Relationship Between Delta Like Ligand 1 (DLL-1) Levels in Serum and Cerebrospinal Fluid (CSF) with The Severity of Tuberculosis Meningitis / Hubungan Kadar Delta Like Ligand 1 (DLL-1) Serum dan Cairan Serebrospinal (CSS) Terhadap Derajat Keparahan Meningitis Tuberkulosis

Tuberculous meningitis (TBM) is an infection caused by Mycobacterium tuberculosis (M.tb) affecting the meninges, characterized by high morbidity rates. The prognosis of TBM is partially determined by clinical severity, classified according to the British Medical Research Council (BMRC) scale. Delta Like Ligand 1 (DLL-1) is a transmembrane protein that plays a role in the formation of lipid cells, which are essential for the survival, virulence, and defense of M.tb against the host immune system. DLL-1 expression can be induced by the stimulation of M.tb cell walls in response to the human immune system. This study aims to analyze the correlation between DLL-1 levels in the serum and cerebrospinal fluid (CSF) with the clinical severity of TBM patients. A cross-sectional study was conducted involving 30 TBM patients treated at M. Djamil Central General Hospital, Padang, from October 2025 to January 2026. Serum and CSF DLL-1 levels were measured using the enzyme-linked immunosorbent assay (ELISA) method, while TBM severity was assessed based on the BMRC criteria. Data analysis was performed using SPSS version 26.0 with a significance level of p < 0.05. The results of the analysis showed no significant difference in serum DLL-1 levels (p = 0.129) or CSS DLL-1 levels in relation to the severity of TBM (p = 0.097).

Meningitis tuberkulosis (TBM) merupakan infeksi Mycobacterium Tuberculosis (M.Tb) pada selaput meningen dengan tingkat morbiditas yang tinggi. Prognosis TBM salah satunya ditentukan oleh derajat keparahan klinis berdasarkan klasifikasi British Medical Research Council (BMRC). Delta Like Ligand 1 (DLL-1) adalah protein transmembran yang berperan dalam pembentukan sel lemak (lipid) yang dibutuhkan M.tb untuk kelangsungan hidup, virulensi, dan pertahanan terhadap sistem imun inang. Ekspresi DLL-1 dapat terinduksi oleh stimulasi dinding sel M.tb terhadap respon imun manusia. Penelitian ini bertujuan untuk menganalisis hubungan antara kadar DLL-1 dalam serum dan cairan serebrospinal (CSS) dengan derajat keparahan klinis pasien TBM. Penelitian ini menggunakan desain potong lintang (cross-sectional) terhadap 30 pasien TBM yang menjalani pengobatan di RS M. Djamil Padang pada periode Oktober 2025 hingga Januari 2026. Kadar DLL-1 serum dan CSS diukur menggunakan metode enzyme-linked immunosorbent assay (ELISA), sedangkan derajat keparahan TBM dinilai berdasarkan kriteria BMRC. Analisis data dilakukan menggunakan SPSS versi 26.0 dengan tingkat signifikansi p< 0,05. Hasil analisis menunjukkan tidak terdapat perbedaan kadar DLL-1 serum (p = 0,129) dan kadar DLL-1 CSS terhadap derajat keparahan TBM (p = 0,097).