KM ARSYAD ED 2011*Sindroma Disrupsi Endokrin (Endocrine Disrupters)Kiagus Muhammad ArsyadBagian Biologi Kedokteran dan AndrologiFakultas Kedokteran Universitas Sriwijaya U

KM ARSYAD ED 2011

KM ARSYAD ED 2011*SASARAN PEMBELAJARAN Agar mahasiswa :Mengetahui faktor faktor yang mungkin dapat mengganggu fungsi endokrin,Memahami sindroma yang disebabkan oleh endocrine disrupters.Memahami faktor faktor etiologI yang menyebabkan gangguan kesehatan manusia

KM ARSYAD ED 2011

KM ARSYAD ED 2011*MATERI PEMELAJARANPendahuluanDefinisi Endocrine DisruptersMekanisme disrupsi endokrinSumber potensial paparan EDCDaftar bahan Endocrine DisruptorsDampak EDC terhadap kesehatan manusia

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KM ARSYAD ED 2011*Endogenic FactorsThe factors influencing healthy life (Boedhi-Darmojo,1994)PENDAHULUAN

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KM ARSYAD ED 2011*PENDAHULUANSistem endokrine mengontrol maturasi,perkembangan, pertumbuhan, dan pengaturan fungsi tubuh. Terdiri dari Kelenjar dan hormon, Kelenjar endocrine mensekresikan hormon dengan jumlah yang tepat ke dalam aliran darah.Hormon ini berjalan ke seluruh bagian tubuh dan terikat kepada reseptor khusus yang mengontrol dan mensesuaikan berbagai fungsi tubuh untuk kehidupan.

KM ARSYAD ED 2011

KM ARSYAD ED 2011*PENDAHULUANPencemaran udara, air, makananLimbah Industri, Transportasi, kerusakan ekosistem, dan teknologiLogam Berat = Pb, Hg, Cd Radikal Bebas,Pestisida, insektisidaEndocrine Disruptor

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KM ARSYAD ED 2011*2. Definisi Endocrine DisruptorsSejumlah bahan kimiawi alam atau buatan manusia , yang dapat mengganggu kelenjar endokrin dan hormon yang disekresikannya atau kerjanya pada jaringan target.Bahan kimiawi ini disebut endocrine disruptors atau endocrine disrupting chemicals (EDCs).

KM ARSYAD ED 2011

KM ARSYAD ED 2011* 3. Mekanisme disrupsiBahan kimiawi bekerja pada sistem endokrin dengan mekanisme :

Efek agonistikEfek antagonistikTerikat dengan protein pembawaMungkin mengganggu proses metabolisme

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KM ARSYAD ED 2011*Mekanisme disrupsiEfek Agonistik :. Menggangu aktivitas biologik hormon dengan cara terikat pada reseptor sel.Menyebabkan respon yang tidak dikehendaki dengan cara menimbulkan respon normal sel pada waktu yang salah atau jumlah yang berlebihan

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KM ARSYAD ED 2011*Efek Agonistik

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KM ARSYAD ED 2011*Mekanisme disrupsiEfek Antagonistik :.

Terikat pada reseptor tapi tidak mengaktikannya. Atau adanya bahan kimiawi pada reseptor akan mencegah terikatnya hormon aslinya.

KM ARSYAD ED 2011

KM ARSYAD ED 2011* Efek Antagonistik

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KM ARSYAD ED 2011*Mekanisme disrupsiTerikat dengan protein pembawaTerikat pada protein pengangkut di dalam darah, yang merubah jumlah hormon aslinya di dalam sirkulasi darah.

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KM ARSYAD ED 2011* Terikat dengan protein pembawa

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KM ARSYAD ED 2011*Mekanisme disrupsiMengganggu proses metabolismeMengganggu proses metabolisme hormon aslinya didalam tubuh yang berdampak pada kecepatan sintesa dan pemecahan hormon aslinya.

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KM ARSYAD ED 2011* Mengganggu proses metabolismeProses Metabolisme

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KM ARSYAD ED 2011*3.5. BioakumulasiKonsentrasi EDC meningkat berkali kali melalui proses bioakumulasi rantai makananPhytoplankton must collect its food from a large amount of water because its required nutrients are in very low concentrations in the water. EDs accompany the nutrients in the form of synthetic man-made chemicals. At this stage, their concentrations are extremely difficult to measure. The chemicals accumulate in the phytoplankton and reach levels that are much higher than the surrounding water. Small fish and zooplankton eat the phytoplankton, further concentrating the levels of EDs, which are in turn eaten by other animals.

KM ARSYAD ED 2011

KM ARSYAD ED 2011*3.5. BioakumulasiThis process of increasing bioaccumulation is repeated until the concentrations of EDs in the top predators reach levels high enough to cause physical deformities, reductions in fertility, and death. The accumulations in the lipid tissues of these animals at the top of the food chain can be millions of times higher than the concentration of the water it first came to rest in.

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KM ARSYAD ED 2011*3.5. BioakumulasiBeing at the top of the food chain, humans have some of the highest EDs concentrations.

The human fetus and infant are at an even higher level. EDs can cross the placenta into the fetus. They are also fed to the suckling infant via the mothers breast milk. It should be noted that recent studies have indicated breast-feeding to be the preferred method, as opposed to formulas.Reduced risk of childhood acute leukemia has been associated with breastfeeding.

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KM ARSYAD ED 2011*An ecological pyramid Food Chain

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4. Apa Sumber utama pemapar ED?

Most of the information on exposure to endocrine disrupting chemicals (EDCs) has focused on the presence of so-called persistent organic pollutants in lakes, rivers and seas. Exposure of humans can occur via contaminated food or water, combustion sources from industrial processes and burning of waste and chemicals used in consumer products. Humans are also exposed to natural oestrogens from plants that are found in foods like soya.

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KM ARSYAD ED 2011*4.1. Bahan kimiawi ED beraktivitas hormonal Natural hormones from any animal, released into the environment, and chemicals produced by one species that exert hormonal actions on other animals, e.g. human hormones unintentionally reactivated during the processing of human waste in sewage effluent, may result in changes to fish

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KM ARSYAD ED 2011*4.1. Bahan kimiawi ED beraktivitas hormonal : Natural chemicals including toxins produced by components of plants (the so-called phytoestrogens, such as genistein or coumestrol) and certain fungi Synthetically produced pharmaceuticals that are intended to be highly hormonally active, e.g. the contraceptive pill and treatments for hormone-responsive cancers may also be detected in sewage effluent

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KM ARSYAD ED 2011*4.1. Bahan kimiawi ED beraktivitas hormonal :Man-made chemicals and by-products released into the environment. Laboratory experiments have suggested that some man-made chemicals might be able to cause endocrine changes. These include some pesticides (e.g. DDT and other chlorinated compounds), chemicals in some consumer and medical products (e.g. some plastic additives), and a number of industrial chemicals (e.g. polychlorinated biphenols (PCBs), dioxins). The hormonal activity of these chemicals, is many times weaker than the body's own naturally present hormones, e.g. nonyl phenol (a breakdown product of alkylphenol ethoxylate surfactants), found as a low level contaminant in some rivers in Europe, has an oestrogenic activity only about one-ten thousandth that of the natural hormone, oestrogen.

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KM ARSYAD ED 2011*4.2. Daftar Endocrine DisruptorsPersistent Organohalogens: Dioxins and furans, PBBs, PCBs, Hexachlorobenzene, Octachlorostyrene, PentachlorophenolPesticides: DBCP, DDT, DDT metabolites, dicofol, dieldrin, endosulfan, esfenvalerate, ethylparathion, fenvalerate, glyphosate (the active ingredient in Roundup), h-epoxide, heptachlor, iprodione, kelthane, kepone, ketoconazole, lindane, linurone, malathion, mancozeb, maneb, methomyl, methoxychlor, metiram, metribuzin, mirex, nitrofen, oxychlordane, permethrin, procymidone, sumithrin, synthetic pyrethroids, toxaphene, trans-nonachlor, tributyltin oxide, trifluralin, vinclozolin, zineb, ziram

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KM ARSYAD ED 2011*4.2.Daftar Endocrine DisruptorsPhthalates: Di-ethylhexyl phthalate (DEHP), Butyl benzyl phthalate (BBP), Di-n-butyl phthalate (DBP), Di-n-pentyl phthalate (DPP), Di-hexyl phthalate (DHP), Di-propyl phthalate (DprP), Dicyclohexyl phthalate (DCHP), Diethyl phthalate (DEP),Metals: Arsenic, Cadmium, Depleted Uranium (Uranium)*, Lead, Mercury

KM ARSYAD ED 2011

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5. Do EDCs affect human health?

At the moment there is no firm evidence that environmental endocrine disrupting chemicals (EDCs) cause health problems at low levels of exposure.

However, the fact that high levels of chemicals can impair human health through interferences with the endocrine system, raises concerns about the possible harmful effects of mixtures of so called endocrine disrupting chemicals, even at low background-levels.

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KM ARSYAD ED 2011*5. Dampak EDC pada kesehatanEDC pada manusia dapat menyebabkan:Penurunan fertilitas pria, Abnormalitas pada organ reproduksi pria, Penyakit organ reproduksi wanita, Pubertas dini, dan Penurunan jumlah kelahiran bayi laki2.

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KM ARSYAD ED 2011*5. Dampak ED pada kesehatan

birth defects; alterations in sexual and functional developmentneurologic disorders,diabetes mellitus, immunologic disorders,early puberty in young girls,

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KM ARSYAD ED 2011*5. Dampak ED pada kesehatancancers: breast, colon, vaginal, endometriosis, cervix, testicular, sexual differentiation of the brain and other estrogen target tissues, structural abnormalities of the oviduct, uterus, cervix and vagina, a contributing factor to subfertility, non-Hodgkin's lymphoma, reduced physical stamina,

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KM ARSYAD ED 2011*5. Dampak ED pada kesehatan

genital birth defects: hypospadias & cryptorchidism,] altered anogenital distance in male,[33] reduced sperm counts, and enlargement/reduction of prostate,developmental, behavioral and mental disorders,anger, inattention, decreased mental capacity, learning disabilities,[37] dyslexia, attention deficit/hyperactivity disorder (ADHD),[38] autism, propensity to violence,[39] reduced motor skills, and gross and fine eye-hand coordination.

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KM ARSYAD ED 2011*5. Dampak ED pada kesehatan

20. The incidence of all cancers among infants less than one year old, both sexes, age adjusted, has risen 36% when comparing the years 1976-1984 to 1986-1994. The incidence for germ cell cancers in that same group has increased 124%. The increases were lower for older children, but still, they were increases.

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6. Yang harus dilakukan untuk mengurangi terpapar ED

Educate yourself about endocrine disruptors, and educate your family and friends. Buy organic food whenever possible. Avoid using pesticides in your home or yard, or on your pet -- use baits or traps instead, keepin your home especially clean to prevent ant or roach infestations. Find out if pesticides are used in your child's school or day care center and campaign for non-toxic alternatives. Avoid fatty foods such as cheese and meat whenever possible.

KM ARSYAD ED 2011

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6. Yang harus dilakukan untuk mengurangi terpapar ED

If you eat fish from lakes, rivers, or bays, check with your state to see if they are contaminated. Avoid heating food in plastic containers, or storing fatty foods in plastic containers or plastic wrap. Do not give young children soft plastic teethers or toys, since these leach potential endocrine disrupting chemicals. Support efforts to get strong government regulation of and increased research on endocrine disrupting chemicals

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KM ARSYAD ED 2011*Efek Agonistik,

Efek Antagonistik,

Terikat dengan protein pembawa

Mempengaruhi proses metabolisme.

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KM ARSYAD ED 2011*HYPOGONADISMDefinisi Hypogonadism adalah kondisi dimana produksi hormon seks pria dan sperma tidak mencukupi batas normal

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KM ARSYAD ED 2011*3. Macam HypogonadismMacam HypgonadismPrimary HypogonadismSecondary HypogonadismBentuk Campuran

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KM ARSYAD ED 2011*3.1. Primary HypogonadismPasien menderita primary hypogonadism jika :Konsentrasi serum testosterone dan jumlah sperma dibawah batas normal dan konsentrasi serum LH and FSH diatas normal.

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KM ARSYAD ED 2011*3.1. Penyebab Primary HypogonadismAnorchiaMaldescended testesSertoli cell-only syndromeKlinefelter syndromeXX male syndromeXYY syndromeNoonan syndrome

Gonadal dysgenesisMale pseudohermaphroditismTrue hermaphroditismGonadotropin receptor mutationsTesticular tumorsLeydig cell hypoplasiaOrchitis

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KM ARSYAD ED 2011*3.2. Secondary HypogonadismPasien menderita secondary hypogonadism jika :Konsentrasi serum testosterone dan the jumlah sperma subnormal, dan Konsentrasi serum LH dan FSH normal atau menurun.

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KM ARSYAD ED 2011*3.2. Penyebab Secondary HypgonadismIdiopathic hypogonadotropichypogonadismKallman syndromePrader-Labhart-Willi syndromeCerebellar ataxia withhypogonadotropic hypogonadismCongenital adrenal hypoplasia with hypogonadotropic hypogonadismConstitutional delay of pubertyBrain tumors causing secondary GnRH deficiency or hypopituitarismInactivating GnRH receptor mutationsIsolated LH or FSH deficiencyHyperprolactinemia

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KM ARSYAD ED 2011*3.3. Bentuk CampuranPenyebab :Terpapar bahan beracun tempat kerja atau dari lingkunganPenyakit khronis yang sistemikPenyakit non-gonad yang akut dan beratPemakaian obat obatan opiates, ketoconazole, barbiturates, phenytoin, anabolic steroids, corticosteroids, spironolactone, cimetidine and digoxin Proses menua

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KM ARSYAD ED 2011*TUGAS TULIS :Efek Biologik TestosteroneDampak Penurunan Testosterone terhadap kesehatan Pria,Hubungan Testosterone dengan Penyakit Gangguan MetabolismDampak Testosterone terhadap perkembangan organ genitalia priaPeran Testostreone pada proses spermatogenesis

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