Introduction: Th17 and Treg cells have important roles in the development and progression of the allergic diseases, such as asthma. Several studies reported that Nigella sativa could improve chronic airway inflammation, and inhibit airway remodeling by regulating the immune system. To examine the effect of Nigella sativa supplementation on Th17/ Treg cells, and asthma control test score in asthmatic children.

ABSTRAKPeran Th17 dalam patogenesis asma dan imunoterapi menjadi konsep dan paradigma terbaru. Imunoterapi merupakan salah satu manajemen di dalam asma dan memerlukan waktu yang lama sehingga sering mengakibatkan kegagalan terapi. Terapi adjuvant antara lain probiotik dan Nigella sativa diduga dapat meningkatkan efektifitas imunoterapi. Penelitian dilakukan untuk mengevaluasi efek pemberian imunoterapi, probiotik dan/atau Nigella sativa terhadap jumlah sel Th17, neutrofil dan skoring asma pada anak asma selama imunoterapi fase rumatan. Penelitian dilakukan pada 31 anak yang dikelompokkan secara acak yaitu imunoterapi plus plasebo atau imunoterapi plus Nigella sativa atau imunoterapi plus probiotik atau imunoterapi plus Nigella sativa plus probiotik selama 56 minggu. Pengukuran jumlah sel Th17 dan neutrofil dilakukan menggunakan flowcytometry setelah perlakuan. Asthma Control Test dilakukan untuk mengevaluasi gejala klinis. Data dianalisis menggunakan uji komparasi Anova One Way dan uji korelasi Pearson. Hasil menunjukkan tidak didapatkan perbedaan yang bermakna jumlah sel Th17 dan neutrophil antara kelompok perlakuan (p-value 0,199 dan 0,326). Asthma control test secara bermakna didapatkan perbedaan antara perlakuan imunoterapi plus probiotik dibandingkan imunoterapi saja. Skoring asma pada kelompok perlakuan imunoterapi plus probiotik adalah yang tertinggi (22,6). Jumlah sel Th17, neutrofil dan ACT menunjukkan hubungan yang lemah dan tidak bermakna secara statistik (r=-0,2) (p= 0,156). Jumlah sel Th17 dan neutrofil tidak didapatkan perbedaan yang bermakna. Skoring asma pada kelompok imunoterapi plus probiotik adalah yang tertinggi. Dapat disimpulkan tidak terdapat hubungan antara Th17, neutrofil dan skoring asma.Kata Kunci: Imunoterapi, neutrofil, Nigella sativa, probiotik, sel Th17, skoring asma (p-value 0,199 and 0,326 ABSTRACT The role of Th17 cells in the pathogenesis of asthma and immunotherapy is being the latest concept and paradigm. Immunotherapy in asthma management requires long periods of time and often causes failure of therapy. Administration of adjuvans such as probiotics or Nigella sativa has been considered to improve its efficacy. This study was conducted

Allergen-specific immunotherapy and allergen reduction which are interventions in allergic disease have potential to + + reduce long-term allergy symptoms. A decrease on CD8 type 2 and T CD4 cells correlates with regulatory mechanisms of immunotherapy. So far, there is no study evaluating the effect of long-term administration of immunotherapy, probiotics, + + and Nigella sativa on modulation of immune response, especially CD4 /CD8 T cells ratio, immunoglobulin E (IgE) level, and + + asthma scoring. This research design was randomized clinical trials (RCTs), pre-post control study for CD4 /CD8 T cells ratio, IgE level, and asthma scoring. The subjects were divided into four groups, immunotherapy+placebo, immunotherapy+Nigella sativa, immunotherapy+probiotics, and immunotherapy+Nigella sativa+probiotics. All treatments were given in 56 weeks. Immunotherapy conducted was house dust mite (HDM) subcutaneous 9 immunotherapy. Probiotic given was ProBi (Medifarma) containing 2x10 colony forming unit (cfu)/gram Lactobacillus + + acidophilus and Bifidobacterium lactis. Asthma scoring was assessed using Asthma Control Test scores. CD4 /CD8 T cell ratio was measured using flowcytometry, and IgE level was measured using Chemiluminescence Enzyme Immunoassay.