SUKMAWATI A. DAMITI, 051415153015 (2017) PENGARUH SUPLEMENTASI PROBIOTIK DAN VITAMIN B1, B6, B12 TERHADAP PERUBAHAN KADAR IFN-γ DAN IL-17 PADA PASIEN TUBERKULOSIS DENGAN OBAT ANTI TUBERKULOSIS KATEGORI 1. Thesis thesis, Universitas Airlangga.

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Abstract

Background: Cellular immunity has a main role for disease progressivity, exposure of mycobacterium tuberculosis can cause more active tuberculolosis disease. Interferon-γ (IFN-γ) as proinflammatory cytokine has important contribution for potection from intracellular pathogen, while Interleukin-17 (IL-17) beside required for the accelerated recruitment of IFN-γ to site of inflammation, it play an immunorregulatory role involved in stimulation of granulopoiesis, recruitment, and activation of neutrophil. Previous study showed that gastrointestinal adverse events of antibiotics can be counteracted by probiotics as a natural substance. Probiotic is an immunomodulator agent which increase permeability of the gut, alleviate the inflamatory response that can decrease risk of infection, and vitamin B can also affect the immune response by neutrophils, NK cells and macrophages. Objectives: This study aimed to analyze the effects of probiotics and vitamin B1, B6, B12 suplementation on plasma IFN-γ and IL-17 levels in patients with TB infection during intensive phase therapy Methods: This study was conducted during December 2016 to February 2017 at Airlangga University Hospital and Community Health Centers in Surabaya, which has been approved by ethical and law committee of Airlangga University Hospital. Patients included in this study had some criteria including aged 18-60 years, received oral antituberculosis drugs during the intensive phase therapy, did not use probiotics, vitamin B1, B6, B12 two weeks before enrollment, able to eat orally or enteral, and signed an informed consent to participate in this study. Patients were divided into two groups by simple randomization. Primary outcomes are plasma Interferon-γ (IFN-γ) and IL-17 levels measured before initiation of study, after one month and two months after treatment. The plasma levels were measured by using the ELISA method. Secondary outcomes are observation of clinical improvements during the intensif phase. Results: A total of 22 patients were enrolled and divided into two groups, 11 patients in suplementation group, and 11 patients in control group. The baseline characteristics of both groups were similar. Plasma IFN-γ levels in the intervention and control group tend to increase in first month (p=0,241 vs p=0,445) then tend to decrease after second months (p=0,007 vs p=0,859), respectively. While IL-17 levels tend to decrease in the first month (p=0.05 vs p=0.182) and second months (p=0.423 vs p=0.023). The observation results of clinical improvements such as AFB smear conversion (9.09% vs 18.18%) and weight gain (9.06% vs 5.63%) in the intervention group is better than the control group.

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