Kadar reseptor glukokortikoid α dan β pada polip hidung tipe eosinofilik dan tipe neutrofilik

Abstract

Latar Belakang: Penatalaksanaan polip hidung banyak didasarkan pada tipe histopatologinya. Polip hidung tipe eosinofilik lebih sensitif terhadap pemberian kortikosteroid sedang tipe neutrofilik lebih resisten. Hasil pengobatan dengan kortikosteroid juga dipengaruhi oleh reseptor glukokortikoid (GR). Kadar reseptor glukokortikoid β yang tinggi  akan lebih resisten dibanding yang rendah. Rasio kadar reseptor glukokortikoid α dan β lebih berperan karena GR β bekerja menghambat GR α. Tujuan: Penelitian ini bertujuan mengetahui hubungan kadar reseptor glukokortikoid α dan β pada polip hidung tipe eosinofilik dan tipe neutrofilik. Metode: Penelitian observasional analitik dengan desain crosssectional. Hasil: Penelitian ini
melibatkan 20 penderita polip hidung yang dilakukan biopsi atau operasi. Hasil biopsi atau operasi diperiksa jenis histopatologinya dan dihitung kadar reseptor glukokortikoid α dan β dengan pemeriksaan imunohistokimia. Data penelitian dianalisa dengan uji sampel t tidak berpasangan. Kadar reseptor glukokortikoid α pada polip hidung tipe eosinofilik didapatkan sama dengan
tipe neutrofilik. Kadar reseptor glukokortikoid β didapatkan lebih tinggi secara bermakna pada polip hidung tipe neutrofilik dibanding tipe eosinofilik. Rasio kadar GRα/GRβ lebih tinggi pada polip hidung tipe eosinofilik dibanding tipe eosinofilik tetapi perbedaannya tidak bermakna. Kesimpulan: penelitian ini kadar reseptor β lebih tinggi pada polip tipe neutrofilik dengan rasio kadar GRα/GRβ lebih tinggi pada polip hidung tipe eosinofilik. Penelitian lebih lanjut diperlukan menghitung kadar reseptor glukokortikoid α dan β lebih akurat dengan menggunakan teknik ELISA (RT-PCR).

Kata kunci: Tipe polip hidung, reseptor glukokortikoid, imunohistokimia.

ABSTRACT
Introduction: Management of nasal polyps is commonly based on its histopathologic type. Eosinophilic nasal polyps are more sensitive to corticosteroid administration, where as neutrophilic types are more resistant. Results of treatment with corticosteroid were also influenced by glucocorticoid receptor. Higher β Glucocorticoid Receptor (β GR) concentration render more resistency compared with lower one. Ratio of α and β GR was more meaningful because β GR acts to inhibit α GR. Purpose: This study aims to
determine relationship between α and β GR concentration in eosinophilic and neutrophilic nasal polyps. Methods: This is an observational analytic study with cross sectional design. Result: This study involves 20 patients with nasal polyp who underwent biopsy or operation. The biopsy or operation specimens
were then evaluated for its histopathologic type. The concentration of α and β GR was counted by immunohistochemistry. Data was analyzed with unpaired T-test. Concentration of α GR in eosinophilic nasal polyps was similar with neutrophilic type. Concentration of β GR in neutrophilic nasal polyps was significantly higher compared with neutrophilic type. Ratio of α GR/β GR concentration was higher in eosinophilic nasal polyps than eosinophilic, but insignificant. Conclusion: β GR concentration is higher in neutrophilic nasal polyps and ratio of α GR/β GR concentration is higher in eosinophilic nasal polyps. Further study is required to count α GR and β GR concentration more accurately using ELISA (RT-PCR).

Keywords: Nasal polyps types, glucocorticoids receptors, immunohistochemistry.