Korelasi IgE terhadap rasio neutrofil/eosinofil jaringan dan darah penderita rinosinusitis kronik Aspergillus fumigatus

Fifin Pradina Duhitatrissari, Endang Retnoningsih, Iriana Maharani

Abstract


Latar Belakang: Prevalensi rinosinusitis kronik (RSK) jamur saat ini cenderung meningkat. Jamurberperan sebagai mikroorganisme dan merupakan salah satu penyebab RSK. Pemeriksaan immunoglobulinE (IgE) Aspergillus fumigatus (Af) digunakan untuk menegakkan diagnosis rinosinusitis jamur tanpa harusmelalui tindakan invasif. Perubahan rasio neutrofil/eosinofil (RNE) digunakan untuk memahami responinflamasinya. Tujuan: Mengetahui korelasi antara kadar IgE Af terhadap perubahan RNE mukosa dandarah pada penderita RSK jamur. Metode: Penelitian cross sectional, melibatkan 13 subjek penelitiandengan pengambilan darah dan mukosa sinus maksila untuk diidentifikasi Af dengan Polymerase ChainReaction (PCR), dilanjutkan ELISA untuk mengukur kadar IgE Af serta flowcytometry untuk mengukurkadar neutrofil dan eosinofil mukosa sinus maksila dan darah. Hasil: Rerata IgE Af mukosa 1,112±0,883kU/mL, darah 1,041±0,876 kU/mL (N<0,35 kU/L). Dengan uji T berpasangan didapatkan kesesuaian antarakadar IgE Af darah dan mukosa (p=0,852). Rerata eosinofil mukosa 3,9±1,92% (N:0,3-0,7%) dan darah4,88±2,02% (N:3-9%). Rerata neutrofil mukosa 4,28±2,04 (N:1,1-1,7%) dan darah 49,41±13,98% (N:55,8-59,6%). Rerata RNE mukosa 1,77±2,28 (N:2,8). Rerata RNE darah 12,12 ± 6,25 (N:9,6). Didapatkan93,3% mukosa subjek penelitian mengalami inflamasi eosinofilik, 53,3% mengalami inflamasi eosinofilikpada darah. Dengan uji T berpasangan terdapat ketidaksesuaian RNE mukosa dengan darah (p:0,000).Tes korelasi Pearson antara IgE Af dengan RNE mukosa, tidak terdapat korelasi bermakna (p:0,523) danantara IgE Af dengan RNE darah, tidak terdapat korelasi bermakna (p:0,607). Kesimpulan: Terdapatkesesuaian antara kadar IgE Af mukosa dan darah, tetapi tidak terdapat kesesuaian antara RNE mukosadan darah. Tidak terdapat korelasi antara peningkatan kadar IgE Af dengan RNE pada mukosa dan darah.

 

ABSTRACT

Background: The prevalence of chronic fungal rhinosinusitis (CFR) nowadays tends to increase.Fungi act as microorganisms and is one of the causes of chronic rhinosinusitis. The examination ofimmunoglobulin E (IgE) Aspergillus fumigatus (Af) is applied to establish the diagnosis of CFR withouthaving to do invasive actions. Neutrophil/eosinophil ratio (NER) changes are used to understand theinflammatory response. Purpose: To determine the correlation between IgE Af levels on changes ofmucosal and blood NER in CFR patients. Method: A cross-sectional study, involving 13 subjects bytaking sample of the blood and maxillary sinus mucosa to identify Af with Polymerase Chain Reaction(PCR), followed by ELISA to measure the levels of IgE Af, and flowcytometry to measure the levels ofneutrophils and eosinophils of the blood and mucosa of maxillary sinuses. Results: The mean IgE ofmucosa: 1.112±0.883kU/mL, and of blood: 1.041± 0.876kU/mL (N<0.35kU/L). With paired T-test,there was a match between blood and mucosal IgE level (p=0.852). The mean eosinophil of mucosa:3.9±1.92%,(N:0.3-0.7%) and of blood 4.88±2.02% (N:3-9%). The mean neutrophil of mucosa:4.28±2.04%(N:1.1-1.7%) and of blood 49.41± 13.98%(N:55.8-59.6%). The mean NER of mucosa:1.77±2.28(N:2.8), and of blood: 12.12±6.25(N:9.6). It was revealed that 93.3% of mucosal subjects hadeosinophilic inflammation, 53.3% had eosinophilic inflammation in blood. With paired T-test there wasa mucosal NER mismatch with blood (p:0.000). The Pearson correlation-test between IgE Af and NERmucosa had no significant correlation (p:0.523), and between IgE Af with NER of blood there was no significant correlation (p:0.607). Conclusion: There was a correspondence between IgE Af of mucosaand blood levels, but there was no match between the mucosal and blood NERs. There was no correlationbetween elevated levels of IgE Af and NER in the mucosa and blood.


Keywords


rinosinusitis kronik jamur; IgE Aspergillus fumigatus; rasio neutrofil/eosinofil; chronic fungal rhinosinusitis; IgE Aspergillus fumigatus; neutrophil/eosinophil ratio

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DOI: https://doi.org/10.32637/orli.v48i1.255

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