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"Background: house dust mites (HDM) are an important inhalant allergen in allergic asthma. However, molecular diagnostic study of specific IgE to HDM allergens has not been done in Indonesia. In addition, the association of quantitative specific IgE measurement with asthma severity has not been investigatedd. This study aimed to investigate the difference of serum quantitative specific IgE levels induced by Dermatophagoides (D.) pteronyssinus, D. farinae and Blomia tropicalis sensitization in intermittent and persistent allergic asthma. Methods:this was a cross-sectional study on adult allergic asthma patients who were invited for serum specific IgE testing. This study was a part of a larger study within the Division of Allergy and Immunology, Cipto Mangunkusumo Hospital. Asthma severity was defined based on Global Initiative on Asthma (GINA) 2015 criteria and were grouped as intermittent or persistent. Quantitative specific IgE testing was done on blood serum using a multiple allergosorbent test (Polycheck Allergy, Biocheck GmbH, Munster, Germany). The HDM allergens tested were D. pteronyssinus, D. farinae, and Blomia tropicalis. Difference between two groups were analyze using Mann-Whitney test. Results: a total of 87 subjects were enrolled in this study; 69 (79.3%) were women. Mean patients’ age was 40, 2 years. Sixty-three (72.4%) subjects had asthma and allergic rhinitis. Fifty-eight (66.7%) subjects were classified as persistent asthma. The prevalence of sensitization was 62.1% for D. farinae, 51.7% for D. pteronyssinus, and 48.3% for Blomia tropicalis. The median of specific IgE levels were significantly higher in persistent asthma compares to intermittent asthma induced by D. farinae (median 1.30 vs. 0.0 kU/L; p=0.024) and B. tropicalis (median 0.57 vs. 0.0 kU/L; p=0.015) sensitization. Level of Specific IgE D. pteronyssinus was also to be higher in persistent asthma than the level measured in intermittent asthma (0.67 vs. 0.00 kU/L; p=0.066). Conclusion: Sensitization of HDM allergens was shown to be highest for D. farinae 62.1%, followed by D. pteronyssinus 51.7% and Blomia tropicalis 48.3%. Specific IgE level induced by D. farinae and Blomia tropicalis sensitization were significantly higher in patients with persistent asthma compared to intermittent asthma, whereas specific IgE level induced by D. pteronyssinus sensitization was higher in persistent asthma although not statistically significant.

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Latar belakang: tungau debu rumah (TDR) merupakan alergen hirup yang penting pada asma alergik. Namun, penelitian diagnostik molekuler menggunakan Imunoglobulin E (IgE) spesifik akibat sensitisasi alergen TDR dihubungkan dengan derajat keparahan asma alergik belum pernah dilakukan di Indonesia. Penelitian ini bertujuan mengetahui perbedaan kadar IgE spesifik serum kuantitatif akibat sensitisasi alergen Dermatophagoides (D.) pteronyssinus, D. farinae dan Blomia (B.) tropicalis pada asma alergik intermiten dan persisten. Metode: desain penelitian potong lintang pada pasien asma alergik dewasa yang diundang untuk pemeriksaan IgE spesifik serum dan merupakan bagian dari penelitian payung di Divisi Alergi dan Imunologi Klinik, RS Cipto Mangunkusumo. Derajat keparahan asma ditentukan berdasarkan kriteria Global Initiative on Asthma (GINA) 2015 dan dikelompokkan menjadi intermiten dan persisten. Pemeriksaan IgE spesifik serum kuantitatif menggunakan metode multiple allergosorbent test (Polycheck Allergy, Biocheck GmbH, Munster, Germany). Alergen TDR yang diperiksa adalah D. pteronyssinus, D. farinae, dan B. tropicalis. Perbedaan antara dua kelompok dianalisis dengan uji Mann-Whitney. Hasil: sebanyak 87 subyek dilibatkan dalam penelitian ini; 69 (79,3%) subyek adalah perempuan. Rerata usia pasien adalah 40,2 tahun. Enam puluh tiga (72,4%) pasien menderita asma dan rinitis alergik. Sebanyak 58 (66,7%) pasien asma persisten. Gambaran sensitisasi alergen TDR adalah 62,1% D. farinae; 51,7% D. pteronyssinus dan 48,3% B.tropicalis. Median kadar IgE spesifik secara bermakna lebih tinggi pada asma persisten dibandingkan asma intermiten untuk alergen D. farinae (1,30 vs. 0,0 kU/L; p=0,024) dan B. tropicalis (0,57 vs. 0,0 kU/L; p=0,015). Kadar IgE spesifik D. pteronyssinus lebih tinggi pada asma persisten dibandingkan intermiten (0,67 vs. 0,00 kU/L; p=0,066). Kesimpulan: gambaran sensitisasi alergen secara berurutan didapatkan D. farinae 62,1%, D. pteronyssinus 51,7% dan B. tropicalis 48,3%. Kadar IgE spesifik akibat sensitisasi D. farinae dan B. tropicalis lebih tinggi secara bermakna pada pasien asma persisten dibandingkan asma intermiten. Kadar IgE spesifik akibat sensitisasi D. pteronyssinus lebih tinggi pada pasien asma persisten dibandingkan asma intermiten, tetapi secara statistik tidak bermakna."

"Latar belakang: Tungau debu rumah TDR merupakan alergen hirup yang penting pada asma alergik. Namun, penelitian diagnostik molekuler menggunakan Imunoglobulin E IgE spesifik akibat sensitisasi alergen TDR dihubungkan dengan derajat keparahan asma alergik belum pernah dilakukan di Indonesia.Tujuan: Mengetahui perbedaan kadar IgE spesifik serum kuantitatif akibat sensitisasi alergen Dermatophagoides D. pteronyssinus, D. farinae dan Blomia B. tropicalis pada asma alergik intermiten dan persisten.Metode: Desain penelitian potong lintang pada pasien asma alergik dewasa yang diundang untuk pemeriksaan IgE spesifik serum dan merupakan bagian dari penelitian payung di Divisi Alergi dan Imunologi Klinik, RS Cipto Mangunkusumo. Derajat keparahan asma ditentukan berdasarkan kriteria Global Initiative on Asthma GINA 2015 dan dikelompokkan menjadi intermiten dan persisten. Pemeriksaan IgE spesifik serum kuantitatif menggunakan metode multiple allergosorbent test Polycheck Allergy, Biocheck GmbH, Munster, Germany . Alergen TDR yang diperiksa adalah D. pteronyssinus, D. farinae, dan B. tropicalis. Perbedaan antara dua kelompok dianalisis dengan uji Mann-Whitney.Hasil: Sebanyak 87 subyek dilibatkan dalam penelitian ini; 69 79,3 subyek adalah perempuan. Rerata usia pasien adalah 40,2 tahun. Enam puluh tiga 72,4 pasien menderita asma dan rinitis alergik. Sebanyak 58 66,7 pasien asma persisten. Gambaran sensitisasi alergen TDR adalah 62,1 D. farinae; 51,7 D. pteronyssinus dan 48,3 B.tropicalis. Median kadar IgE spesifik secara bermakna lebih tinggi pada asma persisten dibandingkan asma intermiten untuk alergen D. farinae 1,30 vs. 0,0 kU/L; p=0,024 dan B. tropicalis 0,57 vs. 0,0 kU/L; p=0,015 . Kadar IgE spesifik D. pteronyssinus lebih tinggi pada asma persisten dibandingkan intermiten 0,67 vs. 0,00 kU/L; p=0,066.Kesimpulan:Gambaran sensitisasi alergen secara berurutan didapatkan D. farinae 62,1, D. pteronyssinus 51,7 dan B. tropicalis 48,3 . Kadar IgE spesifik akibat sensitisasi D. farinae dan B. tropicalis lebih tinggi secara bermakna pada pasien asma persisten dibandingkan asma intermiten. Kadar IgE spesifik akibat sensitisasi D. pteronyssinus lebih tinggi pada pasien asma persisten dibandingkan asma intermiten, tetapi secara statistik tidak bermakna.

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Introduction House dust mites HDM are an important inhalant allergen in allergic asthma. However, molecular diagnostic study using specific IgE level induced by HDM allergens associated with asthma severity has not been done in Indonesia.Objective To investigate the difference of serum quantitative specific IgE levels induced by Dermatophagoides D. pteronyssinus, D. farinae and Blomia B. tropicalis sensitization in intermittent and persistent allergic asthma.Method This was a cross sectional study on adult allergic asthma patients who were invited for serum specific IgE testing. This study was a part of a larger research within the Division of Allergy and Immunology, Cipto Mangunkusumo Hospital. Asthma severity was defined based on Global Initiative on Asthma GINA 2015 criteria and were grouped as intermittent or persistent. Quantitative specific IgE testing was done on blood serum using a multiple allergosorbent test Polycheck Allergy, Biocheck GmbH, Munster, Germany . The HDM allergens tested were D. pteronyssinus, D. farinae, and Blomia tropicalis. Difference between two groups were analyze using Mann Whitney test.Results A total of 87 subjects were enrolled in this study 69 79.3 were women. Mean patients rsquo age was 40, 2 years. Sixty three 72.4 patients had asthma and allergic rhinitis. Fifty eight 66.7 patients were classified as persistent asthma. The prevalence of sensitization was 62.1 D. farinae, 51.7 D. pteronyssinus, and 48.3 Blomia tropicalis. The median of specific IgE levels is significantly higher in persistent asthma compares to intermittent asthma induced by D. farinae median 1.30 vs. 0.0 kU L p 0.024 and B. tropicalis median 0.57 vs. 0.0 kU L p 0.015 sensitization. Level of Specific IgE D. pteronyssinus is also to be higher in persistent asthma than the level measured in intermittent asthma 0.67 vs. 0.00 kU L p 0.066.Conclusion Sensitization of HDM allergens is shown to be highest for D. farinae 62.1 , followed by D. pteronyssinus 51, 7 and Blomia tropicalis 48, 3 . Specific IgE level induced by D. farinae and Blomia tropicalis sensitization are significantly higher in patients with persistent compares to intermittent asthma, whereas specific IgE level induced by D. pteronyssinus sensitization to be higher in persistent asthma although not statistically significant."

"Tungau debu rumah (TDR) adalah salah satu sumber alergen yang paling umum. Sensitisasinya dapat menyebabkan asma. Alergen TDR kelompok 1 adalah alergen kuat anggota keluarga protease sistein yang mampu mengaktifkan alergen lain: kelompok 3, 6, dan 9 yang memiliki aktivitas protease serin. Aktivitas proteolitik terlibat dalam etiologi asma melalui meningkatkan permeabilitas sel epitel saluran napas yang memungkinkan alergen tersebut bersama alergen lain melewati sel epitel dengan memotong protein antar sel. Tubuh manusia memiliki inhibitor protease seperti alpha-1 antitripsin (AAT) merupakan antiprotease serin dan sistatin C merupakan antiprotease sistein. AAT diketahui juga merupakan protein fase aktif positif yang terlibat dalam mekanisme resolusi inflamasi. Sistatin C secara signifikan berhubungan dengan beberapa marker inflamasi seperti protein C-reaktif, IL-6, dan TNF-α. Penelitian kami bertujuan mengetahui keadaan AAT dan sistatin C serum pasien asma TDR. Sebuah studi potong lintang dari 10 pasien asma TDR dan 10 subjek sehat dilakukan. Aktivitas penghambatan AAT dan sistatin C serum diukur dengan uji enzimatik. Konsentrasi AAT dan sistatin C serum diukur dengan metode ELISA. Tidak ada perbedaan signifikan pada aktivitas penghambatan AAT serum (p=0,445, p>0,05), konsentrasi AAT (p=0,290, p>0,05), dan konsentrasi sistatin C (p=0,290, p>0,05). Aktivitas penghambatan sistatin C serum pada pasien asma secara signifikan lebih tinggi daripada subjek sehat (p=0,001, p<0,05). Tidak ada korelasi antara aktivitas penghambatan AAT dan konsentrasi AAT atau korelasi antara aktivitas penghambatan sistatin C dan konsentrasi sistatin C yang diamati. Aktivitas sistatin C pada asma TDR signifikan lebih tinggi daripada subjek sehat. Sedangkan, aktivitas AAT, konsentrasi AAT, dan sistatin C pada pasien asma TDR tinggi tidak signifikan daripada subjek sehat.

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House dust mite (HDM) is one of the most common sources of allergen. Its sensitization can lead to asthma. The group 1 mite allergens are potent allergens belonging to the papain-like cysteine protease family. Moreover, the group 1 mite allergens were able to activate others like groups 3, group 6, and group 9 that have serine protease activity. The proteolytic activity involves the etiology of asthma by increasing the permeability of the airway epithelial cell and allowing themselves and other allergens to pass through the epithelial cells by cleaving the cell surface molecules. The human body has natural inhibitor protease like alpha-1 antitrypsin (AAT) which has anti-serine protease and cystatin C which has anti-cysteine protease. AAT is known as an acute phase protein that is involved in the inflammation resolution mechanism. Cystatin C was significantly correlated with several inflammatory markers such as C-reactive protein, IL-6, and TNF-α. Our study aimed to investigate the behavior of serum alpha-1 antitrypsin and cystatin C in patients with house dust mite asthma. A cross-sectional study of 10 patients with HDM allergic asthma and 10 healthy subjects were carried out. Serum AAT and cystatin C inhibitory activity were measured with enzymatic assays. While serum AAT and cystatin C concentration were determined by ELISA method. No significant differences in serum AAT inhibitory activity (p=0.445, p>0.05), serum AAT concentration (p=0.290, p>0.05), and cystatin C concentration (p=0.290, p>0.05). Serum cystatin C inhibitory activity in asthmatic patients was significantly higher than healthy subject (p=0.001, p<0.05). Neither correlation between the AAT inhibitory activity and the AAT concentration or correlation between cystatin C inhibitory activity and cystatin C concentration was observed. In conclusion, the activity of cystatin C in dust mite asthma is significantly higher than in healthy subjects. Whereas the activity of AAT, concentration of AAT, and cystatin C in dust mite asthma patients are insignificantly higher than in healthy subjects."

"Background: nowadays, specific IgE measurement has been conducted in Indonesia, however there is still lack of data regarding diagnostic test to detect inhalant allergen in patients with respiratory allergies. This study aimed to determine the accuracy of specific IgE test in diagnosing specific sensitization of inhalant allergen in patients with respiratory allergies.Methods: this was a cross sectional study in patients with respiratory allergies and part of epidemiology study regarding to specific IgE sensitization in Allergy-Immunollogy Division, Cipto Mangunkusumo Hospital, Jakarta within November-December 2016. Measurement of specific IgE sensitization using Immunoblot method (Euroline, Euroimmun AG, Germany). The tested allergen is house dust mites Dermatophagoides pteronyssinus (Der p), Dermatophagoides farinae (Der f), Blomia tropicalis (Blo t) and cockroach Blatella germanica (Bla g). The result is compared with gold standard, skin prick test. The diagnostic result includes sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), positive likelihood ratio (LR+), and negative likelihood ratio (LR-).Results: a total of 101 patients were enrolled; 77 (76.2%) were women. Patients mean age was 38.8 years old. Based on SPT, sensitization was highest for Blo t (76.2%), followed by Der p (70.3%), Der f (69.3%), and Bla g (41.6%). Specific IgE-sensitization was highest for Der f (52.9%), followed by Der p (38.2%), Blo t (33.3%) and Bla g (10.8%). Der p allergen had 50.7% sentivity, 90% specificity, 92.3% PPV, 43.5% NPV, 5.1 LR+ and 0.1LR-. Der f showed 71.4% sensitivity, 87.1% specificity, 82.6% PPV, 57.4% NPV, 5.5 LR+ and 0.3 LR-. Blo t allergen had 41.6% sensitivity, 91.7% specificity, 94.1% PPV, 32.8% NPV, 5.0 LR+, and 0.6 LR-. Bla g allergen had 23.8% sensitivity, 98.3% specificity, 90.9% PPV, 64.4% NPV, 14.5 LR+ and 0.8 LR-.Conclusion: serum specific IgE testing to common inhalant allergen in patients with respiratory allergy showed only low-to-moderate sensitivity, but high specificity and PPV. This new assay can be used to diagnose allergen sensitization in the population with high prevalence of TDR and cockroach.

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Latar belakang: pemeriksaan IgE spesifik serum baru diperkenalkan di Indonesia, tetapi belum ada data uji diagnostik mengenai kinerjanya dalam mendeteksi alergen hirupan yang sering pada pasien alergi pernapasan. Tujuan penelitian ini adalah untuk mendapatkan akurasi diagnostik pemeriksaan IgE spesifik serum dalam mendiagnosis sensitisasi alergen hirupan tertentu pada pasien alergi pernapasan.

Metode: penelitian ini adalah studi potong lintang pada pasien alergi pernapasan dan merupakan bagian dari studi epidemiologi mengenai sensitisasi IgE spesifik di Divisi Alergi-Immunologi, RS Cipto Mangunkusumo, Jakarta, pada bulan November sampai Desember 2016. Pengukuran sensitisasi IgE spesifik dilakukan dengan metode imunoblot (Euroline®, Euroimmun AG, Germany). Alergen yang diuji adalah tungau debu rumah [Dermatophagoides pteronyssinus (Der p), Dermatophagoides farinae (Der f), Blomia tropicalis (Blo t)], dan kecoa [Blatella germanica (Bla g)]. Hasilnya dibandingkan dengan baku emas uji tusuk kulit. Uji diagnostik yang dilakukan meliputi sensitivitas, spesifisitas, positive predicitive value (PPV), negative predictive value (NPV), likelihood ratio positif dan negatif (LR+ and LR-).

Hasil: sebanyak 101 pasien dilibatkan dalam studi, 77 (76,2%) di antaranya adalah perempuan. Rerata usia pasien adalah 38,8 tahun. Berdasarkan uji tusuk kulit, sensitisasi tertinggi yang didapatkan adalah terhadap Blo t (76,2%), disusul oleh Der p (70,3%), Der f (69,3%), dan Bla g (41,6%). Sensitisasi IgE-spesifik tertinggi ditunjukkan oleh Der f (52,9%), diikuti oleh Der p (38,2%), Blo t (33,3%) dan Bla g (10,8%). Alergen Der p memiliki 50,7% sentivitas, 90% spesifisitas, 92,3% PPV, 43,5% NPV, 5,1 LR+ dan 0,1 LR-. Der f memperlihatkan 71,4% sensitivitas, 87,1% spesifisitas, 82,6% PPV, 57,4% NPV, 5,5 LR+ dan 0,3 LR-. Alergen Blo t menunjukkan 41,6% sensitivitas, 91,7% spesifisitas, 94,1% PPV, 32,8% NPV, 5,0 LR+, dan 0,6 LR-. Alergen Bla g menghasilkan 23,8% sensitivitas, 98,3% spesifisitas, 90,9% PPV, 64,4% NPV, 14,5 LR+ dan 0,8 LR-.

Kesimpulan: pemeriksaan IgE spesifik serum terhadap alergen inhalan pada pasien alergi pernapasan memperlihatkan sensitivitas rendah sampai sedang, tetapi spesifisitas dan PPV yang tinggi. Pemeriksaan dapat digunakan mendiagnosis sensitisasi alergen pada populasi dengan prevalensi TDR dan kecoa yang tinggi."

"ABSTRAKLatar Belakang: Asma alergi merupakan salah satu jenis fenotipe asma yang terbanyak, ditandai dengan adanya sensitisasi terhadap alergen lingkungan. Pada asma alergi terjadi respons inflamasi tipe 2 yang akan menghasilkan periostin yang dapat dideteksi dalam darah. Salah satu faktor yang mempengaruhi keterkontrolan asma adalah paparan alergen yang dapat bervariasi bergantung pada pola musim. Wilayah Indonesia sebagai benua maritim memiliki dua musim (hujan dan kemarau) berbeda dengan wilayah lain yang memiliki empat musim. Tujuan: Penelitian ini bertujuan untuk melihat perbedaan kadar periostin serum pada asma alergi terkontrol dan tidak terkontrol. Metode: Penelitian ini merupakan penelitian potong lintang dengan subjek penelitian adalah pasien asma alergi yang berobat ke poliklinik divisi Alergi Imunologi Klinik Rumah Sakit Dr Cipto Mangunkusumo bulan Januari-April 2017. Keterkontrolan asma dinilai dengan skor Tes Kontrol Asma sementara periostin serum digunakan sebagai penanda proses inflamasi Th2. Hasil: Dari 80 pasien asma alergi didapatkan rerata usia 39,7 tahun dengan proporsi perempuan lebih banyak (76%). Sebagian besar pasien memiliki riwayat rinitis alergi (73,8%) dan riwayat asma dalam keluarga (71%). Tungau debu rumah merupakan jenis alergen yang banyak memberikan sensitisasi. Kadar periostin serum pada subjek yang tidak terkontrol tidak berbeda dengan subjek yang terkontrol (209,78 ng/mL vs 627,66 ng/mL, p = 0,424) Simpulan: Tidak terdapat perbedaan kadar periostin pada kelompok asma alergi terkontrol dan tidak terkontrol.

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ABSTRACTBackground: Allergic asthma is the most common asthma phenotype, defined by the presence of sensitization to environmental allergens. In allergic asthma, following allergen exposure there will be an activation of T2-type inflammation producing periostin that can be detected from blood. Many factors can influence asthma control, including allergen exposure, which may vary greatly with climatic and seasonal changes. The Indonesia region as the Maritime Continent is characterized by a wet and a dry season which is different from other regions with four seasons. Objective: To see the difference of serum periostin level in uncontrolled and controlled allergic asthma. Methods: This is a cross sectional study using samples from allergic asthma patients who went to Allergy and Clinical Immunology Clinic, Dr. Cipto Mangunkusumo Hospital in January to April 2017. Asthma control was assessed clinically by using Asthma Control Test, while serum periostin was used as biological markers reflecting Th2 inflammation. Results: From 80 allergic asthma patients, the average of age was 39.7 years old with a greater proportion of women (76%). Most of the subjects had history of allergic rhinitis (73.8%) and positive family history of asthma (71%). House dust mites were the most common cause of sensitization. Serum periostin level in uncontrolled allergic asthma was not different from those in controlled allergic asthma (209,78 ng/mL vs 627,66 ng/mL, p = 0,424). Conclusions: There was no difference in the level of serum periostin in controlled and uncontrolled allergic asthma."

"Asma merupakan inflamasi kronik saluran napas yang timbul karena respons tubuh terhadap faktor eksogen, misalnya alergen, iritasi, dan infeksi. Sebagian pasien asma dilaporkan mengalami perkembangan gejala asma karena pajanan tungau debu rumah TDR . Identifikasi TDR, tempat hidupnya, serta densitas tungau penting dilakukan untuk mengendalikan faktor pencetus, sekaligus mencegah berkembangnya penyakit asma. Penelitian kasus kontrol ini bertujuan untuk mengetahui profil TDR pada pasien asma persisten, termasuk jenis dan kepadatan tungau, serta hubungannya dengan kadar serum IgE spesifik anti-TDR. Penelitian dilakukan pada bulan Februari 2017 sampai Desember 2017. Sebanyak 13 pasien asma persisten dan 12 pasien kontrol telah menjalani pemeriksaan kadar serum IgE spesifik anti-TDR menggunakan Immulite 2000 xpi. Sampel debu rumah diambil dari rumah pasien dan diperiksa menggunakan metode Fain. Hasil penelitian menunjukkan variasi spesies TDR didominasi D. pteronyssinus. Kepadatan D. pteronyssinus adalah 83,9 yaitu 120 spesies tungau tersebut dari 143 tungau yang diperoleh. Kadar serum IgE spesifik anti-TDR pada pasien asma persisten lebih tinggi dibandingkan pasien normal, dengan rerata 2,35 kU/L nilai positif bila >0,35 kU/L . Kepadatan D. pteronyssinus dalam debu kamar tidur menunjukkan korelasi positif dengan kadar serum IgE anti-TDR pada pasien asma persisten.

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Asthma is a chronic inflammation of airways, as a response to exogenous factors, such as alergens, irritants, and infections. Some asthmatic patients had symptoms of asthma due to exposure to house dust mites HDM alergen. Identification of HDM, the habitat, and density of mites are important to control the trigger factors, and preventing the asthma pathogenesis. This case control study aimed to determine the HDM profiles in persistent asthmatic patients, including the species, density of mites, as well as its association with specific IgE anti HDM serum levels. The study was conducted in February 2017 to December 2017. A total of 13 patients with persistent asthma and 12 control patients had screened with specific anti HDM IgE levels using Immulite 2000 xpi. The house dust samples was taken and examined using the Fain method. The results showed that HDM species was predominantly D. pteronyssinus. The density was 120 species of D. pteronyssinus from 143 mites found 83.9 . Specific anti HDM IgE serum levels in persistent asthmatic levels were higher than normal patients, with a mean of 2.35 kU L positive values if 0.35 kU L . Density of D. pteronyssinus in dust of bed room showed a positive correlation with serum IgE specific of anti HDM level in persistent asthmatic patients."

"Latar belakang : Asma memengaruhi sekitar 300 juta orang di seluruh dunia dan menjadi masalah kesehatan global yang serius yang mempengaruhi semua kelompok umur. Asma alergi adalah fenotipe asma yang paling mudah dikenali dan sering dimulai sejak masa anak-anak. Sebagian besar asma alergi berhubungan dengan sensitisasi saluran napas akibat pajanan aeroalergen umum, terutama yang berasal dari tungau debu rumah. Proses inflamasi eosinofilik saluran napas menghasilkan produk akhir berupa nitrit oksida. Kadar nitrit oksida udara ekspirasi (FeNO) merupakan salah satu penanda hayati yang mengukur inflamasi saluran napas dan kadar FeNO yang tinggi pada pasien asma berhubungan dengan inflamasi saluran napas eosinofilik.Penilitian ini bertujuan mengetahui hubungan kadar IgE spesifik Der p dan Der f  dengan kadar FeNO pada pasien asma tidak terkontrol di RSUP Persahabatan.Metode : Penelitian ini merupakan studi potong lintang dengan jumlah sampel 86 subjek pasien asma tidak terkontrol berdasarkan asthma control test di RSUP Persahabatan. Metode pengumpulan subjek dilakukan dengan teknik consecutive sampling. Pemeriksaan IgE spesifik tungau debu rumah menggunakan protia Q96M. Pemeriksaan FeNO menggunakan Bedfont NObreath.Hasil : Dari 86 subjek asma tidak terkontrol didapatkan hasil rerata usia pasien asma tidak terkontrol di RSUP Persahabatan adalah  52,45 + 12,94 tahun, sebagian besar berjenis kelamin perempuan (84,9%).Proporsi pasien asma yang alergi terhadap tungau debu rumah  mencapai 64%. Prorporsi alergi Der p dan Der f 58%, alergi Der p 4,7% dan alergi Der f 1,2%. Median kadar IgE spesifik tungau debu rumah pada pasien asma tidak terkontrol di RSUP Persahabatan adalah 3,94 (0-100) IU/ml untuk Der p dan 4,47 (0-100) IU/ml untuk Der f. Median FeNO pasien asma tidak terkontrol adalah 26 (3-92) ppb. Dilakukan uji korelasi Spearman untuk kadar IgE spesifik dan kadar FeNO pasien asma tidak terkontrol. Terdapat hubungan bermakna antara kadar IgE spesifik Der p (nilai p = 0,009, r = 0,279, uji Spearman) dan Der f (nilai p = 0,001, r = 0,339, uji Spearman) dengan FeNO.Kesimpulan : Terdapat hubungan yang bermakna antara kadar IgE spesifik tungau debu rumah Der p dan Der f dengan FeNO pada pasien asma tidak terkontrol. Namun tingkat korelasi yang didapatkan lemah.

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Background : Asthma affects approximately 300 million people worldwide and is a serious global health problem affecting all age groups. Allergic asthma is the most easily recognized asthma phenotype and often begins in childhood. Most allergic asthma is associated with airway sensitization due to exposure to common aeroallergens, particularly those from house dust mites. The eosinophilic inflammatory process of the airways produces the final product in the form of nitric oxide. Fractional exhaled nitric oxide (FeNO) levels are one of the biomarkers that measure airway inflammation and high FeNO levels in asthma patients are associated with eosinophilic airway inflammation. This study aims to determine the relationship between Dermatophagoides pteronysinnus (Der p) and Dermatophagoides  farinae (Der f) specific IgE levels with FeNO levels in uncontrolled asthma patients at Persahabatan Hospital.

Method : This cross sectional study in 86 uncontrolled asthma patients based on asthma control test less than 24 points. The method of collecting subjects was done by consecutive sampling technique. House dust mite specific IgE assay using protia Q96M. FeNO examination using Bedfont NObreath.   

Result : From 86 subjects with uncontrolled asthma, the mean age of uncontrolled asthma patients at Persahabatan Hospital was 52.45 + 12.94 years, most of them were female (84.9%). The proportion of asthma patients who were allergic to house dust mites reached 64. %. The proportion of allergy to Der p and Der f 58%, allergy to Der p 4.7% and allergy to Der f 1.2%. The median level of specific IgE for house dust mites in patients with uncontrolled asthma at the Persahbatan Hospital was 3.94 (0-100) IU/ml for Der p and 4.47 (0-100) IU/ml for Der f. The median FeNO of uncontrolled asthmatic patients was 26 (3-92) ppb. Spearman correlation test was performed for specific IgE levels and FeNO levels in patients with uncontrolled asthma. There was a significant relationship between specific IgE levels Der p (p value = 0.009, r = 0.279) and Der f (p value = 0.001, r = 0.339) and FeNO.

Conclusion : There is a significant relationship between the levels of specific IgE for house dust mites Der p and Der f with FeNO in patients with uncontrolled asthma. However, the correlation level obtained is weak."

"Background: pollens from trees or grasses in Indonesia have a perennial distribution due to the tropical climate. However, pollen allergy has not been well studied. This study aimed to evaluate the profile of pollen IgE sensitization in respiratory allergic patients in Jakarta. Methods: this was a cross-sectional study in patients with a history of respiratory allergy in Jakarta, Indonesia between September and December 2016. Adult asthmatic patients aged 19-60 years were invited to undergo serum specific IgE testing at the Allergy and Immunology Clinic, Cipto Mangunkusumo Hospital, Jakarta. Patients were included if they showed at least one positive skin prick test with environmental allergens. Quantitative determination of specific IgE in serum was carried out by multiple allergosorbent (MAST) assays (Polycheck Allergy, Biocheck GmbH, Munster, Germany). Serum specific IgE levels of more than 0.35 kU/L or Class 1 was considered positive. Results: a total of 106 cases were eligible for analysis; 81 (76.4%) were women. Patients mean age was 38.8+12.1 (range 19-59) years old. 59.4% of patients have both asthma and allergic rhinitis. There are 9 (8.5%) patients positive for IgE-pollen sensitization; 8 among them showed sensitization to at least 2 pollens. Sensitivity to goosefoot pollen is the highest (5.7%), followed by rye pollen (4.7%), plantain pollen (4.7%), wall pellitory pollen (4.7%), and Bermuda grass pollen (3.8%). Conclusion: although most pollens tested are not originated from native plants to Indonesia, a small number of patients showed specific IgE-sensitizations. Allergic persons planning to travel to the endemic areas of the relevant pollen should be advised. A panel of pollen allergens from local plants is highly desired.

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Latar belakang: serbuk sari dari pohon-pohon atau rerumputan di Indonesia mempunyai penyebaran sepanjang masa akibat iklim tropisnya. Meskipun demikian, alergi serbuk sari belum diteliti dengan baik. Penelitian ini bertujuan untuk menilai profil sensitisasi serbuk sari IgE pada pasien dengan alergi pernapasan di Jakarta.

Metode: penelitian ini adalah penelitian potong lintang pada pasien dengan riwayat alergi pernapasan di Jakarta, Indonesia yang dilaksanakan antara bulan September dan Desember 2016. Pasien asma dewasa berusia 19-60 tahun diundang untuk menjalani pemeriksaan serum IgE spesifik di Klinik Alergi dan Imunologi, Rumah Sakit Cipto Mangunkumo, Jakarta. Pasien diikutsertakan dalam penelitian bila mereka menujukkan setidaknya satu hasil positif pada pemeriksaan uji tusuk kulit (prick test) terhadap alergen-alergen lingkungan. Penentuan kuantitatif kadar IgE spesifik dalam serum dilakukan dengan pemeriksaan menggunakan multiple allergosorbent (MAST) assays (Polycheck Allergy®, Biocheck GmbH, Munster, Jerman). Kadar IgE spesifik dalam serum yang melebihi 0,35 kU/L atau Kelas 1 dianggap positif.

Hasil: sejumlah 106 kasus memenuhi syarat untuk dianalisis; 81 (76.4%) di antaranya adalah wanita. Usia rata-rata pasien adalah 38,8 (12,1) tahun (kisaran usia 19-59 tahun). Sekitar 59,4% pasien mempunyai asma sekaligus rinitis alergi. Terdapat 9 (8,5%) pasien dengan hasil positif untuk sensitisasi serbuk sari IgE; 8 di antaranya menunjukkan sensitisasi terhadap setidaknya 2 serbuk sari. Sensitivitas terhadap serbuk sari gulma goosefoot ternyata paling tinggi (5,7%), diikuti oleh serbuk sari gandum hitam (4,7%), serbuk sari pisang raja (4,7%) dan serbuk sari tanaman wall pellitory (4.7%) dan serbuk sari rumput Bermuda (3,8%).

Kesimpulan: meskipun sebagian besar serbuk sari yang diuji bukan merupakan tumbuhan asli di Indonesia, beberapa pasien menunjukkan sensitisasi IgE spesifik. Orang dengan alergi yang berencana bepergian ke daerah endemik tempat asal serbuk sari yang relevan perlu diberi saran. Panel alergen serbuk sari dari tanaman lokal sangat dinantikan,"

"Tungau Debu Rumah (TDR) merupakan aeroalergen utama yang dapat memicu reaksi alergi pada penyakit atopi seperti dermatitis atopi, asma, dan rhinitis alergi. TDR dapat ditemukan di berbagai tempat bersarang baik alami maupun nonalami di dalam rumah. Tujuan penelitian ini adalah untuk mengetahui hubungan bahan alami dan nonalami terhadap keberadaan TDR. Dengan menggunakan desain cross-sectional, penelitian ini dilakukan di Pasar Rebo (Jakarta Timur) dan Pamulang (Tangerang Selatan) pada November 2013 sampai Februari 2014. Data demografi penduduk diperoleh melalui kuesioner. Sampel debu rumah diambil dari bahan alami, yaitu kapuk dan nonalami, yaitu karpet, kasur busa, sofa, dan spring bed. Deteksi spesies TDR pada debu tersebut dilakukan dengan teknik langsung menggunakan mikroskop. Dari hasil penelitian didapatkan 207 sampel debu rumah dari 96 responden (Pasar Rebo = 44 Sampel dan Pamulang = 52 sampel). Spesies TDR yang ditemukan di Pasar Rebo adalah Dermatophagoides pteronyssinus (Dp) dan Glyciphagus destructor (Gd), sedangkan spesies TDR yang ditemukan di Pamulang adalah Dp, D.ferinae (Df), dan Gd. Dp merupakan spesies dominan pada bahan alami dan nonalami. Secara statistik, terdapat hubungan bermakna antara jenis bahan dengan keberadaan TDR (p<0,05). Bahan alami berisiko lebih tinggi dibandingkan nonalami (OR = 1,99, 95% CI 1,06-3,72). Dapat disimpulkan bahwa keberadaan spesies TDR berhubungan dengan jenis bahan bersarang yang terdapat di dalam rumah.

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House Dust Mites (HDM) is the main aeroalergen that can induced allergic reaction at atopic diseases such as dermatitis atopic, asthma, and rhinitis allergy. HDM was found in both nature and non-nature materials on stuffs around living house. The aim of this research was to know association between nature and non-nature materials with HDM. Cross sectional method was used in this research. Primary data was collected in Pasar Rebo (North Jakarta) and Pamulang (South Tangerang) for four months, from November 2013 until February 2014. Demographic profile was collected by filling the questionnaire. House dust was collected from both nature, as kapok matress, and non-nature materials, such as carpet, foam mattress, sofa, and spring bed. HDM was detected by direct examination on microscope. This research includes 207 house dust samples from 96 houses in Pasar Rebo, 44 samples, and Pamulang, 52 samples. Data from statistic show that in Pasar rebo, Dermatophagoides pteronyssinus (Dp) and Glyciphagus destructor (Gd) were found as varies HDM species meanwhile in Pamulang, Dp, D.ferinae (Df), and Gd were found. From both places, Dp was mostly found in nature and non-nature materials. Statistically, there was significance association between any materials and house dust mites (p<0,05). Nature material had a higher risk than non-nature materials to found HDM (OR = 1,99, 95% CI 1,06-3,72). Asconclussion, materials used living house associated with population of HDM."