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Alpha Klotho: Peran Biomolekuler dan Potensinya Sebagai Biomarker Luaran Klinis Dalam Pneumonia Geriatri
Abstract
Pada populasi geriatri, pneumonia menjadi lebih berisiko karena dikaitkan dengan perubahan fisiologis yang mengakibatkan penurunan fungsi paru, berkurangnya regenerasi, remodeling saluran napas, melemahnya respons imun bawaan dan adaptif, peningkatan kerentanan hingga adanya kemungkinan komorbid yang mempersulit pemulihan. Salah satu protein sitoprotektif yang esensial dalam mencegah kerusakan paru adalah α-klotho. α-Klotho utamanya diproduksi pada ginjal merupakan salah satu hormon endokrin yang sangat penting untuk pemeliharaan dan perlindungan jaringan. α-Klotho berperan dalam mencegah penuaan, memperlambat tingkat degenerasi multi-organ prematur, menurunkan stres oksidatif, dan menekan kerusakan jaringan yang diperantarai oleh inflamasi. Efek tersebut diperoleh melaui inhibisi pada jalur transforming growth factor β (TGF-β), insulin-like growth factor 1 (IGF-1), Wnt dan NF-κB. Ekspresi α-klotho menurun seiring bertambahnya usia. Penurunan ekspresi α-klotho pada paru dikaitkan dengan peningkatan stres oksidatif, inflamasi, dan apoptosis serta penurunan fungsi pembersihan mukosiliar dan peningkatan laju pelebaran alveolus. Hingga saat ini belum ada penelitian khusus yang meneliti ekspresi ɑ-klotho pada pneumonia geriatri. Namun, penelitian terbaru mengungkap potensi protein ini sebagai biomarker. Ditemukan bahwa kadar ɑ-klotho memiliki hubungan negatif yang signifikan terhadap berbagai biomarker inflamasi akut yang merupakan komponen penting dalam patogenesis pneumonia. Potensi α-klotho sebagai modulator respon inflamasi menunjukkan kemungkinan untuk digunakan sebagai biomarker yang mewakili kondisi pneumonia pada populasi lanjut usia dalam memprediksi luaran klinis.
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DOI: https://doi.org/10.33024/jmm.v8i4.18882
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