Tesis

Interleukin-6 dan aktivitas penyakit pada pasien Lupus Eritematosus Sistemik anak = Interleukin-6 and Disease Activity in Juvenile Systemic Lupus Erythematosus.

Latar belakang: Lupus eritrematosus sistemik (LES) adalah penyakit yang kompleks dengan manifestasi yang bervariasi. Interleukin-6 (IL-6) merupakan sitokin pleitropik yang mempunyai aktivitas biologis dengan rentang luas yang berperan penting pada regulasi imun dan inflamasi. Saat ini belum ada biomarker yang dapat membedakan kondisi remisi total dengan aktivitas penyakit ringan. Interleukin-6 diharapkan dapat digunakan sebagai parameter aktivitas penyakit terutama pada kasus-kasus dimana antara manifestasi klinis dan skor SLEDAI tidak sesuai yaitu pada pasien LES dengan aktivits ringan dan remisi total. Tujuan: Mengetahui karakteristik IL-6 pada LES anak dengan berbagai aktivitas ringan dan remisi total. Metode: Penelitian kasus kontrol dilakukan di poli rawat jalan Alergi-Imunologi Departemen Ilmu Kesehatan Anak RSUPN dr. Cipto Mangunkusumo, Jakarta dan RSUP Dr. Sardjito, Yogyakarta mulai Mei hingga Juni 2019. Pasien anak usia 1-18 tahun dengan diagnosis LES dinilai kadar IL-6 dan aktivitas penyakit yang dinilai dengan skor SLEDAI. Uji korelasi chi square dilakukan untuk mengetahui hubungan variabel bebas dan luaran. Analisis data dilakukan dengan program SPSS for Window ver 20,0 Hasil: Dari 60 subjek penelitian yang terdiri dari 30 pasien LES aktivitas ringan dan 30 remisi total. tidak ada perbedaan kadar IL-6 tinggi pada kelompok kasus dibanding kelompok kontrol dengan p=0,500, OR= 0,483 (95% IK: 0,041-5,628). Terdapat 2 subyek dengan kadar IL-6 tinggi menderita infeksi saluran kencing. Simpulan: Tidak ada perbedaan aktivitas penyakit pada pasien LES anak dengan aktivitas ringan dibanding remisi total.
Kata kunci: Lupus Eritematosus Sistemik, interleukin-6, aktivitas penyakit, Systemic Lupus Erythematosus Disease Activity Index (SLEDAI)


Background: Systemic Lupus Erythematosus (SLE) is a complex disease with various manifestations. Interleukin-6 (IL-6) is a pleiotropic cytokine with a wide range of biological activities that plays an important role in immune regulation and inflammation. Recently, there is no other biomarker that could differentiate total remission condition and mild disease activity in juvenile SLE. Interleukin-6 may be used as a parameter of disease activity, especially in the cases with different clinical manifestations and SLEDAI scores among SLE patients with mild activities and total remissions. Aim: To indentify the characterictics of serum IL-6 concentration in juvenile systemic lupus erythematosus with mild activities and total remissions. Methods: Case control study was performed at outpatient clinic of allergyimmunology, department of child health dr. Cipto Mangunkusumo hospital, Jakarta and dr. Sardjito hospital, Yogyakarta during May-June 2019. Serum IL-6 consentration and disease activity were assessed in all juvenile SLE patients aged 1-18 year. SLE disease activity was assessed with SLEDAI scores and serum level of IL-6 was measured by enzyme linked immunosorbent assay. Chi square correlation analysis was used to determine the correlation of serum IL-6 concentration with disease activity in juvenile SLE patients. Analyses of data were performed using the SPSS statistical software for windows version 20,0. Results: Among 60 subjects included in this study, 30 subjects with mild activities in the case group and 30 subjects with total remissions in the control group. There was no differences of serum IL-6 concentration between case and control group (p=0,500, OR= 0,483 (95% IK: 0,041-5,628)). In this study, we found 2 subjects with urinary tract infection have high serum IL-6 concentration. Conclusion: There was no differences of serum IL-6 concentration between juvenile SLE patients with mild activities compared with total remissions.
Keywords: Systemic Lupus Erythematosus, interleukin-6, disease activity, Systemic Lupus Erythematosus Disease Activity Index (SLEDAI)