Pengaruh Pemberian Suplementasi Nigella sativa terhadap Persentase Sel Treg, Kadar TNF-, dan Indeks Aktivitas Penyakit pada Pasien Lupus Eritematosus Sistemik.

Rachmaningrum, Rafika Rodhiah and Dr. dr. Wisnu Barlianto, Sp.A(K), M.Si.Med and dr. Anik Puryatni, Sp.A(K) and dr. Desy Wulandari, Sp.A(K), M.Biomed (2023) Pengaruh Pemberian Suplementasi Nigella sativa terhadap Persentase Sel Treg, Kadar TNF-, dan Indeks Aktivitas Penyakit pada Pasien Lupus Eritematosus Sistemik. Magister thesis, Universitas Brawijaya.

Abstract

Lupus eritematosus sistemik (LES) adalah penyakit autoimun sistemik kronis dengan tingkat keparahan dan perjalanan klinis yang bervariasi, ditandai dengan kecenderungan terjadinya flare. Kerusakan jaringan pada LES disebabkan oleh autoantibodi atau deposisi kompleks imun yang dapat terjadi pada ginjal, jantung,pembuluh darah, sistem saraf pusat, kulit, paru, otot dan sendi yang mana dapat menyebabkan peningkatan morbiditas dan mortalitas yang signifikan. LES lebih sering dialami wanita daripada pria, dimana rasio wanita terhadap pria adalah 9:1.2. LES juga dijumpai pada anak dengan onset penyakit yang muncul sebelum usia 18 dan mempengaruhi sekitar 15-20% pasien dengan insiden berkisar antara 0,36-2,5 kasus per 100.000 anak, dan prevalensi 1,89–34,1 kasus per 100.000 anak. Patogenesis LES ditandai dengan hilangnya toleransi terhadap asam nukleat itu sendiri, produksi autoantibodi, ekspresi dan sinyal interferon, dan defek pada kompartemen sel T regulator. Mekanisme patologis LES masih belum sepenuhnya dipahami, namun telah dilaporkan bahwa terjadi ketidakseimbangan antara T helper 17 (Th17) dan sel T regulator (Treg). Sel Th17 memiliki efek proinflamasi, dan berkorelasi positif dengan aktivitas penyakit LES, sedangkan Treg memiliki fungsi imunosupresif dan memainkan peran penting dalam induksi dan mempertahankan toleransi diri. Berkurangnya jumlah dan adanya disfungsi Treg berkaitan erat dengan perkembangan LES. Pasien LES mengalami peningkatan mortalitas dibanding populasi umum dengan standardized mortality ratio (SMR) sebesar 2,6 kali lipat, distandarisasi berdasarkan usia dan jenis kelamin. Presentasi klinis LES dapat dikelompokkan dalam tiga pola, yaitu flare atau krisis, penyakit kronis aktif, dan bentuk quiescent. Pola-pola ini bersifat heterogen, sehingga kontrol aktivitas dan identifikasi dini komplikasi dan morbiditas menjadi sulit. Pengembangan metode penilaian aktivitas penyakit telah digunakan untuk menetapkan perubahan status penyakit khususnya dalam uji klinis. SLE disease activity index (SLEDAI) merupakan metode skoring aktivitas penyakit yang paling sering digunakan dalam stratifikasi aktivitas penyakit LES, dimana skor SLEDAI yang tinggi dikaitkan dengan aktivitas penyakit berat dan tingkat mortalitas dan morbiditas tinggi. Jintan hitam, atau habbatussauda, atau Nigella sativa (NS) adalah tumbuhan dengan beberapa khasiat obat yang telah umumdigunakan dalam pengobatan masalah kesehatan yang berkaitan dengan sistem kardiovaskular, fungsi hati dan ginjal, saluran pencernaan, serta dukungan sistempernapasan dan sistem imun. Penelitian terkait potensi NS sebagai potensi tatalaksana sejumlah penyakit telah dipublikasikan, seperti penelitian Barlianto et al. yang menjelaskan bahwa NS dapat memperbaiki klinis asma anak, dan beberapa penelitan lain yang menjelaskan tentang NS memiliki sifat antikanker dengan efek apoptosis, efek anti-inflamasi dan aktivitas anti-virus. Pemberian minyak Nigella sativa

English Abstract

Systemic lupus erythematosus (SLE) is a chronic systemic autoimmune disease with variable severity and clinical course, characterized by a tendency to flare. Tissue damage in the SLE is caused by autoantibodies or immune complex deposition which can occur in the kidneys, heart, blood vessels, central nervous system, skin, lungs, muscles and joints which can cause a significant increase in morbidity and mortality. SLE is more common in women than men, where the ratio of women to men is 9:1.2. SLE is also found in children with disease onset appearing before the age of 18 and affects approximately 15-20% of patients with an incidence ranging from 0.36-2.5 cases per 100,000 children, and a prevalence of 1.89-34.1 cases per 100,000 children . The pathogenesis of SLE is characterized by loss of tolerance to the nucleic acids themselves, production of autoantibodies, interferon expression and signaling, and defects in the regulatory T cell compartment. The pathological mechanism of SLE is still not fully understood, but it has been reported that there is an imbalance between T helper 17 (Th17) and regulatory T cells (Treg). Th17 cells have proinflammatory effects, and are positively correlated with SLE disease activity, whereas Tregs have immunosuppressive functions and play an important role in the induction and maintenance of self-tolerance. The reduced number and presence of Treg dysfunction is closely related to the development of SLE. SLE patients experience increased mortality compared to the general population with a standardized mortality ratio (SMR) of 2.6 times, standardized by age and sex. The clinical presentation of SLE can be grouped into three patterns, namely flare or crisis, active chronic disease, and quiescent form. These patterns are heterogeneous, making activity control and early identification of complications and morbidity difficult. The development of disease activity assessment methods has been used to determine changes in disease status, especially in clinical trials. SLE disease activity index (SLEDAI) is the disease activity scoring method most often used in stratifying SLE disease activity, where a high SLEDAI score is associated with severe disease activity and high levels of mortality and morbidity. Black cumin, or black seed, or Nigella sativa (NS) is a plant with several medicinal properties that are common used in the treatment of health problems related to the cardiovascular system, liver and kidney function, digestive tract, as well as support of the respiratory system and immune system. Research related to the potential of NS as a potential treatment for a number of diseases has been published, such as research by Barlianto et al. which explains that NS can improve clinical asthma in children, and several other studies which explain that NS has anticancer properties with apoptotic effects, anti-inflammatory effects and anti-viral activity. Administration of Nigella sativa oil has been proven to reduce levels of TNF-α and IL-1β in mouse models of arthritis. The results of scientific studies also show the potential role of NS in the management of autoimmune diseases including rheumatoid arthritis (RA) and multiple sclerosis (MS).

Item Type:	Thesis (Magister)
Identification Number:	0423060120
Uncontrolled Keywords:	Persentase sel Treg, kadar TNF-, indeks aktivitas penyakit, Nigella sativa
Divisions:	Profesi Kedokteran > Spesialis Ilmu Kesehatan Anak, Fakultas Kedokteran
Depositing User:	Endang Susworini
Date Deposited:	14 Mar 2024 06:19
Last Modified:	14 Mar 2024 06:19
URI:	http://repository.ub.ac.id/id/eprint/216810

Text (DALAM MASA EMBARGO) Rafika Rodhiah Rachmaningrum.pdf Restricted to Registered users only Download (3MB)

Actions (login required)

View Item