7856 - 69658 - K5 - Prof Arsyad Dasar Genetika Penyakit CCV
7856 - 69658 - K5 - Prof Arsyad Dasar Genetika Penyakit CCV
Wb
1/4/2020 KMA 2010
1
DASAR GENETIK
PENYAKIT CARDIO
CEREBRO VASCULAR
Kiagus Muhammad Arsyad
Bagian Biologi Kedokteran
Fakultas Kedokteran UNSRI
PYRAMIDA MILLER =
LEVEL KOMPETENSI
1. Pendahuluan
2. Masalah CCV
3. Genetika penyakit CCV
4. Penutup
SEL GENOME
KHROMOSOM
NUKLEUS
GENE : Allele , Locus
DNA
P=G+E
P = Phenotype G = Genotype
E = Environment
KMA DASAR GENETIK CCVD 9
1. PENDAHULUAN
ENVIRONMENT :
1. INTERNAL
2. EXTERNAL
ABNORMAL
GENE MUTATION PHENOTYPE
•Ciri Fisik
•Fungsi Jaringan
POLYMORPHISM •Fungsi Organ
•Fungsi Sistem
POLYMORPHISME
Gene phenotypic effect
Regulatory Cell-cell
genes interactions
Hormones,
gene-product
interactions
Environmental Effect on
effects organism
CENTRAL
DOGMA Effect on
KMA DASAR GENETIK CCVD organism
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2. MASALAH CCVS
1. OTAK
2. JANTUNG
3. PEMBULUH DARAH
4. SIRKULASI DARAH
5. TEKANAN DARAH
6. DARAH + PLASMA DARAH
TRIAS VIRCHOL ?
Stroke :
• Gangguan peredaran darah ke
otak(pecah, sumbatan,
penyempitan pembuluh darah)
• Gejala :
• Lumpuh, kesemutan, mulut
mencong, bicara cadel
• Pemicu :
• hipertensi, diabetes,
lemak darah tinggi,
kegemukan,
rokok, kurang olah raga
KMA DASAR GENETIK CCVD 17
What is a stroke?
Blood carries oxygen via blood vessels to the brain, and a stroke occurs when
blood supply to the brain is compromised.
In a cerebral infarction or ischemic stroke, blood supply is cut off by a blocked
blood vessel.
In a transient ischemic attack (TIA), blood supply is temporarily reduced.
Ischemic strokes are the most common form of stroke.
In a cerebral hemorrhage, a blood vessel leaks or bursts. Hemorrhagic strokes
can occur in the brain itself (an intracerebral hemorrhage) or within the spaces
that line the surface of the brain (subarachnoid hemorrhage and subdural
hemorrhage).
A cerebral aneurysm is an artery with a weak spot that balloons out. If it bursts,
it creates a hemorrhagic stroke. Cerebral aneurysms are silent killers with a
fatality rate of 30 to 40 percent when they rupture.
They occur in the young as well as the old .
Vascular malformations can also lead to stroke if the tangled vessels in the
brain cut off blood supply or burst, causing bleeding in the brain.
Whether from infarction or hemorrhage, stroke leads to brain cell death in the
affected area. In a chain reaction called the ischemic cascade, other cells near
the affected area begin to die too, increasing the potential for damage and
subsequent functional deficits.
Genetic and molecular mechanisms
of stroke
Genetic and molecular mechanisms of stroke and stroke
recovery
Genetic research holds promise not only of identifying who is
at risk for cardiovascular disorders, but also for producing
gene treatments to protect the brain against stroke and
reduce its impact when it occurs.
Genetics of Ischemic Stroke
two multi-center studies of stroke genetics, both funded by
the National Institutes of Health (NIH):
1. the Siblings with Ischemic Stroke Study (SWISS)
2. the Ischemic Stroke Genetics Study (ISGS).
These studies elevate the promise of finding rational gene
targets for neuroprotectants -- drugs that provide immediate
protection against impairment following ischemic strokes.
Neurovascular Genetics
Changes in the lining of the arteries as we age (atherosclerosis)
make us more vulnerable to stroke and heart attack.
Neurovascular genetics, is focused on the molecular structures
and mechanisms responsible for these changes.
the role of nitric oxide have contributed to the finding that loss of
nitric oxide is a key component.
Tetrahydrobiopterin (BH4), an essential factor in the activity of
nitric oxide--looking into how BH4 is metabolized in the vascular
system and means of controlling its biosynthesis and
degradation in cerebral arteries.
in vivo gene delivery of a form of nitric oxide has beneficial
effects on vascular function and may be important as a future
treatment.
Genetics of intracranial aneurysms
Genetics of intracranial aneurysms are investigating
chromosomal regions related to the formation,
enlargement, and rupture of intracranial aneurysms.
Familial Intracranial Aneurysm Study (FIA) designed
to identify the genetic impact on aneurysm
formation.
They are correlating findings from molecular biology
and genomics with imaging techniques, including
computational fluid dynamics (CFD) which allows
the computation of blood flow during aneurysm
growth and rupture.
PROGENITOR CELLS FUNCTION
The role of progenitor cells in maintaining normal
cerebrovascular function.
Progenitor cells, made in the bone marrow and circulating
through the blood stream, were only recently identified as
important in repairing injured blood vessels. Depletion of
these cells is considered a risk factor for cerebrovascular
disease, but their specific effect on vascular dysfunction in
the brain has not been well studied.
that transplantation of progenitor cells does have a
therapeutic effect on injured arteries The next step is to
translate this body of work into human studies where it will
have the potential not only to help prevent stroke, but also
to improve blood supply to the brain, the heart, and the
rest of the body as we age.
2. MASALAH CCVS
3. MASALAH PADA
PEMBULUH DARAH APA ?
Diabetes Melitus :
• Pencegahan :
• mengatur asupan gula ke dalam
tubuh
• DAMPAKNYA PADA
PEMBULUH DARAH, SYARAF KMA DASAR GENETIK CCVD 26
ORGAN
2. MASALAH CCVS
4. MASALAH PADA
SIRKULASI DARAH APA ?
Anemia :
• Kekurangan Haemoglobin di
dalam sel darah merah
• Gejala :
• pucat, lelah, pusing, daya
tahan rendah
• Penyebab :
• kekurangan zat besi, B12
dan asam folat, serta
perdarahan
• DAMPAKNYA
KMA DASAR GENETIK CCVD 28
2. MASALAH CCVS
5. MASALAH PADA
TEKANAN DARAH APA ?
Hipertensi :
• Sistole : saat jantung
memompa darah masuk arteri
• Diastole : saat jantung relaks
• Nilai tekanan darah :
• normal : 120 / 80
• Hipertensi : > 140 / > 90
HIPOTENSI ?
HIPERTENSI ESSENSIAL
PENYEBAB DAN
DAMPAKNYA?
KMA DASAR GENETIK CCVD 30
3.1. Genetika penyakit cardiovascular
2. Kallikrein System
5. Catecholamines
6. Cardiovascular Peptide
7. Neuropeptides
S
Polimorfisme HVK,
N
Gen ACE HTN PAK
H
/
Aktivitas
S
H
ACE
Kadar
Aldosteron
S
Polimorfisme E
Gen ACE H
Normotensi
A
KMA DASAR GENETIK CCVD T35
3.1. Genetika penyakit Cardiovascular
6. Kelainan katup
7. Hipertensi
8. Syok kardiogenik
Kardiomiopati
Hipertensi pulmonal
KDU BERAPA?
KMA DASAR GENETIK CCVD 39
Penyakit kardiovaskular
Nice to know:TUGAS ARTIKEL
1. Carditis
2. Peripheral Artery Disease (PAD)
3. Aneurysma Aorta
4. Emboli arteri
5. Deep Vein Thrombosis (DVT)
KDU BERAPA?
KMA DASAR GENETIK CCVD 40
3.2. PENYAKIT CEREBROVASCULAR
Fungsi Otak :
Bagian bagian berbeda dari otak mengontrol
berbagai aktivita:mulai dari irama jantung
sampai kemampuan untuk melihat dan
mendengar;
Kemampuan untuk bernafas, berpikir, berjalan,
berbicara dan sensasi tentang dunia.
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3.2. Genetika penyakit cerebrovascular