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Abstrak :
Introduction: Constant exposure to a variety of microorganisms in domestic environment plays an important role in the shaping of individual immune response mechanism, which can affect one's susceptibility to the diseases. The aim of the study to get an understanding how the exposure of microorganisms in the the different area where the people living might give a contribution to the profile and the regulation of the immune respons after stimulated to malaria, vaccine BCG and oxLDL antigents in PBMC and whole blood cultures, and to evaluate the character of T reg as a mediator to suppress the cell proliferation. Methode: It is an in vitro experimental study performed at Laboratorium Terpadu, Faculty of Medicine Univertas Indonesia, Jakarta in 2013 2014. As a model of infectious diseases is used pathogenic antigents such as Plasmodium falciparum infected red blood cells malaria and bacille calmette gu rin BCG vaccine, and as a modell of inflammatory disease is used non a patonegic antigen, low density lipoprotein LDL . Whole blood cultures is done for 80 blood samples to know how the regulation of immune respons from people living a rural populatin. PBMC cultures is also done to explore macrophages after stimulated to malaria, BCG and LDL. PHA stimulated to the PBMC culture with and without T reg cells to evaluate the character of T reg. T regulatory cells perhaps play the important roles to suppress the immune respons to microorganisms was also done. Results: The profile of the immune respons of the people living in the unslum area is significantly more inflamatif than that in the slum area. The ratio of pro anti inflammation cytokines TNF IL 10 of the people living in the unslum area is significantly higher than that in the slum area. This is marked by increasing of oxLDL accumulationis that is the important point of the low protection to oxLDL of the people living in the unslum area p 0.01 . T regulatory cell may suppress the proliferation in the PBMC culture for the people living in the slum area marked by increasing not only the expression of IL 10 cytokines but also the sum of T regulatory sells p 0.01 significantly. Conclusion: The immune respons of the people living in the unslum area is more inflamatif and responsive to malaria, BCG vaccine and oxLDL. The character of macrophage of the people living in the slum area is marked by the low ratio of pro anti inflammation cytokines TNF IL 10 to malaria, BCG vaccine and oxLDLstimulations. T regulatory cell may suppress the proliferation in the PBMC culture for the people living in the slum.

Abstrak :
Latar Belakang : Infeksi sering didapatkan pada pasien kenker nasofaring yang menjalani kemoterapi. Infeksi disebabkan oleh rusaknya barier fisik karena efek kemoterapi atau efek kemoterapi yang akan menurunkan imunitas tubuh,Infeksi pasca kemoterapi akan menunda kemoterapi berikutnya, akibatnya respon kemoterapi menjadi tidak optimal. Tujuan : Mendapatkan data status imunitas selular primer dan sekunder, pasca kemoterapi neoajuvan 3 siklus, data kekerapan infeksi dan perbandingan kekerapan infeksi pada pasien KNF stadium lanjut yang mendapatkan kemoterapi neoadjuvan 3 siklus pada pasien kanker nasofaring stadium lanjut, antara yang imunitas selular menurun dan yang tidak menurun. Metode : Penelitian one group before and after observasional, 1 kelompok tanpa kontrol selama 3 bulan di gedung A lantai 8 RSCM, juli ndash; september 2015.Penurunan rerata jumlah lekosit, netrofil, CD4 , CD8, kejadian infeksi dianalisis bivariat dengan uji T berpasangan atau uji Mann Whitney.Penelitian ini juga melihat kekerapan kejadian infejsi post kemoterapi neoadjuvan.Penelitian ini menggunakan tingkat kemaknaan 0,005, interval kepercayaan 95. Hasil : Tidak ada penurunan status imunitas selular primer, lekosit p=0,356 dan netrofil p=0,289.Terdapat penurunan status imunitas selular sekunder, CD 4 P=0,002, CD 8 P=0,001, dengan ratio CD 4 /CD 8 tidak berubah rerata CD 4 sudah rendah sejak sebelum kemoterapi.Mukositis oral dan pneumonia merupakan infeksi yang kerap didapatkan. CD4 yang rendah pada kelompok sebelum kemoterapi meningkatkan potensi infeksi selama dan sesudah kemoterapi neoadjuvan.Penurunan imunitas seluler sekunder nilai rerata jumlah CD4 berhubungan dengan peningkatan kejadian infeksi pasca siklus ke 2 p=0,016. Kesimpulan : Tidak terdapat penurunan imunitas selular primer dan didapatkan penurunan imunitas selular sekunder pada pasien karsinoma nasofaring stadium lanjut yang menjalani kemoterapi neoadjuvan 3 siklus.Pada pasien dengan penurunan imunitas selular sekunder terdapat peningkatan kejadian infeksi mukositis oral dan pneumonia CD 4 yang rendah merupakan prediktor kejadian infeksi. Penurunan imunitas selular sekunder hanya akan meningkatkan kejadian infeksi pasca siklus ke 2 kemoterapi neoadjuvan. ......Background: The infections especially in a the oropharynx often get on cancer patients nasopharyngeal .One of the causes of infection include breakdowns physical mucous barier because the tumor growth or because the effects of chemotherapy and radiation .Chemotherapy and radiation will result in side effects namely the inflammation and ulceration mouth and the oropharynx mucous called mukositis oral.selama endure chemotherapy, besides mukositis oral, infections of the also often found .Chemotherapy resulted in an emphasis on cell production immune response that result in the lekopenia with rob possibilities infection become larger. The purpose: To asess of immunity cellular status on advanced stage nasaofaringeal patient to get 3 cycle neoadjuvan chemotherapy and assess the incident lung infection and tumor area after undergoing 3 cycle neoadjuvan chemotherapy. The methode: Research one group before and after observational use 1 group without control. The research was done during the three months in the building a floor 8 Ciptomangunkusumo Hospital juli september 2015. The Data on the background respondents will be analyzed by a sort of descriptive set by using analysis univariat.hubungan between chemotherapy neoadjuvan and an immune response cellular will be analyzed bivariat by test wilcoxon sign rank test. In this research also be seen the proportion of the infection before pre and post chemotherapy neoadjuvan .This research using level evidence 0.05 to the interval trust 95. Results: From 17 subject of research , 12 subjects 70,6 is laki laki , women made up subjects 29,4 .Median age patient is 46,7 , 10 patients 58,8 less than median age , 7 patients 42,2 more of age median.stadium 4a obtained on 4 patients 23,5 patients , while stadium 4 b obtained on 13 patients 76,5 .Seen from the infection after chemotherapy neoadjuvan 9 subjects 52,8 never would have experienced infection , 8 subjects 47,2 experienced infection. Looks the relationship between chemotherapy neoadjuvan 3 cycle in immunity cellular p 0,007 on cds 4 and p 0,005 on cds 8 , the immunity cellular decline in the infection look after chemotherapy neoadjuvan cycle to 2 p 0,016 on cds 4 while after cycle to 3 not seen the relationship between chemotherapy neoadjuvan 3 cycle in the infection .Count of leukosit and lymphocytes cannot be used to predict a decrease in an immune response cellular after undergoing 3 cycle neoadjuvan chemotherapy. Conclusions: Immune response decreased on advanced stage nasopharynx carcinoma patient are undergoing 3 cycle neoadjuvan chemotherapy neoadjuvan 3 . The Decreased of cellular immune response has played of increased infection in the lung and tumor area post 2 cycle neoadjuvan chemotherapy.