HUBUNGAN PROMOTOR PSEUDOGEN MYCOBACTERIUM LEPRAE-1545, KADAR IMUNOGLOBULIN-M ANTIPHENOLIC GLYCOLIPID 1, DAN MATRIX METALLOPROTEINASE 9 DENGAN TINGKAT KEPARAHAN PENYAKIT KUSTA

Fitriyanti, dr (2019) HUBUNGAN PROMOTOR PSEUDOGEN MYCOBACTERIUM LEPRAE-1545, KADAR IMUNOGLOBULIN-M ANTIPHENOLIC GLYCOLIPID 1, DAN MATRIX METALLOPROTEINASE 9 DENGAN TINGKAT KEPARAHAN PENYAKIT KUSTA. Doctoral thesis, Universitas Andalas.

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Abstract

ABSTRAK HUBUNGAN PROMOTOR PSEUDOGEN MYCOBACTERIUM LEPRAE-1545, KADAR IMUNOGLOBULIN-M ANTI PHENOLIC GLYCOLIPID 1, DAN MATRIX METALLOPROTEINASE 9 DENGAN TINGKAT KEPARAHAN PENYAKIT KUSTA Fitriyanti Kusta adalah penyakit infeksi granulomatosa kronik disebabkan oleh basil obligat intraseluler Mycobacterium leprae (M leprae), terutama mengenai kulit dan saraf perifer serta dapat menyebabkan kecacatan dan kerusakan fisik yang jelas. Identifikasi dini kasus kusta masih menjadi prioritas utama dalam mengontrol penyakit ini, serta merupakan strategi untuk memutuskan rantai penularan dan mencegah kecacatan fisik. Penelitian ini bertujuan untuk mengetahui hubungan Promotor Pseudogen Mycobacterium leprae-1545, kadar Imunoglobulin-M anti Phenolic Glycolipid-1 dan Matrix Metalloproteinase 9 dengan tingkat keparahan kusta. Penelitian ini merupakan penelitian observasional dengan desain potong lintang. Sampel diambil dari darah vena penderita kusta multibasiler sebanyak 32 orang dan narakontak yang tinggal serumah lebih dari 5 tahun sebanyak 32 orang . Pemeriksaan laboratorium hapusan sayatan kulit diperlukan mengetahui nilai Indeks Bakteri (BI). Pemeriksaan Pseudogen regio promotor ML-1545 M leprae dilakukan dengan teknik PCR. Kadar IgM anti PGL-1 dan MMP-9 diperiksa dengan teknik ELISA. Hasil penelitian memperlihatkan terdapat hubungan yang bermakna antara kadar IgM anti PGL-1 dengan tingkat keparahan kusta yaitu narakontak dengan nilai IB ≥ 3 dengan nilai p < 0,05 dan nilai IB < 3 dengan nilai IB ≥ 3 yang memiliki nilai p < 0,05. Hasil penelitian juga menunjukkan terdapat hubungan yang bermakna antara kadar MMP-9 dengan tingkat keparahan kusta. Peranan IgM anti Phenolic Glycolipid-1 dan MMP-9 dalam kejadian kusta bermakna secara statistik dengan nilai p < 0,05, namun nilai p IgM anti Phenolic Glycolipid-1 lebih kecil dibandingkan MMP-9. Dari hasil penelitian ini dapat disimpulkan bahwa semakin tinggi nilai indeks bakteri maka kadar serum IgM anti Phenolic Glycolipid-1 akan semakin meningkat. Semakin tinggi nilai indeks bakteri, maka kadar serum MMP-9 akan semakin menurun. Faktor yang paling berperan dalam tingkat keparahan kusta adalah IgM anti PGL-1. Kata kunci Tingkat keparahan kusta, promotor pseudogen ML-1545 M leprae, IgM anti PGL-1, MMP-9 ABSTRACT RELATIONSHIP OF PSEUDOGEN PROMOTOR MYCOBACTERIUM LEPRAE-1545, Ig-M ANTI PHENOLIC GLYCOLIPID 1 LEVEL, AND MATRIX METALLOPROTEINASE 9 LEVEL WITH SEVERITY OF LEPROSY DISEASE Fitriyanti Leprosy is a chronic granulomatous infection caused by intracellular obligate bacillus Mycobacterium leprae (M leprae), especially regarding the skin and peripheral nerves and can cause disability and obvious physical damage. Early identification of leprosy cases is still a mayor priority in controlling this disease, and become a strategy to break the transmission chain and prevent physical disability. This study aims to determine the relationship between Pseudogen Promoter Mycobacterium leprae-1545, Immunoglobulin-M anti Phenolic Glycolipid-1 levels and Matrix Metalloproteinase 9 with leprosy severity. This study is an observational study with a cross-sectional design. Samples were taken from venous blood of 32 multibacillary leprosy patients and 32 contact persons who lived more than 5 year. Laboratory tests for skin incision smear are required to know the value of the Bacterial Index (BI). Pseudogen promoter region examination of the ML 1545 M leprae was carried out by PCR technique. IgM anti PGL-1 and MMP-9 level were examined by ELISA technique. The results showed a significant correlation between IgM anti PGL-1 level and leprosy severity, that is contact with IB ≥ 3 with p value < 0.05 and IB <3 with IB ≥ 3 which had p value < 0.05. The results also showed a significant relationship between MMP-9 level and the severity of leprosy. The role of IgM anti-phenolic Glycolipid-1 and MMP-9 in the incidence of leprosy was statistically significant with p value < 0.05, but the p value of IgM anti-phenolic Glycolipid-1 was smaller than MMP-9. From the results of this study it can be concluded that, the higher bacterial index value, the serum level of IgM anti-phenolic Glycolipid-1 will increase too. The higher bacterial index value, the MMP-9 serum level will decrease. The most important factor in the severity of leprosy is the anti-PGL-1 IgM. Keywords: Leprosy severity, pseudogen promoter region ML 1545 M leprae, anti PGL-1 IgM, MMP-9

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