Profil sitokin-4 dan IFN- pada penderita dermatitis kontak alergi akibat kerja dengan riwayat atopi :: Kajian pada pabrik penyamakan kulit

WIDHIATI, Suci, Prof. Dr.dr.Harijono KS, Sp.KK(K)

2010 | Tesis | S2 Ilmu Kedokteran Klinik

Latar belakang penelitian: Respon imun penderita dermatitis kontak alergi (DKA) didominasi oleh peningkatan reaksi seluler Th-1 dengan meningkatnya IFN-γ, sedang pada individu atopi terjadi dominansi respon seluler Th-2, dengan sitokin utama adalah IL-4. Ketidak seimbangan respon seluler tersebut diduga menyebabkan individu atopi lebih sulit mengalami DKA. Pekerja penyamakan kulit banyak yang mengalami DKA. Penelitian ini bertujuan untuk mengetahui perbedaan profil sitokin pada penderita DKA dengan riwayat atopi dan tanpa riwayat atopi Metode penelitian: Merupakan penelitian potong lintang. Tiga puluh subyek penelitian dibagi menjadi 2 kelompok, yaitu kelompok DKA dengan riwayat atopi berjumlah 15 orang dan DKA tanpa riwayat atopi dengan jumlah sama. Kedua kelompok dilakukan uji tempel tertutup dan dinyatakan mengalami DKA apabila didapatkan hasil uji tempel minimal+1 pada pembacaan ke 48 dan /atau 96. Riwayat atopi ditegakkan berdasarkan skor atopic skin diathesis > 8. Kadar IL-4 dan IFN-γ didapatkan dari serum subyek yang diperiksa menggunakan ELISA. Data dianalisa menggunakan uji non parametrik Mann-Whitney. Perbedaan signifikan didapatkan bila nilai p < 0,05. Analisa data menggunakan SPSS 15. Hasil: Profil sitokin IL-4 tidak berbeda bermakna antara penderita DKA-atopi dan DKA-non atopi (p=0,917), begitu pula dengan profil IFN- antara kedua kelompok (p=0,096). Penderita DKA dengan lesi kulit mempunyai profil sitokin IL-4 dan IFN-γ yang tidak berbeda bermakna bila dibandingkan dengan penderita tanpa lesi kulit. Skor RKA <4, 8-9 dan >10 tidak mempunyai kadar IL-4 dan IFN-γ yang berbeda. Kesimpulan: Individu atopi yang mengalami DKA mempunyai respon imun yang tidak berbeda dengan individu tanpa riwayat atopi.

Background: The immune response in allergic contact dermatitis (ACD) were dominated by an increment of Th-1, especially IFN-γ. However in atopic individual Th-2 immune response (IL-4) is higher compared to Th-1. According to the condition then hypothesized that atopic individual was hardly to developed ACD. In leather factory, many worker were prone to developed ACD. The aim of this study is to differentiate the cytokine profiles that was developed in ACD patients with or without atopic background. Methods: This was a cross sectional study. Thirty subject were assigned into two groups, one group consists of 15 subjects diagnosed with ACD who had atopic background (ACD-atopic), the other also had 15 subjects with ACD but no atopic background (ACD-non atopic). Both groups were examined by patch test with +1 result in 48 and / or 96 hour examination. Atopic skin diathesis score > 8, was used to determined the possibility of having atopic background. IL-4 and IFN-γ concentration were examined using ELISA. Data were analyzed using SPSS with Mann-Whitney non- parametric test. Result: The cytokine profiles of IL-4 and IFN-γ were not significantly different between ACD-atopic and ACD non atopic individuals (p=0,917, p=0,096). The cytokine profile of IL-4 and IFN-γ were not significant when we compare subject with lesional skin and non lesional skin (p=0,338, p=0,874). The comparation of atopic skin diathesis score less than 4, 8-9, >10 with cytokine profiles (IL-4 and IFN-γ) also not significant (p=0,23 ; p=0,97). Conclusion: Atopic and non-atopic individuals have a similar immunologic response during development of ACD. The cytokine profile of lesional skin ACD compared to no lesional skin did not different also. Comparasion between ASD with cytokine profile did not different significantly also.

Kata Kunci : Dermatitis kontak alergi, Atopi, sitokin, IL-4, IFN-γ, Allergic contact dermatitis, atopy, cytokine, IL-4, IFN-γ