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Abstrak :
Latar belakang: Sepsis neonatorum awitan lambat SNAL , merupakan penyebab morbiditas dan mortalitas terpenting bayi berat lahir rendah di rumah sakit. Klinisnya tidak spesifik sehingga membutuhkan pemeriksaan penunjang untuk mendiagnosisnya. Baku emas kultur darah memiliki nilai diagnostik yang rendah dan hingga kini belum ada penanda infeksi tunggal yang dapat mendiagnosis sepsis neonatorum. Toll-like receptor TLR berperan dalam mengenali patogen dan memulai respon imun. Ekspresi TLR2 dan TLR4 diharapkan dapat menjadi penanda sepsis neonatorum. Tujuan: Mengetahui ekspresi TLR2 dan TLR4 neutrofil dan monosit serta nilai diagnostiknya pada SNAL. Metode: Studi potong lintang pada Mei-Juni 2017 yang melibatkan 52 neonatus >72 jam dengan klinis sepsis. Pemeriksaan darah perifer lengkap, rasio I/T, CRP, PCT, TLR2 dan TLR4 menggunakan flow cytometry dilakukan dan dibandingkan dengan kultur darah. Hasil: Insidens SNAL penelitian ini sebesar 32,6 . Terdapat penurunan ekspresi TLR2 neutrofil maupun monosit pada kasus SNAL. Peningkatan ekspresi TLR4 neutrofil memiliki sensitivitas 88,2 , spesifisitas 20 , dan AUC 0,541. Ekspresi TLR4 monosit memiliki sensitivitas 92,1 , spesifisitas 11,4 , dan AUC 0,528 jika dibandingkan kultur darah. Nilai AUC CRP meningkat hingga lebih dari 0,75 setelah dikombinasikan dengan TLR4. Simpulan: Pada SNAL, ekspresi TLR4 memiliki sensitivitas yang baik namun kurang spesifik. Pemeriksaan TLR4 dapat menunjang nilai diagnostik CRP. ......Background Late onset neonatal sepsis LONS , is the major morbidity and mortality in low birth weight. Unspecific clinical manifestation make laboratory examination is needed to establish the diagnosis. Unfortunately, blood culture as a gold standard has low diagnostic value. While, there is no single infection marker to diagnose neonatal sepsis. TLRs are a sensor to recognize the pathogens and trigger the immune response. Expression of TLR2 and TLR4 are promising to be a septic marker. Aim To know the expression of TLR2 and TLR4 neutrophil and monocyte and their diagnostic value in LONS. Methods A cross sectional study was conducted from May June 2017 which involved 52 neonates 72 hours with clinically sepsis. Complete blood count, I T ratio, CRP, PCT, TLR2 and TLR4 by flow cytometry already done and compared to blood culture. Result The incidence of LONS is 32.6 . There is TLR2 down expression in LONS. Expression of TLR4 neutrophil has sensitivity 88.2 , specificity 20 , and AUC 0.541. While TLR4 monocyte has sensitivity 92.1 , specificity 11.4 , and AUC 0.528. AUC of CRP is increased over to 0.75 after combined with TLR4. Conclusion Expression of TLR4 have good sensitivity but less specific. TLR4 expression could increase the diagnostic value of CRP.

Abstrak :
Background: Toll-like receptor is a pattern recognition receptor (PRR) that recognize pathogen-associated molecular pattern (PAMP) in a microorganism. Macrophages recognize the presence of mycobacteria through Toll-Like Receptor 2 (TLR2) and signaling further lead to the production of cytokines, both proinflammatory TNF-α, IL-1β, IL-6, IL-12, IL-15, IL-18 and IFN-γ, as well as anti-inflammatory IL4, IL-10 and TGF-β. TLR2 gene polymorphism is strongly determined by ethnicity and geography. Therefore it is necessary to uncovered the existence and association between Arg753Gln and Arg677Trp TLR2 gene polymorphism with TB susceptibility and its underlying mechanisms in Indonesian population in Bandung West Java. Methods: analytical observational study with cross-sectional design was conducted in Hasan Sadikin General Hospital Bandung from April 2011 to May 2012. Study population consisted of active pulmonary TB patient with positive AFB smear and Latent TB to ascertain previous MTb exposure. Polymorphism of gen Arg753Gln and Arg677Trp gene was determined with polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) methods. Plasma levels of IFN-γ, TNF-α, IL-10 and IL-12 were also compared between active and latent TB group. Results: heterozygote Arg753Gln TLR2 gene polymorphism was found in 9 of 86 pulmonary TB subjects (10.5%) but none in the latent TB group. The Arg677Trp polymorphism was not found in both groups. The odds ratio for Arg753Gln existence was 28.07 (p=0.022). No differences in the levels of IFN-γ, TNF-α, IL-10 and IL-12 between active pulmonary TB and latent TB subjects with and without Arg753Gln TLR2 gene polymorphism. Conlusion: Arg753Gln polymorphism of TLR2 gene is a risk factor for active pulmonary TB while Arg677Trp polymorphism is not. The Increased risk is not mediated by the difference in IFN-γ, TNF-α, IL-10 and IL-12 serum levels.

Abstrak :
ABSTRAK Latar Belakang: Cheilitis angularis adalah penyakit inflamasi yang dipicu oleh faktor genetik, lingkungan dan agen infektif. Gen Toll Like Receptor 2 (TLR2) merupakan komponen penting dalam respon imun innate. Tujuan: Penelitian ini bertujuan untuk menganalisis distribusi polimorfisme gen Toll Like Receptor 2 (TLR2) pada cheilitis angularis dan non cheilitis angularis. Metode: 50 sampel cheilitis angularis dan 50 sampel non cheilitis angularis digunakan dalam penelitian ini. Campuran TLR2 16934 T/A dengan ddH2O, enzim polimerase dan DNA template dianalisis menggunakan teknik PCR RFLP, yang menggunakan HphI sebagai enzim restriksi, dilanjutkan dengan elektroforesis. Hasil: Genotip terbanyak yang ditemukan pada cheilitis angularis dan non cheilitis angularis adalah genotip TT. Jumlah genotip dan alel polimorfik paling banyak ditemukan pada cheilitis angularis (22% dan 13%) dibandingkan non-cheilitis angularis (12% dan 6%). Uji Continuity Correction menunjukkan tidak terdapat perbedaan bermakna antara cheilitis angularis dan non-cheilitis angularis. Kesimpulan: Terdapat hubungan antara polimorfisme gen TLR2-16934 T/A dan cheilitis angularis.

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ABSTRACT Background: Angular cheilitis is an inflammatory disease induced by genetic, environmental and infective agent factors. Toll Like Receptor 2 (TLR2) gene is essential components for innate immunity response. Objective: This study aimed to analyzed distribution of Toll Like Receptor 2 (TLR2) gene polymorphism in angular cheilitis and non angular cheilitis. Methods: 50 samples angular cheilitis as case group and 50 samples non angular cheilitis as control group were used in this research. TLR2-16934 T/A mixed with ddH2O, polymerase enzyme and DNA template were analyzed using PCR RFLP technique, which used HphI as restriction enzyme, then followed by electrophoresis. Subsequently assessed with statistical analysis using Continuity Corrections test. Results: The most genotype found in angular cheilitis and non angular cheilitis was TT genotype. The amount of polymorphic genotype and allele were recorded greater in angular cheilitis (22% and 13%) than non-angular cheilitis (12% and 6%). Continuity Corrections test showed no significant differences between angular cheilitis and non ngular cheilitis (p-value=0,287). Conclusion: There is an association between TLR2-16934 T/A gene polymorphism and angular cheilitis.