Studi Pilot: Peran Heat Shock Protein 60 (Hsp60) dan Kontrol Metabolik terhadap Infeksi Tuberkulosis pada Anak dan Remaja dengan Diabetes Mellitus Tipe-1
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Latar belakang. Heat shock protein 60 (Hsp60) ditemukan pada individu dengan Diabetes Mellitus (DM) tipe-1 dan merupakan mimikri molecular Hsp65 pada mycobacterium. Fenomena ini dapat menyebabkan penundaan identifikasi mycobacterium dan memperparah kondisi DM tipe-1.
Tujuan. Studi ini bertujuan untuk meneliti peran Hsp60 dalam kontrol metabolik terhadap infeksi tuberkulosis (TB) pada anak dan remaja dengan DM tipe-1.
Metode. Penelitian ini merupakan studi potong lintang yang dilaksanakan di Rumah Sakit Cipto Mangunkusumo. Anak dan remaja dengan DM tipe I memenuhi kriteria inklusi. Setelah memperoleh data dasar, dilakukan pemeriksaan HbA1c, Hsp60, dan IGRA. Dilakukan analisis data.
Hasil. Sebanyak 32 subjek dengan DM tipe-1 diidentifikasi. Insidens infeksi TB yang terdeteksi dengan IGRA pada anak dan remaja dengan DM tipe-1 adalah 12,5%. Tiga dari empat pasien dengan hasil IGRA positif memiliki nilai HbA1c >9.0. Nilai rerata Hsp60 pada subjek IGRA positif lebih rendah dibandingkan subjek IGRA negatif (1.16 ± 0.59 vs 115.18 ± 364.73), dengan nilai P>0,05.
Kesimpulan. Tidak didapatkan hubungan signifikan antara Hsp60 dan control glikemik dengan insidens TB pada anak dan remaja dengan DM tipe-1. Hasil ini mungkin dipengaruhi oleh jumlah subjek yang sedikit, penggunaan IGRA untuk mendiagnosis TB pada anak, dan reaktivitas rendah Hsp60 dengan Hsp65.
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Thomas CC, Philipson LH. Update on diabetes classification. Med Clin North Am 2015;99:1-16.
American Diabetes Association. 2. Classification and Diagnosis of Diabetes. Diabetes Care 2016;39 Suppl 1: S13-22.
Bluestone JA, Herold K, Eisenbarth G. Genetics, pathogenesis and clinical interventions in type 1 diabetes. Nature 2010;464:1293-300.
Pulungan AB, Batubara JRL, Tridjaja B, Soesanti F, Fadiana G, Annisa D, dkk. Profile of Diabetic Ketoacidosis in Children with Diabetes Mellitus in A Tertiary Care Hospital in Jakarta: A Retrospective Study. Acta Scientific Paediatrics 2019;2:24-9.
World Health Organization. Global Tuberculosis Report 2018. France: World Health Organization; 2018.
Workneh MH, Bjune GA, Yimer SA. Prevalence and associated factors of tuberculosis and diabetes mellitus comorbidity: A systematic review. PLoS One 2017;21:e0175925.
Alisjahbana B, van Crevel R, Sahiratmadja E, den Heijer M, Maya A, Istriana E. Diabetes mellitus is strongly associated with tuberculosis in Indonesia. Int J Tuberc Lung Dis 2006;10:696-700.
Webb EA, Hesseling AC, Schaaf HS, dkk. High prevalence of Mycobacterium tuberculosis infection and disease in children and adolescents with type 1 diabetes mellitus. Int J Tuberc Lung Dis 2009; 13:868-74.
Root H. The association of diabetes and tuberculosis. N Engl J Med 1934;210:127-47.
Indonesian Ministry of Health. Consensus of Tuberculosis and Diabetes Mellitus (TB-DM) Management in Indonesia. Jakarta: Indonesian Ministry of Health; 2015.
Stevenson CR, Critchley JA, Forouhi NG, dkk. Diabetes and the risk of tuberculosis: a neglected threat to public health? Chronic Illn 2007;3:228-45.
Chiang CY, Bai KJ, Lin HH, dkk. The influence of diabetes, glycemic control, and diabetes-related comorbidities on pulmonary tuberculosis. PLoS One 2015;10: e0121698.
Leegaard A, Riis A, Kornum JB, dkk. Diabetes, glycemic control, and risk of tuberculosis: a population-based case-control study. Diabetes Care 2011;34:2530-5.
Takahashi K, Satoh J, Kojima Y, dkk. Promoter polymorphism of SLC11A1 (formerly NRAMP1) confers susceptibility to autoimmune type 1 diabetes mellitus in Japanese. Tissue Antigens 2004;63: 231-6.
Yang JH, Downes K, Howson JM, dkk. Evidence of association with type 1 diabetes in the SLC11A1 gene region. BMC Med Genet 2011;12: 59.
Malik S, Abel L, Tooker H, dkk. Alleles of the NRAMP1 gene are risk factors for pediatric tuberculosis disease. Proc Natl Acad Sci USA 2005;102:12183-8.
Abe T, Iinuma Y, Ando M, dkk. NRAMP1 polymorphisms, susceptibility and clinical features of tuberculosis. J Infect 2003;46:215-20.
Paccagnini D, Sieswerda L, Rosu V, dkk. Linking chronic infection and autoimmune diseases: Mycobacterium avium subspecies paratuberculosis, SLC11A1 polymorphisms and type-1 diabetes mellitus. PLoS One 2009;4:e7109
Dai YD, Marrero IG, Gros P, Zaghouani H, Wicker LS, Sercarz EE. Slc11a1 enhances the autoimmune diabetogenic T-cell response by altering processing and presentation of pancreatic islet antigens. Diabetes 2009;58:156-64.
Dow CT. M. paratuberculosis Heat Shock Protein 65 and Human Diseases: Bridging Infection and Autoimmunity. Autoimmune Dis 2012;2012:150824.
Rosu V, Ahmed N, Paccagnini D, dkk. Specific immunoassays confirm association of Mycobacterium avium Subsp. paratuberculosis with type-1 but not type-2 diabetes mellitus. PLoS One 2009;4:e4386.
Rani PS, Babajan B, Tulsian NK, Begum M, Kumar A, Ahmed N. Mycobacterial Hsp65 potentially cross-reacts with autoantibodies of diabetes sera and also induces (in vitro) cytokine responses relevant to diabetes mellitus. Mol Biosyst 2013;9:2932-41.
Martinez N, Kornfeld H. Diabetes and immunity to tuberculosis. Eur J Immunol. 2014; 44: 617-26.
Dooley KE, Chaisson RE. Tuberculosis and diabetes mellitus: convergence of two epidemics. Lancet Infect Dis 2009;9:737-46.
Skowronski M, Zozulinska-Ziolkiewicz D, Barinow-Wojewodzki A. Tuberculosis and diabetes mellitus - an underappreciated association. Arch Med Sci 2014;10:1019-27.
Nair A, Guleria R, Kandasamy D, dkk. Prevalence of pulmonary tuberculosis in young adult patients with Type 1 diabetes mellitus in India. Multidiscip Respir Med 2016;11:22.
Hanandita W, Tampubolon G. The double burden of malnutrition in Indonesia: Social determinants and geographical variations. SSM - Population Health 2015;1:16-25.
Odone A, Houben RM, White RG, Lonnroth K. The effect of diabetes and undernutrition trends on reaching 2035 global tuberculosis targets. Lancet Diabetes Endocrinol 2014;2:754-64.
Restrepo B, Schlesinger L. Impact of diabetes on the natural history of tuberculosis. Diabetes Res Clin Pract 2014; 106: 191-9.
Sollai S, Galli L, de Martino M, Chiappini E. Systematic review and meta-analysis on the utility of Interferon-gamma release assays for the diagnosis of Mycobacterium tuberculosis infection in children: a 2013 update. BMC Infect Dis 2014;14 Suppl 1:S6.
Carvalho AC, Schumacher RF, Bigoni S, dkk. Contact investigation based on serial interferon-gamma release assays (IGRA) in children from the hematology-oncology ward after exposure to a patient with pulmonary tuberculosis. Infection 2013;41:827-31.
Restrepo BI, Fisher-Hoch SP, Pino PA, dkk. Tuberculosis in poorly controlled type 2 diabetes: altered cytokine expression in peripheral white blood cells. Clin Infect Dis 2008;47: 634-41.
Tsukaguchi K, Okamura H, Ikuno M, dkk. [The relation between diabetes mellitus and IFN-gamma, IL-12 and IL-10 productions by CD4+ alpha beta T cells and monocytes in patients with pulmonary tuberculosis]. Kekkaku 1997;72: 617-22.
MacRury SM, Gemmell CG, Paterson KR, MacCuish AC. Changes in phagocytic function with glycaemic control in diabetic patients. J Clin Pathol 1989;42:1143-7.
Ardawi M, Nasrat H, Bahnassy A. Serum immunoglobulin concentrations in diabetic patients. Diabet Med 1994;11:384-7.
Randons J. HSP60: Disease relevance. Diakses 13 Juli 2016. Didapat dari: http://hsp60.com/disease-relevance/.
Elias D, Markovits D, Reshef T, van der Zee R, Cohen IR. Induction and therapy of autoimmune diabetes in the non-obese diabetic (NOD/Lt) mouse by a 65-kDa heat shock protein. Proc Natl Acad Sci USA 1990; 87:1576-80.
Abulafia-Lapid R, Elias D, Raz I, Keren-Zur Y, Atlan H, Cohen IR. T cell proliferative responses of type 1 diabetes patients and healthy individuals to human hsp60 and its peptides. J Autoimmun 1999;12:121-9.
DOI: http://dx.doi.org/10.14238/sp21.2.2019.121-8
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