Kadar Cathelicidin rendah berkorelasi negatif terhadap indeks bakteri pasien Morbus Hansen Tipe Multibasiler
Authors: Hostiadi Michael , Rusyati Luh Made Mas , Puspawati Ni Made Dwi , Indira I Gusti Ayu Agung Elis , Darmaputra I Gusti Nyoman , Karna Ni Luh Putu Ratih Vibriyanti 
Published: May 2024

Background: One of the immunological factors that are thought to have a potential relationship to Mycobacterium leprae infection is cathelicidin. Cathelicidin is an essential component of the innate immune system against infection with various pathogens, including gram-positive and gram-negative bacteria, fungi, parasites, and viruses. This study aimed to determine the relationship between cathelicidin levels with bacterial index (BI) and duration of multi-drug therapy (MDT) treatment in multibacillary (MB) type leprosy patients.
Methods: This research is an analytic observational study with a cross-sectional design at Dermatology and Venereology Polyclinic, Prof. General Hospital. dr. I.G.N.G Ngoerah Denpasar and Integrated Biomedical Laboratory, Faculty of Medicine, Udayana University, Denpasar from April 2023 to May 2023. The research variables were the bacterial index from examining acid-fast bacteria (AFB) and cathelicidin levels. Subjects were selected by consecutive sampling method with inclusion criteria for the case group, patients with multibacillary type leprosy, and the control group, which were healthy subjects. Analysis was analyzed descriptively and analytically with the Mann-Whitney test and Spearman's correlation using the SPSS program.
Results: Sixty-eight samples were divided into 34 subjects in the control group and 34 in the case group. In terms of BI, negative/zero and +4 were the most common BI with a frequency of 11.8% (n=8) and 16.2% (n=11), and IB +2 of 8.8% (n=6). The mean cathelicidin levels in the case and control groups were 21.64±12.18 g/mL and 37.92±33.86 g/mL (p<0.05; mean difference: 16.26 g/mL). The correlation between cathelicidin levels and IB was r=-0.77 (p<0.001), and cathelicidin level with the duration of treatment was r=-0.36 (p=0.033).
Conclusion: Cathelicidin levels have a significant negative correlation to the BI in MB type leprosy patients. Duration of treatment has an influence on BI in MB type leprosy patients.
 
Latar Belakang: Salah satu faktor imunologis yang diduga memiliki hubungan potensial terhadap infeksi Mycobacterium leprae adalah cathelicidin. Cathelicidin merupakan komponen penting dari pertahanan inang bawaan (innate immune system) terhadap infeksi berbagai patogen, termasuk bakteri gram-positif maupun bakteri gram-negatif, jamur, parasit, dan virus. Penelitian ini bertujuan untuk mengetahui hubungan antara kadar cathelicidin dengan indeks bakteri (IB) dan lama pengobatan multi drug therapy (MDT) pada pasien kusta tipe multibasiler (MB).
Metode: Penelitian ini merupakan penelitian observasional analitik dengan rancangan cross-sectional, bertempat di Poliklinik Kulit dan Kelamin, RSUP Prof. dr. I.G.N.G Ngoerah Denpasar dan Laboratorium Biokimia Fakultas Kedokteran Universitas Udayana, Denpasar pada bulan April 2023 sampai bulan Mei 2023. Variabel penelitian yaitu indeks bakteri dari pemeriksaan bakteri tahan asam (BTA) dan kadar cathelicidin.  Subjek dipilih dengan metode consecutive sampling dengan kriteria inkulsi kelompok kasus yaitu pasien kusta tipe multibasiler dan kelompok kontrol yaitu subjek sehat. Analisis dilakukan secara deskriptif dan analitik dengan uji Mann-Whitney dan korelasi Spearman menggunakan program SPSS.
Hasil: Sejumlah 68 sampel terbagi menjadi 34 subjek kelompok kontrol dan 34 subjek kelompok kasus. Ditinjau dari segi indeks bakterinya, IB negatif/nol dan +4 merupakan IB terbanyak dengan frekuensi 11,8% (n=8) dan 16,2% (n=11), serta IB +2 sebesar 8,8% (n=6). Rerata kadar cathelicidin pada kelompok kasus dan kontrol yaitu 21,64±12,18 g/mL dan 37,92±33,86 g/mL (p<0,05; beda rerata: 16,26 g/mL). Korelasi kadar cathelicidin dengan IB didapatkan r=-0,77 (p<0,001) dan dengan lama pengobatan didapatkan r=-0,36 (p=0,033).
Simpulan: Kadar cathelicidin memiliki korelasi negatif yang signifikan terhadap indeks bakteri pada penderita kusta tipe MB. Durasi pengobatan memiliki pengaruh terhadap IB pada penderita kusta tipe MB.