{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,26]],"date-time":"2026-08-26T17:04:17Z","timestamp":1787763857088,"version":"build-2784847793"},"reference-count":0,"publisher":"Narra Sains Indonesia","issue":"1","license":[{"start":{"date-parts":[[2025,3,24]],"date-time":"2025-03-24T00:00:00Z","timestamp":1742774400000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Narra J"],"abstract":"<jats:p>Cardiopulmonary bypass in tetralogy of Fallot (TOF) corrective surgery induces hyperinflammation by activating NLRP3, caspase-1, and interleukin-1\u03b2 (IL-1\u03b2), subsequently triggering an interleukin-10 (IL-10) response. Despite its known metabolic and anti-inflammatory effects, the impact of the modified Atkins diet (MAD) in pediatric cardiac surgery remains unexplored, with no studies on its use in TOF patients undergoing open-heart surgery. The aim of this study was to assess the effect of MAD on the expression of NLRP3, caspase-1, IL-1\u03b2, and IL-10, in TOF patients undergoing open-heart surgery. A double-arm, randomized-controlled trial was conducted with 44 TOF patients. The treatment group (n=22) received the MAD, a low-carbohydrate, high-fat regimen with unrestricted fat and protein intake for at least 14 days preoperatively, while the control group (n=22) followed a standard diet without carbohydrate restriction. Blood plasma and infundibulum heart tissues were collected for analysis. Whole blood samples were collected using a winged infusion needle before the intervention, an Abbocath infusion needle after 14 days of intervention, and a syringe without a needle connected to an arterial line in patients undergoing open-heart surgery at 6, 24, and 48 hours post-surgical correction. Infundibulum heart tissues were collected during the open-heart surgery. This study demonstrated significant differences in NLRP3 protein expression (p=0.015), caspase-1 protein expression (p=0.001), and IL-10 levels between before intervention and 6-, 24-, and 48-hours post-surgery in the MAD group compared to the control group. In contrast, no significant differences in IL-10 levels were observed in the control group between before intervention and 48 hours post-surgery (p=0.654). In conclusion, MAD may modulate perioperative inflammation in TOF patients undergoing open-heart surgery by downregulating NLRP3 and caspase-1 expression while sustaining IL-10 levels. Despite reduced NLRP3 and caspase-1 expression, unchanged IL-1\u03b2 levels indicate alternative regulatory mechanisms.<\/jats:p>","DOI":"10.52225\/narra.v5i1.2138","type":"journal-article","created":{"date-parts":[[2025,3,24]],"date-time":"2025-03-24T02:53:03Z","timestamp":1742784783000},"page":"e2138","source":"Crossref","is-referenced-by-count":1,"title":["Effect of the modified Atkins diet on NLRP3, caspase-1, IL-1\u03b2, and IL-10 in patients with tetralogy of Fallot undergoing open-heart surgery: A randomized controlled trial"],"prefix":"10.52225","volume":"5","author":[{"ORCID":"https:\/\/orcid.org\/0009-0009-3387-3346","authenticated-orcid":false,"given":"Piprim B.","family":"Yanuarso","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mulyadi M.","family":"Djer","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aryono","family":"Hendarto","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5675-195X","authenticated-orcid":false,"given":"Antonius H.","family":"Pudjiadi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5307-3671","authenticated-orcid":false,"given":"Lisnawati","family":"Rachmadi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7708-5135","authenticated-orcid":false,"given":"Heri","family":"Wibowo","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9331-3174","authenticated-orcid":false,"given":"Najib","family":"Advani","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9174-8425","authenticated-orcid":false,"given":"Indah K.","family":"Murni","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7811-097X","authenticated-orcid":false,"given":"Aria","family":"Kekalih","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5405-8599","authenticated-orcid":false,"given":"Rubiana","family":"Sukardi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1915-1349","authenticated-orcid":false,"given":"Ismail","family":"Dilawar","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0005-4977-4335","authenticated-orcid":false,"given":"Dhama S.","family":"Susanti","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0002-6598-3901","authenticated-orcid":false,"given":"Novianti","family":"Supriatna","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"29794","published-online":{"date-parts":[[2025,3,24]]},"container-title":["Narra J"],"original-title":[],"link":[{"URL":"https:\/\/narraj.org\/main\/article\/download\/2138\/816","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/narraj.org\/main\/article\/download\/2138\/816","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,3,24]],"date-time":"2025-03-24T02:53:04Z","timestamp":1742784784000},"score":1,"resource":{"primary":{"URL":"https:\/\/narraj.org\/main\/article\/view\/2138"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,3,24]]},"references-count":0,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2025,1,1]]}},"URL":"https:\/\/doi.org\/10.52225\/narra.v5i1.2138","relation":{},"ISSN":["2807-2618"],"issn-type":[{"value":"2807-2618","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,3,24]]}}}