KORELASI KADAR TRANSFORMING GROWTH FACTORBETA 1 PLASMA, PLASMINOGEN ACTIVATOR INHIBITOR 1 DAN MANIFESTASI PERDARAHAN PADA DEMAM BERDARAH DENGUE

Abstract

Background. Immunity responses play a role in the clinical severity of dengue viral infections, and both antiinflammatory and proinflammatory cytokines are responsible for it. Transforming growth factor beta 1 (TGF- 1) is one of cytokines that suggested taking apart in pathogenesis of dengue hemorrhagic fever (DHF), and Plasminogen activator inhibitor 1 (PAI-1) especially affects the hemorrhagic manifestation. Aims. To determine the correlation between TGF- 1, PAI-1 and hemorrhagic manifestation in DHF. Methods. This is an observational analytic study with cross sectional design. Subjects were DHF patients that hospitalized in Dr. Kariadi Hospital during July 2005 – July 2006, 3-14 years old and had written informed consent. TGF- 1 and PAI-1 were measured by ELISA. The correlation test was used to determine the correlation between TGF- 1, PAI-1 levels and hemorrhgic manifestation at day- 0 and day-2. Results. Only 51 (61,4%) of 83 participated subjects could be analyzed. Mostly females, with means of age 7,4 ± 2,5 years, fever onset 4,1 ± 1,5 days, length of stay 5,4 ± 4,2 days. Means of TGF- 1 levels on day-2 (46360 ± 29766 pg/ml) were higher than day-0 (36457,8 ± 19234 pg/ml); p=0,09, whereas PAI-1 levels on day-2 (58,5 ± 5,7 ng/ml) were lower than day-0 (102,2 ± 5,9 ng/ml); p=0,003. Correlation test between TGF- 1 to PAI-1 levels and hemorrhagic manifestation on day-0 (r=-0,36, p=0,009 and r=-0,24, p=0,09); on day-2 (r=-0,12, p= 0,4 and r=-0,0057, p=0,7). Correlation test between PAI-1 levels and hemorrhagic manifestation on day 0 and day 2 (r=0,28; p=0,04 and r=0,13; p=0,3) Conclusions. Significant correlation of TGF- 1 to PAI-1 levels is showed on day-0, but is not on day-2, whereas correlation of TGF- 1 to hemorrhagic manifestation is not significant. Significant correlation between PAI-1 levels and hemorrhagic manifestation is showed on day 0 but not on day 2. Keywords. DHF, TGF- 1, PAI-1, hemorrhagic manifestation