Perbedaan Skor ACT, CD4+CD25+Foxp3treg, CD4+IFN-γ pada Pemberian Imunoterapi, Probiotik dan Nigella Sativa
DOI:
https://doi.org/10.21776/ub.jkb.2015.028.04.5Abstract
Probiotik dan Nigella sativa memiliki efek imunomodulator dan telah banyak banyak dikaji penggunaannya dalam kombinasi dengan imunoterapi asma. Imunoterapi dapat merubah perjalanan alamiah asma yang melibatkan perubahan respon imun Th2 menjadi Th1 dengan peningkatan IFN-γ. Proses tersebut juga berhubungan dengan pembentukan Tregulator, tetapi belum jelas mekanisme mana yang lebih dominan. Penelitian dilakukan untuk mengetahui perbedaan skor ACT serta jumlah sel CD4+CD25+FoxP3Treg dan CD4+IFN-γ pada anak asma ringan yang mendapat imunoterapi, probiotik dan Nigella sativa. Penelitian dilakukan dengan desain randomized clinical trial posttest only with control pada 32 subjek penelitian yang memenuhi kriteria inklusi dalam 4 kelompok yaitu kelompok A (imunoterapi+plasebo), kelompok B (imunoterapi+Nigella sativa), kelompok C (imunoterapi+probiotik), dan kelompok D (imunoterapi+Nigella sativa+probiotik). Perlakuan diberikan selama 56 minggu (imunoterapi fase induksi 14 minggu dan fase rumatan 42 minggu). Imunoterapi berupa ekstrak house dust mite diberikan subkutan, probiotik berupa Lactobacillus acidophilus dan Bifidobacterium lactis, dengan penilaian skoring asma menggunakan Asthma Control Test (ACT). Jumlah sel CD4+CD25+FoxP3+Treg dan CD4+IFN-γ diukur menggunakan flowcytometry. Hasil menunjukkan skor ACT kelompok C lebih tinggi bermakna dibandingkan kelompok A (p=0,04). Jumlah CD4+CD25+FoxP3+Treg paling tinggi pada kelompok D (15,966±9,720) , sedangkan jumlah CD4+IFN-γ paling tinggi pada kelompok C (17,506±11,576), tetapi tidak didapatkan perbedaan bermakna pada jumlah CD4+CD25+FoxP3+Treg (p=0,278) dan CD4+IFN-γ (p=0,367) antar semua kelompok. Dapat disimpulkan bahwa Imunoterapi+probiotik dapat meningkatkan skor ACT lebih baik dibandingkan imunoterapi saja. Imunoterapi, Nigella sativa, dan probiotik tidak memberikan perbedaan bermakna pada jumlah CD4+CD25+FoxP3 Treg dan CD4+IFN-γ.Kata Kunci: Asthma Control Test, CD4+CD25+FoxP3+Treg, CD4+IFN-γ, imunoterapi, Nigella sativa, probiotik
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DAFTAR PUSTAKA
Holgate ST. Pathogenesis of Asthma. Clinical and Experimental Allergy. 2008; 38(6): 872–897.
Hill V and Wood P. Asthma Epidemiology, Pathophysiology, and Initial Evaluation. Pediatric in Review. 2009; 30(9): 331-336.
Mohammed EK, Asheiba ZF, and Ali MME. Role of Circulating CD4+CD25 High Foxp3+ Regulatory T-cells in Paediatric Asthma. The Egyptian Journal of Hospital Medicine. 2011; 42:73-84.
Global Initiative for Asthma. Global Strategy for Asthma Management and Prevention Update 2011. Cape Town: National Heart and Blood Institute; 2011; hal. 1-79.
Barnes PJ. Immunology of Asthma and Chronic Obstructive Pulmonary Disease. Nature Reviews Immunology. 2008; 8(3): 183-192.
de Azevedo MS, Innocentin S, Dorella FA, et al. Immunotherapy of Allergic Diseases Using Probiotics or Recombinant Probiotics. Journal of Applied Microbiology. 2013; 115(2): 319-333.
Huang TJ, MacAry PA, Eynott P, et al. Allergen-Specific Th1 Cells Counteract Effecrent Th2 Cell-Dependent Bronchial Hyperresponsiveness and Eosinophilic Inflammation, Partly Via IFN-G. The Journal of Immunolgy. 2001; 166(1): 207–217.
Langier S, Sade K, and Kivity S. Regulatory T Cells In Allergic Asthma. Israel Medical Association Journal. 2012; 14(3): 180-183.
Fujimura T, Okamoto Y, and Taniguchi M. Therapeutic Effects and Biomarkers in Sublingual Immunotherapy: A Review. Journal of Allergy. 2012; 37: 9.
Taher YA, Henricks PA, and van Oosterhout AJ. Allergen-Specific Subcutaneous Immunotherapy in Allergic Asthma: Immunologic Mechanisms and Improvement. Libyan Journal of Medicine. 2010; 15: 1-11.
Oosterhout AJ and Bloksma N. Regulatory T-Lymphocytes in Asthma. The European Respiratory Journal. 2005; 26(5): 918-932.
Masoli M, Fabian D, Holt S, Beasley R, and Global Initiative for Asthma (GINA) Program. The Global Burden of Asthma: Executive Summary of the Gina Dissemination Comitte Report. 2004; 59(5): 469-478.
Ozdemir C, Akdis M, and Akdis CA. Nature of Regulatory T Cells in the Context of Allergic Disease. Allergy, Asthma, and Clinical Immunology. 2008; 4(3): 106–110.
Frew AJ. Allergen Immunotherapy. Journal of Allergy and Clinical Immunology. 2010; 125(2): 306-313.
Moote W and Kim H. Allergen-Specific Immunotherapy. Allergy, Asthma, & Clinical Immunology. 2011; 7(1):5.
Toh ZQ, Anzela A, Tang ML, and Licciardi PV. Probiotic Therapy as a Novel Approach for Allergic Disease. Frontiers in Pharmacology. 2012; 3: 171.
Galdeano CM, de Moreno de LeBlanc A, Vinderola G, Bonet ME, and Perdigón G. Proposed Model: Mechanisms of Immunomodulation Induced by Probiotic Bacteria. Clinical and Vaccine Immunology. 2007; 14(5): 485-492.
Yu J, Jang SO, Kim BJ, et al. The Effects of Lactobacillus Rhamnosus on the Prevention of Asthma in a Murine Model. Allergy Asthma & Immunology Research. 2010; 2(3): 199-205.
Salem ML. Immunomodulatory and Therapeutic Properties of the Nigella Sativa L. Seed. International Immunopharmacology. 2005; 5(13-14): 1749-1770.
Azis AEAE, Sayed NSE, and Mahran LG. Anti-Asthmatic and Anti-Allergic Effects of Thymoquinone on Experimentally- Induced Hypersensitivity in Experimental Animals. Journal of Applied Pharmaceutical Science. 2011; 8: 109-117.
Harsono A, Subrata LA, and Endaryanto A. Immunomodulatory Effect of Probiotic & Sublingual Immunotherapy in Asthmatic Children. Folia Medica Indonesiana. 2009; 45(1): 14-21.
Isik H, Cevikbas A, Gurer US, et al. Potential Adjuvant Effects of Nigella Sativa Seeds to Improve Specific Immunotherapy in Allergic Rhinitis Patients. Medical Principles and Practice. 2010; 19(3): 206-211.
Adhisty RA. Pengaruh Pemberian Probiotik (Mixed Live Bacteria Lactobacillus Acidophilus La-5TM dan Bifidobacterium Lactis Bb-12TM) dan Jinten Hitam (Nigella sativa) terhadap Jumlah CD4+Ifnγ, CD8+ Ifnγ, dan Perbaikan Klinis Asma Ringan yang Mendapatkan Imunoterapi. [Tesis]. Universitas Brawijaya, Malang. 2013.
Irmawati M, Endaryanto A, and Harsono A. Role of Sublingual Immunotherapy and Probiotics in Clinical Improvements of Childhood Asthma. Paediatrica Indonesiana. 2008; 48(5): 261-268.
Miratu N. Perbaikan Klinis dan Perubahan Jumlah Sel T CD4+, Jumlah Sel T CD8+ Dan Rasio Sel T CD4+/CD8+ pada Anak Asma Ringan yang Mendapat Imunoterapi House Dust Mite, Probiotik dan Nigella Sativa. [Tesis]. Universitas Brawijaya, Malang. 2013.
Moussu H, Van Overtvelt L, Horiot S, et al. Bifidobacterium Bifidum NCC 453 Promotes Tolerance Induction in Murine Models of Sublingual Immunotherapy. International Archives of Allergy and Immunology. 2012; 158(1): 35-42.
Borchers AT, Selmi C, Meyers FJ, Keen CL, and Gershwin ME. Probiotics and Immunity. Journal of Gastroenterology. 2009; 44(1): 26-46.
Lin SY, Erekosima N, Kim JM, et al. Sublingual Immunotherapy for the Treatment of Allergic Rhinoconjunctivitis and Asthma: A Systematic Review. Journal of the American Medical Association. 2013; 309(12): 1278-1288.
O'Hehir RE, Gardner LM, de Leon MP, et al. House Dust Mite Sublingual Immunotherapy the Role for Transforming Growth Faktor–b and Functional Regulatory T Cells. American Journal of Respiratory and Critical Care Medicine. 2009; 180(10): 936–947.
Chen YS, Jan RL, Lin YL, Chen HH, and Wang JY. Randomized Placebo-Controlled Trial of Lactobacillus on Asthmatic Children with Allergic Rhinitis. Pediatric Pulmonology. 2010; 45(11): 1111-1120.
Lee SC, Yang YH, Chuang SY, Huang SY, and Pan WH. Reduced Medication Use and Improved Pulmonary Function with Supplements Containing Vegetable and Fruit Concentrate, Fish Oil and Probiotics in Asthmatic School Children: A Randomised Controlled Trial. British Journal of Nutrition. 2013; 110(1): 145-155.
Vliagoftis H, Kouranos VD, Betsi GI, and Falagas ME. Probiotics for the Treatment of Allergic Rhinitis and Asthma: Systematic Review of Randomized Controlled Trials. Annals ofAllergy,AsthmaandImmunology. 2008; 101(6): 570-579.
Rashmi RD, Singh M, and Shafiq N. Probiotics for Prevention or Treatment of Asthma. Chest. 2010; 138(4): 1-12.
Giovannini M, Agostoni C, Riva E, et al. A Randomized Prospective Double Blind Controlled Trial on Effects of Long-Term Consumption of Fermented Milk Containing Lactobacillus Casei In Pre-School Children with Allergic Asthma and/or Rhinitis. Pediatric Research. 2007; 62(2): 215-220.
Stockert K, Schneider B, and Porenta G. The Effect of Acupuncture and Probiotics in Children with Asthma. Focus on Alternative and Complementary Therapies. 2007; 12(3): 194-196.
Jang SO, Kim HJ, Kim YJ, et al. Asthma Prevention by Lactobacillus Rhamnosus in a Mouse Model is Associated with CD4+CD25+Foxp3+ T Cells. Allergy Asthma & Immunology Research. 2012; 4(3): 150-156.
Noverr M and Huffnagle GB. Does the Microbiota Regulate Immune Responses Outside the Gut? Trends in Microbiology. 2004; 12(12): 562-568.
Barlianto W, Kusuma HMSC, Widodo A, and Suharto S. Rude Extract of Black Seed (Nigella Sativa) Can Modulate TCD4+CD25+Foxp3+ Lymphocytes in Asthmatic Mouse Model. Paediatric Respiratory Reviews. 2012; 13: 554-560.
El Gazzar M, El Mezayen R, Marecki JC, Nicolls MR, Canastar A, and Dreskin SC. Anti-Inflammatory Effect of Thymoquinone in a Mouse Model of Allergic Lung Inflammation. International Immunopharmacology. 2006; 6(7): 1135-1142.
Wei W, Liu Y, Wang Y, et al. Induction of CD4+CD25+Foxp3+IL-10+ T Cells in HDM-Allergic Asthmatic Children with or Without SIT. International Archives of Allergy and Immunology. 2010; 153(1): 19-26.
Feleszko W, Jaworska J, Rha RD, et al. Probiotic-Induced Suppression of Allergic Sensitization and Airway Inflammation is Associated with an Increase of T Regulatory-Dependent Mechanisms in a Murine Model of Asthma. Clinical & Experimental Allergy. 2007; 37(4): 498-505.
Al-Snafi AE, Al-Samarai AGM, and Al-Sabawi AM. The Therapeutic Effect of Nigella Sativa Seed Oil in Treatment of Chronic Urticaria. Tikrit Journal of Pharmaceutical Science. 2005; 1(1): 1-6.
Alsamarai AM, Satar MA, and Alobaidi AHA. Evaluation of Therapeutic Efficacy of Nigella Sativa (Black Seed) for Treatment of Allergic Rhinitis. Allergic Rhinitis. 2012; 12: 197-215.
Kim HB, Jin HS, Lee SY, et al. The Effect of Rush Immunotherapy with House Dust Mite in the Production of IL-5 and IFN-Γ from the Peripheral Blood T Cells of Asthmatic Children. Journal of Korean Medical Science. 2009; 24(3): 392-397.
Pereira-Santos MC, Baptista AP, Melo A, et al. Expansion of Circulatory Foxp3+CD25 Bright CD4+T Cells During Specific Venom Immunotherapy. Clinical & Experimental Allergy. 2008; 38(2): 291-297.
Morais MB and Jacob CM. The Role of Probiotics and Prebiotics in Pediatric Practice. Jornal de Pediatria. 2006; 82(5): 189-197.
Check W. Innate Immunity Depends On Toll-Like Receptors. American Society for Microbiology News. 2004; 70(7): 317-322.
Endaryanto A and Harsono A. The Different Profile of Th1, Treg and Th2 Cytokines between Asthma and Non-Asthma Allergic Child with Chronic Cough. Kongres Nasional Ilmu Kesehatan Anak XIV. Surabaya, 2008; hal. 22-45.
Holvoet S, Zuercher AW, Julien-Javaux F, Perrot M, and Mercenier A. Characterization of Candidate Anti-Allergic Probiotic Strains in a Model of Th2-Skewed Human Peripheral Blood Mononuclear Cells. International Archives of Allergy and Immunology. 2013; 161(2): 142-154.
Choi IS. Immune Tolerance by Induced Regulatory T Cells in Asthma. Allergy Asthma & Immunology Research. 2012; 4(3): 113-115.
Nonaka Y, Izumo T, Izumi F et al. Antiallergic Effects of Lactobacillus Pentosus Strain SPT84 Mediated by Modulation of Th1/Th2 Immunobalance and Induction of IL-10 Production. International Archives of Allergy and Immunology. 2008; 145(3): 249–257.
Niers LE, Timmermanw HM, Rijkersw GT, et al. Identification of Strong Interleukin-10 Inducing Lactic Acid Bacteria which Down-Regulate T Helper Type 2 Cytokines. Clinical & Experimental Allergy. 2005; 35(11): 1481–1489.
Doege K, Grajecki D, Zyriax BC, Detinkina E, Eulenburg C, and Buhling KJ. Impact of Maternal Supplementation with Probiotics During Pregnancy on Atopic Eczema in Childhood–a Meta-Analysis. The British Journal of Nutrition. 2012; 107(1): 1–6.
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