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Abstrak :
Latar belakang: Penyakit Graves merupakan penyakit autoimun yang memiliki kemungkinan untuk kambuh setelah remisi. Sebanyak 50% pasien berisiko mengalami kekambuhan setelah menyelesaikan terapi obat antitiroid (OAT). Salah satu prediktor kekambuhan penyakit Graves adalah faktor genetik. Gen PTPN22 rs2476601 merupakan gen yang berperan dalam persinyalan sel T. Polimorfisme pada gen ini dapat memicu proses autoimun pada penyakit Graves. Tujuan: Mengetahui hubungan polimorfisme gen PTPN22 rs2476601 terhadap risiko kekambuhan penyakit Graves. Metode: Penelitian ini adalah penelitian observasional dengan metode cross sectional. Subjek penelitian merupakan 80 sampel DNA pasien penyakit Graves yang telah mendapatkan terapi OAT selama >12 bulan. Kekambuhan pada pasien dinilai dalam 12 bulan pasca pasien berhenti menggunakan OAT. Pemeriksaan genotip gen PTPN22 rs2476601 dilakukan menggunakan teknik Tetra-primer amplification refractory mutation system-polymerase chain reaction (T-ARMS-PCR). Hasil: Pada pasien penyakit Graves di Jakarta, frekuensi genotip GA ditemukan paling tinggi (77.5%) dibandingkan GG (18.75%) dan AA (3.75%). Genotip AA lebih sering ditemukan pada kelompok kambuh (6%) dibandingkan tidak kambuh (0%). Sementara itu, Genotip GA dan GG lebih sering ditemukan pada kelompok tidak kambuh (79% dan 21%) dibandingkan kambuh (77% dan 17%). Namun, hasil uji fisher tidak menunjukkan adanya perbedaan yang bermakna antara genotip gen PTPN22 rs2476601 dengan kekambuhan penyakit Graves (p=0.264). Frekuensi alotip alel A ditemukan lebih tinggi pada kelompok kambuh (45%) dibandingkan tidak kambuh (39%). Sedangkan, frekuensi alotip alel G ditemukan lebih tinggi pada kelompok tidak kambuh (61%) dibandingkan kambuh (53%). Namun, hasil uji chi-square juga tidak menunjukkan adanya perbedaan yang bermakna antara alotip gen PTPN22 rs2476601 dengan kekambuhan penyakit Graves (p=0.505). Kesimpulan: Polimorfisme gen PTPN22 rs2476601 tidak berhubungan dengan kekambuhan penyakit Graves pada populasi di Jakarta ......Background: Graves’ disease is an autoimmune disease that has a chance to recur after remission. 50% of patients have the risk of recurrence after completed anti-thyroid drugs (ATD) therapy. One of the recurrence predictors of Graves’ disease is the genetic factor. The PTPN22 rs2476601 gene is a gene involved in T cell signaling. Polymorphism in this gene may trigger the autoimmune process in Graves’ disease. Aim: Determine the association between PTPN22 rs2476601 gene polymorphism and the recurrence risk of Graves’ disease. Methods: This study was an observational study with a cross-sectional design. The subjects of this study were 80 DNA samples from patients with Graves’ disease who received ATD therapy for >12 months. Recurrence of the disease was assessed within 12 months after patients completed ATD therapy. Genotype examination of PTPN22 rs2476601 gene was performed using Tetra-primer amplification refractory mutation system-polymerase chain reaction (T-ARMS-PCR) technique. Results: Patients with Graves’ disease in Jakarta had the highest genotype frequency of GA (77.5%) compared to GG (18.75%) and AA (3.75%). AA genotype was more frequent in the recurrence group (6%) compared to non-recurrence (0%). In contrast, GA and GG genotype were more frequent in the non-recurrence group (79% and 21%) compared to recurrence (77% and 17%). However, the result of fisher test showed there was no significant difference between the genotype of PTPN22 rs2476601 gene and recurrence of Graves’ disease (p=0.264). The allotype frequency of A allele was higher in the recurrence group (45%) compared to non-recurrence (39%). Meanwhile, the allotype frequency of G allele was higher in the non-recurrence group (61%) compared to recurrence (53%). However, the result of chi-square test also showed there was no significant difference between the allotype of PTPN22 rs2476601 gene and recurrence of Graves’ disease (p=0.505). Conclusion: PTPN22 rs2476601 gene polymorphism is not associated with the recurrence of Graves’ disease in Jakarta’s population.

Abstrak :
Alopecia areata (AA) merupakan jenis kerontokan rambut pada manusia yang disebabkan oleh serangan sel-sel imun tubuh terhadap folikel rambut di fase anagen. Single nucleotide polymorphism (SNP) rs2476601 adalah salah satu varian gen yang terletak di gen protein tyrosine phosphatase non-receptor type 22 (PTPN22) dan diketahui berasosiasi dengan kemunculan AA berdasarkan penelitian yang dilakukan di berbagai negara. Perubahan basa sitosin menjadi timin pada posisi ke-1858 diprediksi menyebabkan penurunan kemampuan protein lymphoid-specific tyrosine phosphatase (Lyp) untuk menghambat aktivasi sel T. Penelitian ini bertujuan untuk mengetahui keberadaan asosiasi SNP rs2476601 dengan kemunculan fenotipe AA pada populasi Indonesia. Pengambilan sampel buccal swab dilakukan terhadap 50 pasien penderita AA dan 50 individu normal sebagai subjek kontrol. Penentuan genotipe subjek dilakukan dengan teknik PCR-RFLP menggunakan enzim restriksi RsaI, lalu analisis statistik dilakukan dengan uji Fisher’s exact. Dari seluruh subjek yang diteliti, sebanyak 99% genotipe merupakan genotipe CC yang ditandai dengan 4 pita dan 1% genotipe merupakan genotipe CT yang ditandai dengan 5 pita. Tidak ditemukan adanya genotipe homozigot TT pada kedua kelompok studi. Populasi subjek yang terlibat dalam penelitian berada dalam keseimbangan Hardy-Weinberg. Nilai p yang ditemukan dari hasil uji Fisher’s exact tidak menunjukkan adanya asosiasi yang bermakna antara genotipe CT/TT dan kondisi AA (p>0,05). Penelitian ini memberikan kesimpulan bahwa rs2476601 gen PTPN22 tidak memiliki asosiasi terhadap kemunculan AA pada populasi di Indonesia. ......Alopecia areata (AA) is a type of hair loss in human caused by the body's immune cells attacking hair follicles in the anagen phase. Single nucleotide polymorphism (SNP) rs2476601 is a gene variant located in the protein tyrosine phosphatase non-receptor type 22 (PTPN22) gene and associated with the emergence of AA based on studies conducted in various countries. The substitution of cytosine to thymine base at position 1858 decreases the ability of lymphoid-specific tyrosine phosphatase (Lyp) protein to inhibit T cell activation. This study aimed to determine the association of SNP rs2476601 with the appearance of the AA phenotype in the Indonesian population. Buccal swabs were extracted from 50 patients with AA and 50 normal individuals as control subjects. PCRRFLP technique were used to determine the subject’s genotype using the RsaI restriction enzyme, then the statistical analysis were conducted using Fisher’s exact test calculations. From all the subjects involved, 99% of the genotypes belonged to CC genotype indicated by four bands and 1% belonged to CT genotype indicated by five bands. No homozygous TT genotype was detected in both study groups. This study implies that the subject population involed is at Hardy-Weinberg equilibrium. However, the p-value generated from the Fisher’s exact test shows that there was no association between the CT/TT genotype and AA conditions (p>0.05). In conclusion, this study found that rs2476601 from the PTPN22 gene is not associated with the emergence of AA in the Indonesian population.