LAPORAN PENELITIAN HIBAH BERSAING TAHUN ANGGARAN 2011

PERAN METABOLIT VITAMIN D PADA FUNGSI SEL DENDRITIK DAN SEL LIMFOSIT Th 17 PADA PASIEN LUPUS

ERITEMATOSUS SISTEMIK

Dr. dr. Kusworini Handono, MKes, SpPK Dr. Singgih Wahono, SpPD

Dr. Wira Daramatasia Herin Mawarti S,Kep Ners.

Dibiayai oleh Direktorat Jenderal Pendidian Tinggi, Kementerian Pendidikan Nasional, melalui

DIPA Universitas Brawijaya REV.1 Nomor: 0636/023-04.2.16/15/2011 R,

tanggal 30 Maret 2011 dan berdasarkan surat dari DP2M Dikti Nomor: 121/D3/PL/2011

tanggal 7 Februari 2011

UNIVERSITAS BRAWIJAYA

NOPEMBER 2011

Bidang Ilmu:

KESEHATAN

RINGKASAN

Latar Belakang. Lupus Eritematosus Sistemik (LES) merupakan penyakit autoimun yang semakin sering dijumpai dengan angka kematian tinggi. Etiopatogenesis penyakit ini belum begitu jelas, meskipun telah ditunjukkan adanya abnormalitas berbagai sel-sel imun termasuk hiper-reaktivitas sel T, sel B, sel dendrit; dan menurunnya fungsi sel T regulator (Treg). Vitamin D memiliki peran dalam pengaturan sistem imun. Penelitian pada ras Kaukasia menunjukkan bahwa kadar vitamin D yang rendah berkaitan dengan timbulnya penyakit autoimun termasuk LES. Peran vitamin D pada sistem imun pasien LES masih banyak kontroversi. Penelitian ini bertujuan untuk mengetahui hubungan kadar vitamin D dengan jumlah sel Th17 dan Aktivasi sel dendritik.

Metoda Penelitian. Penelitian ini adalah penelitian kasus-kontrol yang membandingkan

jumlah sel Th17 dan aktivasi sel sel dendritik pada pasien LES dan kontrol sehat dengan melihat status vitamin D-nya. Kadar vitamin D diukur dengan metoda ELISA, jumlah sel Th17 (CD4+,IL17A), Aktivasi sel dendritik (CD11c+,CD40,CD86,CD83) ditentukan dengan metoda flowcytometri. Hasil. Kadar vitamin D pada pasien LESlebih rendah daripada kontrol sehat (p=0,001) dan tidak ada hubungan antara status vitamin D dengan aktivasi sel dendritik maupun Th 17 (P= >0,05 dan P=0,22). Hasil inilah yang mungkin bisa menjelaskan bagaimana kemampuan toleransi perifer dirusak dan menyebabkan teraktivasinya sel autoreaktif.

Kesimpulan.Tidak ada hubungan antara status vitamin D dengan sel Th 17 dan aktivasi

sel dendritk.

Kata kunci: LES, vitamin D, Th17, sel dendritik.

SUMMARY

Background. Systemic Lupus Erythematosus (SLE) is an autoimmune disease that is more often found nowadayswith high mortality rate. Ethiopathogenesis of the disease is not clear, although it has been shown the abnormality of various immune cells including hyperreactivity of T cells, B cells, dendritic cells, and decreased function of regulatory T cells (Treg). Vitamin D has a role in the regulation of the immune system. Research in Caucasians showed that low vitamin D levels associated with the onset of autoimmune diseases including SLE. The role of vitamin D in SLE patient's immune system is still controversy. This study aims to determine the relationship of vitamin D levels with the number and percentage of Th17 cells and activity of dendritic cells.

Methods. This study is a case-control study that compares the number of Th17 cells

and activation of dendritic cells in SLEpatients and healthy controls by looking at their vitamin Dstatus. Vitamin D levels were measured by ELISA method, the number of Th17 cells (CD4 +, IL17A), Activation of dendritic cells (CD11c +, CD40, CD86, CD83) was determined by the method flowcytometri.

Results.Levels of vitamin D in SLE patients is lower than healthy controls (p = 0.001)

and no association between vitamin Dstatus with activation of dendritic cells and Th 17 (P => 0.05 and P = 0.22). This results that might partly explain how peripheral tolerance is broken in SLE patient and why autoreactive T-cells are activated. cells. Conclusion. There was no association between vitamin Dstatus with Th cells 17 and dendritk cell activation. Keywords: LES, vitamin D, Th17,Dendritic cells.

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