In the world, as many as 214 countries spread across all continents participate affected, with more than 18.000 deaths (WHO data June 13, 2010). In Asia, the pandemic is still actively circulating in Malaysia and Singapore with the downward trend.
In Indonesia alone, although the June 13, 2010 WHO report mentions the lack of new transmission activities in Indonesia during the month of June 2010, has occurred despite the accumulation of more than 1000 transmission (MOH Report August 23, 2009) with five deaths.
In today's modern society, it is very difficult to completely avoid exposure to the virus A (H1N1). Even restrictions on travel (travel restriction) undoubtedly a benefit as an effective method to stem this pandemic.
Most people would never exposed to this virus, with rates varying exposure. But we do not see relative fantastic figures on the number of people infected. Meanwhile, among people infected with the disease only slightly worse until a crisis stage.
Loius Pasteur, one of the foundation stone of the science of microbiology, admitted that the most important question that can not be answered (in his time) by the infectious disease research is that there is variability in the level of exceptional severity of infection among people infected by the same microorganism.
Today people understand that the difference in the level of variability in the severity of the infection was caused by the difference of one level of immunity. But why does this happen? Why do people have different levels of immune response?
Composition and variation of genetic material is one answer. Our genetic material, with different levels, to determine how much risk you are infected, how severe illness if infected, and even what the most appropriate treatment to prevent the development of disease severity.
This is called genetic susceptibility to infection (genetic susceptibility to infection). Genetic variation can involve only one gene (monogenic), but can also be many genes (polygenic).
Human genetic susceptibility to various infections
Genetic variations that determine differences in susceptibility to infectious diseases such as malaria, HIV / AIDS and tuberculosis has been studied enough.
Best known example is how people with various disorders of red blood cells such as sickle cell disease (sickle-cell disease) and thalassemia have immunity against malaria infection.
Human genetic susceptibility to influenza A (H1N1)
Is pandemic A (H1N1) also shows the vulnerability that is influenced by genetic factors? There is no definitive answer to this question. But there are many similar research to other strains of flu virus are showing vulnerability.
A research report published in 2008 showed that the population of Utah (USA) had a risk of increased deaths from flu among people who have a kinship relationship (far or near). This shows the contribution of genetic factors.
Another more recent research (2009) in rats showed that a large contribution from genetic factors to infections of influenza A, a class where the H1N1 strain of influenza virus are clustered.
Although there are many advances in influenza research, there has been no recent studies on human susceptibility to infections of influenza A (H1N1). The evidence obtained so far are all from animals. This is understandable because many non-genetic factors also play a role in human susceptibility to infection, such as nutrition, lifestyle, exposure to certain drugs, exposure to other infectious agents and others.
These factors are non-genetic, complicate the study of genetic susceptibility to infection, because they interact with genetic factors in causing a certain level of vulnerability. Meanwhile, in animals of this interaction is more easily controlled.
What needs to be done? Need for multi-center research
It is very possible that the pandemic A (H1N1) that occurred when this will happen again periodically, along with its potential to mutate into new strains with unknown levels of virulence.
Required knowledge of specific genes that contribute to the risk of infection A (H1N1) to enhance efforts toward infection prevention and treatment of healthy people who are sick.
These studies on genetic susceptibility to be followed by research that studies how genetic factors that contribute to the effectiveness and safety prevention efforts (ranging from vaccines to simply wash their hands), progression of disease and the efficacy and safety of current treatment operational.
Attention to ethnic variations also need to be emphasized, since a lot of evidence showing the influence of genetic differences among different ethnic-ethnic.
The factors of non-genetic, as noted above, in the human population can not be avoided. By nature, the human population genetic factors and non-genetic exist and interact with each other.
Therefore, studies on humans needs to be done with attention to these factors. In this case, it is very important to start identifying the various factors secara existing in the human population, and then monitored throughout the research goes. Thus, their conclusions must be carefully made in the limited context of the factors involved.
In the last decade, biology researchers witnessed remarkable progress in understanding the role of genetic factors in many diseases that attack humans, such as diabetes, cardiovascular disease, allergies, schizophrenia, and others.
True, that so many questions remain a mystery. However it should also recognized that now seems obvious candidate genes that play a role in the occurrence of the above diseases.
Many of the findings of the present research was born from the Genome-wide association studies (GWAS), where a large number of human genetic variations can be analyzed simultaneously in a population sample of men who very much.
Recent advances in the analysis of genetic variation is called the Next-Generation Sequencing (NGS), which has the ability to identify the entire three billion nucleotides in the human genome array with a count of only a few weeks and the cost is relatively cheap.
Both this relatively new method can greatly assist researchers in analyzing the complexity of the genetic factors contributing to various diseases, including susceptibility to infection of A (H1N1).
Attempts integrated research needs to be done to coordinate the resources available for this purpose.
Considering the health effects
community, an effort spearheaded by the cooperation necessary coordinative MOH, LIPI and various universities.
1 comments:
Write commentsThe error introduced by the next generation sequencing makes it difficult to detect rare mutations, which play an important role in cancer and other diseases.
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