Hubungan kadar matriks metalloproteinase-3 (MMP3) serum dengan gradasi klinis pada penderita Osteoartritis lutut di RSUP Dr. Sardjito

LIE, Arif Lianto, dr. Nyoman Kertia, SpPD-KR

2007 | Tesis | PPDS I Ilmu Penyakit Dalam

Latar Belakang. Proses fundamental yang mendasari kerusakan rawan sendi pada OA terjadi akibat ketidakseimbangan antara regulasi biosintesa kondrosit dan aktivitas katabolik, degenerasi matriks ekstraseluler dan adanya stres mekanik serta didukung ekspresi genetik. Matriks ekstra seluler rawan sendi dirusak oleh matriks metalloproteinase (MMP) yang diinduksi oleh sitokin. MMP- 3 berperanan penting dalam mendegradasi bermacam komponen tulang rawan seperti gelatin, aggrecan dan collagen. Gradasi klinis diukur dengan Visual Analogue Scale dan Indeks Lequesne. Tujuan Penelitian. untuk mengetahui hubungan antara kadar matriks metalloproteinase-3 serum dengan gradasi klinis OA lutut. Metode dan cara penelitian. Penelitian ini dilakukan secara potong lintang pada penderita Osteoartritis lutut yang kontrol di Poliklinik Reumatologi RSUP Dr. Sardjito pada bulan September-Desember 2006. Kadar MMP-3 serum diperiksa dengan instant ELISA. Hubungan antara MMP-3 serum dengan VAS dan Indeks Lequesne dianalisis dengan korelasi Spearman. Hasil penelitian: Didapatkan 40 subyek penelitian dengan rerata kadar MMP-3 serum 18,18 ± 21 ng/ml. Hasil penelitian menunjukkan bahwa kadar MMP-3 serum dan VAS mempunyai hubungan negatif lemah namun tidak bermakna (r= –0,259; p=0,106), sedangkan antara MMP-3 serum dan Indeks Lequesne mempunyai hubungan tidak bermakna (r= – 0,075; p= 0,644). Simpulan: Hasil penelitian menunjukkan bahwa kadar matriks metalloproteinase-3 (MMP-3) serum tidak ada hubungannya dengan gradasi klinis.

Background. Imbalance of chondrosit biosynthesis regulation with catabolic activity, extracellular matrix degeneration, and mechanical stress, and genetic expression is fundamental processes for articular cartilage disruption of osteoarthritis. Extracellular matrix of articular cartilage disrupted by matrix metalloproteinase (MMP), induced cytokine. MMP-3 play important role in degradation of articular cartilage components such as gelatine, aggrecant, and collagen. Clinical gradation measured by Visual analogue scale and Lequesne index. Objectives. The purpose of the study was to assess the correlation between serum matrix metalloproteinase level with clinical gradation of knee osteoarthritis. Methods. This is a cross-sectional study in patients with osteoarthritis of the knee recruited from Rheumatology Department, RSUP Dr. Sardjito, Yogyakarta on September-December 2006. Correlations between matrix metalloproteinase level with Visual analogue scale and Lequesne index analyze with Spearman’s rho. Results. From 40 subjects that fulfilled the criteria, mean of matrix metalloproteinase level was 18,18 + 21 ng/mL. Correlation between matrix metalloproteinase-3 (MMP-3) and Visual analogue scale was negative and weak (r = -0,259, p = 0,106), with Lequesne index had no correlation (r = -0.075, p = 0,644). Conclusion. There was no correlation between serum matrix metalloproteinase-3 (MMP-3) with clinical gradation.

Kata Kunci : Osteoartritis Lutut,Matriks Metalloproteinase,Matrix metalloproteinase,Visual analogue scale,Lequesne index