Sitti Wahyuni sittiwahyuni@gmail.

com
Education
• 2008: Diploma of Trop.Epid., Gothenborg Public Health
Institute, Sweden
• 2006: Diploma of Virology, Pasteur Institute, Hongkong
• 2006: PhD , Leiden University Medical Center The
Netherlands “Helminth infections, allergy and immune
system: Studies in Indonesia”
Interest:
• 1993: MD Hasanuddin University Medical Faculty, • The cross-talk of foreign body to immune system
Indonesia
• Epidemiology of tropical diseases
Occupation
• Medical education development
• 2018-now: Chairman of Medical faculty Hasanuddin
University Quality Assurance
• 2014-2018: Head of Education and Training Unit, Research activities:
Hasanuddin University Hospital • Epidemiology and immunology of infectious diseases
• 2012-2014: Chairman of Hasanuddin University Medical • Microbiome in different social economic status
Research Center (HUM_RC)
• Helminth-co infection
• 2006-2011: NEHCRI head and clinical investigator on TB
and Dengue research
Publications
• 1996-now: Lecturer in Parasitology Depart. Faculty of
Medicine, Hasanuddin • https://scholar.google.co.id/citations?user=CCb6likAAAA
J&hl=en
• 1993-1996: Physician in primary health centre in Maros
district, South Sulawesi.
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 IMMUNE RESPONSES TO SARS-CoV2
Sitti Wahyuni, MD., PhD
Hasanuddin University Medical Research Center HUMRC

Presented in
MARINE WEBINAR
4/30/2020 SWahyuni MARINE Webinar2020
30 April 2020
2
 Clinical Spectrum of COVID-19

Confirmed Death CFR

World 30,523,700 216,563 0.7
Indonesia 9,771 784 8.0

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 COVID-19 Mortality by Age and Pre-Existing Condition

*Case Fatality Rate (%) = (number of deaths / number of COVID-19 cases) x 100 for each group
Source: Worldometers.info

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 Interaction between SARS-CoV2 and
The Renin–Angiotensin–Aldosterone System

Vaduganathan M, et al.
30 March 2020
N Engl J Med

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 Innate Immune Responses to SARS-CoV2 infections

Rokni M, et al., 20 April 2020 Medical Virology

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 SARS-COV2 and Complement

Risitano AM, et al., Nature Reviews Immunology 2020

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4/30/2020 SWahyuni MARINE Webinar2020 8
 T and B Cells activation

TH17 CEEL?

March 3, 2020 by Immunitrack

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 Cytokine pathogenesis of COVID-19

Schett G, et al., Nature Reviews Immunology 15 April 20

 TH17 and Cytokine Storm of COVID-19

CRS
TH-0

IL6-TGFβ IL21-TGFβ G-CSF

IL-17 (Granulopoiesis and
IL-1β, IL-6, TNFα Neutrophils recruitment)
TH17
TH17
(SIRS and fever)
IL-22 ?
Modified from Huang C, et al. Lancet 2020

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 SARS-CoV2 specific Antibody

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• PBMC 522 patients CoViD-19 and 40 control subjects
• Total number of T cells, the CD4+ and CD8+ T were lower in COVID-19 patients,
especially elderly patients (≥60 years of age) and in patients requiring Intensive Care
Unit (ICU) care.
• T cell numbers negatively correlated to serum IL-6, IL-10 and TNF-α concentration and
to patient survivals
• Compared to healthy controls, COVID-19 patients have significantly higher levels of
the PD-1.

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 Cytokine storm and T cell lymphopenia is associated
with COVID-19 severity

Pedersen SF and Ho YC, J Clin Invest. 13 April 2020

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 SARS-CoV2

ACE2
IMMUNE-
PATHOLOGY
PRE-EXISTING CONDITION

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 Immune Therapy?
PROBLEM EFFECT POSSIBILITY AGENT
Suppression of IRF3 Low production of IFN type-1 Interferon-α dan IFN-β
& IRF7
Complement Leucocyte recruitemen C3-Complement blocking
activation (Eculizumab)
Th17 activation Granulopoiesis and neutrophils JAK2 inhibitor (Fedratinib)
recruitments (via GCSF)
SIRS (via KC, MIP2A, IL-8, IP10,
MIP3A)
Leucocyt Cytokine storm Blocking pro-inflammatory agent,
recruitement and anti IL-6 (tocilizumab or sarilumab)
activation Corticosteroid
T exhausted (T-ex) Low number of CD8 Cytotoxic, Inhibitors for PD-1/PD-1L pathway
CD4Th1 (Atezolizumab)
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4/30/2020
Thank You
TERIMA KASIH
SWahyuni MARINE Webinar2020 17