Kadar Interleukin (IL) 17 dan Tumor Necrosis Factor-α (TNF-α) Serum Pasien DA Fase Akut Dibanding dengan Fase Kronik

Abstract

Sitokin sel T helper (Th)2 lebih berperan dalam patogenesis dermatitis atopik (DA) fase akut, sedangkan sitokin sel Th1 pada fase kronik. Patogenesis DA dipengaruhi pula oleh interleukin (IL)-17 yang dihasilkan sel Th17, sel Th1, sel Th2, dan sel B. Ekspresi IL-17 meningkat pada lesi kulit DA fase akut dibanding dengan fase kronik. Tumor necrosis factor-α (TNF-α) merupakan sitokin proinflamasi yang dapat dihasilkan sel Th1 dan Th17. Tujuan penelitian ini adalah mengetahui kadar IL-17 dan TNF-α serum pasien DA fase akut dibanding dengan fase kronik. Penelitian dilaksanakan periode Januari–Februari 2013 di Poliklinik Alergi dan Imunologi Departemen Ilmu Kesehatan Kulit dan Kelamin RSUP Dr. Hasan Sadikin Bandung. Penelitian ini merupakan penelitian klinis secara potong lintang berdasar atas studi analitik observasional. Subjek penelitian berjumlah 31 pasien, terdiri atas 15 pasien DA fase akut dan 16 fase kronik yang didapatkan melalui consecutive sampling. Terhadap subjek penelitian dilakukan anamnesis, pemeriksaan fisis, dan diagnosis ditegakkan sesuai dengan kriteria Hanifin dan Rajka, kemudian dilakukan pengambilan serum untuk pemeriksaan IL-17 dan TNF-α. Hasil penelitian memperlihatkan kadar IL-17 dan TNF-α serum pasien DA fase akut secara berurutan adalah 16,50 pg/mL dan 7,70 pg/mL, sedangkan pada fase kronik secara berurutan adalah 14,84 pg/mL dan 7,69 pg/mL. Berdasar atas uji beda kadar IL-17 dan TNF-α pada fase akut dan fase kronik  (p >0,05). Simpulan, kadar IL-17 dan TNF-α serum pasien DA fase akut tidak berbeda dibanding dengan fase kronik.

COMPARISON OF INTERLEUKIN (IL) AND NECROSE TUMOR FACTOR LEVEL SERUM ON CHRONIC AND ACUTE PHASE OF DA PATIENTS

T helper (Th)2 cytokines have an essential role in the pathogenesis of acute-phase atopic dermatitis (AD). Meanwhile, Th1 cytokines in chronic phase. Pathogenesis of AD is also affected by interleukin (IL)-17 produced by Th17, Th1, Th2, and B cells. The expression of IL-17 increased in the acute phase compared to chronic phase of skin lesion of AD. Tumor necrosis factor-α (TNF-α) is a proinflammatory cytokines that can be produced by Th1 and Th17 cells. This study aims to evaluate the IL-17 and TNF-α in serum level from acute compared to chronic phase of AD patients. This study was conducted from January-February 2013 in the Allergy and Immunology Clinic, Department of Dermatovenereology, Hasan Sadikin General Hospital Bandung. This was a clinical study with observational analytical and cross-sectional design. Subjects were 31 AD patients, consisted of 15 acute and 16 chronic phases of AD patients, and obtained through consecutive sampling. The subjects underwent history taking, physical examination, and were diagnosed based on Hanifin and Rajka criteria. The serum was taken to measure IL-17 and TNF-α levels. This study showed that the IL-17 and TNF-α serum level in the acute phase of AD were 16.50 pg/mL and 7.70 pg/mL, respectively, meanwhile in chronic phase of AD were 14.84 pg/mL and 7.69 pg/mL, respectively. The analysis of IL-17 and TNF-α serum level in acute and chronic phase of AD do not differ statistically (p >0.05). In conclusion, there is no difference of IL-17 and TNF-α serum level in the acute compared to chronic phase AD patients.