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Abstrak :
Alergen menyebabkan penyakit alergi,. Alergen yang terpenting ialah tungau Dermatophag oides pteronyssinus. Masalah dalam penelitian ini ialah adanya penemuan bahwa kadar igE total dan IgG- total yang kontroversial, pada penderita alergi atopik dan orang yang tidak menderita alergi. Tujuan penelitian ini ialah untuk meneliti kadar IgE total dan IgG total penderita asma bronkial dan/atau rinitis atopik yang rentan terhadap D. pteronyssinxis, dan belum mendapat pengobatan secara disensibilisasi. Penentuan kadiar IgE total dilakukan dengan teknik ELISA ("Enzyme Linked Immuno Sorbent Assay"), dan IgG total dengan teknik RID ("Radial Immuno Diffusion"). Dari u^i Mann-Whitney pada

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Nangapanda merupakan salah satu kecamatan di Flores, Indonesia yang memiliki prevalensi kecacingan usus sebesar 87,2 . Terdapat tiga jenis spesies cacing usus yang paling sering menyebabkan infeksi kecacingan, yaitu Ascaris lumbricoides, Trichuris trichiura, serta cacing tambang. Infeksi cacing usus akan menimbulkan respon imun tipe 2, sehingga menghasilkan respon imun humoral berupa pembentukan Immunoglobulin E IgE. Penelitian ini bertujuan untuk mengetahui hubungan antara status infeksi kecacingan usus dengan kadar IgE Total dan IgE spesifik terhadap Ascaris lumbricoides pada penduduk Nangapanda. Status infeksi kecacingan usus ditentukan dengan menggunakan metode Kato Katz, dimana dilakukan pencarian terhadap telur cacing pada sampel tinja pasien secara mikroskopis. Pada penelitian ini, dilakukan pengukuran antibodi IgE total dan spesifik terhadap Ascaris dalam sampel plasma dengan menggunakan metode ELISA. Didapatkan peningkatan kadar antibodi IgE Total yang bermakna pada kelompok terinfeksi oleh setidaknya satu jenis cacing usus P ......Nangapanda is one of the endemic areas in Indonesia with a very high STH prevalence 87,2 . Ascaris lumbricoides, Trichuris trichiura, and hookworms are the most prevalent etiologies of helminth infection. When helminth infects the body, it will enhance the type 2 immune response which will lead to the production of humoral immunity such as Immunoglobulin E. This research aimed to identify the relationship between STH infection status with the Total IgE and Ascaris specific IgE levels. The STH infection status was determined by Kato Katz method to identify the presence of STH rsquo s eggs in the stool sample microscopically. In this research, the levels of total and specific IgE in the plasma samples were detected by ELISA. The levels of Total IgE was increased significantly in helminth infected group.

Abstrak :
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.

Abstrak :
ABSTRAK
Latar Belakang: Pemeriksaan IgE spesifik serum baru diperkenalkan di Indonesia, tetapi belum ada data uji diagnostik mengenai akurasinya dalam mendeteksi alergen tungau debu rumah dan kecoa pada pasien asma dan atau rinitis alergi. Tujuan: Tujuan penelitian ini adalah untuk mendapatkan akurasi diagnosis pemeriksaan IgE spesifik serum dalam mendiagnosis sensitisasi alergen Dermatophagoides pteronyssinus Der p , Dermatophagoides farinae Der f , Blomia tropicalis Blo t dan Blatella germanica Bla g pada pasien asma dan atau rinitis alergi.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, antara September dan Desember 2016. Pengukuran sensitisasi IgE spesifik dilakukan dengan metode imunoblot Euroline , Euroimmun AG, Germany . Alergen yang diuji adalah Der p, Der f, Blo t, dan 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: Serbanyak 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 dalam mendiagnosis sensitisasi alergen Dermatophagoides pteronyssinus, Dermatophagoides farinae, Blomia tropicalis, dan Blatella germanica pada pasien asma dan atau rinitis alergi memperlihatkan sensitivitas rendah sampai sedang, tetapi spesifisitas dan PPV yang tinggi.

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ABSTRACT
Background Serum specific IgE testing has recently been introduced in Indonesia, but diagnostic test has not been performed to know its performance to detect house dust mite and cockroach allergens in patients with allergic asthma and or rhinitis.Objective The objective of this study was to obtain diagnostic accuracy of serum specific IgE testing in diagnosing allergen sensitization to Dermatophagoides pteronyssinus, Dermatophagoides farinae, Blomia tropicalis, and Blatella germanica allergens in patients with allergic asthma and or rhinitis.Method This was a cross sectional study among patients with respiratory allergy and was part of a larger epidemiology study on specific IgE sensitization in the Division of Allergy Immunology, Cipto Mangunkusumo Hospital, Jakarta between September and December 2016. Specific IgE sensitization was measured using immunoblot method Euroline , EuroImmun AG, Germany . Allergens tested were Dermatophagoides pteronyssinus Der p , Dermatophagoides farinae Der f , Blomia tropicalis Blo t , and Blatella germanica Bla g . The results was compared to the standard skin prick test . Diagnostic test were performed and include sensitivity, specificity, positive predicitive value PPV , negative predictive value NPV , positive and negative likelihood ratio LR and 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 Dermatophagoides pteronyssinus, Dermatophagoides farinae, Blomia tropicalis, and Blatella germanica allergens in patients with allergic asthma and or rhinitis showed only low to moderate sensitivity, but high specificity and PPV.

Abstrak :
ABSTRAK
Infeksi soil-transmitted helminths STH dengan prevalensi terbanyak Ascaris, diketahui dapat menstimulasi aktivasi Th-2 untuk menghasilkan sitokin yang dapat mengaktivasi IgE dan sel T regulator yang menekan inflamasi kronik tubuh. Hal ini diduga dapat mengurangi risiko terjadinya penyakit akibat inflamasi kronik, salah satunya diabetes melitus DM . Studi ini bertujuan untuk mengetahui hubungan antara infeksi STH yang ditandai dengan kehadiran antibodi IgE total dan spesifik dengan parameter metabolik berupa kadar glukosa darah puasa GDP dan setelah tes toleransi glukosa oral TTGO . Partisipan dari penelitian potong lintang cross section ini adalah penduduk berusia 15 tahun ke atas di 3 desa di Nangapanda daerah endemik infeksi STH yang berjumlah 298 partisipan. Kadar antibodi IgE merupakan hasil pengukuran ELISA sedangkan, kadar gula darah yang diukur menggunakan glukometer di darah kapiler merupakan data sekunder penelitian SUGARSPIN. Ditemukan hubungan negatif sangat lemah antara kadar IgE total dengan kadar TTGO rs=-0.197, p=0.001 . Sementara itu, tidak ditemukan hubungan antara kadar IgE total dengan kadar GDP, serta IgE spesifik dengan kadar GDP dan TTGO. Dari penelitian, dapat disimpulkan bahwa peningkatan kadar IgE total akan diikuti oleh penurunan kadar TTGO yang menggambarkan toleransi glukosa yang semakin baik.

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ABSTRACT
Soil transmitted helminths infection, whichthe most prevalent is Ascaris, is known with its capability to stimulate the activation of Th 2 to produce cytokines which can activate IgE and T reg resulting in suppression of chronic inflammation response. This may reduce the risk of diseases due to chronic inflammation, such as diabetes mellitus DM . Total and Specific Ascaris IgE level together with fasting blood glucose and oral glucose tolerance test level, are used as a study parameter. The aim of the study is to find out the relationship between STH infection, marked by total IgE and IgE specific level, and metabolic parameter, which is fasting blood glucose FBG and blood glucose after oral glucose tolerance test OGTT . Participants from this cross sectional study is population aged 15 years old and above, living in 3 villages in Nangapanda endemic for STH with total population 298. IgE level was the result of ELISA done in Leiden University while the blood glucose level, which is measured by glucometer from capillary blood, is a secondary data from SUGARSPIN study. Very weak negative association was found between total IgE level and OGTT level rs 0.197, dan p 0.001 meanwhile, no other association was found between dependent and independent variables. From this study, it can be concluded that the increased level of total IgE may lower OGTT level, which representate a better blood glucose tolerance.

Abstrak :
ABSTRAK
Tungau debu rumah (TDR) merupakan alergen pencetus asma. Sebanyak 85% pasien asma, alergi terhadap Dermatophagoides pteronyssinus. Atopi adalah kecenderungan untuk menghasilkan antibodi IgE sebagai respons terhadap paparan alergen. Paparan berulang pada proses desensititasi menginduksi peningkatan sel T regulator yang memproduksi IL-10 sehingga dapat menginduksi produksi IgG4. Selama ini, IgE spesifik alergen dijadikan penanda adanya alergen namun hanya terdeteksi pada orang yang atopi. Untuk menghindari adanya pajanan alergen sebagai sumber alergi baik pada subjek atopi maupun normal, diperlukan pengembangan metode yang dapat memindai daerah/lokasi yang diduga menjadi habitat TDR. Hal ini penting agar dapat dilakukan upacaya pencegahan dan pengendalian asma. Berdasarkan hal tesebut, peneliti tertarik untuk mengetahui respon IgE dan IgG4 dan korelasinya dengan kepadatan TDR. Penelitian dilakukan pada bulan Juli 2018 sampai April 2019. Sebanyak 25 pasien asma atopi dan 21 subjek normal dilakukan pengukuran kadar serum IgE dan IgG4 Der p menggunakan metode indirek ELISA. Sampel debu rumah diambil dari rumah pasien, diidentifikasi dan dihitung jumlahnya menggunakan metode Hart & Fain. Hasil penelitian menunjukkan spesies TDR yang paling mendominasi yaitu D. pteronyssinus. Kadar serum IgE spesifik Der p pada pasien asma atopi lebih tinggi dibandingkan pasien normal (p=0,002) sedangkan kadar serum IgG4 spesifik Der p baik pada pasien asma atopi maupun normal tidak menunjukan beda signifikan (p=0,667). Kepadatan D. pteronyssinus baik di ruang tidur maupun ruang keluarga menunjukkan korelasi positif dengan kadar serum IgG4 Der p baik pada asma atopi maupun normal (Spearman,Rho=0,388,p=0,008). IgG4 spesifik Der p dapat dijadikan prediktor adanya TDR di rumah.

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ABSTRACT
As many as 85% of asthma patients are allergic to Dermatophagoides pteronyssinus. Repeated exposure to allergens induces an increase in regulator T cells that produce IL-10 which can affect B cells to switch to IgG4. Allergen-specific IgE was used as a marker of allergen exposure but was only detected in people who were atopic while in normal subjects this IgE marker did not appear, So an immunological marker was needed which could be used to scan for exposure. This is important so that efforts can be made to prevent and control asthma. Based on this, the researchers were interested in knowing correlation Der p density with the response of IgE and IgG4 spesific Der p. Twenty Five atopic asthma and 21 normal subjects were measured for serum IgE and IgG4 spesific Der p levels using the indirect ELISA method. Dust samples were taken from the patient's home, identified and counted using the Hart & Fain method. The results showed that the most dominant TDR species was D. pteronyssinus. IgE specific Der p level in atopic asthma were higher than normal (p=0.002) while IgG4 specific Der p level in both atopic asthma and normal did not show significant differences (p=0.667). Density of D. pteronyssinus showed a positive correlation with IgG4 spesific Der p level (Spearman r=0.388, p=0.008) compared to IgE spesific Der p.IgG4 can be used as a predictor of the presence of house dust mites in atopic asthma and normal subjects.

Abstrak :

Latar Belakang: Asma merupakan penyakit inflamasi kronik pada saluran napas. Menurut Global Initiative for Asthma (GINA) latihan fisis merupakan salah satu penatalaksanaan non farmakologi yang direkomendasikan. Tujuan penelitian ini untuk mengetahui pengaruh senam asma terhadap hormon kortisol yang meregulasi beberapa faktor sistem imun (IL-10, IL-5, IgE, eosinofil) dan parameter perbaikan fungsi paru.

Metode Penelitian: Rancangan penelitian adalah quasi eksperimen dengan pre post grup design. Jumlah sampel 39 kelompok asma atopi daari Rumah Sakit Prof. Dr. dr. Margono Soekarjo Purwokerto Jawa Tengah tahun 2017-2018 dan 26 sampel kelompok non asma non atopi. IL-10 dan IL-5 diambil dari supernatan dengan isolasi PBMC dengan stimulasi alergen Der p, kontrol negatif menggunakan medium Roswell Park Memorial Institute (RPMI) dan kontrol positif menggunakan medium phytohemagglutinin (PHA). Hormon kortisol dan IgE diambil dari plasma darah dan eosinofil dengan pemeriksaan darah rutin. IL-10, IL-5, hormon kortisol dan IgE dianalisis dengan ELISA, sedangkan VEP₁ dan VEP₁/KVP diukur dengan spirometri H-101 dengan penghitungan prediksi dengan Pneumobile 2009. Kualitas hidup diukur dengan kuesioner Asthma Quality of Life Questionnaire (AQLQ) dan kemampuan mengontrol asma diukur dengan kuesioner Asthma Control Questionnaire (ACQ). Analisis statistik dengan uji t-test berpasangan dan Wilcoxon untuk uji pengaruh sebelum dan setelah  senam asma, sedangkan Pearson untuk analisis hubungan antar variabel.

Hasil: Terdapat peningkatan bermakna antara kadar hormon kortisol, IL-10, VEP₁, VEP₁/KVP, kualitas hidup, kemampuan mengontrol asma dan penurunan IL-5, IgE dan eosinofil setelah senam asma pada pasien asma atopi persisten ringan-sedang dibandingkan sebelumnya. Terdapat hubungan bermakna antara peningkatan hormon kortisol dengan perbaikan fungsi paru (VEP₁ dan KVP) dan peningkatan hormon kortisol dengan penurunan IL-5, sedangkan peningkatan hormon kortisol berhubungan tidak bermakna dengan peningkatan IL-10 dan penurunan IgE.

Kesimpulan: Senam asma meningkatkan kadar hormon kortisol, IL-10, perbaikan fungsi paru, kualitas hidup dan kemampuan mengontrol asma serta dapat menurunkan IL-5, IgE, eosinofil pada asma atopi persisten.

 

 

Kata Kunci : Hormon Kortisol, IL-10, IL-5, IgE, Eosinofil, Fungsi paru, Asma Atopi Persisten

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Background: Asthma is a chronic inflammatory disease of the airways. One of the management of non-pharmacological asthma recommended by the Global Initiative for Asthma (GINA) is physical exercise. The purpose of this study was to investigate the role of exercise on cortisol which regulates several immune system factors (IL-10, IL-5, IgE, eosinophil) and lung function improvement parameters.

Methods: This study was a quasi-experiment with pre-post group design. The number of samples was 39 atopic asthma groups conducted at Prof. Dr. dr. Margono Soekarjo Hospital Purwokerto Central Java 2017-2018 and 26 non-atopy non-asthma groups which the inclusion criteria. Cortisol hormone and IgE were taken from blood plasma and eosinophil by routine blood test. IL-10, IL-5, cortisol and IgE were analyzed by Enzyme-Linked Immunosorbent Assay (ELISA), while Force Expiration Volume in 1 second / FEV₁ and FEV₁ / FVC (Force Vital Capacity) were measured by H-101 spirometry with predictive calculations with Pneumobile 2009. Quality of life was assessed by the Asthma Quality of Life Questionnaire (AQLQ) and asthma control ability by the Asthma Control Questionnaire (ACQ). Statistical analysis was conducted using paired t-test and Wilcoxon before and after asthma exercise, and Pearson method for the analysis of relationships between variables.

 Results: There were a significant increases in blood cortisol level, IL-10, FEV₁, FEV₁ / FVC, quality of life and the ability to control asthmatic attack and significant decreases in IL-5, IgE and eosinophil blood counts after compared to before asthma exercise. There were correlation among increases cortisol hormone with improving pulmonal function (FEV₁ and FVC), IL-5, eosinophil with increased FEV₁ and FEV₁ / FVC volume. The incerases in hormone cortisol was associated with no significant increases in IL-10 and decreased IgE.

Conclusion: Asthma exercise increases levels of cortisol, IL-10, pulmonary functions, quality of life and control ability, and reduces IL-5, IgE, eosinophil in atopic asthma persistent

 

Abstrak :
Background The prevalence of allergic disease to be increasing across the world. More than 20 of the population worldwide suffer from diseases which mediated by immunoglobulin E, such as asthma, rhinoconjunctivitis, atopic dermatitis or eczema. There is no data about allergen sensitization of allergic disease in Manado. Objective The purpose of this study is to know the allergen sensitization in children with allergic diseases atopic dermatitis, allergic rhinitis, asthma . Children were divided into group less than and more than or equal to 3 years old, which was evidenced by skin prick test or IgE Atopy test in Prof. Dr. R.D. Kandou Hospital Manado. Methods This study was a descriptive cross sectional study, conducted from June until August 2016. Results A total of 95 children were included in the study, of which 77 children were ge 3 years old and 18 children were 3 years old. Seventy five children underwent skin prick test and 20 children underwent IgEAtopy test. In 3 years old children, there were 14 children diagnosed with atopic dermatitis and 4 children diagnosed with atopic dermatitis and asthma. In ge 3 years old children, the most common diagnosis was allergic rhinitis, as many as 21 children. Allergen sensitization found in 3 years old children with atopic dermatitis and atopic dermatitis asthma was cow rsquo s milk, house dust mites and egg white. Sensitization to house dust mites most commonly found in patients with atopic dermatitis. The most common allergen sensitization in ge 3 years old children was house dust mites, egg white, potatoes, dog fur, cow 39 s milk, wheat flour and soya formula. Conclusion The most common allergen sensitization in 3 years old children with atopic dermatitis is cow 39 s milk, while in children with asthma and atopic dermatitis is house dust mites, whereas in ge 3 years old children with atopic dermatitis, allergic rhinitis, asthma, or combination of the disease is house dust mites.

Abstrak :
Latar Belakang : Skin prick test SPT merupakan baku emas mendiagnosis sensitisasi alergen, namun memiliki keterbatasan. Pemeriksaan IgE spesifik merupakan pemeriksaan in vitro, nyaman dan tidak ada risiko anafilaksis.Tujuan: Mendapatkan akurasi pemeriksaan IgE spesifik serum metode ELISA dalam mendiagnosis sensitisasi alergen hirup pada pasien asma dan/atau rinitis alergi.Metode: Merupakan uji diagnostik dengan desain cross sectional pada pasien asma dan rinitis alergi di poliklinik Alergi-Imunologi FKUI-RSCM. Seratus pasien diperiksa IgE spesifik serum tungau debu rumah D.pterossinus, D.farinae, B.tropicalis , kulit anjing, kulit kucing dan kecoak dengan metode ELISA serta SPT sebagai baku emas mendiagnosis sensitisasi alergen tersebut. Sensitivitas, spesifisitas, nilai duga, dan rasio kemungkinan dari IgE spesifik serum dinilai untuk masing-masing alergen.Hasil: Sensitivitas IgE spesifik serum dalam mendiagnosis sensitisasi alergen tungau debu rumah berkisar 48-77 , dengan sensitivitas tertinggi 77 IK 95 66-86 pada D.farinae. Spesifisitas berkisar 64-95 , dengan spesifitas tertinggi 95 IK 95 76-99 pada B.tropicalis, serta nilai RK antara 2,1-11, dengan tertinggi untuk B.tropicalis. Sensitivitas mendiagnosis sensitisasi kecoak 12 IK 95 4,5-27 , namun spesifisitas 100 IK 95 92-100 , dengan RK . Spesifisitas mendiagnosis sensitisasi kulit anjing 89 IK 95 79-95 , namun senstitivitas 3 IK 95 1,5-17 , dengan RK hanya 0,29 IK 95 0,03-2,26 . IgE spesifik serum memiliki spesifitas 88 IK 95 77-95 dalam mendiagnosis sensitisasi kulit kucing, namun sensitivitas 10 IK 95 3,5-26 dan RK 0,9 IK 95 0,3-3,1 .Kesimpuan: Pemeriksaan IgE spesifik serum metode ELISA memiliki akurasi diagnostik yang sedang dalam mendiagnosis sensitisasi terhadap tungau debu rumah dan kecoak, namun akurasi rendah untuk kulit anjing dan kucingKata Kunci: Skin prick test IgE spesifik serum, Akurasi, Alergen hirup ......Background Skin prick test SPT is the gold standard to diagnose allergen sensitization, but has some limitations. Serum specific IgE SSIgE is in vitro test, comfortable and has no anaphylaxis risk.Aim To get the accuracy of SSIgE test using ELISA method in diagnosing inhalant allergens sensitization in asthma and or allergic rhinitis patients.Method This is diagnostic study with subjects were asthma and or allergic rhinitis patients. One hundreds patients had SSIgE test for house dust mites D.pterossinus, D.farinae, B.tropicalis , dog dander, cat dander and cockroach allergens and SPT as gold standard to diagnose allergen sensitization. Sensitivity, specificity, predictive value, and likelihood ratio of SSIgE were evaluated.Result To diagnose house dust mites sensitization SSIgE has 48 77 sensitivity, with the highest is for D.farinae 77 95 CI 66 86 , while specificity is 64 95 , with the highest is for B.tropicalis 95 95 CI 76 99 and LR around 2,1 11, with the highest is for B.tropicalis. Sensitivity of SSIgE to diagnose cockroach sensitization is 12 95 CI 4.5 27 , but has high specificity 100 95 CI 92 100 , and high LR . SSIgE has high specificity 89 95 CI 79 95 in diagnosing dog dander sensitization, but low sensitivity 3 95 CI 1.5 17 and low LR 0.29 95 CI 0.03 2.26 . To diagnose cat dander sensitization SSIgE has 88 95 CI 77 95 specificity, but low sensitivity 10 95 CI 3.5 26 and low LR 0.9 95 CI 0.3 3.1 Conclusion SSIgE test using ELISA method has moderate accuracy in diagnosing house dust mites and cockroach sensitization, but low accuracy for dog and cat dander sensitization.Keywords Skin prick test, Serum specific IgE, Accuracy, Inhalant Allergens

Abstrak :
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.