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Review : Imunoterapi Penanganan Infeksi Virus

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Review : Imunoterapi Penanganan Infeksi Virus Jurnal Mandala Pharmacon Indonesia, Vol 7.No.1 Juni 2021 Avaiable online at www.jurnal-pharmaconmw.com/jmpi p-ISSN : 2442-6032 e-ISSN : 2598-9979 Review : Imunoterapi Penanganan Infeksi Virus Usmar1, Andi Maqhfirah Nurul Fitri1, Dewi Yuliana2, Firzan Nainu1* 1Fakultas Farmasi, Universitas Hasanuddin, Makassar 2Fakultas Farmasi, Universitas Muslim Indonesia, Makassar ABSTRAK Penyakit menular akibat virus merupakan salah satu perkembangan yang pesat terutama dalam kondisi masalah kesehatan global yang mempengaruhi sistem pandemi COVID-19 yang dihadapi saat ini. Meskipun kesehatan masyarakat dan ekonomi di seluruh dunia. terapi dan obat-obatan yang digunakan dalam bidang Hal tersebut mendorong disusunnya artikel ini untuk imunofarmakologi masih terbatas serta banyak hal yang mendiskusikan relevansi dan pentingnya imunoterapi belum dapat ditemukan, namun teknologi baru dan dalam menentukan pilihan terapetik terkait infeksi kemajuan pesat dalam pengetahuan tentang regulasi virus, dengan menitikberatkan pembahasan pada sistem imun telah menjadikan imunoterapi sebagai ketersediaan pilihan vaksin dan obat yang telah bidang yang memiliki potensi besar dan menjanjikan ditemukan untuk membantu manusia melawan berbagai dalam penanganan infeksi virus maupun patogen lain. jenis infeksi yang disebabkan oleh virus. Penulisan Oleh karena itu, konsep imunoterapi serta relevansinya artikel review naratif ini dilakukan menggunakan dengan penyakit manusia merupakan salah satu solusi metode analisis pustaka primer maupun sekunder yang menawarkan pilihan baru untuk kebutuhan medis terkait yang berhasil dikumpulkan dari database online yang belum terpenuhi terkait penyakit infeksi akibat Google Scholar dan NCBI-PubMed. Selain itu, sumber virus. acuan pustaka juga diambil dari beberapa buku teks akademik. Imunoterapi merupakan bidang yang Kata Kunci: COVID-19, imunofarmakologi, imunoterapi, berkembang melalui interaksi bidang imunologi, infeksi virus, imunitas farmakologi dan farmakoterapi yang memiliki ABSTRACT Viral infectious disease is a global health problem that development, especially in the current state of the affects public health systems and economies worldwide. COVID-19 pandemic. Although therapies and drugs used Such reason prompts the preparation of this article to in the field of immunopharmacology are still limited and discuss the relevance and importance of immunotherapy many things have not yet been discovered, new in determining therapeutic options related to viral technologies and rapid advances in knowledge about the infections, focusing on the availability of vaccines and regulation of the immune system have made drugs that have been found to help humans to fight immunotherapy a field that has great and promising various types of infections caused by viruses. The writing potential in the treatment of viral and other pathogenic of this narrative review article was carried out using the infections. Therefore, the concept of immunotherapy related primary and secondary literature analysis and its relevance to human disease is one solution that methods that were collected from the online databases of offers new options for medical needs that have not been Google Scholar and NCBI-PubMed. In addition, met related to viral infectious diseases. reference sources are also taken from several academic textbooks. Immunotherapy is a field that is developing Keywords: COVID-19, immunopharmacology, through the interaction of the fields of immunology, immunotherapy, viral infections, immunity pharmacology and pharmacotherapy which has rapid Penulis Korespondensi : Informasi Artikel Firzan Nainu Submitted : 14 Juni 2021 Fakultas Farmasi, Universitas Hasanuddin, Accepted : 23 Juni 2021 E-mail : [email protected] Published : 30 Juni 2021 DOI : https://doi.org/10.35311/jmpi. v7i1.76 84 PENDAHULUAN hewan yang terinfeksi, atau benda mati Dalam beberapa dekade terakhir, yang terkontaminasi ke inang yang rentan penyakit menular akibat virus merupakan (Usmar et al., 2017). Secara umum, salah satu masalah kesehatan global yang pengendalian penyakit menular akibat mempengaruhi sistem kesehatan virus telah mulai mengalami kemajuan. masyarakat dan ekonomi di seluruh dunia Hal ini tercapai melalui peningkatan (Graham and Sullivan, 2018, Riley and kepedulian masyarakat global dalam Blanton, 2018). Infeksi virus dapat terjadi aspek sanitasi, peningkatan kualitas kapan saja dan tidak terbatas pada umur, perawatan medis, dan maraknya ras, maupun jenis kelamin tertentu (Riley pengembangan vaksin dan antivirus baru and Blanton, 2018). Sebagai parasit dari berbagai sumber hayati sebagai salah intraseluler, virus dapat menginvasi satu upaya imunofarmakologi dan berbagai organ pada tubuh manusia imunoterapi (Graham and Sullivan, 2018, maupun spesies lainnya, mengakibatkan Verhoef et al., 2019). berbagai jenis penyakit, dari ringan hingga Mekanisme pertahanan tubuh parah. Misalnya, infeksi oleh empat jenis terhadap infeksi virus dapat dibagi human coronavirus (229E, NL63, OC43, menjadi respons imun alamiah (bawaan) and HKU1) yang dapat menyebabkan dan respons imun adaptif (dapatan). infeksi ringan hingga sedang pada saluran Respons imun alamiah merupakan pernapasan (Zumla et al., 2016), infeksi respons awal terhadap infeksi, tidak herpes simplex virus 1 dan 2 (HSV-1 dan spesifik untuk patogen, dan tidak HSV-2) pada bagian kulit (Whitley and membuat organisme resisten terhadap Roizman, 2001) hingga infeksi pada infeksi berikutnya oleh patogen yang sama organ-organ tubuh bagian dalam oleh (Murphy and Weaver, 2016). Sebaliknya, virus hepatitis dan HIV yang hingga kini respons imun adaptif membutuhkan masih menjadi ancaman global (Deeks et waktu untuk berkembang, spesifik untuk al., 2015, Yuen et al., 2018). Bahkan, sejak patogen yang menyerang, dan diikuti oleh akhir 2019 hingga sekarang, penduduk memori imunologis sehingga bila terjadi dunia masih terancam dengan keberadaan paparan yang sama, maka akan SARS-CoV-2, coronavirus jenis baru yang menghasilkan respon yang lebih cepat menyebabkan pandemi COVID-19 untuk melawan dan menghancurkan (Harapan et al., 2020). patogen tersebut (Murphy and Weaver, Infeksi virus didefinisikan sebagai 2016). Respons imun alamiah dan adaptif penyakit yang disebabkan oleh patogen tidak berfungsi secara independen satu berupa virus yang timbul melalui sama lain dan sistem imun yang memadai penularan dari orang yang terinfeksi, membutuhkan aktivitas keduanya. Usmar Dkk., Jurnal Mandala Pharmacon Indonesia 7(1);2021 : 83-111 85 Konsekuensi dari tidak memadainya menentukan pilihan terapetik terkait sistem imun pada tubuh diilustrasikan infeksi virus, dengan menitikberatkan dengan baik oleh pengamatan pada tubuh pembahasan pada ketersediaan pilihan bayi baru lahir yang sangat rentan vaksin dan obat yang telah ditemukan terhadap infeksi virus maupun mikroba untuk membantu manusia melawan sebab imunitas adaptifnya belum pernah berbagai jenis infeksi yang disebabkan terpapar sebelumnya. Hal ini memberikan oleh berbagai jenis virus. perbedaan yang signifikan jika dibandingkan dengan orang dewasa METODE PENELITIAN (Murphy and Weaver, 2016, Yu et al., Penulisan artikel review naratif ini 2018). dilakukan menggunakan metode analisis Salah satu langkah yang dapat pustaka primer maupun sekunder dalam dilakukan untuk menangani infeksi virus rentang waktu terbitan 2000-2021 yang adalah melalui pendekatan berhasil dikumpulkan dari database imunofarmakologi dan imunoterapi. online Google Scholar dan NCBI-PubMed. Dalam studi imunofarmakologi, modulasi Selain itu, sumber acuan pustaka juga respon imun dipelajari dan dianalisis diambil dari beberapa buku teks melalui regulasi inhibisi maupun induksi akademik. Kata kunci yang digunakan terhadap aktivitas sel dan jaringan, baik dalam penelusuran pustaka adalah dari sistem imun alamiah maupun sistem “immunopharmacology,“immunotherapy imun adaptif dengan tujuan untuk ”, “viral infection”,“immunity”, mendapatkan pilihan terapeutik yang “pharmacology of viral lebih efektif dan lebih aman bagi pasien. infection”,“imunofarmakologi”,“imunoter Saat ini, imunofarmakologi dan api”, “infeksi virus”, “imunitas”, dan imunoterapi dipandang penting untuk “farmakologi infeksi virus”. Literatur yang memenuhi kebutuhan klinis berbagai terkumpul kemudian diklasifikasikan dan kondisi patologis seperti penyakit ditelaah serta disusun menjadi sebuah autoimun, alergi dan asma, review naratif berdasarkan format yang imunodefisiensi, infeksi kronis, tumor, ditentukan. penyakit inflamasi dan degeneratif kronis, hingga gangguan metabolisme (Harding et HASIL DAN PEMBAHASAN al., 2018, Khan, 2016, Rouse and Virus adalah patogen subseluler Sehrawat, 2010, Verhoef et al., 2019). dan merupakan parasit obligat Dalam artikel review ini, kami akan intraseluler yang menginfeksi dan mendiskusikan mengenai relevansi dan mengambil alih fungsi komponen pentingnya imunoterapi dalam Usmar Dkk., Jurnal Mandala Pharmacon Indonesia 7(1);2021 : 83-111 86 sitoplasma sel inang untuk bereplikasi bertanggung jawab dalam mekanisme (Fields et al., 2013). Secara umum, virus infeksi sel inang oleh virus. Melalui diselubungi oleh pelindung yang terdiri interaksi ligan tertentu pada selubung atas protein, lipid, glikopropein, atau virus dengan reseptor spesifik pada sel kombinasi ketiganya, yang disebut kapsid, inang, virus akan melekatkan diri pada sel serta mengandung genom asam nukleat inang dan menembus membrane sel DNA atau RNA (Fields et al., 2013). (Fields et al., 2013, Wagner et al., 2007). Sebagai parasit obligat intraseluler, virus Selain selubung,
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