Askariasis di Daerah Endemis Rendah Askariasis Tidak Meningkatkan Kejadian Tuberkulosis Aktif

Abstract

Askariasis di daerah endemis seperti Indonesia menyebabkan polarisasi respons Th2 yang dapat menekan respons Th1 yang penting dalam perlawanan terhadap tuberkulosis melalui penekanan ekspresi IL-12Rẞ2 oleh IL-4. Tujuan penelitian ini adalah mencari hubungan antara kejadian askariasis dan tuberkulosis aktif di daerah endemis rendah askariasis. Penelitian observasional analitik dilakukan pada 30 penderita dewasa tuberkulosis paru aktif baru dan 29 penderita tuberkulosis laten. Penelitian dilaksanakan di Kota Bandung selama periode April–Juni 2014. Pemeriksaan telur Ascaris lumbricoides dilakukan dengan teknik Kato-Katz smear dan pengukuran kadar reseptor terlarut IL-12Rẞ2 dalam plasma mengunakan metode enzyme linked immunosorbent assay (ELISA). Hasil penelitian menunjukkan proporsi askariasis pada penderita tuberkulosis aktif secara signifikan lebih rendah (5 dari 30 subjek) dari proporsi askariasis pada penderita tuberkulosis laten (13 dari 29 subjek) dengan p=0,019. Penghitungan jumlah telur menunjukkan semua subjek askariasis menderita askariasis intensitas ringan. Kadar reseptor terlarut IL-12Rẞ2 pada penderita tuberkulosis aktif dan laten dengan askariasis maupun tanpa askariasis tidak berbeda signifikan. Simpulan penelitian ini adalah askariasis intensitas ringan tidak menekan respons Th1 dan tidak meningkatkan kejadian tuberkulosis aktif di daerah endemis rendah askariasis.

ASCARIASIS IN LOW ENDEMIC AREA DOES NOT ASSOCIATE WITH THE INCREASE INCIDENCE OF ACTIVE TUBERCULOSIS

Polarization toward Th2 response in ascaris investation suppresses Th1 responses which is important in defence against tuberculosis. Such suppression is hipothesized to supress the expression of IL-12Rẞ2 by IL-4. The purpose of this study was to find out the relationship between ascaris investation and TB in low endemic area of ascariasis that is endemic for TB. We gathered samples from 30 adult active pulmonary TB patients and 29 adult latent TB patients as control. The study was performed in Bandung during April to June 2014. Ascaris investation was established with Kato-Katz smear technique and the detection of plasma level of the soluble receptor of IL-12Rẞ2 was conducted with enzyme linked immunosorbent assay (ELISA). We showed that the proportion of ascaris investation significantly higher in latent TB patients (13 from 29 subjects) compared to in active Tb patients (5 from 30 subjects) with p value 0.019. All subjects positive for ascaris investation had low intensity of investation in accordance with low endemicity. Also, the median level of IL-12Rẞ2 did not differ between active and latent TB patients with ascaris or without ascaris investation. We concluded that low intensity of ascaris investation does not associate with suppression of Th1 response, as assessed by IL-12Rẞ2 receptor level, hence does not associate with the increase incidence of active tuberculosis.