BAB VI KESIMPULAN DAN SARAN
6.2 Saran
1. TNF α sebaiknya mulai juga dilakukan sebagai salah satu pemeriksaan rutin untuk penderita PPOK.
2. Tatalaksana penderita PPOK sebaiknya juga didasarkan kepada
kadar TNFα serum. Sehingga dengan melihat kadar TNFαserum, tatalaksana terhadap PPOK menjadi lebih holistik sehingga dapat
mengurangi angka morbiditas dan mortalitas.
3. Sebaiknya juga dapat dilakukan penelitian nilai dasar dari TNFα
pada sampel yang sehat yang dapat dijadikan patokan untuk
melihat kadar TNFα yang sebenarnya untuk diwakilkan pada populasi.
4. Perlu dilakukan penelitian serupa dengan sampel yang lebih besar
dan metodologi yang lebih baik dimasa yang akan datang.
DAFTAR PUSTAKA
1. Roisin Roberto R, Rabe K, Anzueto, Buist A Sonia, Carverley Peter, deGuia
Teresita S, Fukuchi Yoshinosuke, Jenkins Christine, Kocabas Ali, Casas
Alejandro, Mogilnicka Ewa Nizankowska, Zielinski Zan. Global strategy for
the diagnosis, management and prevention of Chronic Obstructive
Pulmonary Disease. NHLBI/WHO Global initiatiative for Chronic Obstructive
Pulmonary Disease (GOLD) 2008.
2. Bahar Asril. Penyakit Paru Obsruksi Kronik Penatalaksanaan Secara
Paripurna, dalam Current Diagnosis and Treatment in Internal Medicine
2001; Hal : 207-208.
3. Amin Muhammad. Perkembangan Konsep Patogenesis Penyakit Paru
Obstruktif Kronik, dalam Pendidikan Kedokteran Berkelanjutan VII Ilmu
Penyakit Paru, UNAIR Surabaya, 2004; Hal : 95 – 100.
4. Barnes.J. Peter.Chronic Obstructive Pulmonary Disease, Departement of
Thoracic Medicine, National Heart and Lung Institute, Imperial College
School of Medicine, London, 2000; Hal : 269 – 278.
5. Agusti AGN, Noguera A, Sauleda J, Sala E, Pons J, Busquets X. Systemic
efects of chronic obstructive pulmonary disease. Eur Respi J 2003; 21: 347
– 360.
6. Khader A K Abdul. Systemic Effects ini COPD, MES Medical Colege.
7. Rumende Cleopas Martin. Terapi Kuinolon Baru pada PPOK Eksaserbasi
Akut. Dalam Current Diagnosis and Treatment in Internal Medicine 2002;
Hal : 43 – 48.
8. Baeyens et al. TNF-Alpha, dalam assingment for an undergraduate course
at Davidson College ; Hal : 1 -7.
9. Sarir Hadi,Henricks Paul A.J, Van Houwelingen Anneke H, Nijkamp Frans P,
Folkerts Gert. Cells, mediators and Toll-like receptor in COPD, European
Journal of Farmacology, Elsevier,2008; Hal : 346 – 353.
10. Tumor Necrosis factor-alpha from www. Wikipiedia. Tumor necrosis alpha,
the free encyclopedia.; hal : 1 - 6
11. Mukhopadhyay Srirupa, Hoidal John R, Mukherjee Tapan K. Role of TNFα in pulmonary pathophisiology, Respiratory research 2006, 7:125; Hal : 1- 11
12. Mukhopadhyay Srirupa. Role of TNFα in Chronic Obstructive Pulmonary Disease and Chronic Bronchitis, Respiratory research 2006; Hal : 1 – 2.
13. Matera Maria Gabriella, Calzetta Luigino, Cazzola Mario. TNFα inhibitor in asthma and COPD: We must not throw the baby out with the bath water,
Pulmonary Pharmacology & Therapeutics, Elsevier, 2009; Hal: 121 - 128
14. Calikoglu Mukadder, Sahin Gulsah, Unlu Ali, Oztrurk Candan, Tamer
Lulufer, Ercan Bahadir, Kanik Arzu, Atik Ugur. Leptin and TNF Alpha levels
in Patients with Chronic Obstructive Pulmonary Disease and Their
Relationship to Nutritional Parameters. International Journal of Thoracic
Medicine, vol. 71. No. 1. 2004; Hal: 1-2
15. Keatings Vera M, Cave Samantha J, Henry Micheal J, Morgan Kevin,
Tumor Necrosis Factor α Gene Promoter Region May Predispose to a poor Prognosis in COPD, American College of Chest Physicians, 2000; hal : 971-
975.
16. Macnee W. Chronic Bronchitis and Emphysema. In Seaton A, Seaton D,
Leitch AG editors. Crofton and Douglas’s Respiratory Disease. Vol 1. 5th ed.
London. Blackwell Science; 2000: Hal : 617-695.
17. Honig EG, Ingram Jr RH. Chronic Bronchitis, Emphysema and Airways
Obstruction. In Braunwald E, Fauci AS, Kesper DL, Hauser SL, Longo DL,
Jameson JL, editors. Harrison’s Principles of Internal Medicine, Vol II. 15 th
Edition. New York, McGraw-Hill; 2001: hal: 1491-1499.
18. Macnee W. ABC of Chronic Obstructif Pulmonary Disease. Pathology,
pathogenesis, and phatophysiology. BMJ 2006;332:1202-1204
19. Casio MG, Majo J. Inflammation of the Airways and Lung Parenchyma in
COPD. Chest 2002;121:160s-165s.
20. Pettersen CA, Adler KB. Airways Inflammation and COPD. Chest
2002;212:142s-150s.
21. Wouters EFM. Local and Systemic Inflammation in Chronic Obstructif
Pulmonary disease. Proc AM Thorac Soc 2005;2:26-33.
22. Corless John. The Aetiology and Epidemiologi of Chronic Obstructiive
Pulmonary Disease, in: Chronic Obstuctive Pulmonary Disease, Critical
Debate, Blacwell Science Ltd;2003: 1-6
23. Sahab L, Jarvis MJ, Britton J, West R. Prevalence, dignosis and relation to
tobacco dependence of chronik obstructive pulmonary disease in nationally
24. Silverman EK, Weiss ST, Drazen JM, Chapman HA, Carey V, Campbell EJ.
Gender-related differences in severe early onset chronic obstructive
pulmonary disease. Am J Respir Crit Care Med;2000;162(6):2152-2158
25. Paul Man SF, Sin DD. Effects of Corticosteroid on systemic inflammation in
chronic obstructive pulmonary disease. Proc Am Thorac Soc;2005;2:78-82
26. Agusti AGN. A multicomponent disease: implications for management,
Elsevier;2005;99:670-682.
27. Celli BR. The importance of spirometry in COPD and Asma.
Chest;2000;117:15S-19S.
28. Lee TA, Bartle B, Weiss KB. Spirometry Use in Clinical Practice Following
Diagnosis of COPD. Chest;2006;129:1509-1515
29. Franciosi Luigi G, Page Clive P, Celli Bartolome R, Cazzalo Mario, Walker
Michael J, Danhol Meindert, Rabe Klaus F, Pasqua Oscar E Della. Markers
of disease severity in chronic obstructive pulmonary disease,
Elsevier;2006;19:189-199
30. Dentener MA, Louis R, Cloots RHE, Henket M, Wouters EFM. Differences in
local versus systemic TNF α production in COPD: inhibitory effect of hyaluronan on LPS induced blood cell TNFα release. Thorax;2006;61:478- 484
31. Sinden Nicola J, Stockley Robert A. Systemic inflamation and comorbiditi in
COPD: a result of ˝overspill˝ of inflammatory mediators from the lungs? Review of the evidence. Thorax ;2010;65:930-936
32. Tanni Suzana E, Pelegrino Nilva RG, Angeleli Aparecida YO, Correa
mediated systemic inflammation in COPD patients. Journal of
Inflammation;2010;7;9:1-7
33. Tzortzaki Eleni G, Tsoumakidou Maria, Makris Demosthenes, Siafakas
Nikolaos M. Laboratory markers for COPD in ˝susceptible˝ smokers. Elsevier;2006:124-138
34. Vestbo J, Wouters E, Rennard S, Miller B, Edwards L, Tal-Singer R. TNFα and Systemic Manifestations in COPD Patients and Controls. Am J Respir
Crit Care Med 179;2009.
35. Rennard Stephen I, Roisin Roberto Rodriguez, Huchon Gerard, Rocje
Nicholas. Understanding COPD and its impact, The Burden of COPD. In :
Clinical Management of Chronic Obstructive Pulmonary Disease, second