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Tuberkulosis (TB) sampai dengan saat ini masih merupakan salah satu masalah kesehatanutama di Indonesia. Sepuluh persen dari TB ekstraparu adalah TB tulang, dan sekitar 50%penderita TB tulang menyerang tulang belakang (Spinal Tuberkulosis). Respon tubuhterhadap Mycobacterium tuberculosis (M.tb) sehingga menimbulkan penyebaranekstraparu, khususnya respon makrofag sebagai pertahanan lini pertama, masih belumsepenuhnya dimengerti. Makrofag menghasilkan molekul reactive oxygen species (ROS)sebagai hasil dari oxygen burst untuk mengeliminasi antigen. Nitrat Oksida (NO) danmieloperoksidase (MPO) berperan pada oxygen burst Selain itu, Pada fagositosisterdapat organel lisosom yang di dalamnya terdapat enzim hidrolase (fosfatase asam danbeta glukuronidase) berguna pada pencernaan intraseluler. Penelitian ini mengujihipotesis bahwa ada gangguan fungsi makrofag pada pasien TB tulang belakang. Monositdiisolasi dari peripheral blood mononuclear cells (PBMC) dari lima pasien TB tulangbelakang dan lima orang sehat sebagai kontrol. Monosit yang terisolasi dikultur denganstimulasi dari macrophage colony-stimulating factor (M-CSF) selama tujuh hari untukpematangan. Kemampuan fagositosis makrofag dinilai aktivitasnya terhadapa sel darahmerah domba (SDMD). Sedangkan nitrat oksida (NO), mieloperoksidase (MPO), betaglukuronidase,dan aktivitas fosfatase asam diselidiki dengan metode spektrofotometer.Analisis data dengan menggunakan aplikasi SPSS versi 20. Kami menemukan bahwamonosit yang diisolasi dari PBMC pasien TB tulang belakang secara signifikan lebihsedikit dibandingkan dengan kelompok kontrol (2992.103 vs 6474.103 (sel / mL)) danjuga lebih sedikit makrofag yang melekat pada sel darah merah domba (SDMD) (264.103vs 598.103 (sel / mL)). Namun, produksi NO (2346 vs 325,17 (μmol / gram protein)), danMPO (570,7 vs 17,4 (unit / mg), beta-glukuronide (0,149 vs 0,123 (unit / mg)), dan asamfosfatase aktivitas (1776,9 vs 287,9 (unit / mg)) dari makrofag kelompok TB tulangbelakang lebih tinggi daripada kelompok yang sehat serta korelasi negatif kuat danbermakna antara fagositosis makrofag dengan tiap variabel tersebut. Selain itu, Terdapatkorelasi positif lemah dan tidak bermakna antara kejadian fagositosis dan uji WST.Meskipun pengenalan rendah pada benda asing, proses makrofag intraseluler, termasukaktivitas oksidatif dan fungsi lisosom, tinggi secara signifikan. Hasil ini menunjukanpenurunan fungsi makrofag pada pasien TB tulang belakang serta terdapat kemungkinanadanya dominasi imunitas non-spesifik bawaan pada infeksi TB tulang belakangTuberculosis (TB) is still one of the main health problems in Indonesia. Ten percent ofextrapulmonary TB is bone TB and about 50% of people with bone TB affected to thespine. The immune response against Mycobacterium tuberculosis (M.tb), which causesextrapulmonary spread, particularly the response of macrophages as a first-line defense,is still not fully understood. Macrophages produce reactive oxygen species (ROS)molecules as a result of oxygen bursts to eliminate antigens. Nitric Oxide (NO) andmyeloperoxidase (MPO) play a role in oxygen burst. Also, phagocytosis process involvedlysosomal organelles in which there are hydrolase enzymes (acid phosphatase and betaglucuronidase),which have important role in intracellular digestion. This study examinedthe hypothesis about impairment of macrophage function in spondylitis TB patients.Monocytes were isolated from peripheral blood mononuclear cells (PBMC) collectedfrom five spinal TB patients and five healthy people as controls. Isolated monocytes werecultured by stimulation of macrophage colony-stimulating factor (M-CSF) for seven daysfor maturation. The phagocytic ability of macrophages is assessed as to their activity onsheep red blood cells. Whereas nitric oxide (NO), myeloperoxidase (MPO), betaglucuronidase,and acid phosphatase activity were investigated by spectrophotometermethods. Data was analyzed using SPSS version 20. We found that monocytes isolatedfrom PBMC of spondylitis TB patients were significantly less than in the control group(2992,103 vs 6474,103 (cells / mL)) and also fewer macrophages attached to red bloodcells sheep (264,103 vs 598,103 (cells / mL)). However, NO production (2346 vs 325.17(μmol / gram protein)), MPO (570.7 vs. 17.4 (units/mg), beta-glucuronide (0.149 vs 0.123(units/mg)), and acids phosphatase activity (1776.9 vs 287.9 (units/mg)) of macrophagesin the spondylitis TB group were higher than in the healthy group. There was a strongand significant negative correlation between phagocytosis of macrophages with each ofthe previous variables. There was no significant difference between phagocytic abilityand the WST test. Although the recognition against foreign bodies was low, intracellularmacrophage processes, including oxidative activity and lysosomal function, weresignificantly higher than control. This result showed a decrease of macrophage functionin spondylitis TB patients as well as a possible dominance of non- specific immunity. |
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