Efek Imunoterapi, Probiotik, Nigella Sativa terhadap Rasio CD4+/CD8+, Kadar Imunoglobulin E, dan Skoring Asma
DOI:
https://doi.org/10.21776/ub.jkb.2015.028.04.13Abstract
Imunoterapi alergen-spesifik dan reduksi alergen merupakan intervensi pada penyakit alergi yang berpotensi untuk mengurangi gejala alergi jangka panjang. Penurunan sel T CD4+ dan CD8+ type 2 berkorelasi erat dengan mekanisme regulasi dari imunoterapi. Sejauh ini belum ada penelitian yang mengkaji pemberian jangka panjang imunoterapi, probiotik dan Nigella sativa terhadap modulasi respon imun, khususnya rasio sel T CD4+/CD8+, kadar imunoglobulin E (IgE) dan skoring asma. Desain penelitian berupa eksperimental randomized clinical trial (RCT), pre-post control study untuk rasio sel T CD4+/CD8+, kadar IgE dan skoring asma. Subjek dibagi 4 kelompok, imunoterapi+plasebo, imunoterapi+Nigella sativa, imunoterapi+probiotik, dan imunoterapi+Nigella sativa+probiotik. Semua perlakuan diberikan selama 56 minggu. Imunoterapi yang digunakan adalah imunoterapi house dust mite subkutan. Probiotik yang diberikan ProBi (Medifarma) berisi 2x109 colony forming unit (cfu)/gram Lactobacillus acidophilus dan Bifidobacterium lactis. Skoring asma dinilai dengan skor Asthma Control Test. Rasio sel T CD4+/CD8+ diukur dengan flowcytometry, dan kadar IgE diukur menggunakan Chemiluminescence Enzyme Immunoassay. Hasil penelitian menunjukkan rasio sel T CD4+/CD8+ meningkat bermakna pada kelompok imunoterapi+Nigella sativa (p=0,027), imunoterapi+probiotik (p=0,001), dan imunoterapi+Nigella sativa+probiotik (p=0,046). Kadar IgE tidak berbeda bermakna pada kelompok imunoterapi+plasebo (p=0.,993), kelompok imunoterapi+Nigella sativa (p=0,756), imunoterapi+probiotik (p=0,105), dan imunoterapi+Nigella sativa+probiotik (p=0,630). Skoring asma meningkat bermakna pada kelompok imunoterapi+plasebo (p=0.000), imunoterapi+Nigella sativa (p=0,002), imunoterapi+probiotik (p=0,000), dan imunoterapi+Nigella sativa+probiotik (p=0,000). Sebagai kesimpulan, pemberianimunoterapi dengan ajuvan probiotik danatau Nigella sativa dapat meningkatkan secara bermakna rasio sel T CD4+/CD8+ dan skoring asma.Kata Kunci: Imunoglobulin E, imunoterapi, Nigella sativa, probiotik, rasio sel T CD4+/CD8+, skoring asma
Downloads
References
Makmuri MS. Patofisiologi Anak. Di dalam: Rahajoe NN, Supriyatno B, Setyanto DB, dan Ikatan Dokter Anak Indonesia (Eds). Buku Ajar Respirologi Anak first edition. Jakarta: Badan Penerbit Ikatan Dokter Anak Indonesia; 2013: hal. 98-104.
Hill VL and Wood PR. Asthma Epidemiology, Patophysiology, and Initial Evaluation. Pediatrics in Review. 2009; 30(9): 331-335.
Supriyatno B and Wahyudin B. Patogenesis dan Patofisiologi Asma Anak. Di dalam: Rahajoe NN, Supriyatno B, Setyanto DB, dan Ikatan Dokter Anak Indonesia (Eds). Buku Ajar Respirologi Anak first edition. Jakarta: Badan Penerbit Ikatan Dokter Anak Indonesia; 2013: hal. 85-96.
Corry SM and Munasir Z. Imunitas Selular. Di dalam: Ikatan Dokter Anak Indonesia (Ed). Buku Ajar Alergi Imunologi Anak edisi kedua. Jakarta: Badan Penerbit Ikatan Dokter Anak Indonesia; 2008: hal. 81-90.
Gardner LM, Thien FC, Douglass JA, Rolland JM, O'Hehir RE. Induction of T 'Regulatory' Cells by Standardized House Dust Mite Immunotherapy: An Increase in CD4+ CD25+ Interleukin-10+ T Cells Expressing Peripheral Tissue Trafficking Markers. Clinical & Experimental Allergy Reviews. 2004; 34(8): 1209-1219.
Peng Z. Vaccines Targeting IgE in the Treatment of Asthma and Allergy. Human Vaccines. 2009; 5(5): 302-309.
Miller C, Krishnaswamy N, Johnston C, and Krishnaswamy G. Severe Asthma and the Omalizumab Option. Clinical and Mollecular Allergy. 2008; 6: 1-14.
Moote W and Kim H. Alergen-Specific Immunotherapy. Allergy, Asthma & Clinical Immunology. 2011; 7(1): 1-7.
Ezendam J and Loveren H. Probiotics: Immunomodulation and Evaluation of Safety and Efï¬cacy. Nutrition Reviews. 2006; 64(1): 1-14.
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.
Salem ML. Immunomodulatory and Therapeutic Properties of the Nigella Sativa L. Seed. International Immunopharmacology. 2005; 5(13-14): 1749-1770.
Paarakh PM. Nigella Sativa: A Comprehensive Review. Indian Journal of Natural Products and Resources. 2010; 1(4): 409-429.
Shahzad M, Yang X, Raza Asim MB, et al. Black Seed Oil Ameliorates Allergic Airway Inflammation by Inhibiting T-Cell Proliferation in Rats. Pulmonary Pharmacology & Therapeutics. 2009; 22(1): 37-43.
Ciepiela O, Krajewska A, Kotula I, and Demkow U. The Influence of Sublingual Immunotherapy on Lymphocytes Subpopulations from Children Suffering from Controlled Bronchial Asthma. Central European Journal of Immunology. 2011; 36: 243-247.
Jacobsen L, Whan U, and Bilo MB. Allergen Specific Immunotherapy Provide Immediate, Longterm and Preventive Clinical Effect in Children and Adults: The Effects of Immunotherapy Can be Categorised by Level of Benefit -the Centenary of Allergen Specific Subcutaneous Immunotherapy Clinical and Translational Allergy. 2012; 2: 8.
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.
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.
Jang SO, Kim HJ, Kim Y, Kang M, 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.
Barlianto W, Kusuma HMS, and Widodo A. Rude Extract of Black Seed (Nigella Sativa) Can Modulate Tcd4+Cd25+Foxp3+ Lymphocytes in Asthmatic Mouse Model. Paediatric Respiratory Reviews. 2012; 13(1): 554.
Leung DYM, Sampson H, Geha R, and Szefler SJ. Pediatric Allergy: Principles and Practice. Second edition. Philadelphia: Saunders; 2010: pp. 688.
Shi Y, Tatavoosian AV, Aledia AS, George SC, Galant SP. Cut Points for Asthma Control Tests in Mexican Children in Orange County, California. Annals of Allergy, Asthma & Immunology. 2012; 109(2): 108-113.
Lin SY, Erekosima N, Suarez-Cuervo C, Ramananthan M, et al. Allergen Specific Immunotherapy for The Treatment Allergic Rhinoconjunctivitis and/or Asthma: Comparative Effectiveness Review. Baltimore: Johns Hopkins University Evidence-based Practice Center; 2013.
Taher YA, Henricks PAJ, and van Oosterhout AJM. Allergen Specific Immunotherapy: The Future Cure for Allergic Asthma Mechanisms and Improvement in a Mouse Model. Libyan Journal of Medicine. 20105: 11.
Akdis CA and Akdis M. Mechanisms of allergen-specific immunotherapy. Journal of Allergy and Clinical Immunology. 2011; 127(1): 18-27.
Boskabady MH, Keyhanmanesh R, Khamneh S, and Ebrahimi MA. The Effect of Nigella Sativa Extract on Tracheal Responsiveness and Lung Inflamation in Ova-Albumin Sensitized Guinea Pigs. Clinics. 2011; 66(5): 879-887.
Işik H, Cevikbaş A, Gürer US, et al. Potential Adjuvant Effects of Nigella sativa Seeds to Improve Spesific Immunotherapy in Allergic Rhinitis Patients. Medical Principles and Practice. 2010; 19(3): 206-211.
Beets RJ and Kemeny DM. CD8+ T Cells in Asthma: Friend or Foe? Pharmacology and Therapeutic. 2009; 121(2): 123-131.
Harsono A, Subrata LA, and Endaryanto A. Immunomodulatory Effect of Probiotic and Sublingual Immunotherapy in Asthmatic Children. Folia Medica Indonesiana. 2009; 45: 14-21.
Gutkowski P, Madalinski K, Grek M, Dmenska H, Syczewska M, and Michalkiewicz J. Effect of Orally Administered Probiotic Strains Lactobacillus and Bifidobacterium in Children with Atopic Asthma. Central European Journal of Immunology. 2010; 35(4): 233-238.
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.
Kardani AK, Fitri LE, Barlianto W, Olivianto E, and Kusuma HMSC. The Effect of House Dust Mite Immunotherapy, Probiotics and Nigella sativa in The Number of Th17 Cell and Asthma Control Test Score. IOSR Journal of Dental and Medical Sciences. 2013; 6(4): 37-47.
Downloads
Published
Issue
Section
License
Authors who publish with this journal agree to the following terms:- Authors retain copyright and grant the journal right of first publication with the work simultaneously licensed under a Creative Commons Attribution License that allows others to share the work with an acknowledgement of the work's authorship and initial publication in this journal.
- Authors are able to enter into separate, additional contractual arrangements for the non-exclusive distribution of the journal's published version of the work (e.g., post it to an institutional repository or publish it in a book), with an acknowledgement of its initial publication in this journal.
- Authors are permitted and encouraged to post their work online (e.g., in institutional repositories or on their website) prior to and during the submission process, as it can lead to productive exchanges, as well as earlier and greater citation of published work (See The Effect of Open Access).
