PENGARUH BILIRUBIN TERHADAP T HELPER PADA NEONATUS DAPAT MENINGKATKAN TERJADINYA RESIKO ALERGI
Abstract
ABTRACT
The prevalence of allergic diseases globally increased in the last decade influenced by various factors.1 One of the factors associated is hyperbilirubinemia at neonatal period, which can later develop into an allergic disease.2 Bilirubin is a powerful antioxidant, which can be distributed into tissues. Bilirubin also has an immunomudulatory effect, it inhibit the response of Th1 cells and lowering interleukin-2 (IL-2) production. This decrease in IL-2 levels disrupted the balance of Th1-Th2 to Th2.3 At the time of the increase in bilirubin levels, there is an increase in the complement of prooxidant effects due to the breakdown of heme that can trigger the occurrence of inflammation of the respiratory tract in the future.4 In addition, in a study it was found that the effects of bilirubin that are not contracted can inhibit the growth of anaerobic bacteria in the gastrointestinal tract, thereby altering the composition of the intestinal microbiota and inhibiting the response of Th1 so that it can develop into an allergic disease.5 This rise a hypothesis that there is an influence of bilirubin on balance T helper that can increase the risk of occurrence of allergies in the future.
Keywords: Bilirubin, neonates, T helper, immune system, allergy
ABSTRAK
Prevalensi penyakit alergi secara global meningkat pada dekade akhir ini yang dipengaruhi oleh berbagai faktor.1 Salah satu faktor yang dihubungkan yaitu hiperbilirubinemia pada saat neonatus, yang kemudian hari dapat berkembang menjadi penyakit alergi. 2 Bilirubin merupakan antioksidan kuat, yang dapat didistribusikan kedalam jaringan. Bilirubin juga memiliki efek immunomudulator, yaitu dengan menghambat respon sel Th1 dan menurunkan produksi interleukin-2 (IL-2). Penurunan kadar IL-2 ini mengganggu keseimbangan Th1-Th2 menuju ke Th2.3 Pada saat terjadinya peningkatan kadar bilirubin, terjadi peningkatan komplemen efek prooksidan akibat pemecahan heme yang dapat memicu terjadinya inflamasi pada saluran pernafasan dikemudian hari.4 Selain itu, pada sebuah penelitian didapatkan bahwa efek bilirubin yang tidak terkonyugasi dapat menghambat pertumbuhan bakteri anaerob pada saluran cerna, sehingga mengubah komposisi mikrobiota usus dan menghambat respon Th1 sehingga dapat berkembang menjadi penyakit alergi .5 Hal ini memunculkan hipotesis bahwa terdapat pengaruh bilirubin terhadap keseimbangan T helper yang dapat meningkatkan terjadinya resiko terjadinya alergi dikemudian hari.
Kata kunci: Bilirubin, neonatus, T helper, sistem imun, alergi
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DOI: http://dx.doi.org/10.32883/hcj.v6i1.1081
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