Pratama, Mirza Zaka and Prof. Dr. dr. Handono Kalim, SpPD-KR and Dr. dr. Cesarius Singgih Wahono, SpPD-KR (2021) Hubungan Persentase dan Fungsi Sel T CD4+CD57+ dan CD8+CD57+ dengan Anemia pada Pasien Lupus Eritematosus Sistemik. Magister thesis, Universitas Brawijaya.
Abstract
Pendahuluan: Kemunculan sel T senesens pada pasien lupus eritematosus sistemik (LES) merupakan salah satu mekanisme yang diduga memperberat kondisi anemia. Penelitian ini bertujuan untuk mengamati hubungan jumlah dan fungsi sel T senesens, meliputi sel T CD4+CD57+ dan CD8+CD57+ terhadap kejadian dan keparahan anemia pada LES serta mengamati hubungannya terhadap marker keradangan dan status besi. Metode: Penelitian ini adalah penelitian potong lintang dengan subjek 60 wanita LES berusia 16-45 tahun. Subjek dicatat data demografik dan klinis, dilakukan pemeriksaan darah lengkap, status besi (serum besi, total iron-binding capacity, saturasi transferrin), ferritin, marker keradangan (laju endap darah [LED], C-reactive protein [CRP]), dan anti-dsDNA. Persentase sel T senesens diukur dari peripheral blood mononuclear cells (PBMC) dengan flowsitometri yang diukur sebagai sel T CD4+CD57+ dan CD8+CD57+. Serum IFNγ yang merupakan sitokin yang diproduksi sel T senesens diukur dengan menggunakan ELISA. Hasil: Pasien LES dengan anemia memiliki persentase yang lebih tinggi untuk CD4+CD57+ (8.2 [4.3 – 12.8]% vs 2.8 [0.9 – 6.6]%, p=0.000), CD8+CD57+ (4.6 [1.8 – 10.6]% vs 1.0 [0.3 – 1.7]%, p=0.000), dan IFNγ (199.5 [170.7 – 234.4] pg/ml vs 15.4 [8.5 – 42.0] pg/ml, p=0.000). Persentase sel CD8+CD57+ berkorelasi dengan anti-dsDNA (r=0.345, p=0.003), ESR (r=0.273, p=0.017), CRP (r=0.267, p=0.020), ferritin (r=0.426, p=0.000), serum besi (r=-0.299, p=0.027), dan saturasi transferrin (r=-0.273, p=0.040). IFNγ berkorelasi dengan anti-dsDNA (r=0.296, p=0.011), serum besi (r=-0.613, p=0.000), dan ferritin (r=-0.397, p=0.002). Tidak didapatkan korelasi antara status besi dan marker keradangan dengan persentase sel T CD4+CD57+. Kesimpulan: Sel T senesens berhubungan dengan kejadian dan keparahan anemia dengan memodulasi respon inflamasi dan mengakibatkan disregulasi besi pada LES.
English Abstract
Introduction: The presence of T cell senescence in systemic lupus erythematosus (SLE) is one of the causes that contribute to the severity of anemia. This study aimed to observe the correlation between the number and functions of T cells senescence, including CD4+CD57+ and CD8+CD57+ T cells with the presence and severity of anemia, inflammatory markers, and iron status in SLE. Methods: This was a cross-sectional study with the subject was sixty SLE women aged 16-45 years-old. Subjects were recorded for demographic, clinical data, complete blood counts, iron status (iron serum, total iron-binding capacity, transferrin saturation), ferritin, inflammatory markers (erythrocyte sedimentation rate [ESR], and C-reactive protein [CRP]), and anti-dsDNA. T cell senescence was measured from the peripheral blood mononuclear cell (PBMC) by flowcytometry which counted as CD4+CD57+ and CD8+CD57+ T cells. Serum IFNγ was measured by ELISA. Results: Anemic SLE patients had higher CD4+CD57+ (8.2 [4.3 – 12.8]% vs 2.8 [0.9 – 6.6]%, p=0.000), CD8+CD57+ percentages (4.6 [1.8 – 10.6]% vs 1.0 [0.3 – 1.7]%, p=0.000), and IFNγ (199.5 [170.7 – 234.4] pg/ml vs 15.4 [8.5 – 42.0] pg/ml, p=0.000). CD8+CD57+ percentages was correlated with anti-dsDNA (r=0.345, p=0.003), ESR (r=0.273, p=0.017), CRP (r=0.267, p=0.020), ferritin (r=0.426, p=0.000), iron serum (r=-0.299, p=0.027), and transferrin saturation (r=-0.273, p=0.040). IFNγ also correlated with anti-dsDNA (r=0.296, p=0.011), iron serum (r=-0.613, p=0.000), and ferritin (r=-0.397, p=0.002). No correlation was found between iron status and inflammatory markers with CD4+CD57+ percentages. Conclusion: T cell senescence is correlated with the presence and severity of anemia by modulating the inflammatory response and iron dysregulation in SLE.
| Item Type: | Thesis (Magister) |
|---|---|
| Identification Number: | 0421060014 |
| Uncontrolled Keywords: | Lupus eritematosus sistemik, anemia, imunosenesens, sel T senesens, Systemic Lupus Erythematosus, Anemia, Immunosenescence, T cell Senescence |
| Subjects: | 600 Technology (Applied sciences) > 616 Diseases |
| Divisions: | Profesi Kedokteran > Spesialis Ilmu Penyakit Dalam, Fakultas Kedokteran |
| Depositing User: | Budi Wahyono Wahyono |
| Date Deposited: | 22 Dec 2021 07:38 |
| Last Modified: | 23 Feb 2022 07:17 |
| URI: | http://repository.ub.ac.id/id/eprint/187604 |
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