Tesis

Aktivitas Enzim Lisosom dan Oxygen Burst Makrofag Pasien Tuberkulosis Resisten Obat serta Kaitannya dengan Kemampuan Fagositosis Dibandingkan dengan Tuberkulosis Laten dan Subjek Sehat = The Activity of Lysosome Enzymes and Oxygen Burst Monocyte Derived Macrophages in Drug-Resistant Tuberculosis Patients and Their Relation with Phagocytic Ability Compared to Latent Tuberculosis and Healthy Subject.

Pendekatan sistem imun pada pejamu M. tuberculosis merupakan salah satu pilihan dalam pengembangan terapi tuberkulosis, terutama pada kasus TB resisten obat. Tujuan penelitian ini adalah untuk menganalisis perbedaan fungsi makrofag pada penderita TB resisten obat dibandingkan dengan kontak erat yang terinfeksi laten dan sehat. SMDT diisolasi dan dikultur selama 7 hari. Fagositosis dinyatakan jika terdapat minimal satu sel darah merah domba tampak melekat pada membran makrofag. Kemampuan oxygen burst makrofag ditentukan melalui pemeriksaan WST, produksi NO, dan aktivitas mieloperoksidase. Kemampuan lisosom diperiksa dengan uji aktivitas enzim β-glukuronidase dan fosfatase asam. Enam pasien TBRO dan 18 kasus kontak erat (8 TB laten;10 sehat) di RS Universitas Indonesia direkrut sebagai subyek penelitian. Hasil menunjukkan bahwa aktivitas fagositosis kelompok infeksi laten lebih tinggi dibandingkan kelompok sehat dan TB RO (oneway ANOVA, p < 0,05). Produksi NO, aktivitas mieloperoksidase, β-glukuronidase dan fosfatase asam lebih tinggi pada kelompok TB RO. Terdapat korelasi positif antara kemampuan fagositosis dengan kemampuan oksidasi antigen (uji WST), tapi terdapat korelasi negatif antara fagositosis dengan produksi NO, aktivitas mieloperoksidase dan enzim lisosom. Perbedaan fungsi makrofag ini diharapkan dapat menjadi referensi selanjutnya dalam terapi TB RO ataupun terapi pencegahan.
Kata kunci: makrofag, TB resisten obat, infeksi TB laten, fagositosis, oxygen burst


The immune system approach to the host of M. tuberculosis is an option in developing tuberculosis therapy, especially in cases of drug-resistant TB. This study aimed to analyze the differences in macrophage function in drug-resistant TB patients compared to close contacts who were latently infected and healthy. PMBC was isolated and cultured for seven days. Phagocytosis is expressed when at least one sheep red blood cell appears attached to the macrophage membrane. Macrophage oxygen burst ability was determined by examining WST, NO production, and myeloperoxidase activity. The ability of lysosomes was examined by testing the activity of the β-glucuronidase and acid phosphatase enzymes. Six DR-TB patients and 18 close contact cases (8 LTBI; 10 healthy) at Universitas Indonesia Hospital were recruited as research subjects. The results showed that the phagocytosis activity of the latent infection group was higher than that of the healthy and TB RO groups (one-way ANOVA, p < 0.05). NO production, myeloperoxidase activity, β-glucuronidase, and acid phosphatase were higher in the DR-TB group. There is a positive correlation between phagocytosis and antigen oxidizing ability (WST test), but there is a negative correlation between phagocytosis and NO production, myeloperoxidase activity, and lysosomal enzymes. The difference in macrophage function is expected to be a further reference in DR-TB treatment or preventive therapy.
Keywords: drug-resistant tuberculosis; latent tuberculosis; macrophages; phagocytosis; oxygen burst