Penurunan Kadar Pro-adrenomedullin Mencit Balb/C Model Sepsis dengan Kortikosteroid Dosis Rendah

Abstract

Penggunaan kortikosteroid dosis rendah pada penatalaksanaan sepsis tahap awal masih diperdebatkan. Pemberian kortikosteroid dosis rendah pada sepsis dapat mengurangi respons inflamasi sitemik, menghambat produksi sitokin proinflamasi dan mediator inflamasi, serta menurunkan adhesi leukosit ke endotel. Pro-adrenomedullin (pro-ADM) merupakan biomarker keparahan sepsis. Penelitian ini bertujuan untuk menganalisis efek penggunaan kortikosteroid dosis rendah pada kadar pro-ADM serum pada mencit Balb/C model sepsis tahap awal. Penelitian ini merupakan penelitian eksperimental laboratoris, dengan sampel 30 ekor mencit Balb/C jantan yang dibagi menjadi kelompok kontrol, sepsis, dan sepsis+kortikosteroid dosis rendah. Penelitian dilakukan di Laboratorium Histologi dan Biomedik, Fakultas Kedokteran, Universitas Sebelas Maret Surakarta, selama periode April–September 2012. Untuk membuat model sepsis, hewan coba diinokulasi lipopolisakarisa/LPS (E. coli) dosis 0,1 mg/mencit secara intraperitoneal (i.p). Kelompok tikus kontrol tidak diinokulasi selama penelitian. Kortikosteroid dosis rendah yang digunakan adalah metil prednisolon dosis 0,05 mg/mencit/12 jam secara i.p. Mencit kontrol tidak diinokulasi selama penelitian. Kadar pro-ADM serum ditentukan menggunakan enzyme-linked immunosorbent assay (ELISA). Uji kadar pro-ADM serum menggunakan analysis of variance (ANOVA) dan untuk menentukan perbedaan kemaknaan digunakan p<0,05. Kortikosteroid dosis rendah secara bermakna menurunkan kadar pro-ADM dibandingkan dengan kelompok sepsis (33,0±2,9 pg/mL vs 48,5±6,1 pg/mL; p<0,001). Simpulan, penggunaan kortikosteroid dosis rendah menurunkan kadar pro-ADM pada hewan coba model sepsis tahap awal. [MKB. 2014;46(2):68–72]

Kata kunci: Kortikosteroid dosis rendah, pro-adrenomedullin, sepsis

Pro-adrenomedullin Level Reduction in Balb/C Sepsis Model Mice through the Use of Low-Dose Corticosteroid

The use of low-dose corticosteroids in the management of early stage of sepsis is still debated. Low-dose corticosteroids in sepsis can reduce the systemic inflammatory response, inhibit the production of pro-inflammatory cytokine, inflammatory mediators, and decrease adhesion of leukocytes to the endothelium. Pro-adrenomedullin (pro-ADM) is a biomarker of sepsis severity. This study aimed to analyze the effects of the use of low-dose corticosteroids on the levels of pro-ADM in the serum in Balb/C mice model of sepsis at the early stage. This study was an experimental research laboratory, with 30 male Balb/C mice which were divided into control, sepsis, and sepsis+low-dose corticosteroids groups. The study was conducted at the Histology and Biomedical Laboratory, Faculty of Medicine, Sebelas Maret University, Surakarta, during the period of April to September 2012. Sepsis was induced in the male Balb/C mice by inoculation through an intraperitoneally (i.p) injection of lipopolysaccharide/LPS (E. coli) with 0.1 mg/mice/i.p. dose for sepsis mice model. Control mice were not inoculated during the study. Low-dose corticosteroids used was methyl prednisolone at a dose of 0.05 mg/mice/12 hours/i.p. Pro-ADM serum level was measured with enzyme-linked immunosorbent assay (ELISA). One way analysis of variance (ANOVA) for pro-ADM serum level and p<0.05 were used to determine the significant differences. Low-dose corticosteroids significantly decreased pro-ADM level (33.0±2.9 pg/mL vs 48.5±6.1 pg/mL, p<0.001) compared to the sepsis group. In conclusion, the use of low-dose corticosteroids reduce levels of pro-ADM in the early stages of sepsis. [MKB. 2014;46(2):68–72]

Key words: Low-dose corticosteroids, pro-adrenomedullin, sepsis

DOI: 10.15395/mkb.v46n2.276