KORELASI TGF-β1 PRODUK MONOSIT DARAH TEPI DENGAN KEBOCORAN VASKULER PADA DEMAM BERDARAH DENGUE (Correlation between Monocyte Transforming Growth Factor – Beta 1, and Vascular Leakage in Dengue Hemorrhagic Fever)

Abstract

ABSTRACT Background. The generally accepted view that blood monocytes are the principal target of virus infection suggests that virus-infected monocytes may produce a vasoactive factor which might affect endothelial cell function, possibly contributing to vascular leakage. Transforming growth factor beta 1 (TGF-β1) is one of cytokines that plays a variety of roles in pathogenesis of dengue hemorrhagic fever (DHF). Aims. To determine the correlation among TGF-β1 to PEI,total protein, albumin and hematocrit as vascular leakage markers on DHF. Methods. This was an observational study with cross sectional design. Subjects were DHF patients that hospitalized in Dr. Kariadi Hospital during July, 2005 – July 2006,3-14 years old. TGF-ß1 product of monocyte, PEI, total protein and albumin levels, and hematocrit were measured on day 0 and 2. The correlation between TGF-β1 levels and PEI, total protein and albumin levels, and hematocrit on day 0 and 2 were analyzed Results. Subjects were mostly females, means of age 7,1 ± 2,43 years. Means of TGF-β1 product of monocyte levels on day-2 (43.29 ± 28.012 pg/ml) were higher than day-0 (35.27 ± 34.642 pg/ml);p=0,09(Wilcoxon test). Correlation test among TGF-β1 monocyte level, IEP, protein total, albumin, hematocrit on day-0 (r = - 0,31p=0,04 ; r= 0,19 p=0,2 ; r=0,11 p=0,5; r=- 0,08 p=0,6 ); on day-2 (r = -0,2 p=0,3; r= 0,2 p=0,2; r=0,2 p=0,2; r=-0,04 p=0,8) Conclusions. There is correlation between TGF-β1 monocyte product level and PEI on day-0. There is no correlation between TGF-β1 monocyte product level and PEI on day-2 ,neither, Total protein, albumin and hematocrit on day-0 and on day-2. Keywords : TGF-β1, PEI, protein total , albumin ,hematocrit, DHF ABSTRAK Latar Belakang. Monosit merupakan target utama infeksi virus dengue yang mengakibatkan sekresi vasoaktif yang mempengaruhi endotel dan mengakibatkan kebocoran vaskuler. Transforming growth factor beta 1 (TGF-β1) merupakan salah satu sitokin yang memiliki berbagai peran dalam patogenesis demam berdarah dengue (DBD). Tujuan. Untuk mengetahui korelasi antara kadar TGF-β1 produk monosit terhadap IEP, protein total,albumin dan hematokrit sebagai petanda kebocoran vaskuler. Metoda. Penelitian observasional analitik dengan desain belah lintang. Subjek adalah pasien DBD yang dirawat di bangsal anak RSUP. Dr. Kariadi selama bulan Juli 2005 – Juli 2006,berumur 3-14 tahun. Dilakukan uji korelasi untuk mengetahui hubungan kadar TGF-β1 monosit dengan IEP,protein total ,albumin dan hematokrit pada hari ke 0 dan ke-2 Hasil. Sebagian besar subjek adalah perempuan, rerata umur 7,1 ± 2,43 tahun. Rerata kadar TGF-β1 hari ke-2 (43.29 ± 28.012 pg/ml) lebih tinggi daripada hari ke-0 (35.27 ± 34.642 pg/ml); p=0,09(uji Wilcoxon ). Uji korelasi kadar TGF-β1 monosit dengan IEP, protein total, albumin, hematokrit hari ke-0 r = - 0,31p=0,04 ; r= 0,19 p=0,2 ; r=0,11 p=0,5; r=- 0,08 p=0,6 ,hari ke-2 r = -0,2 p=0,3; r= 0,2 p=0,2; r=0,2 p=0,2; r=-0,04 p=0,8. Simpulan. Terdapat korelasi negatif bermakna kadar TGF-β1 produk monosit darah tepi dengan IEP pada hari pengamatan ke-0,tidak terdapat korelasi bermakna pada pengamatan hari ke-2.Tidak terdapat korelasi bermakna antara kadar TGF-β1 produk monosit darah tepi dengan protein total, albumin dan hematokrit pada hari pengamatan ke-0 dan hari pengamatan ke-2 Kata kunci : TGF-β1, IEP,protein total,hematokrit,albumin, demam berdarah dengue