Imunopatomekanisme Demam Berdarah Dengue (DBD)
DOI:
https://doi.org/10.30742/cmj.v3i1.211Keywords:
Antibody-Dependent Enhancement, cytokine storm, Demam Berdarah Dengue, imunopatogenesis, kebocoran plasmaAbstract
Latar Belakang: Demam Berdarah Dengue (DBD) merupakan komplikasi berat infeksi virus dengue yang dipicu oleh disregulasi imun selama infeksi sekunder heterolog, dengan mortalitas mencapai 20% tanpa penanganan. Tujuan: Mengkaji mekanisme imunopatogenesis DBD, termasuk peran ADE, cytokine storm, dan gangguan hemostasis, serta implikasinya untuk tata laksana klinis. Metode: Tinjauan naratif menggunakan database PubMed, ScienceDirect, dan repositori institusi (2007–2023) dengan kata kunci: “imunopatogenesis dengue”, “ADE dengue”, “cytokine storm DHF”. Hasil: Antibody-Dependent Enhancement (ADE) memfasilitasi masuknya virus ke monosit/makrofag, memicu produksi TNF-α/IL-6 berlebihan. Reaktivitas silang sel T (original antigenic sin) dan cytokine storm menyebabkan kebocoran plasma yang ditunjukkan dengan peningkatan kadar hematokrit >20%) dan trombositopenia (<100.000/μL). Infeksi sekunder meningkatkan risiko DBD 15–80 kali. Kesimpulan: Imunopatogenesis Demam Berdarah Dengue (DBD) bersifat multifaktorial. Deteksi dini hemokonsentrasi dan terapi imunomodulator berbasis sitokin merupakan strategi potensial.
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