Ketidakseimbangan Th17 dan Treg Pada Pasien PCOS Dengan Resistensi Insulin: Tinjauan Literatur Terhadap Potensi Suntikan Terapi
DOI:
https://doi.org/10.37304/jkupr.v13i1.17456Kata Kunci:
PCOS, Th17, Treg, resistensi insulinAbstrak
Sindrom ovarium polikistik atau polycystic ovarian syndrome (PCOS) adalah gangguan metabolik-endokrin yang ditandai dengan oligoovulasi/anovulasi, hiperandrogenisme, dan ovarium polikistik pada USG. Secara global, PCOS memengaruhi 6-21% perempuan usia reproduksi dan sekitar 95% di antaranya mengalami resistensi insulin. Prevalensi PCOS mencapai 5-10% dimana 72,04% berhubungan dengan infertilitas dan resistensi insulin di Indonesia. Imunoendokrinologi mencatat bahwa respons kekebalan berperan dalam perkembangan PCOS. Beberapa mekanisme menyebabkan peradangan kronis yang diperparah oleh resistensi insulin, hiperandrogenemia, dan dislipidemia. Penelitian menunjukkan korelasi antara sitokin pro-inflamasi, terutama sel T-helper 17 (Th17) dan sel T-regulator (Treg), pada PCOS dan resistensi insulin. Sel Th17 meningkatkan peradangan, sementara Treg berperan sebaliknya, dengan diferensiasinya dimodulasi oleh interleukin-6 (IL-6) dan Transforming Growth Factor-β (TGF-β). Keseimbangan Th17/Treg dapat diatur dengan menargetkan IL-6. Studi ini membandingkan tingkat Th17 dan Treg pada pasien PCOS dengan dan tanpa resistensi insulin menggunakan penanda IL-17 dan IL-10. Th17 lebih tinggi dan Treg lebih rendah pada PCOS dengan resistensi insulin, menghasilkan rasio Th17/Treg lebih tinggi dibandingkan dengan pasien tanpa resistensi insulin. Hasil studi ini memberikan peluang untuk menargetkan aksis Th17/Treg dalam terapi baru untuk memutus siklus PCOS dan resistensi insulin serta mengurangi komplikasi.
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