Korelasi Kadar Transforming Growth Factor Beta (TGF-β) dengan Indeks Bakteri pada Reaksi Eritema Nodosum Leprosum Berulang

Abstract

Introduction : Leprosy is a chronic granulomatous infection caused by infections of Mycobacterium leprae and Mycobacterium lepromatosis. Erythema nodosum leprosum (ENL) is an immunological complication of leprosy due to a type III hypersensitivity reaction. Recurrent ENL reaction was defined as the occurrence of a second or more episode of ENL reaction after 28 days of the end of the previous treatment. Transforming growth factor beta (TGF-β) is a suppressor cytokine that can inhibit the work of macrophages and caused increased of bacterial proliferation. TGF-β levels and bacterial index have been shown to have an important relationship in the pathogenesis of ENL reactions. Subjects and Methods: Observational analytical study with a cross-sectional approach on 31 subjects aged ≥18 years with recurrent type 2 leprosy reactions. Basic data recording and subject examination included calculating the bacterial index of leprosy patients using a slit skin smear to measure TGF-β levels. The correlation between TGF-β and the bacterial index was analyzed using the Spearman correlation test. Results: There was a weak negative correlation between TGF-β levels and bacterial index in recurrent ENL sunjects (p=<0.05, r=-0.390). The majority of recurrent ENL subjects were aged 18–25 years and 26–35 years, 10 patients each (32,3%), male gender, 21 patients (67,7%), highest level of education was secondary education, 26 patients (83,9%) and more did not work as many as 20 patients (64,5%). Most of the research subjects experienced recurrent ENL reactions during MDT as many as 21 patients (67,7%), with majority of subjects have BI +2 wich is 10 patients (32,2%), and the mean value of TGF- β levels in all subjects was 305.12 ± 45.77. Conclusion: There is a weak negative correlation between TGF-β levels and the bacterial index in recurrent ENL patients.