Efek Pemberian Probiotik, Nigella Sativa, Imunoterapi terhadap CD4+IL-4+, CD8+IL-4+ dan Skoring Asma
DOI:
https://doi.org/10.21776/ub.jkb.2014.028.02.9Abstract
Sel CD4+IL-4+ berperan dalam inflamasi asma. Peran pro-inflamasi CD8+ dalam asma dikaitkan dengan subset Tc2 yang menghasilkan IL-4+. Imunoterapi merupakan tatalaksana asma yang bermanfaat dan imunomodulator dipertimbangkan untuk meningkatkan efektivitasnya. Sejauh ini belum ada penelitian yang mengkaji pemberian jangka panjang imunoterapi, probiotik dan Nigella sativa terhadap modulasi respon imun, khususnya CD4+IL4+, CD8+IL4+ dan skoring asma. Desain penelitian berupa eksperimental randomized clinical trial (RCT), post test control study untuk CD4+IL4+ dan CD8+IL4+ dan pre-post control study untuk skoring asma. Subjek dibagi 4 kelompok, imunoterapi+plasebo, imunoterapi+Nigella sativa, imunoterapi+probiotik, imunoterapi+Nigella sativa+probiotik, dengan perlakuan selama 56 minggu. Imunoterapi yang digunakan adalah imunoterapi house dust mite (HDM) 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 (ACT), bila skor≥19 menunjukkan asma terkontrol. Jumlah CD4+IL4+ dan CD8+IL4+ diukur dengan flowcytometry. Hasil penelitian menunjukkan jumlah CD4+IL4+ dan CD8+IL4+ tidak berbeda bermakna antar kelompok. Jumlah CD4+IL4+ terendah dan jumlah CD8+IL4+ tertinggi terdapat pada kelompok imunoterapi+Nigella sativa+probiotik. Skoring asma meningkat bermakna setelah perlakuan pada kelompok imunoterapi+Nigella sativa (p=0,002), imunoterapi+probiotik (p=0,000), dan imunoterapi+Nigella sativa+probiotik (p=0,000). Kelompok imunoterapi+probiotik memiliki skoring asma lebih tinggi dibandingkan imunoterapi (p=0,04). Dapat disimpulkan pemberian imunoterapi+Nigella sativa+probiotik menurunkan jumlah CD4+IL4+ lebih rendah  dan meningkatkan jumlah CD8+IL4+ lebih tinggi meskipun tidak bermakna dibandingkan imunoterapi saja. Pemberian kombinasi imunoterapi+probiotik meningkatkan skoring asma lebih baik dibandingkan imunoterapi saja.
Kata Kunci: CD4+IL4+, CD8+IL4+, imunoterapi, Nigella sativa, probiotik, skoring asma
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