PENGARUH POLYPHENOLS TEH HIJAU TERHADAP KAPASITAS PRODUKSI TNF-α OLEH SEL MONONUKLEAR DARAH TEPI PADA PENDERITA KARSINOMA NASOFARING YANG MENDAPAT RADIOTERAPI

Abstract

Latar belakang: Polyphenols teh hijau (PTH) merupakan antioksidan kuat dan mampu mencegah peningkatan produksi sitokin inflamasi (IL-1, IL-6, IL-8 dan TNF-α) oleh sel makrofag dan limfosit yang teraktivasi oleh radikal bebas. Radioterapi pada penderita Karsinoma Nasofaring (KNF) menimbulkan kerusakan sel imunologis yang berefek pada penurunan respons imun seluler. Tujuan: Membuktikan bahwa PTH mencegah peningkatan produksi TNF-α oleh sel mononuklear darah tepi akibat radioterapi pada penderita karsinoma nasofaring. Metode: Penelitian randomized controlled trial pre-post test design menggunakan 50 penderita KNF dengan radioterapi sebagai sampel, dan memenuhi kriteria inklusi dan eksklusi. Sampel dibagi secara randomisasi blok menjadi dua kelompok; kelompok kontrol (KNF radioterapi + plasebo), dan kelompok perlakuan (KNF radioterapi + PTH). Pengukuran kadar TNF-α secara buta ganda dengan metode ELISA di laboratorium Bioteknologi FK UNDIP Semarang. Data hasil penelitian dilakukan uji normalitas dan homogenitas, dilanjutkan dengan uji beda dengan program SPSS for Windows 11,5 version. Hasil: Selama penelitian didapatkan 5 sampel di tiap kelompok yang drop out, sehingga hanya 40 sampel diperiksa kadar TNF-α. Rerata kadar TNF-α kelompok kontrol sebesar 1.764,6±1.897,65, sedangkan kelompok perlakuan adalah 1.461,8±832,25. Uji Mann-Whitney terhadap kadar TNF-α membuktikan tidak terdapat perbedaan bermakna pada kedua kelompok (p=0,640). Simpulan: Pemberian PTH pada penderita KNF yang dilakukan radioterapi tidak bermakna dalam mencegah peningkatan produksi TNF-α oleh sel mononuklear darah tepi. Backgrounds: The green tea polyphenols (GTP) is a strong antioxidant that has a potential effect on inhibiting the overproduction of cytokine inflammation (IL-1, IL-6, IL-8 and TNF-α) by macrophages and free radicalsactivated lymphocytes. The radiotherapy of nasopharyngeal cancer (NPC) induce the immune-cell damages that effect on decreasing of cellular immune responses. Objective: To prove the effect of PTH in inhibiting the TNF-α production capacity by peripheral blood mononuclear cells caused by radiotherapy to the nasopharyngeal carcinoma patients. Methods: This was a randomized controlled trial pre-post test design using 50 NPC-radiotherapy induced patients as sample, that fulfilled the inclusion and exclusion criteria. The sample was divided into two groups randomly; NPC-radiotherapy induced patients plus placebo as control group, and NPC-radiotherapy induced patients plus GTP as treatment group. The TNF-α level was double blind-measured using ELISA at Biotechnology of Medical Faculty of Diponegoro University Semarang. The data was analyzed using normality and homogeneity tests, followed by test for differentiation by SPSS for Windows 11,5 version. Result: The 5 sample were drop out in each group, so there were only 40 TNF-α. level’s data. The mean of TNF-α level in control group was 1764.6±1897.65, besides the treatment group was 1461.8±832.25. The Mann- Whitney test for TNF-α level was not significantly different in that two grups (p=0,640). Conclusion: The GTP dietary on NPC-radiotherapy induced patients was not significantly inhibit the overproduction of TNF-α by peripheral blood mononuclear cells.