A potential mechanism of miana (Coleus scutellariodes) and quercetin via NF-κB in Salmonella typhi infection.

Purpose: To prove the effect of Miana (M), Quercetin (Q), and the combination as an anti-inflammatory agent and Cefixime (C) as an antibiotic in Balb/c mice infected with Salmonella enterica serovar Typhi (S. Typhi) and related to the dynamics of NF-κB mRNA expression and NF-κB protein levels. Methods: A cohort study on male Balb/c mice with subjects consisted of 8 groups with 5 each group by administration of M, Q, M + Q, M + C, Q + C, M + Q + C, C only and sterile distilled water group as negative control. The statistical significance of the difference group was defined as P values less than 0.05. Results: Decreased mRNA expression of NF-κB, NF-κB protein levels, and bacterial load after administration of M + C, Q + C, or M + Q + C showed significant differences when compared to the negative control. The decline in NF-κB was stronger when M + Q + C was given compared to M, Q, M + Q, or C only. Conclusion: The effects of NF-κB suppression appear to be the same between the administration of M, Q and the M + Q when C added. However, the suppression of NF-κB was not significant without adding C.

Anti-inflammatory effects of banana (Musa balbisiana) peel extract on acne vulgaris: In vivo and in silico study.

Objective: Acne vulgaris (AV) is a common problem with a relatively high incidence rate among Asian people. The potential antimicrobial and anti-inflammatory properties of banana peels have been demonstrated in previous studies but have not been studied in cases of AV. Therefore, this study was aimed at investigating the protective effects of banana (Musa balbisiana) peel extract (MBPE) against AV. Methods: Thirty rats were divided into five groups (n = 6 rats per group): an AV group, AV group treated with 0.15% MBPE, AV group administered 0.30% MBPE, AV group administered 0.60% MBPE, and AV group administered clindamycin (the standard drug treatment). We assessed nodule size, bacterial count, histopathology, and cytokine levels (IL-1α, IFN-γ, tumor necrosis factor (TNF)-α, and IL-8). Enzyme linked immunoassays were used to measure the cytokine levels. In addition, we performed molecular docking studies to determine the interactions between phytochemicals (trigonelline, vanillin, ferulic acid, isovanillic acid, rutin, and salsolinol) via the Toll-like receptor 2 (TLR2) and nuclear factor-kappa B (NF-κB) pathways. Results: All MBPE treatment groups, compared with the AV group, showed suppression of both bacterial growth and proinflammatory cytokine production, as well as resolved tissue inflammation. The nodule size was significantly suppressed in the groups receiving the two highest doses of MBPE, compared with the AV group. However, the pharmacological action of MBPE remained inferior to that of clindamycin. Docking studies demonstrated that rutin was the phytocompound with the most negative interaction energy with TLR2 or NF-κB. Conclusions: Our results indicated that MBPE has anti-inflammatory effects against AV, by suppressing nodule formation, inhibiting bacterial growth, and decreasing proinflammatory cytokine production.

Serum iron levels in tuberculosis patients and household contacts and its association with natural resistance-associated macrophage protein 1 polymorphism and expression.

BACKGROUND: Iron deficiency can impair immune function, increasing tuberculosis (TB) susceptibility and severity. The research aimed to investigate iron deficiency anemia in TB patients and household contacts and its association with natural resistance-associated macrophage protein 1 (NRAMP1) polymorphism and expression. METHODS: The levels of iron, ferritin, and transferrin were measured in the serum by ELISA (Enzyme-Linked Immunosorbent Assay). NRAMP1 polymorphisms were determined by polymerase chain reaction (PCR) and sequencing. NRAMP1 gene expression was measured by real-time PCR. Interferon-gamma release assay (IGRA) checked on household contacts to screen household contacts with positive IGRA as the control. RESULTS: This study involved 35 TB cases and 35 TB contacts. The results showed that the serum Fe levels were found to be lower in the TB case group (median 149.6 µmol/L) than in the positive IGRA household contacts group (median 628.53 µmol/L) with a p-value <0.001. Meanwhile, ferritin levels in TB cases tended to be higher, in contrast to transferrin, which was found to tend to be lower in TB cases than household contacts but did not show a significant difference. This study found no association between the polymorphism of exon 15 D543 and active TB. However, NRAMP1 gene expression was lower in TB cases than in positive IGRA household contacts (p = 0.011). Besides, there was a positive correlation between NRAMP1 gene expression and serum Fe levels (r = 0.367, p = 0.006). TB was associated with decreased NRAMP1 gene expression (OR 0.086 95% CI 0.02-0.366, p = 0.001). Besides, TB was associated with low Fe levels (OR 0.533 95% CI 0.453-0.629, p < 0.001). CONCLUSION: Comparing the TB case to the household contacts group, decreased serum Fe levels were discovered in the TB case group. This study also shows a correlation of NRAMP1 gene expression to Fe levels in TB patients and household contacts and describes that TB may lead to decreased Fe levels by downregulating NRAMP1 expression.

Effectiveness of Topical Cyclosporin-A 0.1% Compared to Combined Topical Cyclosporin-A 0.1% with Topical Sodium Hyaluronate on Interleukin-6 Levels in the Tears of Patients with Dry Eye Disease.

INTRODUCTION: Pro-inflammatory cytokines are important contributors to dry eye disease (DED). The cytokine interleukin (IL)-6 has become a therapeutic target in several DED drug studies. This randomized controlled trial aimed to determine the effectiveness of topical cyclosporin-A 0.1% compared to the combination of topical cyclosporin-A 0.1% and sodium hyaluronate in reducing tear IL-6 levels in DED patients. METHODS: The participants were 20 patients, each with two eyes, who had moderate-to-severe DED. Before and after treatment, the clinical degree of DED was examined in each group, using ocular surface disease index (OSDI) scores, tear break-up time (TBUT), fluorescent tests, and Schirmer I tests. In addition, tear samples were taken to examine IL-6 levels through the ELISA method. The results were analyzed using the t-test, Wilcoxon test, and Mann-Whitney test. The correlation between tear IL-6 levels and the severity of DED was analyzed using the Spearman correlation test. RESULTS: The study showed a significantly lower tear IL-6 level, OSDI score, and degree of ocular staining after either topical cyclosporin-A 0.1% or a combination of topical cyclosporin-A 0.1% and sodium hyaluronate (all values p < 0.05). CONCLUSIONS: The combination therapy was superior in reducing tear IL-6 levels. In addition, a correlation existed between tear IL-6 levels and the severity of DED based on the TBUT, although it was weak and not statistically significant.

Effect of Probiotic Adjuvant Therapy on Improvement of Clinical Symptoms & Interleukin 6 Levels in Patients With Schizophrenia.

OBJECTIVE: This study aims to examine the effect of giving probiotic adjuvant therapy on improving clinical symptoms & IL-6 levels in patients with schizophrenia. METHODS: This research was a double-blind, placebo-controlled trial conducted at Dadi Psychiatric Hospital, South Sulawesi Province, Indonesia in November-December 2021. The sample of the research was patients with schizophrenia undergoing hospitalization who received therapeutic doses of risperidone with a total of 21 samples in each treatment and control group. Research subjects were measured with Positive and Negative Syndrome Scale (PANSS) at baseline, 2nd, 4th, and 6th weeks. The treatment group received one capsule/12 hours/oral of probiotics for six weeks and the control group received 1 capsule/12 hours/oral placebo for 6 weeks. In addition, two measurements of IL-6 using enzyme-linked immunosorbent assay were performed in both groups, namely at the beginning of week 0 and the end of the 6th week. RESULTS: We found the decrease in the PANSS value which described the improvement in clinical symptoms of the schizophrenic group after receiving therapeutic doses of antipsychotics and probiotic capsules or the treatment group as well as the schizophrenia group receiving therapeutic doses of antipsychotics and placebo capsules or the control group. CONCLUSION: Improvements in clinical symptoms and decreased levels of IL-6 in the group of patients with schizophrenia who received risperidone with probiotic adjuvant therapy were better than in the group of patients with schizophrenia who received risperidone without probiotics as adjuvant therapy.

Relation between expression of hMLH1 and p53 mRNA genes, in the feces of patients with colorectal carcinoma. Cross-sectional study.

Colorectal carcinoma (CRC) is one of the main public health problems. The mortality of CRC is about 8%. Early detection of CRC is very important to prevent death because this cancer could be cured through surgery if the diagnosis can be made as early as possible. Therefore screening strategy for early detection of CRC is critical in reducing mortality. Many investigations supporting the detection of CRC have been developed, including the fecal DNA mutation test using advanced cytological techniques. It is capable of assessing colonocytes for the presence of DNA, RNA, and protein as molecular biomarkers of neoplasia in CRC, including p53 and hMLH1. This study implemented observational approach with a cross-sectional study of the feces of patients with CRC regardless of the stage and grade. The purpose of this study was to determine the expression of the hMLH1 and p53 mRNA genes in the feces of 48 patients with CRC from two hospitals in Indonesia, Siloam Hospitals in Cikarang and Dr. Wahidin Sudirohusodo Hospital in Makassar. The results showed that all adenocarcinoma feces samples with various tumor stages and grades had excess mRNA expression (more than twice the normal amount in Fold Change units) for both the hMLH1 and p53 genes. The average expression of the hMLH1 mRNA gene was the highest at stage two and grade one, while the lowest was at stage four and grade three. In contrast, the average p53 mRNA gene expression was the highest at stage four and grade three, while the lowest was at stage two and grade one. The study suggested that there was a relation between and the expression of hMLH1 and p53 mRNA gene. We concluded that while both hMLH1 and p53 genes in patients' feces with CRC were overexpressed, they did not significantly affect the grade of CRC.

Moringa oleifera capsule and diet in young women with dropout school.

BACKGROUND: Teenagers are the second phase in life after the children's phase. The adolescent phase is called the transitional or transitional phase because in this phase it has not gained status as an adult but is no longer a childhood. The adolescent phase is called the critical period, a phase where there are many problems in growth and development, both physically, mentally, and in activities so that the need for food containing nutrients is large enough. Therefore, intervention efforts to improve adolescent nutrition are very necessary. The purpose of this study was to determine the effect of Moringa Oleifera leaf capsules on eating patterns in school drop-out adolescent girls aged 12-18 years in Polobangkeng sub-district, Takalar Regency, South Sulawesi Province. METHODS: The study was a quasi experiment, the design used was Randomized Controlled Double-Blind Pre-Posttest. This research was conducted in Polobangkeng Utara Subdistrict, Takalar Regency, South Sulawesi on March 15, 2020 to May 23, 2020. The population in this study was all young women breaking up schools aged 12-18 years in Polobangkeng Utara District, Takalar Regency, South Sulawesi Province as many as 75 people. The sampling technique uses simple random sampling. Data were analyzed using the McNemar and Man Whitney tests. RESULTS: Moringa leaf extract capsules of respondents who had a good diet before the intervention were 40% and less than 60% but after the intervention had a good diet as much as 100%. The Mc Nemar test p value was 0.004 which the p value α value (0.05) which shows that there is no difference in eating patterns before and after TTD capsule intervention. CONCLUSION: There is an effect of giving Moringa leaf extract capsules to the diet seen from the average median value in the Moringa leaf extract capsule group is greater than 23 of the TTD capsule group which is 8 in teenage girls dropping out of school age 12-18 years in the North Polongbangkeng region Regency. Takalar, South Sulawesi.

Malnutrition in children associated with low insulin-like growth factor binding protein-3 (IGFBP-3) levels.

OBJECTIVE: This study aimed to compare serum levels of Insulin-like Growth Factor Binding Protein-3 in children with malnutrition and good nutritional status. METHOD: This cross-sectional study included 41 participants consisting of 31 malnourished, 10 well-nourished children aged between 36 and 60 months. Demographic data of participants were obtained utilizing a questionnaire. Nutritional status was determined by calculating the Z-score of body weight for age, height for age, and body weight for height indices using the WHO classification. IGFBP-3 levels were determined by the Enzyme-Linked Immunosorbent Assay (ELISA) method. RESULT: Median serum IGFBP-3 levels in malnourished children were found to be lower i.e. 0.35mcg/mL (minimum-maximum: 0.04-1.52mcg/mL) compared to well-nourished children 1.52ng/mL (minimum-maximum 0.47-3.17mcg/mL). CONCLUSION: Serum IGFBP-3 levels can be used as indicators to assess nutritional status.

Leptin levels in children with malnutrition.

OBJECTIVE: This study aimed at comparing serum levels of leptin in children with malnutrition and good nutritional status. METHOD: This cross-sectional study included 41 participants consisting of 31 malnutrition, 10 well-nourished children aged between 36 and 60 months. Demographic data of participants were obtained utilizing a questionnaire. Nutritional status was determined by calculating the Z-score of body weight for age, height for age, and body weight for height indices using the WHO classification. Leptin levels were determined by ELISA (Enzyme-Linked Immunosorbent Assay) method. RESULTS: Median serum leptin level for malnutrition children were found to be lower, i.e., 9.23 (6.02-197.2) ng/mL compared to well-nourished children 30.95 (6.02-89.36) ng/mL. CONCLUSION: Serum leptin levels can be used as indicators to assess nutritional status.

Comparison of nitric oxide levels, roll over test value, and body mass index in preeclampsia and normotension.

OBJECTIVE: The study aims to compare levels NO, the ROT, and BMI values in preeclampsia and normotension. METHOD: This study was an observational analytical study that combined the draft case-control study and a cross-sectional study (hybrid method) conducted in February-June 2020. This study was conducted in the Hospital Dr. Wahidin Sudirohusodo Makasar, Antang Health Center, Barabaraya Health Center, and Mamajang Health Center. Respondents in this study were pregnant women divided into two groups, 108 mothers with normal pregnancies and 42 mothers with preeclampsia. The criteria of the study respondents were single pregnancies, pregnancy of more than 20 weeks, and the gestational age of 20-35 years old. Data collected includes age, parity, gestational age, pregnancy interval, body mass index (BMI), and education. In addition, Nitric oxide levels are determined using Elisa Kit, and roll over test is collected by performing blood pressure measurements at two different positions. RESULTS: The mean serum NO levels in the preeclampsia 176.43±50.8 and 152.75±51.3 in normotension, and there is a meaningful relationship p=0.012. Mean value of ROT in preeclampsia 23.21±8.54 and 19.63±8.85 in normotension p=0.026. There is a meaningful difference in IMT with preeclampsia p=0.003. CONCLUSION: NO, ROT and BMI are significantly higher in pregnant mothers with preeclampsia than in normal pregnancies.

Malnutrition in children associated with low growth hormone (Gh) Levels.

OBJECTIVE: This study aimed to compare serum levels of Growth Hormone in children with malnutrition and good nutritional status. METHOD: This cross-sectional study included 41 participants consisting of 31 malnourished, 10 well-nourished children aged between 36 and 60 months. Demographic data of participants were obtained utilizing a questionnaire. Nutritional status was determined by calculating the Z-score of body weight for age, height for age, and body weight for height indices using the WHO classification. GH levels were determined by the Enzyme-Linked Immunosorbent Assay (ELISA) method. RESULT: Median serum GH levels in malnourished children were found to be lower i.e. 1.25ng/mL (minimum-maximum: 0.10-6.19ng/mL) compared to well-nourished children 11.01ng/mL (1.72-15.64ng/mL). CONCLUSION: Serum GH levels can be used as indicators to assess nutritional status.

Serum vitamin D receptor and High Mobility Group Box-1 (HMGB1) levels in HIV-infected patients with different immunodeficiency status: A cross-sectional study.

BACKGROUND: HIV-AIDS patients typically have hypovitaminosis D. Vitamin D is a key mediator in inflammatory and infectious diseases, which VDR mediates its biological effect. High-mobility group box 1 protein (HMGB1) modulates HIV-1 replication in vitro. Vitamin D played a role in inhibiting HMGB1 secretion in the animal study. OBJECTIVES: This study aimed to examine differences and correlation of vitamin D receptor and HMGB1 protein levels in HIV patients with mild and severe immunodeficiency and healthy control participants. METHODS: This study using a cross-sectional design conducted at Volunteer Counseling and Testing (VCT) Clinic in Mataram, West Nusa Tenggara, Indonesia, from January to June 2020. Three groups of study participants were classified as HIV patients with severe immune deficiency (SID), HIV patients with mild immune deficiency (MID), and healthy controls (HC). RESULTS: Mean level of vitamin D receptor in SID HIV group was 25.89 ± 3.95 ng/ml, lower than those in MID-HIV group; 33.72 ± 1.69 ng/ml and in HC group; 50.65 ± 3.64 ng/ml. Mean levels of HMGB1 protein in the SID HIV group were 3119.81 ± 292.38 pg/ml higher than those in the MID HIV group 1553.55 ± 231.08 pg/ml and HC 680.82 ± 365.51 pg/ml. There was a significant and strong negative correlation (r = -0.932) between vitamin D receptor and HMGB1 levels (p < 0.01). CONCLUSIONS: Strong negative correlation between VDR and HMGB1 in different immunodeficiency statuses suggesting an important role of vitamin D in inflammation control in HIV infection. However, it needs to be confirmed in a further prospective study.

Detection of voluntary dehydration in paediatric populations using non-invasive point-of-care saliva and urine testing.

AIM: Voluntary dehydration, or lack of fluid intake despite water availability, is common in otherwise healthy children, and can lead to adverse effects. Most dehydration biomarkers are impractical for routine assessment in paediatric populations. This study aimed to assess two non-invasive hydration assessment tools, urine specific gravity (USG ) and a novel point-of-care (POC) salivary osmolarity (SOSM) sensor, in healthy children. METHODS: Volunteers were tested by colorimetric USG and a handheld SOSM system. Observed values were compared against previous studies to determine hydration status, as was the concordance between parameters. RESULTS: At the common USG threshold of 1.020, 42.4% of the 139 healthy children were dehydrated. The same prevalence was found using the 70-mOSM cut-off value. Comparative analysis of SOSM at varying USG thresholds demonstrated significantly higher SOSM in dehydrated children with a USG  ≥ 1.030 (P = 0.002). CONCLUSION: At the USG threshold of 1.020 and SOSM threshold of 70 mOSM, 42.4% of healthy children were found to be voluntarily dehydrated. Significantly higher SOSM was observed in dehydrated children (USG ≥ 1.030). As the first study on the utility of POC SOSM measurements for detecting dehydration, these results provide a foundation for future POC characterisation of SOSM in other populations and clinical contexts.

Moringa oleifera capsule and diet in young women with dropout school

Background: Teenagers are the second phase in life after the children's phase. The adolescent phase is called the transitional or transitional phase because in this phase it has not gained status as an adult but is no longer a childhood. The adolescent phase is called the critical period, a phase where there are many problems in growth and development, both physically, mentally, and in activities so that the need for food containing nutrients is large enough. Therefore, intervention efforts to improve adolescent nutrition are very necessary. The purpose of this study was to determine the effect of Moringa Oleifera leaf capsules on eating patterns in school drop-out adolescent girls aged 12–18 years in Polobangkeng sub-district, Takalar Regency, South Sulawesi Province. Methods: The study was a quasi experiment, the design used was Randomized Controlled Double-Blind Pre-Posttest. This research was conducted in Polobangkeng Utara Subdistrict, Takalar Regency, South Sulawesi on March 15, 2020 to May 23, 2020. The population in this study was all young women breaking up schools aged 12–18 years in Polobangkeng Utara District, Takalar Regency, South Sulawesi Province as many as 75 people. The sampling technique uses simple random sampling. Data were analyzed using the McNemar and Man Whitney tests. Results: Moringa leaf extract capsules of respondents who had a good diet before the intervention were 40% and less than 60% but after the intervention had a good diet as much as 100%. The Mc Nemar test p value was 0.004 which the p value

Malnutrition in children associated with low insulin-like growth factor binding protein-3 (IGFBP-3) levels

Objective: This study aimed to compare serum levels of Insulin-like Growth Factor Binding Protein-3 in children with malnutrition and good nutritional status. Method: This cross-sectional study included 41 participants consisting of 31 malnourished, 10 well-nourished children aged between 36 and 60 months. Demographic data of participants were obtained utilizing a questionnaire. Nutritional status was determined by calculating the Z-score of body weight for age, height for age, and body weight for height indices using the WHO classification. IGFBP-3 levels were determined by the Enzyme-Linked Immunosorbent Assay (ELISA) method. Result: Median serum IGFBP-3 levels in malnourished children were found to be lower i.e. 0.35 mcg/mL (minimum–maximum: 0.04–1.52 mcg/mL) compared to well-nourished children 1.52 ng/mL (minimum–maximum 0.47–3.17 mcg/mL). Conclusion: Serum IGFBP-3 levels can be used as indicators to assess nutritional status. (AU)

Leptin levels in children with malnutrition

Objective: This study aimed at comparing serum levels of leptin in children with malnutrition and good nutritional status. Method: This cross-sectional study included 41 participants consisting of 31 malnutrition, 10 well-nourished children aged between 36 and 60 months. Demographic data of participants were obtained utilizing a questionnaire. Nutritional status was determined by calculating the Z-score of body weight for age, height for age, and body weight for height indices using the WHO classification. Leptin levels were determined by ELISA (Enzyme-Linked Immunosorbent Assay) method. Results: Median serum leptin level for malnutrition children were found to be lower, i.e., 9.23 (6.02–197.2) ng/mL compared to well-nourished children 30.95 (6.02–89.36) ng/mL. Conclusion: Serum leptin levels can be used as indicators to assess nutritional status. (AU)

Comparison of nitric oxide levels, roll over test value, and body mass index in preeclampsia and normotension

Objective: The study aims to compare levels NO, the ROT, and BMI values in preeclampsia and normotension. Method: This study was an observational analytical study that combined the draft case–control study and a cross-sectional study (hybrid method) conducted in February–June 2020. This study was conducted in the Hospital Dr. Wahidin Sudirohusodo Makasar, Antang Health Center, Barabaraya Health Center, and Mamajang Health Center. Respondents in this study were pregnant women divided into two groups, 108 mothers with normal pregnancies and 42 mothers with preeclampsia. The criteria of the study respondents were single pregnancies, pregnancy of more than 20 weeks, and the gestational age of 20–35 years old. Data collected includes age, parity, gestational age, pregnancy interval, body mass index (BMI), and education. In addition, Nitric oxide levels are determined using Elisa Kit, and roll over test is collected by performing blood pressure measurements at two different positions. Results: The mean serum NO levels in the preeclampsia 176.43 ± 50.8 and 152.75 ± 51.3 in normotension, and there is a meaningful relationship p = 0.012. Mean value of ROT in preeclampsia 23.21 ± 8.54 and 19.63 ± 8.85 in normotension p = 0.026. There is a meaningful difference in IMT with preeclampsia p = 0.003. Conclusion: NO, ROT and BMI are significantly higher in pregnant mothers with preeclampsia than in normal pregnancies. (AU)

Malnutrition in children associated with low growth hormone (Gh) Levels

Objective: This study aimed to compare serum levels of Growth Hormone in children with malnutrition and good nutritional status. Method: This cross-sectional study included 41 participants consisting of 31 malnourished, 10 well-nourished children aged between 36 and 60 months. Demographic data of participants were obtained utilizing a questionnaire. Nutritional status was determined by calculating the Z-score of body weight for age, height for age, and body weight for height indices using the WHO classification. GH levels were determined by the Enzyme-Linked Immunosorbent Assay (ELISA) method. Result: Median serum GH levels in malnourished children were found to be lower i.e. 1.25 ng/mL (minimum–maximum: 0.10–6.19 ng/mL) compared to well-nourished children 11.01 ng/mL (1.72–15.64 ng/mL). Conclusion: Serum GH levels can be used as indicators to assess nutritional status. (AU)

Relationship between Vitamin D Level and Serum TNF-α Concentration on the Severity of Chronic Obstructive Pulmonary Disease.

BACKGROUND: Chronic Obstructive Pulmonary Disease (COPD) is a chronic inflammatory disease and disturbed bacterial clearance. Vitamin D deficiency is sometimes observed in COPD patients and as significant roles in increasing inflammation of airway obstruction and systemic obstruction, increasing pro-inflammatory cytokine including TNF-α, reduction of bacterial clearance and increase exacerbation risk due to infection. Also, vitamin D plays significant roles in the metabolism of calcium and mineralisation of bones and regulation system of immune. TNF-α also has essential roles in pathogenesis and inflammation of COPD. Several studies that investigate the relationship between vitamin D level and serum TNF-α concentration in COPD patients are relatively uncommon, including in Indonesia. AIM: This study aimed to assess the relationship between vitamin D level and TNF-α concentration in patients on the severity of the chronic obstructive pulmonary disease. METHODS: This study was a hospital-based descriptive cross-sectional study. Total samples were 50 COPD patients with the average age of older than 60 years during their enrollments at the Department of Pulmonology and Respiratory Medicine of the Dr Wahidin Sudirohusodo General Hospital Makassar in September 2018-January 2019. All procedures of the present study were reviewed and approved by the Research Ethics Committee of Medicine Faculty of Hasanuddin University. The severity of COPD was assessed according to the combination of COPD assessment stages that referred to the Global Initiative for Chronic Obstructive Lung Disease (GOLD) Guideline 2015 that consisted of the combination of scoring COPD Assessment Test (CAT), the modified Medical Research Council (mMRC) questionnaire and results of the spirometry measurement. Assessment of airway obstruction levels referred to the GOLD spirometry criteria. Determination of thoracic photographs was conducted to verify the COPD diagnosis of the severity of COPD. Determination of serum TNF-α concentration and vitamin D3 [1,25(OH)2D3] level used the ELISA method. RESULTS: The majority of COPD patients were observed in the category of older than 60 years old accounted for 34 COPD patients (68%), and the majority of COPD patients were males accounted for 47 males with COPD (94%). The majority of COPD patients were observed in the group of D (38%). All the study subjects observed in this study were smokers, and 82% of them were in the category of heavy smokers. 21 study subjects had higher concentration of serum TNF-α (tertile 3 = 0.21-1.83 pg/dl), 20 study subjects and lower level of vitamin D (tertile 1 = 182.1-364.5 pg/dl). The majority of the study subjects (38%) were in the category of severe COPD (category D of the severity of COPD at the tertile 3) according to the GOLD Combine Assessment. Given the relationship between vitamin D level and serum TNF-α concentration on the airway obstruction, there were significant positive correlations between the increase of vitamin D levels and the increase of serum TNF-α concentrations on airway obstruction. Given the relationship between vitamin D level and serum TNF-α concentration on the severity of COPD, there were significant positive correlations between the increase of vitamin D levels (tertiles 1, 2 and 3) and the increase of serum TNF-α concentrations on the severity of COPD at p-value < 0.05. Overall, there were non-linear relationships between vitamin D level and serum TNF-α concentration on the severity of COPD. CONCLUSIONS: Serum TNF-α concentration was positively associated with airway obstruction level and severity of COPD. Low level of vitamin D was negatively associated with airway obstruction level and severity of COPD. Vitamin D3 level (1,25(OH)2D) was negatively associated with serum TNF-α concentration and airway obstruction level and severity of COPD.