ABSTRAK
Latar Belakang: Aktivitas penyakit Artritis Reumatoid (AR) merupakan ekspresidari kaskade inflamasi. Inflamasi jaringan sinovium yang disertai pembentukanpannus memerlukan asupan nutrisi dan oksigen melalui angiogenesis.Peningkatan penanda angiogenik menunjukkan inflamasi sendi yang progresif danpeningkatan aktivitas penyakit. Salah satu faktor pertumbuhan yang memilikiperan pada angiogenesis adalah nerve growth factor (NGF). Beberapa penelitianterdahulu mendapatkan kadar NGF yang meningkat baik pada serum maupunpada cairan sinovium pasien AR. Nerve growth factor (NGF) dapat menginduksifaktor-faktor pro-angiogenik dan faktor pertumbuhan lain yang berperan pada AR.Saat ini belum ada penelitian yang menghubungkan kadar serum NGF terhadapaktivitas penyakit AR.Tujuan: Mengetahui korelasi antara kadar NGF dengan aktivitas penyakit (yangdinilai dengan DAS28 LED dan DAS28 CRP) pada pasien AR di Rumah SakitCipto Mangunkusumo.Metode: Penelitian potong lintang yang mengevaluasi kadar NGF menggunakantwo site immunoenzymatic assay (ELISA) pada 50 pasien (47 orang perempuandan 3 orang laki-laki) AR di poliklinik Reumatologi Rumah Sakit CiptoMangunkusumo pada Oktober sampai Desember 2015. Aktivitas penyakit ARpada penelitian ini dinilai menggunakan skor DAS28 LED dan DAS28 CRPmelalui kalkulator yang diakses dari internet pada http://www.das-score.nl/.Analisis statistik bivariat digunakan untuk mendapatkan korelasi antara NGFdengan aktivitas penyakit AR.Hasil: Rerata usia subjek penelitian ini adalah 43,44 tahun. Median kadar serumNGF adalah 4,33 pg/mL (2,35-20,83). Hasil analisis memperlihatkan korelasiantara kadar serum NGF dengan skor DAS28 LED (r = +0,427; p = 0,002) danDAS28 CRP (r =+0.407; p = 0,003).Kesimpulan: Terdapat korelasi positif sedang antara kadar serum NGF denganaktivitas penyakit AR.

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ABSTRACT
Background: Disease activity of Rheumatoid Arthritis (RA) is an expression ofthe inflammatory cascade. Disease activity of a given joint is correlated with thesynovial vascularization. Synovial tissue inflammation accompanied by pannusformation requires intake of nutrients and oxygen through angiogenesis.Angiogenesis plays an integral part of the development of the pannus formation.Increased angiogenic markers shows a progressive increase of joint inflammationand disease activity. One of the contributing factors to angiogenesis is the nervegrowth factor (NGF). Several previous studies show increased NGFconcentrations in both the serum and synovial fluid of RA. Nerve growth factorcan induce pro-angiogenic factors and other growth factors contribute in RA.Currently, there has not been any studies yet that correlates the NGF serumconcentration with RA disease activity.Objective: To determine the correlation between the serum concentration of NGFand disease activity of RA patients at Cipto Mangunkusumo General Hospital(using DAS28 ESR and DAS28 CRP score).Methods: A cross-sectional study was used. Recruited were 50 RA patients (47women and 3 men) of outpatient clinic of Rheumatology at Cipto MangunkusumoGeneral Hospital from October to December 2015. Concentrations of NGF wereevaluated with a two site immunoenzymatic assay (ELISA). Disease activity inthis study was assessed using DAS28 ESR and DAS28 CRP score using acalculator accessible from the internet on http://www.das-score.nl/. Thecorrelation between NGF with disease activity was analyzed by bivariate analysis.Results: The mean age of the study subjects was 43.44 years. Median serum NGFwas 4.33 pg / mL (2.35 to 20.83). The results shows correlation between serumNGF with DAS28 ESR (r = +0.427; p = 0.002) and DAS28 CRP (r = + 0407; p =0.003).Conclusion: Significant positive correlation between serum concentration of NGFwith diesease activity in patient with AR was found.