Korelasi Jumlah Streptococcus mutans (S. mutans) dan Level Ekspresi Interlukin 8 (IL-8) pada Severe Early Childhood Caries

Abstract

ABSTRAKKaries gigi pada anak usia dini merupakan masalah kesehatan yang sangat serius karena merupakan penyakit infeksi kronis yang menular. Dalam beberapa tahun terakhir pandangan tentang neutrofil telah berubah secara dramatis. Neutrofil tidak hanya berperan sebagai pembunuh mikroba melalui proses fagositosis, pelepasan reactive oxigen species (ROS) dan peptida antimikrobialnya tetapi neutrofil turut mengatur aktifasi respon imun. Interleukin-8 (IL-8) berfungsi sebagai aktivator kuat dan kemoatraktan neutrofil oleh karena itu IL-8 merupakan mediator kunci dalam migrasi neutrofil ke lokasi peradangan dan infeksi. Untuk menganalisis hubungan dari jumlah S. mutans dan ekspresi IL-8 neutrofil saliva pada anak usia dini bebas karies dan severe early childhood caries (S-ECC). Perlakuan dilakukan pada dua kelompok yaitu isolasi dan menghitung jumlah S. mutans pada sampel saliva dan sampel hasil kumur dengan NaCl 1,5% yang diisolasi neutrofilnya kemudian dianalisis ekspresi IL-8 menggunakan flow cytometry dari 20 anak bebas karies dan 20 anak severe early childhood caries. Hasil nilai rata-rata diketahui bahwa jumlah S. mutans anak usia dini bebas karies lebih rendah (513.500,00±185.565,28 CFU/ml) dibandingkan dengan S-ECC (977.000,00±222.500,15 CFU/ml), sedangkan ekspresi IL-8 neutrofil saliva anak usia dini bebas karies lebih tinggi (3,31±0,50) dibandingkan dengan S-ECC (2,95+0,56). Penurunan ekspresi IL-8 neutrofil saliva kemungkinan sebagai penyebab meningkatnya jumlah S. mutans pada S-ECC. Karies gigi dimulai setelah gigi sulung tumbuh dan berkembang pada permukaan gigi dengan sangat cepat dan progresif dengan manifestasi berupa nyeri, abses akut maupun kronis, demam, pembengkakan pada bibir sehingga nafsu makan menurun. 2Severe early chilhood caries dengan decay exfolation filling teeth (def-t) ≥ 6 merupakan bentuk yang sangat destruktif karena melibatkan beberapa gigi, termasuk gigi anterior rahang atas.

Analysis of Lymphocyte T(CD4+) Cells Expression on Severe Early Childhood Caries and Free Caries

“…19 , 20 The results of the study as shown in Table 1 show that the expression of T lymphocytes (CD4 + ) cells in S-ECC is significantly lower than in free caries, this may cause the high S. mutans bacteria found in S-ECC saliva cannot be in acquisition by adaptive immunity because TCR and its co-receptors, such as CD4 which can form complexes with class 2 major receptor histocompatibility complex (MHC) receptors and antigens, cannot function optimally so that quantitatively the number of S. mutans which are bacteria that causes caries is higher compared to cariesfree children. 21 Expression of T lymphocytes (CD4 + ) in S-ECC causes the release of pro-inflammatory cytokines that function as chemoattractant of neutrophil cells, because the movement of neutrophils toward the infection area is less than optimal, the movement of macrophages is also less than optimal towards the area of infection, giving S. mutans the opportunity to develop and do damage to the teeth.…”

CD89/CD35 Expression Ratio in Salivary Neutrophil as an Early Detection Marker for Severe Early Childhood Caries

“…The increase of S. mutans in the S-ECC group with a more varying virulent strain proved capable of evading the host immune system, both innate and adaptive, despite the complex host innate immune system in saliva. 31 S-ECC denotes chronic infection, producing the high level of proinflammatory cytokine C5a, IL-8, tumor necrosis factor-α, and the formation of antigen-IgA complex due to an elevated level of antigen. Individuals with S-ECC tend to present high levels of S. mutans in the oral cavity, 29 inducing an immune response which increases the production of immunoglobulin.…”

“…The increase of S. mutans in the S-ECC group with a more varying virulent strain proved capable of evading the host immune system, both innate and adaptive, despite the complex host innate immune system in saliva. 31 …”

Analysis of interleukin-10 anti-inflammatory cytokines in salivary lymphocyte surface: A cross sectional study

“…This may be preschool children with S-ECC responding to more antigens in the form of S. mutans bacteria, which are relatively high in number compared to children with free caries. [11] Antigen structures called PAMPs, which will be recognized by PRRs, namely TLRs, are very important to trigger the effect or phase of the innate immune response. [12] TLR2 and TLR4 involved in the introduction of gram-positive and gram-negative bacteria that have been detected in the odontoblast cell membrane in healthy pulp show that odontoblasts are equipped to recognize these pathogens when they diffuse through dentinal tubules during carious infection.…”