Hubungan Kadar Bromotyrosine Urin Dengan Terapi Montelukast, Beclometasone/Formoterol, Dan Kombinasi Selama 3 Bulan Pada Pasien Asma Di Klinik Harum Melati Pringsewu

Dimas Trend Pinaka Baladika, Retno Ariza Soeprihatini Soemarwoto, Syazili Mustofa, Faisal Yunus, Diyan Ekawati, Adityo Wibowo

Sari


Bromotyrosine urin memiliki banyak keuntungan sebagai biomarker potensial penyakit asma mengingat stabilitasnya dan pengumpulan sampel urin yang bersifat non-invasif. Dalam manajemen tatalaksana asma leukotriene receptor antagonist (LTRA) merupakan obat alternatif lini pertama setelah kortikosteroid inhalasi. Penelitian ini bertujuan untuk mengetahui hubungan kadar bromotyrosine urin dengan terapi montelukast selama 3 bulan. Penelitian ini melibatkan 82 pasien berusia antara 6-65 tahun dari Klinik Harum Melati, Pringsewu dari bulan Mei – Desember 2023. Dilakukan uji spirometri, urin, differential count sebelum dan setelah terapi 3 bulan, diklasifikasikan derajat obstruksi ringan (n= 66) dan sedang-berat (n=6) serta pasien non-asma untuk kontrol (n= 10). Hanya 28 pasien yang datang untuk evaluasi setelah 3 bulan terapi. Pasien dibagi menjadi 3 kelompok, yaitu kelompok terapi montelukast (n=14), beclometason/formoterol (n=5), dan kombinasi montelukast dan beclometason/formoterol (n=9). Kadar bromotyrosine urin penderita asma secara bermakna lebih tinggi dibandingkan dengan kontrol (154.11 ng/ml vs 11,87 ng/ml, p= 0,000). Tidak terdapat perbedaan bermakna kadar bromotyrosine urin setelah terapi montelukast (104.24 ng/ml vs 40.79 ng/ml, p=0,433) dan setelah terapi beclometason/formoterol (136,25 ng/ml vs 33,20 ng/ml, p= 0,345. Terjadi penurunan kadar bromotyrosine urin yang bermakna pada kelompok setelah terapi kombinasi montelukast dan beclometasone/formoterol (39.63 ng/ml vs 11.13 ng/ml) (95% CI 3.90-42.43, p= 0.028). Hasil penelitian menunjukkan pasien asma memiliki kadar bromotyrosine urin jauh lebih tinggi dibandingkan dengan non-asma. Kadar bromotyrosine urin menurun secara bermakna setelah terapi kombinasi (montelukast dan beclometason/formoterol) selama 3 bulan.


Kata Kunci


Asma; Bromotyrosine Urin; Montelukast

Teks Lengkap:

PDF

Referensi


Abbafati C. 2020. Global burden of 369 diseases and injuries in 204 countries and territories, 1990–2019: a systematic analysis for the Global Burden of Disease Study 2019. Lancet 396, 1204–1222.

Albassam A, Alharbi A, Awaisu A. 2020. Assessing Adherence to Inhaled Corticosteroids Among Adults with Asthma in Kuwait Using the Medication Adherence Report Scale for Asthma. Patient Prefer Adherence. 14:963- 970.

Beasley, R., Bruce, P., Houghton, C. and Hatter, L. 2023. The ICS/Formoterol Reliever Therapy Regimen in Asthma: A Review. Journal of Allergy and Clinical Immunology: In Practice 11(3), pp. 762-772.e1. doi: 10.1016/j.jaip.2023.01.002.

Choi J, Azmat CE. 2022. Leukotriene Receptor Antagonists. Treasure Island (FL): StatPearls Publishing.

Carr, T.F. and Kraft, M. 2018. ‘Use of biomarkers to identify phenotypes and endotypes of severe asthma’, Annals of Allergy, Asthma and Immunology. American College of Allergy, Asthma and Immunology, pp. 414–420. Available at: https://doi.org/10.1016/j.anai.2018.07.029.

Dębowski, T. et al. 2024. ‘Improvement of asthma control in adult patients using extrafine inhaled beclomethasone/formoterol fixed combination as maintenance therapy as well as maintenance and reliever therapy – CONTROL study’, Pulmonary Pharmacology and Therapeutics, 84. Available at: https://doi.org/10.1016/j.pupt.2023.102272.

Dharmage SC, Perret JL, Custovic A. 2019. Epidemiology of asthma in children and adults. Front. Pediatr. 7, 1–15.

Di Palmo E, Cantarelli E, Catelli A, Ricci G, Gallucci M, Miniaci A, et al. 2021. The Predictive Role of Biomarkers and Genetics in Childhood Asthma Exacerbations. Int J Mol Sci. 22(9):4651.

Erzurum SC. 2016. New insights in oxidant biology in asthma’, Annals of the American Thoracic Society, 13(35), pp. S35–S39. Available at: https://doi.org/10.1513/AnnalsATS.201506-385MG.

Global asthma Network ( GAN ). 2018. The Global Asthma Report 2018. http://www.who.int/news-room/fact-sheets/detail/asthma.

Hossny, E., Rosario, N., Lee, B.W., Singh, M., El-Ghoneimy, D., Soh,

J.Y. and Le Souef, P. 2016. The use of inhaled corticosteroids in pediatric asthma: Update. World Allergy Organization Journal 9(1). doi: 10.1186/s40413-016-0117-0.

Kang, M., Sohn, S.-J. and Shin, M.-H. 2020. Association between Body Mass Index and Prevalence of Asthma in Korean Adults. Chonnam Medical Journal 56(1), p. 62. doi: 10.4068/cmj.2020.56.1.62.

Kementrian kesehatan RI. 2018. Riset kesehatan dasar. Jakarta:

Badan penelitian dan pengembangan kesehatan.

Mani AR, Moreno JC, Visser TJ, Moore KP. 2016. The metabolism and de- bromination of bromotyrosine in vivo. Free Radic Biol Med. 90:243-51.

Michaeloudes, C. et al. 2022. Molecular mechanisms of oxidative stress in asthma. Molecular Aspects of Medicine 85, p. 101026. doi: 10.1016/J.MAM.2021.101026.

Popović-Grle S, Štajduhar A, Lampalo M, Rnjak D. 2021. Biomarkers in different asthma phenotypes. Genes (Basel).

Ramadan, A.A., Gaffin, J.M., Israel, E. and Phipatanakul, W. 2019. Asthma and Corticosteroid Responses in Childhood and Adult Asthma. Clinics in Chest Medicine 40(1), pp. 163–177. doi: 10.1016/j.ccm.2018.10.010.

Reddel HK, Bacharier LB, Bateman ED, Brightling CE, Brusselle GG, Buhl R, et al. 2022. Global Initiative for Asthma Strategy 2021: Executive Summary and Rationale for Key Changes. Am J Respir Crit Care Med. 205(1):17-35.

Reichardt, S.D., Amouret, A., Muzzi, C., Vettorazzi, S., Tuckermann, J.P., Lühder, F. and Reichardt, H.M. 2021. The role of glucocorticoids in inflammatory diseases. Cells 10(11). doi: 10.3390/cells10112921.

Soemarwoto RA, Mustofa S, Rusmini H, Febriani A, Muslimah N. 2019. Relationship between allergic rhinitis and asthma in the elementary school children in Bandar Lampung, Indonesia. Eur Respir J. 56(64):670.

Tang M. et al. 2024. Utility of eosinophil peroxidase as a biomarker of eosinophilic inflammation in asthma. Journal of Allergy and Clinical Immunology, 154(3), pp. 580-591.e6. Available at: https://doi.org/10.1016/j.jaci.2024.03.023.

Tiotiu A. 2018. Biomarkers in asthma: state of the art. Asthma Res Pract. 4:10.

Zein JG, et al. 2016. Impact of Age and Sex on Outcomes and Hospital Cost of Acute Asthma in the United States, 2011-2012’, PLoS ONE, 11(6). Available at: https://doi.org/10.1371/journal.pone.0157301.

Zuberi FF, et al. 2020. Role of montelukast in asthma and allergic rhinitis patients. Pakistan Journal of Medical Sciences, 36(7), pp. 1517–1522. Available at: https://doi.org/10.12669/pjms.36.7.2657.




DOI: https://doi.org/10.33024/jikk.v12i7.20239

Refbacks

  • Saat ini tidak ada refbacks.


##submission.copyrightStatement##

##submission.license.cc.by-nc4.footer##

Pendidikan Dokter Universitas Malahayati Lampung


Creative Commons License
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.