with AML in our centre from 2004 till today.

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Saturday, 22 May 2010, Dinner SymposiumIMPORTANCE OF BLOOD PRESSURE CONTROL TO PREVENT CARDIOVASCULAR EVENT

Jan StaessenProfessor, Studies Coordinating Centre, Hypertension Unit, Division of Hypertension and Cardiovascular Rehabilitation, Department of Cardiovascular Disease, University of Leuven, Leuven, Belgium

Background In a meta-analysis published in October 2001, we reported that new and old classes of antihypertensive drugs had similar long-term efficacy and safety. Furthermore, we observed that in clinical trials in hypertensive or high-risk patients gradients in systolic pressure accounted for most differences in outcome. Objective To test whether our previous conclusions would hold, we updated our quantitative overview with new information from 14 clinical trials presented before and after March 2003. Methods To compare new and old antihypertensive drugs, we computed pooled odds ratios from stratified 2 X 2 contingency tables. If Zelen’s test of heterogeneity was significant, we used a random effects model. In a meta-regression analysis, we correlated odd ratios with corresponding between-group differences in systolic pressure. We then contrasted observed odds ratios with those predicted from gradients in systolic pressure. Main outcomes Differences in achieved systolic blood pressure and incidence of total and cardiovascular mortality, cardiovascular events, stroke, myocardial infarction and heart failure. New versus old drugs In 15 trials, 120 574 hypertensive patients were randomised to old drugs (diuretics or blockers) or new agents (calcium-channel blockers, -blockers, angiotensin converting-enzyme [ACE] inhibitors or angiotensin type 1 receptor [AR1] blockers). Old and new drugs provided similar protection against total and cardiovascular mortality and fatal plus non-fatal myocardial infarction. Calcium-channel blockers, including (–8%, P = 0.07) or excluding verapamil (–10%, P = 0.02), as well as AR1 blockers (–24%, P = 0.0002) resulted in better stroke prevention than did the old drugs, whereas the opposite trend was observed for ACE inhibitors (+10%, P = 0.03). The risk of heart failure was higher (P < 0.0001) on calcium-channel blockers (+33%) and blockers (+102%) than on conventional therapy involving diuretics. Meta-regression Between-group differences in achieved systolic pressure ranged from 0.1 to 3.2 mm Hg in 7 actively controlled trials (73 237 patients) and from 2.1 to 22.1 mm Hg in 7 studies comparing varying intensities of blood pressure lowering (11 128 patients). For these 14 new trials, we predicted outcome from achieved systolic blood pressure using our previously published meta-regression models based on 30 trials with 149 407 patients. In general, predicted and observed odds ratios were similar. Larger reductions in systolic pressure (weighted mean 1.8 mm Hg) in 2 trials accounted for the advantage of AR1 blockers over conventional therapy in the prevention of stroke. Only for cardiovascular mortality in very old patients (P = 0.02) and for cardiovascular events and myocardial infarction in old Australians (P = 0.02), the observed odds ratios deviated from our predictions based on the gradients in systolic blood pressure. Interpretation The hypothesis that new antihypertensive drugs, such as calcium-channel blockers, blockers, ACE inhibitors or AR1 blockers might influence cardiovascular prognosis over and beyond their antihypertensive effects remains unproven. The finding that blood pressure differences largely accounted for cardiovascular outcome emphasises the necessity of

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tight blood pressure control. However, the level to which blood pressure must be lowered to achieve maximal benefit remains currently unknown. References Staessen JA, Wang JG, Thijs L. Cardiovascular prevention and blood pressure reduction: a meta-analysis. Lancet 2001; 358:1305–15. Staessen JA, Wang JG, Thijs L. Calcium-channel blockade and cardiovascular prognosis: recent evidence from clinical outcome trials. Am J Hypertens 2002; 15:85S–93S. Staessen JA, Wang JG, Thijs L. Cardiovascular prevention and blood pressure reduction : a quantitative overview updated until 1 March 2003. J.Hypertens. 2003; 21: 1055–76. Staessen JA, Li Y, Thijs L, Wang JG. Blood pressure reduction and cardiovascular protection : an update including the 2003-2004 secondary prevention trials. Hyp Res 2005; 28: 385-407.Staessen JA, Wang ZW, Richart T, Thijs L. Implications of recently published trials of blood pressure lowering drugs in hypertensive or high-risk patients. Hypertension 2010; 55: 819-831.

Saturday, 22 May 2010, Dinner SymposiumTHERAPY OF ACUTE CORONARY SYNDROME

Frans Van De WerfProfessor, University of Leuven, Belgium

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Saturday, 22 May 2010, Dinner SymposiumEFFECTIVENESS OF STATIN IN LDL GOAL ATTAINMENT

PWM Olly IndrayaniFaculty of Medicine, Brawijaya University, Malang, Indonesia

Atherosclerosis is the root cause of the biggest killer of the 21st century and Coronary artery disease (CAD) is the most common cause of death in the developed countries in both men and women. Low density lipoprotein cholesterol (LDL-C) is the primary therapeutic target of CVD prevention guidelines, partly because data from epidemiological and observational studies have demonstrated that individuals with elevated levels of low-density cholesterol (LDL-C) are at increased risk of CHD.The NCEP ATPIII guidelines highlighted the importance of aggressive treatment by recommending LDL C goal < 100mg/dl for highrisk patients and < 70mg/dl for very highrisk patients was recommended.Rosuvastatin is more effective in lowering LDL-C when compared with other statins. More over , Rosuvastatin patients had higher LDL-C goal attainment rates in high and moderate risk patients

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Saturday, 22 May 2010, Dinner SymposiumSTATIN UPDATE: TO CONQUER ATEROSLEROSIS PROGRESSION FROM VOYAGER STUDY

Djanggan SargowoProfessor, Faculty of Medicne, Brawijaya UniversityMalang, Indonesia

Statins are the most commonly prescribed agents for lowering levels of low-density lipoprotein (LDL) cholesterol. Although dose-dependent reductions in levels of atherogenic lipids are observed with all statins, the impact of increasing dose has not been fully elucidated. An individual patient data pooled analysis was performed of 32,258 patients in studies comparing the efficacy of rosuvastatin with that of atorvastatin or simvastatin. The impact of increasing dose on lowering LDL cholesterol, triglycerides, non-high-density lipoprotein (HDL) cholesterol, and apolipoprotein B was investigated. Doubling the dose of each statin was accompanied by a 4% to 7% greater degree of lowering of all atherogenic lipids. A stronger correlation was observed between changes in LDL cholesterol and non-HDL cholesterol (r = 0,92, p <0.001) or apolipoprotein B (r = 0,76, p <0.001) than triglycerides (r = 0.14, p <0.001). On multivariate analysis, baseline lipid level (p <0.001) than triglycerides and increasing statin dose (p <0.0001) were strong predictors of achieving treatment goals in high-risk patients. Increasing age was a strong independents predictors of achieving goal for all atherogenic lipids (p <0.0001). Achieving LDL cholesterol goals was also more likely in women (p <0.0001), patients with diabetes (p <0.0001), and patients without atherosclerotic disease (p = 0.0002). in contrast, normal triglyceride levels were more often observed in men (p <0.0001) and patients without diabetes mellitus (p = 0.03). In conclusion, doubling statin dose was associated with greater lowering of LDL cholesterol by 4% to 6% and non-HDL cholesterol by 3% to 6%. Greater lipid goal achievement with increasing dose supports the use of high-dose statin therapy for more effective cardiovascular prevention.

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Sunday, 23 MaySTEM CELL APPLICATION IN HEPATOCELLULAR CANCER

Ali SulaimanProfessor, Hepatology Division, Dept of Internal Medicine University of IndonesiaJakarta, Indonesia

End stage liver disease (ESLD) is the final stage of acute or chronic liver damage and is irreversibly associated with liver failure. ESLD can develop rapidly, over days or weeks (acute and sub-acute liver failure, respectively), or gradually, over months or years (chronic liver failure).. ESLD is a health problem worldwide. Liver transplantation is currently the only effective therapy, but its many drawbacks include a shortage of donors, operative damage, risk of rejection and in some cases recidivism of the pre-transplant disease. These factors account for the recent growing interest in regenerative medicine Alternative solutions are being examined in the liver therapy field..Animal studies and preclinical trials have indicated that hepatocyte transplantation (LCT) can serve as an alternative to liver transplantation. Hepatocyte transplantation to treat metabolic deficiencies has shown promising early improvement in liver function; however, long-term success has not been achieved. The harvesting of hepatocytes is associated with the same problem as organ transplantation, i.e., a lack of a suitable cell source. Therefore, current stem cell technology, which is attempting to establish an unlimited supply of hepatocytes, would facilitate the clinical application of hepatocyte transplantation Ethical issues, availability, potential rejection and limited understanding of the totipotent capabilities of embryonic stem cells are the limitations that prevent their use for restoration of liver function. The effectiveness of embryonic stem cells to support liver function has been proven with their application in the bioartificial liver model in rodents. There is ongoing research to restore liver function in cell biology, animal models and clinical trials using mature hepatocytes, liver progenitor cells, mesenchymal stem cells and embryonic stem cells. A stem cell is an undifferentiated cell capable of renewing itself throughout its life and of generating one or more types of differentiated cells. While embryonic stem cells (ESCs) are the only ones to be totipotential, adult tissues with high cellular turnover (e.g. skin, gut mucosa and bone marrow) retain a population of stem cells with restricted differentiation potential thatconstantly supply the tissue with new cellsTheoretical advantages of stem cells for tissue regenerative medicine are multiple: ease of harvest, proliferation capacity, efficiency of in vitro transfection and potential use of autologous cells. Different types of stem cells are eligible for liver cell therapy according to their hepatic potential, for instance mesenchymal stem cells (MSCs), hematopoietic stem cells (HSCs) and adult liver stem/progenitor cells. During mammalian embryonic development, pluripotent embryonic stem cells originate from the blastocyst inner cell mass and give rise to somatic stem cells that further differentiate into multipotent tissue-specific stem or progenitor cells. In the adult liver, mature hepatocytes seldom proliferate and have a life span of over a year.

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After partial hepatectomy, however, proliferation of the normally quiescent hepatocytes and cholangiocytes, followed by proliferation of the hepatic stellate cells and endothelial cells, quickly restores the liver to its original mass In the rodent model, DNA synthesis starts 12 to 16 hours after the standard partial hepatectomy and peaks at 24 to 48 hours. The original organ mass is almost restored 3 days postresection.When mature hepatocytes and cholangiocytes are damaged or inhibited in their replication, however, a reserve compartment of hepatic progenitor cells is activated. The activation of the stem cell compartment, referred to as a “ductular reaction” in humans and “oval cell reaction” in rodents, is observed in circumstances of prolonged necrosis, cirrhosis, and chronic inflammatory liver diseases.Different types of stem cells are eligible for liver cell therapy according to their hepaticpotential, for instance mesenchymal stem cells (MSCs), hematopoietic stem cells (HSCs) and adult liver stem progenitor cells. Mesenchymal stem cells firstly described in 1970 from bone marrow (BM) isolates. These cells can currently be obtained from various tissue sources such as BM, cord blood (CB), adipose tissue, umbilical cord blood (UCB). A key advantage of MSCs is their immunological properties making them lesser immunogenic and possibly able to induce tolerance as highlighted by promising in vitro studies and clinical trialsExperiments have sought to identify an optimal source of stem cells, sufficient to generate large amounts of hepatocytes to be used in bioartificial livers or injected in vivo to repair the diseased organ. Stem cells from extra- or intrahepatic sources have been recently characterized and their usefulness for the generation of hepatocyte-like lineages has been demonstrated. Therefore, they are being increasingly considered for future applications in liver cell therapy. Literature concerning the use of stem cells for clinical therapy is uncreasingly growing in many fields (including hematology, cardiology, neurology and orthopedics) However, to date, there is no clear documentation about long-term safety of such procedure.. In the hepatology field, liver-based inborn errors of metabolism are the most attractive candidate because of the possibility for elective treatment and, in some cases, the absence of global liver function impairment making technical procedures more feasible. The lack of liver injury may limit stem cells engraftment and differentiation. Liver cirrhosis/fibrosis has been considered: besides encouraging results, there is, to date, no evidence about a direct or a mediated cell involvement, nor about how the fibrosis could hamper cell implantation. Before considering acute liver failure for stem cell therapy, it would be necessary to achieve a performing banking of functional hepatocyte-like cells. Globally, the possibility of repeated cell infusions could render cell therapy advantageous over OLT in patients whose disorder is not life-threatening. In this condition, whether stem cells could have an advantage on liver cells according to their proliferative capacity needs further assessment. Other points requiring consensus is the technique and route of cell delivery (surgically placed catheter vs transcutaneous injection), the amount of delivered cells and timing of infusions, and the protocol of immunosuppression.

In SummaryStem cell transplantation is another promising procedure in end stage of liver disease..These cells can be of hematopoietic or mesenchymal origin. The latter can be obtained from various tissues, including bone marrow, skin, cord blood, or theliver itself These mesenchymal cells have the potential to be differentiated into partially functional hepatocytes in vitro. When transplanted in animal models, these cells engraft, proliferate in the recipient liver, and differentiate into human functioning hepatocytes .Stem cells to day bring us the hope for therapy for end-stage liver diseases and supplies ideal seed cells for bio-artificial liver,hepatocyte transplantation,and liver tissue engeneering. However,there are lots of doubts and uncertainties in the influencing factors and control agents of effectively inducing stem cell differentiation, the efficiency of stem cells’ differentiation into hepatocytes,differentiate cells’ life-span and functional state, etc, and there are still many obstacles in application of them clinically In hepa6tology the study is still a preliminary clinical study. Further experiments and clinical study should be performed to investigate the efficacy of this treatment.

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Sunday, 23 MayCLINICAL APPLICATION OF ADULT STEM CELLS IN REGENARATIVE TREATMENT

Boenjamin SetiawanKalbe FarmaJakarta, Indonesia

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Sunday, 23 MaySTEM CELL THERPY IN HAEMATOLOGY

Koen TheuniessenUniversity of Leuven, Belgium

Hematopoietic stem cell transplantation (HSCT) is by far the oldest form of stem cell therapy developed to treat inherited or acquired disease in man. It was pioneered in the 1950’s, originally for the treatment of bone marrow failure syndromes. More then 15 years later, a first successful bone marrow allograft was performed.Since these early years, major developments in basic and clinical science have changed the aspect of HSCT dramatically. The first major breakthrough was the understanding of the HLA system and its importance in matching donor and patient. Also, the potential of using autologous hematopoietic stem cells to overcome the lethality of myeloablative chemo- and/or radiotherapy has led to higher cure rates of otherwise hard to treat malignant disorders. The understanding of stem cell mobilization with chemotherapy, hematopoietic growth factors and – more recently –with antagonists to anchoring proteins has made stem cell harvest more successful and less dangerous for the donor.The search for a suitable donor in the allogeneic setting remains problematic up to this date. Only a minority of patients has a matched sibling donor, and even though more then 12 million volunteer donors have registered their HLA type in a worldwide available donor registry, more then 30% of patients do not find a donor on time. This could in part be overcome by using cord blood as a source for HSCT. Another important development is the use of haplo-identical donors.Another impediment to the more widespread use of HSCT for mostly malignant disease is the toxicity of the myeloablative radio- and/or chemotherapy. Even with the increasing availability of better diagnostics and supportive care to manage mostly infectious complications, the use of myeloablative therapy is restricted to fit and young patients, which are only the minority of patients potentially cured by an HSCT. The understanding that, at least in some diseases, the immune response of a healthy allograft might be at least as important for disease control, has lead to the development of non myeloablative conditioning, which can now be administered to patients up to the age of 75.It is clear that HSCT is a model for other stem cell therapies. A lot of the principles that have been learned (HLA compatibility, engraftment, stem cell source, “conditioning”) can now be applied in other fields, speeding up their progress. Still, it has taken hematologists more then 50 years to make this therapy widely available, and a lot of questions still need to be answered.

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Sunday, 23 MaySTEM AND PROGENITOR CELLS FOR MYOCARDIAL REPAIR

Stefan JanssensProfessor of Medicine, Cardiology Division, Gasthuisberg University Hospital, University of Leuven, Belgium

Progenitor cell transfer to repair the damaged heart has emerged as an innovative and promising recent development in cardiovascular medicine. The failure of state of the art pharmacological and device therapies to significantly enhance the long-term clinical outcome of patients with advanced heart disease and compromised LV function have emphasized the clinical need for alternative therapeutic strategies. A variety of progenitor cell types residing in bone marrow, adipose tissue, and skeletal muscle or circulating in the blood are capable of improving function of the infarcted heart in preclinical models but underlying mechanisms remain incompletely understood. Subsequent early clinical studies using mononuclear bone marrow cells have shown mixed results with limited efficacy at best, as suggested by changes in surrogate endpoints including global systolic function and infarct size. Moreover, the traditional view of the heart as a terminally differentiated organ has been challenged by recent discoveries of various populations of cardiac resident stem or precursor cells, which are characterized by the absence of traditional cardiomyocyte, endothelial, or smooth muscle markers, have a slow turn-over rate, and may constitute an endogenous reservoir for cell-based repair. However, massive cell loss or dysfunction of cardiomyocytes and these progenitors alike such as after acute myocardial infarction or in advanced heart failure compromizes endogenous repair capacity. Therefore, inventive strategies are required at different levels: 1) to mobilize or deliver significant numbers of exogenous progenitor cells to sites of injury and secure their survival, integration, and coupling with spared myocardium, 2) to stimulate endogenous cardiac precursor cells to multiply and 3) to integrate the necessary enabling technologies for successful cell therapy. In this rapidly evolving field of translational medicine, clinical experience in patients with advanced heart failure is still limited and many obstacles remain. Cell transfer for cardiac repair is currently not ready for widespread clinical application.

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However, carefully designed focused mechanistic clinical studies paralleled by preclinical studies in models representative of human disease, will undoubtedly foster clinical development of this exciting medical therapy for patients with advanced heart disease.

Sunday, 23 MayPROGENITOR CELL Myf5 FOR OBESITY MANAGEMENT

M Rasjad IndraProfessor, Faculty of Medicine, Brawijaya University,Malang, Indonesia

Fatty tissues are divided into white adipose tissue (WAT) and brown adipose tissue (BAT). WAT plays a role in energy storage and release of hormones and cytokines that regulates metabolism and insulin sensitivity, while BAT has a bigger role in energy consumption, which was amended in the form of heat or through the mechanism of thermo-genesis. Several recent studies showed that adult humans also have high levels of BAT, although the levels may be different for each individual. BAT and muscle tissue derived from the same progenitor cells that express the transcription factor Myf5. PR Domain of transcription factors containing 16 (PRDM16) is known to regulate the development of Myf5 progenitor cells into BAT. However, there are several other factors that also are known to interact directly with PRDM16 in inducing the formation of BAT, such as PPAR α/γ, PGC1 α/γ, and CEBP α and fibroblast growth factors (FGFs) as well.FGF-16 is excessively expressed in BAT, especially at the level of late stage of embryonic development. It also increases the content of BAT and reduces the tendency of obesity in transgenic mice. Although the role of PRDM16 and FGF-16 in the development of BAT separately have been recognized, the correlation between those two factors has not been revealed, so the effect of FGF16 on Myf5 progenitor cell and its relation with the content of PRDM16 are necessary to be examined. Since BAT detection in human body has been possible and Myf5 progenitor cell could be developed from adult human adipose stem cell, it is suggested to develop new approach upon obesity through

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inducing brown fat tissue growth to replace white fat tissue as the therapy of obesity.

Sunday, 23 MayNEURONAL STEM CELLS

Diana LyrawtiLaboratory of Pharmacy, Faculty of Medicine, Brawijaya UniversityMalang, Indonesia

Recent studies have shed light about neural stem cells and the differentially more restricted progenitor neuronal cells. These cells are the major players in adult neurogenesis, both as part of adaptation to the environment, memory and insults to the brain. This presentation will briefly discuss the basic of properties of neuronal progenitor cells, their proliferation, migration and differentiation, as well as identified factors to modulate these processes. Neurogenesis in post-stroke will be used as an example to appreciate that the fate of the progenitor cells are influenced by their immediate microenvironment and cross talk with other distant cells. Increasing understanding of molecular control adult neurogenesis would provide opportunities of utilizing endogenous neuronal progenitor cells to treat neurologic disease.

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Sunday, 23 May

QUERCETIN, A NATURAL PRODUCT AS CHEMICAL TREATMENT FOR BREAST CANCER STEM CELLS

Satuman*, Heni F, Didik Soediarto, Retty Ratnawati, M. Rasjad Indra*Laboratory of Human Physiology, Faculty of Medicine, Brawijaya UniversityMalang, Indonesia

The aims of this symposium are to discuss cancer stem cell especially breast cancer stem cell (BCSC), identification and understanding the biology of cancer stem cell, as well as reexamination our research that natural product can be implemented for chemically therapy development paradigms which includes the cancer stem cell concepts. While the cancer stem cell is not the direct subject of our study, we agree that the cancer stem cell is a notion that may potent to change radically our strategy of cancer treatment. Cancer has been long thought to originate and develop from cancer stem cells. In breast cancer, the study was to identify a subpopulation of human breast cancer stem cells which initiated tumors in NOD/SCID mice, using a set of cell surface markers to sorted cells with an increased tumorigenic capacity. Cells which were CD44+, CD24low, ESA+ and lineage- (cell lacking markers CD2, DC3, CD10, CD16, CD18, CD31 and CD140b) isolated from one primary and nine metastatic breast cancer were able to form heterogenous tumours.

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There were studies exploring target cancer stem cells using phytochemicals. Phytochemicals are natural products found in our diets. These compounds have anti-oxidant, anti-proliferative, and pro-apoptotic effects on a variety of cancers, including breast, colon, brain, melanoma, and pancreatic. Cancer stem cells have been identified for each of these blood and solid tumors, paving the way for future studies to evaluate efficacy of phytochemicals against cancer SCs. Our study showed that BCSC expressed of CD44+/CD24low. Quercetin at 40, 80 and 100 mg/mL doses significantly increased TRAIL-R1 density compared to control no treatment. Quercetin at doses 40 or 80 mg/mL decreased the translocation of p50/p65 subunit from cytoplasm into nucleus. Quercetin increased caspase-3 activity significantly at doses 40 mg/mL, (227,460±95,765), 80 mg/mL (213,426±180,501) and 100 mg/mL (222,296±20,193). Quercetin inhibited proliferation of breast cancer stem cells through increasing of apoptosis but not necrosis. Quercetin could induce apoptosis of breast cancer stem cell via TRAIL-R1 activation, increase caspase-3 activity and inhibit proliferation cell and p50/p65 NFkB translocation. Thus, phytochemicals such as quercetin may be used as a prevention of breast cancer stem cells.

Sunday, 23 MayFREEZE DRIED TENDON ALLOGRAFT AND MESENCHYMA STEM CELL FOR TENDON TISSUE ENGINEERING

Heri Suroto1, Panji Sananta1, Djoko Roeshadi1, Fedik Abdul Rantam2

Dept. Orthopaedic and Traumatology Dr. Soetomo Hospital-Airlangga University; Institute of Tropical Disease, Airlangga UniversitySurabaya, Indonesia

Objective : To assess toxicity effect of freeze dried and fresh frozen tendon allograft on mesenchymal stem cell in vitro and to evaluate attachment and proliferation of mesenchymal stem cell on freeze dried tendon allograft.Design : The post test only control group design of human bone marrow mesenchymal stem cell and human freeze dried and fresh frozen tendon allograft. The observational of cell attachment and

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proliferation of New Zealand White rabbit mesenchymal stem cell on freeze dried tendon allograft. These are the preliminary research.Subjects : We studied human mesenchymal stem cell cultured and expanded. 15 freeze dried and 15 fresh frozen human tendon allograft. We also studied New Zealand White rabbit mesenchymal stem cell cultured and expanded associated with freeze dried tendon allograft.Methods : 20 cc of bone marrow as a product of the reaming in Nailing Femur surgery, sent to ITD for culturing and expanding. 15 freeze dried and 15 fresh frozen human tendon allograft as the product of Tissue Bank Instalation Dr Soetomo Hospital. Each tendon allograft seeded in well plate contained of mesenchymal stem cell to do viability test by MTT Assay. 4 cc bone marrow aspiration from trochanter femur New Zealand White rabbit sent to ITD for culturing and expanding. Freeze dried tendon allograft seeded in well plate contained of mesenchymal stem cell to evaluate cell attachment and proliferation by Scanning Electrone Microscope (SEM).Results : The measurement of optic density by elisa reader spectrophotometer from each group are: 1.8261 for fresh frozen tendon allograft, 1.8263 for freeze dried tendon allograft and 1.8475 for control. From the above data can be accounted the viability of mesenchymal stem cell: 98,84% for fresh frozen tendon allograft, 98,85% for freeze dried tendon allograft and 100% for control. So Fresh frozen and freeze dried tendon allograft are nontoxic for mesenchymal stem cell. The description from SEM revealed that mesenchymal stem cell can attach and even proliferate in freeze dried tendon allograft in vitro.

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WORKSHOP QUANTITATIVE AND QUALITATIVE EVALUATION OF EPC(Endothelial progenitor cells)

The functional integrity of the vascular endothelium is essential to protect against the development of atherosclerosis. Disturbances in endothelial functions are associated with the loss of anti-adhesive and antiproliferative properties of the vessel wall, vascular inflammation, and vasoconstriction in the short term, and lead to structural changes and the development of atherosclerotic lesion when present chronically. Successful endothelial regeneration is crucial for the prevention of atherosclerotic lesion formation. Until recently, it was thought that endothelial repair mechanisms constitute mainly of proliferation and migration of mature endothelial cells. More recent studies have shown that bone marrow-derived endothelial progenitor cells (EPCs) contribute to the regeneration and maintenance of endothelium.Endothelial progenitor cells are at the hierarchy, given their restricted potential to one cell type, i.e., EC. EPCs can be isolated from bone marrow or peripheral blood. In addition, EPCs have also been isolated from fetal liver or umbilical cord blood. The classical isolation methods include the use of adherence culture of total peripheral blood mononuclear cells or the use of magnetic microbeads, coated with anti-CD133 or anti-CD 34 antibodies. After isolation, the cells are cultured in medium with specific growth factors (eg. VEGF, bovine brain extract, and epidermal growth factor), which facilitate the growth factor), which facilitate the growth of endothelial-like cells.The study of EPC biology consists of two related aspects: quantitative evaluation of the EPC pool and functional assessment. Circulating EPCs can be quantified directly ex vivo using flow cytometry, which is considered the gold standard for this purpose; typical surface antigens to identify EPCs are CD34, CD133 and KDR. Functional characteristics are explored in vitro using standardized protocols, i.e.,1. Proliferation refers to the ability of EPCs to expand and form colonies in culture.2. Adhesion is assessed as the ability of EPCs to adhere to a monolayer of mature

endothelium in culture.3. Migration of EPCs is generally assessed in vitro as the ability to invade the lower side of a

Boyden-like chamber.4. Finally, after EPCs have adhered to the vessel wall, migrated into the interstitium, and

expanded locally, they should spatially organize to form vascular structures; this property can be assssed in vitro as tube formation assay in which EPCs are seeded with human umbilical vein endothelial cells on a gel of extracellular matrix proteins.

Aims of workshop:1. To culture and characterize EPCs2. To assess the function of EPCs in tube formation

Schedule :14.45 – 15.30 : Introduction to workshop15.30 – 16.15 : Preparation of buffy coat and culture of MNCs16.15 – 16.45 : Characterization of early and late EPCs16.45 – 17.45 : Tube Formation Assay17.45 – 18.00 : Discussion

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POSTER PRESENTATION Abstract of poster presentation 1

CYP1A1*2A, CYP1A1*2B AND CYP1A1*2C GENE POLYMORPHISMS IN CERVICAL CANCER PATIENTS AT EAST KALIMANTAN

Swandari Paramita*, Soetomo Soewarto**, M. Aris Widodo**, Sutiman B. Sumitro**** Faculty of Medicine Mulawarman University Samarinda** Faculty of Medicine Brawijaya University Malang*** Faculty of Mathematics and Natural Sciences (Biology) Brawijaya University Malang

Cervical Cancer was number one from all cancer that frequently happened in Indonesia. Although HPV (Human Papillomavirus) is the etiology, but smoking, high parity and hormonal contraception are risk factors that often associated with Cervical Cancer. Those risk factors has associated with role of chemical carcinogen in carcinogenesis process. Benzo[a]pyrene was assumpted plays role in risk factor of smoking, and Estrogen was assumpted plays role in risk factors of high parity and hormonal contraception. Both Benzo[a]pyrene and Estrogen was metabolized by CYP1A1. There are differences on activity and induction of CYP1A1 enzyme between individuals that are alleged to be caused by the CYP1A1 gene polymorphisms. Up to now 5 genotype variants have been found on the CYP1A1 gene polymorphisms. There CYP1A1*2A, CYP1A1*2B and CYP1A1*2C variants are more often found in the Asian. The aim of this study was to find association between CYP1A1*2A, CYP1A1*2B and CYP1A1*2C gene polymorphisms with Cervical Cancer. Study was conducted in A.W. Sjahranie County General Hospital Samarinda, with total 116 patients for case and control group. CYP1A1 gene polymorphisms was determined by PCR-RFLP. Data was analyzed using Chi-square tests and Odds Ratio. The result did not find any significant relationship between CYP1A1*2A, CYP1A1*2B and CYP1A1*2C gene polymorphisms with Cervical Cancer. There was decreased risk for Cervical Cancer in CYP1A1*2A (OR = 0,671; 95% CI = 0,306-1,473), CYP1A1*2B (OR = 0,749; 95% CI = 0,355-1,580) and CYP1A1*2C (OR = 0,660; 95% CI = 0,317-1,372) gene polymorphisms with homozygote and heterozygote, but the results are not significant. The result showed similarity with study of CYP1A1 gene polymorphisms in Breast Cancer at Asian. It is assumed that hormonal aspect may play critical role in carcinogenesis process of Cervical Cancer that involved CYP1A1 gene polymorphisms.

Key words: cervical cancer, CYP1A1 gene polymorphisms

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Abstract of poster presentation 2

QUERCETIN IMPROVES VASODILATOR EFFECT OF AORTA IN DIET-INDUCED OBESITY RAT MODEL VIA SUPRESSION OF THE NUCLEAR FACTOR- κB ACTIVITIES

Heni Fatmawati1

1. Biomedical/Histology Laboratory, Faculty of Medicine University of Jember IndonesiaE-mail: [email protected]

Objectives. Flavonoids are semiessential food components that ubiquitously distributed in food plants. These dietary antioxidants exert significant antitumor, antiallergic, and anti-inflammatory effects.The molecular mechanisms of their biological effects remain to be clearly understood. This report describes a potential of bioflavonoid quercetin as an increasing the vascular effects of aorta in diet-induced obesity (DIO) rat model. Method. For this purpose, rats made obesity by diet-induced. Diet-induced obesity composed chow, wheat, cholesterol, cholic acid and pig fat (3:2:1:1:2). The rat received a daily diet-induced obesity for 90 days. The rat received a daily dose quercetin (2, 10 and 50 mg/kg BW) or vehicle for 60 days. Body weight and food intake were recorded weekly. After 160 days, NF-κB activities were examined by ELISA and aorta vasodilatations were measured by bioassay. Results. NF-κB activities was significantly decreased on obese rat treated with 10 mg/kg body weight/day (63.668 ± 69.335) quercetin dosage, and vasodilatation tends to elevated on 2 mg/kg body weight /day and 10 mg/kg body weight/day quercetin dosage. Thus, the higher vasodilatation amplification was occurred on 10 mg/kg body weight/day quercetin treatment (49.92±10.463).Conclusion. Chronic administration of quercetin on 10 mg/kg body weight/day could amplified aorta vasodilatation through supression of the nuclear factor- κB activities on aorta tissue of obese’s rat.

Key words : quercetin, obesity, NF-κB, vasodilatation

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INHIBITION THE TRANSLOCATION OF NFKB TO NUCLEUS BY LOKAL PROPOLIS EXTRACT

Zauhani Kusnul H1, M.Aris Widodo2

, 1 Akper bahrul Ulum, Jombang, [email protected]

2 Lab. Farmakologi, Fakultas Kedokteran Universita Brawijaya, Malang

Most of cancer cells have a constitutive of NFκB activation, while the activation of NFκB caused expression of several target gen that promote proliferation, inhibit apoptosis, promote invasivness and metastasis of cancer cells, promote resistance of cancer cell to radiotherapy and chemotherapy. The aim of this research is to evaluate the activity of local propolis on inhibition the translocation of NFκB to nucleus, using HeLa cell line that incubated with serial concentration of propolis and then the level of NFκB on the nucleus analyzed by elisa. The result showed that local propolis extract able to inhibit the translocation of NFκB to the nucleus.

Key words : propolis, NFkB, HeLa cell line

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mailto:[email protected]



ACUTE AND SUB CHRONIC EFFECT OF COAL DUST TO CHLORINATIVE STRESS AND CIRCULATING ENDOTHELIAL CELL IN VIVO

Bambang Setiawan1, Nia Kania2, Agus Yuwono3, Dyah Paramita4

1Center for Free Radical and Natural Product Studies, Department of Medical Chemistry, Lambung Mangkurat Medical School, Jl. A. Yani Km 36, Banjarbaru-South Kalimantan, Telp +6281351111307, Email: [email protected] of Pathology Anatomy, Ulin General Hospital, Lambung Mangkurat Medical School, Banjarmasin-South Kalimantan3Department of Internal Medicine, Ulin General Hospital, Lambung Mangkurat Medical School, Banjarmasin-South Kalimantan4General Medical Practitioner, Banjarbaru General Hospital, Banjarbaru, South Kalimantan

Objective: To know 1) effect of acute and chronic exposure of coal dust to chlorinative stress measured by Advanced Oxidation Protein Product (AOPP) formation and circulating endothelial cell in vivo.

Methods: Subject of this study was Wistar male rat obtained from UGM Yogyakarta. Coal was obtained from PT. Bokornas Wahana Makmur Mining from Karuh Asam-asam. Exposure of coal dust was done by coal dust exposure equipment 2009 model for one hour a day for 1 day (acute) and 28 days (sub chronic). Advanced Oxidation Protein Product was measured by method from Witko-Sarsat. Circulating endothelial cell was measured by method from Hladovec (1976) modified by Widodo, Widjajanto and Rudiyanto that developed in Pharmacology Laboratory, Brawijaya Medical School.

Results: Acute coal dust exposure increases AOPP and circulating endothelial cell significantly than control (p<0.05). Sub chronic coal dust exposure doesn’t increase AOPP and circulating endothelial cell than control (p>0.05). There are not correlation between AOPP and CEC in acute and subchronic exposure of coal dust (p>0.05).

Conclusions: Effect of coal dust to chlorinative stress and circulating endothelial cell found in acute exposure.

Key words: coal dust, acute, sub chronic, endothelial, chlorinative stress

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mailto:[email protected]



DETECTION OF FC GAMMA RECEPTOR III EXPRESSION IN HEMATOPOETIC STEM CELL

Caroline T. Sardjono1, Teresa L. Wargasetia1, Ernawati G. Rachman2, Marselina I. Tan2

1Medical Faculty, Maranatha Christian UniversityJl. Prof. drg. Suria Sumantri MPH No. 65 Bandung 40164 Indonesia2School of Life Sciences and Technology, Bandung Institute of TechnologyJl. Ganesha 10 Bandung 40132 Indonesia

The use of stem cells offers prospects to cure various diseases including autoimmune diseases. In the therapy of autoimmune diseases, hematopoetic stem cells are used with the aim to replace abnormal cells and at the same time to repopulate leukocyte cells which have decreased in number after chemotherapy. However, up to now there has been no publication concerning the existence of FcγR, which constitute IgG receptor in hematopoetic stem cell. Therefore, it is not known whether there is interaction that may occur between FcγRs of hematopoetic stem cells and IgG immune complexes in the blood circulation of autoimmune diseases patients. The objective of this research is to find out the possibility of interaction between hematopoetic stem cells and IgG immune complexes through detection of the existence of FcγRIIIa and FcγRIIIb mRNAs in hematopoetic stem cells. The method used in this research is laboratory experimental by isolating hematopoetic stem cells mRNAs from the peripheral blood and then RT-PCR is carried out by means of specific primers for FcγRIIIa and FcγRIIIb. The result of this research has detected the existence of FcγRIIIa and FcγRIIIb mRNAs in hematopoetic stem cells, so it can be predicted that FcγRIIIa and FcγRIIIb proteins exist as IgG receptors in hematopoetic stem cells. This implies that Fcγ receptors may interact with the immune complexes of autoimmune patients. However, further reasearch is required to characterize the effect that may occur through immune complex stimuli in hematopoetic stem cell.

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ROLE OF ADHESIN OF OUTER MEMBRANE PROTEIN Chlamydia pneumonia IN COLLAGEN TYPE-IV DEGRADATION THROUGH MACROPHAGE ACTIVATION AND INCREASING OF MMP-9

Sri Murwani*, Djanggan Sargowo**, Handono Kalim**, Mulyohadi Ali***, Ketut Muliartha****, Sumarno*

*Department of Microbiology, School of Medicine, Brawijaya University**Department of Internal Medicine, School of Medicine, Brawijaya University***Department of Pharmacology, School of Medicine, Brawijaya University****Department of Pathology Anatomy, School of Medicine, Brawijaya University

Chlamydia pneumoniae recently was associated with atherosclerosis and acute myocardial infarction. The aim of research was to prove role of the outer membrane protein (OMP) adhesin of C.pneumoniae in collagen type-IV degradation through macrophage activation and increasing of MMP-9. Research was divided into sequential of three steps: 1).Detection of adhesin in the OMP of C.pneumoniae. C.pneumoniae was obtained from ATCC-VR1310, and was cultured in HEp-2 cell line ATCC-CCL23. To reach this purpose, were done isolation of the OMP, immunogenicity, hemagglutination and adhesion tests; 2).Test the ability of the adhesin of OMP C.pneumoniae in macrophage activation. It was true experimental laboratories in vitro. As subject was used monocyte-derived macrophage that exposed by adhesin in optimum dose. As parameter was measured macrophage apoptosis, production of ROI, TNF-α, IL-1ß, MMPs, MMP-9, and phagocytosis activity. 3).Test the ability of the MMP-9 to degraded collagen type-IV. Results: in the OMP of C.pneumoniae was found a major protein 61kDa. It was an immunogenic, immunodominant protein, hemagglutinin and an adhesin. The adhesin was significantly activate macrophage: inhibited macrophage apoptosis, induced increasing of ROI,IL-1ß,MMPs,MMP-9 productions, phagocytosis activity, but insignificantly production of TNF-α. MMPs and MMP-9 able to degraded collagen type-IV. MMPs stronger than MMP-9.It was concluded that protein 61 kDa OMP C.pneumoniae is an adhesin that able to activate macrophage and induce the increasing of MMP-9 and its may play role in rupturing of atherosclerotic plaques.

Key words: adhesin, C. pneumoniae, macrophage, MMP-9, collagen type-IV

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THE ROLE OF HUMAN UMBILICAL CORD STEM CELL IN ISCHEMIC STROKE THROUGH VASCULOGENESIS< AINGIOGENESIS AND RE_CANALIZATION MECHANISM

I Putu Juniartha*, Nur Hidayati Azhar*, Nurona Azizah*Faculty of Medicine, Brawijaya Dept. Orthopaedic and Traumatology Dr Soetomo Hospital / School of Medicine Airlangga University*. Institute of Tropical Disease (ITD) – Airlangga University**

Background. Stroke is a dangerous chronic disease and it is the third causes of mortality in Indonesia. Stroke attacks at 79.9% people were classified as ischemic stroke. Ischemic stroke is caused by the presence of thrombus in blood vessels that makes an obstruction in the blood flow and stops the nutrition and oxygen supply to the brain. Death can occur if this condition continues. The pharmacological therapy that usually used for ischemic stroke just give small effect, even makes any side effect for the patient.Objectives. The purpose of this report is to recommend the use of Human Umbilical Cord stem Cells (HUCSC) as an alternative therapy for ischemic stroke, consider that it has an ability to provoke revascularization. Methods. We employed descriptive explorative method analyzing published studies. The analysis method includes 4 steps f (1) data collection; (2) data reduction; (3) data fusion; (4) conclusion.Results and discussion. The principal mechanism of HUCSC therapy for ischemic stroke is the isolation of HUCSC, manipulation with addition of growth factor VEGF, and injection to the ischemic area. The HUCSC have endothelial progenitor cells (EPC) that have rple in neovascularization, formation of new collated blood vessels in ischemic area. EPC is important in re-endothelialization. KDR, a protein found in EPC stimulates proliferation, sprouting of new blood vessels, and angiogenesis. HUCSC treatment resulted in 10 times greater of re-endothelialization than other EPC resources. HUCSC also safe because it needs 3 matched HLA out of 6 HLA. HUCSC are available in abundance in Indonesia due to high birth rate. Conclusion. HUCSC can be used as alternative therapy for ischemic stroke considering its high availability, may provoke neovascularization, safe and simple in processing.

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POLYCLONAL ANTIBODY OF WHOLE TYPE IV COLLAGEN DETECTED THE FRAGMENTS OF TYPE IV COLLAGEN AS RESULT OF MACROPHAGE-ACTIVATED MMP-9 INDUCED BY PORPHYROMONAS GINGIVALIS

Mubarokah SN*, Susilawati IDA*, Sumarno*, Muliartha IKG*, Sargowo Djanggan**Postgraduate Program, Faculty of Medicine, Brawijaya UniversityMalang - Indonesia

Background. Porphyrimonas gingivalis, a major cause of periodontitis is known to relate to acute coronary syndrome. It readily invades into blood circulation and potentially induces collagenoytic activity of inflammatory cells which result in collagen vascular degradation leading to atheroscleoic plaque rupture (APR). APR is responsible for occurrence of fatal cardiovascular events such as acute myocardial infarction (AMI). Detection of vascular collagen fragmentation would prove the occurrence of such degradation.Aims. To detect fragmentation of type IV vascular collagen due to macrophage activated MMP-9 as a result of P. gingivalis induction.Methods. The ability of P. gingivalis to induce type IV collgen fragmentation was shown by digesting type IV collagen with the supernatant of monocyte-derived macrophage activated by exposure of P. gingivalis suspension for 18 h at 37 C and 5%CO2. Fragments were analyzed using SDS-PAGE and Western-blot. The presence of MMP-9 was detected using dot-blot and Western-blot techniques, whereas its activity was assayed using SDS-PAGE and zymograms.Results. P. gingivalis induced the production of MMP-9 took formed as one of collagenolytic components and increase MMP-9 proteolytic activity. Polyclonal antibody generated from whole type IV collagen detected fragments of 80 and 60 kDa following exposure of P. gingivalis. Conclusions. P. gingivalis induced the production of MMP-9 and increase MMP-9 proteolysis of type IV collagen. Our polyclonal antibody generated from whole type IV collagen could detect collagen type IV fragments of 80 and 60 kDa.

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OMP ADHESIN AdhO36 S.typhi MALANG ISOLATE: A PROMISING CANDIDATE ORAL VACCINE FOR THYPOID FEVER

Sri Winarsih*, Sanarto Santoso*, Sumarno**Laboratry of Microbiology, Faculty of Medicine, Brawijaya UniversityMalang - Indonesia

Typhoid fever, caused by Salmonella Typhi (S.Typhi), is still an important public health problem in many developing countries. Up to now, the substance of surface bacterium called adhesin is a target of vaccine development The series of co-laboratory experiments revealed that a new adhesin of S.Typhi originating from outer membrane protein (OMP) was evident. It has about 36 kDa in molecular weight and is hereinafter referred to adhesin protein 36kD (AdhO36). The result of this research is expected to become the basis of development of safe vaccine, effective, protective and easy to use. The objective of this research was to know the ablity of OMP AdhO36 to induce cellular immune response and to protect against Salmonella invasion into systemic organ compare to whole cell protein. S.Typhi obtained from typhoid fever patient of Dr.Saiful Anwar General Hospital-Malang. In this reseach, both the protein AdhO36 and whole cell (wc) proteins of S.Typhi was conjugated with ISCOM (Immunostimulating Complex), given intramuscularly and orally to Balb/c mice to measure cellular immune response and protectivity respectively. The result showed that the AdhO36-ISCOM increased significantly (ANOVA, p<0,05) of s-IgA level as well as IL-12 and IgG2a level, respiratory burst, bacterial uptake, amount of activated macrophage, microbicidal effect, amount of TCD8+ cells and DTH reaction compared to control, ISCOM and wc-ISCOM. The AdhO36-ISCOM decreased significantly (ANOVA, p<0,05) of bacterial amount in intestine, liver and spleen. Path analysis showed that the protectivity of AdhO36 is mostly affected by increasing of IL-12. AdhO36 protein-ISCOM also increased amount of NK cell. The results indicate that the AdhO36- not only induced Th1 response but also induced Th2 response especially mucosal immune response. In conclusion, AdhO36 protein of S.Typhi (Malang isolate) is a potent immunogen that induce mucosal also cellular immune response that will protect the bacteria invasion and thus, can be recommended as a more effective, practical, and safer new candidate oral vaccine based on adhesin molecule. Whether this protein AdhO36 is the property of other S.Typhi isolated from other region of Indonesia is still under investigation.

Key words: S.typhi, AdhO36, cellular immunity, protectivity

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