Polimorfisme Gen MMP-9, Ekspresi MMP-9, dan Indeks Apoptosis Sel Serviks pada Kehamilan 21–36 Minggu

Abstract

Ekspresi berlebihan serta aktivasi beberapa matriks metaloproteinase (MMP) sebelum persalinan mengarah pada degradasi jaringan amnion korion yang secara klinis disebut ketuban pecah dini (KPD). Peningkatan aktivitas MMP akibat polimorfisme gen matrik metaloproteinase-9 (MMP-9) (C-1562T) akan diikuti oleh apoptosis. Penelitian ini bertujuan mencari perbedaan ekspresi MMP-9, indeks apoptosis (IA) sel serviks, serta polimorfisme gen MMP-9 (C-1562T) pada kehamilan 21–36 minggu tanpa dan disertai KPD. Penelitian ini merupakan penelitian kasus kontrol yang dilakukan di RS Dr. Hasan Sadikin dan RS jejaring Bandung (Mei−November 2009). Tidak terdapat hubungan bermakna antara ekspresi MMP-9 dan IA sel serviks dengan setiap variabel pada kedua kelompok. Tiga kasus KPD ditemukan pada ibu berusia di bawah 20 tahun. Usia kehamilan 28−34 minggu memiliki peluang mengalami KPD lebih besar dibandingkan dengan usia kehamilan 21−28 minggu. Ibu hamil dengan indeks massa tubuh (IMT) 19–26 memiliki risiko mengalami KPD. Hanya terdapat satu sampel yang menunjukkan polimorfisme MMP-9 (C-1562T) di kelompok kehamilan 21–36 minggu disertai KPD. Dapat disimpulkan, tidak ditemukan hubungan bermakna antara ekspresi MMP-9 dan IA sel serviks pada kedua kelompok penelitian, begitu pula dengan polimorfisme MMP-9 (C-1562T) yang dapat menyebabkan peningkatan ekspresi MMP-9. [MKB.2011;43(4):199–206].

Kata kunci: Apoptosis sel serviks, ekspresi MMP-9, ketuban pecah dini, polimorfisme gen MMP-9

MMP-9 Gene Polymorphism, MMP-9 Expression and Cervical Apoptotic Index on 21–36 Weeks of Pregnancy

Over expression and premature activation of matrix metalloproteinase (MMP) can lead to degradation of amnion chorionic membrane which clinically called premature rupture of membrane (PROM). Increasing MMP activity caused by matrix metalloproteinase-9 (MMP-9) gene polymorphism (C-1562T) will be followed by apoptosis. This study was aimed to find the differences between MMP-9 expression and cervical apoptotic index (AI) and also MMP-9 (C-1562T) polymorphism on 21–36 weeks of pregnancy with or without PROM. This was case control study and conducted in Dr. Hasan Sadikin Hospital and Bandung Networking Hospitals (May−November 2009). There were no significant correlation between MMP-9 expression and cervical AI in every variable on both groups. Three cases of PROM were found in mothers below 20 years of age. Women with 28−34 weeks of pregnancy had a greater risk for PROM than 21−28 weeks. Pregnant women with body mass index (BMI) 19−26, had risk to have PROM. Only one sample that showed a MMP-9 (C-1562T) polymorphism in the premature labor with PROM group. It can be concluded that there are no significant correlation between MMP-9 expression and cervical cells AI on both groups as well as MMP-9 (C-1562T) polymorphism which can alter MMP-9 expression. [MKB. 2011;43(4):199–206].

Key words: Cervical cell apopt

DOI: http://dx.doi.org/10.15395/mkb.v43n4.70