Peran Limfosit T Helper-1 (TH1) dan T Helper-2 (TH2) pada Patogenesis Artritis Lepra

Tahun 2008 Volume 43 Nomor 1
Oleh : Suyanto Hadi ,Sunarto,Hardyanto S, Triyuliati,Susanto J, FX Hartono

Latar belakang: TH1 CD4+ autoreactive diduga kuat berperan pada patogenesis artritis lepra. Apakah autoimunitas yang terJadi akibat dominansi aktivasi timfosit TH1 atau TH2 pada penderita lepra belum pernah diteliti .

Metode: Berbagai Ag M.leprae (35 kDa, 10 kDa, 45 kDa LAM. 85 kDa, dan MLSA dosis 2 ug/ml) distimulasikanpada kultur timfosit darah perifer (l0 cc darah vena), menggunakan media RP MI 1640 dari 22 kasus artritis lepra. 12 kontrol-1 (lepra tanpa artritis), dan 12 kontrol-2 (tetangga sehat kontak positive). Nilai delta kadar IFN-y dan IL-4 (ELISA) diukur untuk mengetahui peran aktivitas limfosit TH1 dan TH2. Statistik yang dipergunakan adalah ANOVA, Kruskal-Wallis atau Mann Whitney. dan Chi-square.

Hasil: Nilai delta IFN-y kultur timfosit kasus artritis lepra (median 132,234 pg/ml, 60,347 pg/ml, 14,093 pg/ml. 16,6/9 pg/ml dan138,394 pg/ml) kelompok artritis lepra lebih tinggi dibandingkan nilai delta 1L-4 (median 0,317 pg/ml, 0.017 pg/ml, -0.206 pg/ml, -0,200 pg/ml and 0,492 pg/ml) pasca stimulasi dengan Ag M. leprae 35 kDa, 10 kDa MMP-1, 45 kDa LAM, 85 kDa dan MLSA dosis 2 ug/ml, (p<O.OOl). Nilai deltal FN-y kelompokkasusjuga lebih tinggi dibandingkan kedua kelompok kontrol (p<0.05).

Simpulan: Aktivitas limfosit TH1 CD4+ lebih dominan dibandingkan TH2CD4+ pada kelompokpenderita artritis lepra.

The role of lymphocyte T Helper-1 (TH1) and T Helper-2(TH2) In the pathogenesis of leprosy arthritis

Background: The autoreactive of TH CD4 cells is the thought to play an important role in arthritis leprosy pathogenesis. However.  whether TH1 or TH2 which is predominant has never been studied.

Methods: Various Ag M. leprae (Ag 35 kDa, 10 kDa, 45 kDa, 85 kDa, and MLSA 2ug/ml were stimulated in the peripheral blood (10cc) lymphocyte culture (PBMC) using 96 wee/s microplate and RPMI 1640 media of 22 leprosy arthritis cases, control-1 (n=12) (leprosy without arthritis) and control 2 (n=12) (healthy contact). The activity difference between TH1 and TH2 CD4+ lymphocyte was analysed using the difference delta levels oflFN-y and IL-4 (ELISA) of the three group studies. Statistical analysis used were ANOVA, Kruskal
Wallis or Mann Whitney. and Chi-square.

Results: lFN-y delta levels was significantly higher in the lymphocytes cultures in LA group (the median 132.234 pg/ml, 60.347 pg/ml, 14.093 pg/ml. 16.619 pg/ml dan 138.394 pg/ml) compared with 1L-4 value level (median 0.31 7 pg/ml, 0.017 pg/ml, -0.206 pg/ml. -0.200 pg/ml and 0.492 pg/ml) after being stimulated with 35 kDa, 10 kDa MMP-1, 45 kDa LAM. 85 kDa dan MLSA of 2 ug/ml dose consecutively (all p<O.OOl). The lFN-y delta value in LA group also showed significantly higher level in response to all M. leprae Ag compared to all control-groups. with all p value <0.05.

Conclusions: TH1 CD4+ ~ymphocyte activity is more dominant compared than TH2 CD4+ lymphocyte activity in leprosy arthritis group
patients"