Makrolid menurunkan IL-8 sekret hidung dan meningkatkan fungsi penghidu pada rinosinusitis kronik tanpa polip

Edo Wira Candra, Teti Madiadipoera, Iwin Sumarman, Sinta Sari Ratunanda

Abstract


Latar belakang: Rinosinusitis kronik (RSK) merupakan inflamasi kronik dengan etiologi multifaktorial.Interleukin-8 (IL-8) adalah sitokin proinflamasi yang dominan pada RSK tanpa polip. Penurunan fungsi penghidumerupakan suatu gejala yang sering dikeluhkan pada RSK. Klaritromisin merupakan antibiotik makrolid yang efektifkarena memiliki efek antibakteri dan antiinflamasi. Tujuan: Untuk mengetahui perbaikan gejala klinis, fungsipenghidu dan kadar IL-8 sekret mukosa hidung, serta mencari korelasi antara IL-8 dengan fungsi penghidu pada RSKtanpa polip. Metode: Penelitian ini merupakan randomized clinical trial open labeled pre and posttest design. Datadianalisis dengan menggunakan uji Wilcoxon, Mann Whitney, dan korelasi Rank Spearman. Penelitian berlangsung dipoliklinik Ilmu Kesehatan Telinga Hidung Tenggorok Bedah Kepala Leher Rumah Sakit Dr. Hasan Sadikin pada 26subjek yang dibagi menjadi dua kelompok. Kelompok pertama diberikan klaritromisin dan kelompok kedua diberikanamoksisilin/klavulanat. Diagnosis berdasarkan penilaian skor gejala dengan visual analogue scale (VAS),nasoendoskopi, fungsi penghidu dengan sniffin sticks test, dan dilakukan pengukuran kadar IL-8 sekret mukosa hidungdengan metode enzyme-linked immunosorbent assay (ELISA). Hasil: Didapatkan perbaikan VAS, fungsi penghidu,dan kadar IL-8 yang signifikan (p=0,001) pada kedua kelompok pascaterapi, dan penurunan skor VAS total yangsignifikan pada kelompok klaritromisin (p=0,036). Terdapat korelasi signifikan antara penurunan IL-8 denganpeningkatan fungsi penghidu (p=0,05) dan dengan gejala hidung tersumbat (p=0,022) hanya pada kelompokklaritromisin. Kesimpulan: Pemberian klaritromisin efektif menurunkan gejala klinis terutama hidung tersumbat,menurunkan kadar IL-8 sekret hidung, dan meningkatkan fungsi penghidu pada RSK tanpa polip.

Kata kunci: Interleukin-8, klaritromisin, rinosinusitis kronik tanpa polip, sniffin sticks test.

ABSTRACT

Background: Chronic rhinosinusitis (CRS) is a chronic inflammatory disease with multifactorial etiology.Interleukin-8 (IL-8) plays an important role as a major proinflammatory cytokine in CRS without nasal polyp.The common symptom is of olfactory function impairment. Claritrhomycin as macrolide antibiotic is effective forCRS because of their antibacterial and antiinflamatory activity. Purpose: To observe improvement of clinicalsymptoms, olfactory function, IL-8 level of nasal secretion and correlation between IL-8 with olfactory functionin CRS without nasal polyp. Method: This was a randomized controlled trial open labeled pre and posttestdesign. Data was analysed using Wilcoxon, Mann Whitney, and Rank Spearman correlation test. This study wasconducted in Otorhinolaryngology-Head and Neck Surgery Department Dr. Hasan Sadikin hospital. There were26 subjects divided in two groups, the first group was given clarithromycin and the second group was givenamoxicillin/clavulanate. The two groups underwent visual analogue scale (VAS), nasoendoscopy, sniffin stickstest and nasal secretion of IL-8 by enzyme-linked immunosorbent assay (ELISA). Result: The two groups had asignificant improvement VAS score after therapy (p=0.001) and clarithromycin group showed statisticallysignificant (p=0.036) on decreasing total VAS score than amoxcicillin/clavulanate group. There was significantcorrelations between reduction of IL-8, improvement of olfactory function (p=0.05) and nasal obstructionsymptom in VAS (p=0.022) only in clarithromycin group.Conclussion: Clarithromycin was effective in clinicalsymptoms reduction especially in nasal obstruction, IL-8 reduction in nasal secretion, and improvement ofolfactory function in chronic rhinosinusitis without nasal polyp.

Keywords: Clarithromycin, interleukin-8, chronic rhinosinusitis without nasal polyp, sniffin sticks test.


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DOI: https://doi.org/10.32637/orli.v43i1.18

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