Retnoningrum, Ambar Dwi (2017) Pengaruh Glucomannan Hydrolysates (Gmh) Dan Bv Gel Terhadap Skor Nugent, Presentasi Sel Treg Dan Kadar Tgf-Β Pada Bakterial Vaginosis Wanita Usia Subur. Magister thesis, Universitas Brawijaya.
Abstract
Bakterial vaginosis (BV) merupakan infeksi polimikrobial, ditandai oleh berkurangnya hidrogen peroksida yang diproduksi oleh Lactobacilli dan pertumbuhan berlebihan dari organisme anaerob. Bakterial vaginosis secara umum dialami oleh wanita usia reproduktif. Alternatif terapi BV dengan menggunakan prebiotik Glucomannan Hydrolysates (GMH). GMH dapat meningkatkan pertumbuhan bakteri asam laktat, merangsang sistem kekebalan tubuh in vitro dan in vivo, serta mempunyai efek immunomodulator dalam imunitas humoral, seluler dan mukosa. Skor Nugent mempunyai nilai objektivitas, sensitivitas, dan spesifitas yang baik, sehingga merupakan gold standard dalam mendiagnosis bakterial vaginosis. Sel Treg berperan penting untuk pemeliharaan dan keseimbangan imunitas perifer dan jaringan mukosa. TGF-β merupakan sitokin pleiotropik yang penting bersama dengan IL-10 melawan efek dari sitokin proinflamasi dengan menghambat proliferasi sel T dan mengaktivasi makrofag. Penelitian ini untuk membuktikan pengaruh GMH dan BV Gel terhadap skor Nugent, presentasi sel Treg, dan kadar TGF β pada bakterial vaginosis wanita usia subur Jenis metode penelitian menggunakan true experiment pretest posttest group design. Sampel penelitian wanita usia subur yang didiagnosis bakterial vaginosis (skor nugent ≥ 7) sebanyak 24 responden dibagi : kelompok antibiotik oral metronidazol (500mg), kombinasi GMH (300mg) dan metronidazol, BV Gel tube 5 mL, kombinasi GMH dan BV Gel Pengukuran skor Nugent, presentasi sel Treg, dan kadar TGF β pada hari-0, hari ke 11 dan hari ke-22. Pengukuran skor Nugent dilakukan setelah pewarnaan gram staining dengan pengamatan pada mikroskop per lapang pandang gambaran bakteri (penghitungan jumlah skor sesuai dengan tabel Nugent. Pengukuran presentasi sel Treg dengan menggunakan flow citometry. Sel Treg menggunakan antibodi FITC Anti-Human CD4 antibody, PE/Cy5 anti-human CD25 Antibody dan PE anti-human FOXP3 Antibody (BioLegend). Pengukuran kadar TGF β menggunakan teknik ELISA (BioLegend). Dalam penelitian ini ditemukan adanya skor Nugent tertinggi pada H0 yaitu sebelum diberi perlakuan pada semua kelompok. Pada kelompok antibiotik didapatkan hasil skor Nugent mengalami penurunan tetapi tidak ada perbedaan yang bermakna pada H0 dan H11, namun pada H11 dan H22 ada perbedaan yang bermakna. Pada kelompok pemberian BV Gel pengamatan skor Nugent ada perbedaan yang bermakna pada H0 dan H11, tetapi pada H11 dan H22 tidak ada perbedaan yang bermakna. Sedangkan kelompok GMH+antibiotik dan kombinasi GMH+BV Gel didapatkan pada H0, H11 dan H22 terdapat perbedaan yang bermakna yang berarti hasil skor Nugent mengalami penurunan yang signifikan. Hasil penelitian didapatkan presentasi sel Treg paling rendah pada pengamatan hari ke-0 sebelum perlakuan, kemudian rerata jumlah sel Treg meningkat pada pengamatan hari ke-11 dan meningkat lagi pada pengamatan hari ke-22. Penilaian presentasi sel Treg pada kelompok antibiotik dan BV Gel perbandingan H0 dan H11 didapatkan hasil presentasi sel Treg mengalami peningkatan tetapi tidak ada perbedaan yang bermakna, sedangkan pada H11 dan H22 ada perbedaan yang bermakna. Pada kelompok kombinasi GMH+antibiotik dan GMH+BV Gel didapatkan hasil viii presentasi sel Treg mengalami peningkatan dan ada perbedaan yang signifikan pada H0, H11 dan H22. Tampak histogram tertinggi pada kelompok pengamatan hari ke-22. Sedangkan kadar TGF β paling rendah pada pengamatan hari ke-0 sebelum perlakuan, kemudian rerata kadar TGF-β meningkat pada pengamatan hari ke-11 dan meningkat lagi pada pengamatan hari ke-22. Tampak histogram tertinggi pada kelompok pengamatan hari ke-22 Penilaian kadar TGF-β pada kelompok antibiotik, kelompok GMH+Ab, dan kelompok BV Gel, perbandingan H0 dan H11 didapatkan hasil presentasi sel Treg mengalami peningkatan tetapi tidak ada perbedaan yang bermakna, tetapi pada H22 terdapat perbedaan yang bermakna. Pada kelompok kombinasi GMH+BV Gel didapatkan kadar TGF-β mengalami peningkatan dan ada perbedaan yang signifikan pada H0, H11 dan H22. Hasil analisis pada semua kelompok setelah pengobatan pada hari ke 22 menunjukkan Glucomannan Hydrolysates dan BV Gel mampu menurunkan skor Nugent, meningkatkan presentasi sel Treg dan kadar TGF β pada bakterial vaginosis wanita usia subur. Pemberian Glucomannan Hydrolysates (GMH) dan BV Gel berpengaruh terhadap Skor Nugent, Presentasi sel Treg dan kadar TGF-β pada bakterial vaginosis wanita usia subur. Glucomannan Hydrolysates sebagai alternatif terapi pada bakterial vaginosis dibandingkan dengan pengobatan antibiotik dan dapat meningkatkan flora normal vagina dan merangsang sistem kekebalan tubuh in vitro dan in vivo secara signifikan.
English Abstract
Bacterial vaginosis (BV) is a polymicrobial infection, characterized by reduced hydrogen peroxide produced by lactobacilli and the overgrowth of anaerobic organisms. Bacterial vaginosis is commonly experienced by women of reproductive age. Alternative BV therapy using Glucomannan Hydrolysates (GMH) prebiotics. GMH can promote the growth of lactic acid bacteria, stimulate the immune system in vitro and in vivo, and have immunomodulatory effects in humoral, cellular and mucosal immunity. Nugent score has good objectivity, sensitivity, and specificity, so it is a gold standard in diagnosing bacterial vaginosis. Treg cells play an important role for the maintenance and balance of peripheral immunity and mucosal tissue. TGF-β is an important pleiotropic cytokine along with IL-10 against the effects of proinflammatory cytokines by inhibiting T cell proliferation and activating macrophages. This study to prove the effect of GMH and BV Gel on Nugent score, Treg cell presentation, and TGF β levels in bacterial vaginosis of women of childbearing age Design of research method using true experiment pretest posttest group design. Research sample of women of childbearing age diagnosed with bacterial vaginosis (nugent score ≥ 7) was 24 divided: oral antibiotic group metronidazole (500mg), combination of GMH (300mg) and metronidazole, 5 mL Gel tube, combination of GMH and BV Gel Measurement of Nugent score , Treg cell presentation, and TGF levels β on day 0, day 11 and day 22. Nugent score measurements were performed after staining of gram staining by observation on a microscope per field of view of bacteria (counting the number of scores according to Nugent table) Treg cell presentation measurements using flowcitometry Treg cells using FITC Anti-Human CD4 antibody antibody, PE / Cy5 anti- human CD25 Antibody and PE anti-human FOXP3 Antibody (BioLegend) Measurement of TGF β level using ELISA technique (BioLegend). The results of In this study found the highest Nugent score on H0 before being treated in all groups. In the antibiotic group the Nugent score was decreased but there was no significant difference in H0 and H11, but in H11 and H22 there was a significant difference. In the BV gel group, Nugent score scoring was no significant difference in H0 and H11, but in H11 and H22 there was no significant difference. While the GMH + antibiotic group and the combination of GMH + BV Gel were found in H0, H11 and H22 there was a significant difference which means that the score of Nugent had significant decrease. The results showed the lowest Treg cell presentation on observation day 0 before treatment, then the average Treg cell count increased on observation day 11 and increased again on observation day-22. Assessment of Treg cell presentations in the antibiotic group and BV Gel comparison of H0 and H11 showed that Treg cell presentation was increased but no difference was significant, whereas in H11 and H22 there was a significant difference. In the combination group of GMH + antibiotics and GMH + BV Gel the results of Treg cell presentation were increased and there were significant differences in H0, H11 and H22. The highest histogram appeared in the 22nd day observation group. While TGF levels of β were lowest on observation day 0 before treatment, then mean TGF-β levels increased on observation day 11 and increased again on observation day-22. The highest histogram was observed on the 22nd day observational group. Assessment of TGF-β levels in the antibiotic group, GMH + Ab group, and BV Gel group, the comparison of H0 and H11 showed that the Treg cell presentation increased but no significant difference, but on H22 there is a significant difference. In the combination group of GMH + BV Gel, TGF-β levels were elevated and x there were significant differences in H0, H11 and H22. Results of analysis in all groups after treatment on day 22 showed Glucomannan Hydrolysates and BV Gel able to decrease Nugent score, increase Treg cell presentation and TGF β levels in bacterial vaginosis of women of childbearing age. Giving Glucomannan Hydrolysates (GMH) and BV Gel effect on Nugent Score, Treg cells presentations and TGF-β levels in Bacterial Vaginosis of women of childbearing age. Glucomannan Hydrolisated as an alternative therapy in bacterial vaginosis compared with antibiotic treatment and can increase normal vaginal flora and stimulate the immune system in vitro and in vivo significantly.
| Item Type: | Thesis (Magister) |
|---|---|
| Identification Number: | TES/615.324 64/RET/p/2017/041708503 |
| Uncontrolled Keywords: | POLYSACCHARIDES, VAGINA - DISEASES, TRANSFORMING GROWTH FACTORS BETA |
| Subjects: | 600 Technology (Applied sciences) > 615 Pharmacology and therapeutics > 615.3 Organics drugs > 615.32 Drugs derived from plants and mikroorganisms > 615.323 64 Drugs derived from specific plants (Capparales) |
| Divisions: | S2/S3 > Magister Kebidanan, Fakultas Kedokteran |
| Depositing User: | Nur Cholis |
| Date Deposited: | 18 Sep 2017 08:18 |
| Last Modified: | 24 Dec 2020 09:51 |
| URI: | http://repository.ub.ac.id/id/eprint/2662 |
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