POTENSI PEMANFAATAN MEDIA ELECTROSPUN SEBAGAI LEUKODEPLESI TERHADAP PERTUSIS BERAT DENGAN HIPERTENSI PULMONAL PADA ANAK
POTENTIAL USE OF ELECTROSPUN MEDIA AS LEUKODEPHILIN FOR SEVERE PERTUSSIS WITH PULMONARY HYPERTENSION IN CHILDREN
Abstract
Severe pertussis in children complicated by pulmonary hypertension is a life-threatening condition caused by hyperleukocytosis, leading to pulmonary microvascular obstruction and right heart failure. Rapid leukocyte reduction is crucial to improving patient outcomes. This study employed a literature review approach using databases such as PubMed, Science Direct, and Google Scholar, focusing on publications from the last ten years discussing severe pertussis, pulmonary hypertension, leukodepletion, and electrospun nanofiber technology. Electrospun membranes made of poly(ethylene-vinyl alcohol) (EVAL) and its modifications with bovine serum albumin and glycine demonstrated leukodepletion efficiency exceeding 90%, with minimal hemolysis and preserved erythrocyte stability. Physical properties of the membrane such as pore size, fiber diameter, and water contact angle play essential roles in selective leukocyte filtration. This technology offers a non-cytotoxic and efficient alternative to conventional methods like centrifugation or chemotherapeutic induction. Electrospun nanofiber media show strong potential as a biomedical innovation for selective leukocyte reduction in severe pertussis with pulmonary hypertension, though further clinical validation is required to confirm its safety and therapeutic effectiveness.
Abstrak
Pertusis berat pada anak dengan komplikasi hipertensi pulmonal merupakan kondisi yang mengancam jiwa akibat hiperleukositosis yang menimbulkan obstruksi mikrovaskular paru dan gagal jantung kanan. Penurunan leukosit cepat menjadi kunci dalam memperbaiki prognosis pasien. Kajian ini menggunakan pendekatan literature review melalui basis data PubMed, Science Direct, dan Google Scholar dengan kriteria inklusi artikel 10 tahun terakhir yang membahas pertussis berat, hipertensi pulmonal, leukodeplesi, dan electrospun nanofiber. Media electrospun berbasis poly(ethylene-vinyl alcohol) (EVAL) serta modifikasinya dengan bovine serum albumin dan glycine menunjukkan efisiensi leukodeplesi lebih dari 90% tanpa menimbulkan hemolisis bermakna dan mempertahankan stabilitas eritrosit. Karakteristik fisik membran seperti ukuran pori, diameter serat, dan sudut kontak air berperan penting dalam selektivitas filtrasi leukosit. Teknologi ini memberikan alternatif non-sitotoksik dibanding metode konvensional seperti sentrifugasi atau kemoterapi induksi. Media electrospun nanofiber berpotensi besar sebagai inovasi biomedis untuk menurunkan leukosit secara selektif pada pertusis berat dengan hipertensi pulmonal, meskipun masih memerlukan validasi klinis lebih lanjut.
References
World Health Organization. Pertussis. 2018. Accessed October 11, 2025. https://www.who.int/health-topics/pertussis#tab=tab_1
Kemenkes Republik Indonesia. Profil Kesehatan indonesia.; 2022.
Kemenkes Direktorat Jenderal Pelayanan Kesehatan RI. Survei kesehatan Indonesia (SKI); 2023.
Ismah Z, Harahap N, Aurallia N, Pratiwi DA. Buku Ajar Epidemiologi Penyakit Menular. Published online 2021.
Scanlon KM, Chen L, Carbonetti NH. Pertussis Toxin Promotes Pulmonary Hypertension in an Infant Mouse Model of Bordetella pertussis Infection. J Infect Dis. 2022;225(1):172-176. doi:10.1093/INFDIS/JIAB325
Son PT, Reda A, Viet DC, et al. Exchange transfusion in the management of critical pertussis in young infants: a case series. Vox Sang. 2021;116(9):976-982. doi:10.1111/VOX.13085
Etskovitz H, Anastasio N, Green E, May M. Role of Evolutionary Selection Acting on Vaccine Antigens in the Re-Emergence of Bordetella Pertussis. Diseases. 2019;7(2):35. doi:10.3390/DISEASES7020035
Mayuri P V., Bhatt A, Sabareeswaran A, Ramesh P. Effect of membrane parameters and filter structure on the efficiency of leukocyte removal by electrospun poly(ethylene-co-vinyl alcohol) membranes. J Biomater Sci Polym Ed. 2021;32(5):595-612. doi:10.1080/09205063.2020.1851559
Nguyen VTN, Simon L. Pertussis: The Whooping Cough. Prim Care. 2018;45(3):423-431. doi:10.1016/J.POP.2018.05.003
Machado MB, Passos SD. Severe Pertussis in Childhood: Update and Controversy - Systematic Review. Rev Paul Pediatr. 2019;37(3):351-362. doi:10.1590/1984-0462/;2019;37;3;00006
Scanlon K, Skerry C, Carbonetti N. Association of Pertussis Toxin with Severe Pertussis Disease. Toxins (Basel). 2019;11(7). doi:10.3390/TOXINS11070373
Carbonetti NH. Bordetella pertussis: new concepts in pathogenesis and treatment. Curr Opin Infect Dis. 2016;29(3):287-294. doi:10.1097/QCO.0000000000000264
Galiza EP, Calvert A, Drysdale SB, Heath PT. Pertussis. Medicine (United Kingdom). 2022;49(12):739-742. doi:10.1016/j.mpmed.2021.09.002
Long S, Lowe RB. Severe Pertussis Infection With Hyperleukocytosis in a 10-Month-Old Unvaccinated Amish Female: A Case Report. Cureus. 2022;14(7). doi:10.7759/CUREUS.26885
Zhang C, Zong Y, Wang Z, Wang L, Li Y, Yang Y. Risk factors and prediction model of severe pertussis in infants < 12 months of age in Tianjin, China. BMC Infect Dis. 2022;22(1). doi:10.1186/S12879-021-07001-X
Shi T, Wang L, Du S, et al. Mortality risk factors among hospitalized children with severe pertussis. BMC Infect Dis. 2021;21(1). doi:10.1186/S12879-021-06732-1
Wang C, Zhang H, Zhang Y, et al. Analysis of clinical characteristics of severe pertussis in infants and children: a retrospective study. BMC Pediatr. 2021;21(1). doi:10.1186/S12887-021-02507-4
Aldairi N, Alali H, Kazzaz Y. Leukoreduction and hydroxyurea in malignant pertussis: A case series. Clin Case Rep. 2020;8(12):2705-2711. doi:10.1002/CCR3.3264
Zhang D, Zhu Y, Jin Y, Kaweme NM, Dong Y. Leukapheresis and Hyperleukocytosis, Past and Future. Int J Gen Med. 2021;14:3457-3467. doi:10.2147/IJGM.S321787
Bacal CJO, Maina JW, Nandurkar HH, et al. Blood apheresis technologies – a critical review on challenges towards efficient blood separation and treatment. Mater Adv. 2021;2(22):7210-7236. doi:10.1039/D1MA00859E
Mayuri P V., Anugya B, Sabareeswaran A, Ramesh P. A novel leukodepletion filter from electrospun poly(ethylene-vinyl alcohol) membranes and evaluation of its efficiency. International Journal of Polymeric Materials and Polymeric Biomaterials. 2016;65(4):183-190. doi:10.1080/00914037.2015.1099101
Fueta PO, Eyituoyo HO, Igbinoba O, Roberts J. Cardiopulmonary Arrest and Pulmonary Hypertension in an Infant with Pertussis Case Report. Case Rep Infect Dis. 2021;2021:1-5. doi:10.1155/2021/6686185
Liu C, Yang L, Cheng Y, Xu H, Xu F. Risk factors associated with death in infants <120 days old with severe pertussis: a case-control study. BMC Infect Dis. 2020;20(1). doi:10.1186/S12879-020-05535-0
Şık G, Demirbuğa A, Annayev A, Çıtak A. The clinical characteristics and prognosis of pertussis among unvaccinated infants in the pediatric intensive care unit. Turk Pediatri Ars. 2020;55(1):54-59. doi:10.14744/TURKPEDIATRIARS.2020.82435
Cherry JD, Wendorf K, Bregman B, et al. An Observational Study of Severe Pertussis in 100 Infants ≤120 Days of Age. Pediatr Infect Dis J. 2018;37(3):202-205. doi:10.1097/INF.0000000000001710
Tian SF, Wang HM, Deng JK. Fatal malignant pertussis with hyperleukocytosis in a Chinese infant: A case report and literature review. Medicine. 2018;97(17). doi:10.1097/MD.0000000000010549
Kazantzi MS, Prezerakou A, Kalamitsou SN, et al. Characteristics of Bordetella pertussis infection among infants and children admitted to paediatric intensive care units in Greece: A multicentre, 11-year study. J Paediatr Child Health. 2017;53(3):257-262. doi:10.1111/JPC.13427
Palvo F, Fabro AT, Cervi MC, Aragon DC, Ramalho FS, De Carvalho Panzeri Carlotti AP. Severe pertussis infection: A clinicopathological study. Medicine. 2017;96(48). doi:10.1097/MD.0000000000008823
Winter K, Zipprich J, Harriman K, et al. Risk Factors Associated With Infant Deaths From Pertussis: A Case-Control Study. Clin Infect Dis. 2015;61(7):1099-1106. doi:10.1093/CID/CIV472
Mayuri P V., Bhatt A, Parameswaran R. Investigation of the potency of leukodepletion filter membranes immobilized with bovine serum albumin via polydopamine spacer. SN Appl Sci. 2020;2(10):1-11. doi:10.1007/S42452-020-03515-2/FIGURES/7
Mayuri P V., Bhatt A, Sabareeswaran A, Parameswaran R. An explicit correlation between surface functionality, wettability, and leukocyte removal by electrospun filter media. Mater Today Commun. 2021;26. doi:10.1016/J.MTCOMM.2021.102075
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