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Suplementasi seng (Zn) menurunkan kadar IgM anti PGL-1 pada narakontak serumah pasien kusta tipe multibasiler

Abstract

Background: Indonesia ranks third highest of new cases of leprosy after India and Brazil. Transmission of leprosy through inhalation and prolonged close contact. Families who live in the same house have the highest risk for infection. Currently, several studies have found a correlation between IgM anti-PGL-1 levels with micronutrient deficiencies, especially zinc, which is associated with cellular immunity. This study aimed to investigate the effect of 40 mg elemental zinc supplementation per day for four weeks on IgM anti-PGL-1 levels.

Methods: An experimental one-group pre-test and post-test design conducted from February to May 2021. The samples were all close contact persons with multibacillary leprosy patients aged 18-65 years who visited the Dermatology and Venereology Outpatient Clinic, Sanglah General Hospital, Denpasar during the study period by consecutive sampling. The history taking, physical examination, and blood sampling were carried out at the to evaluate IgM anti-PGL-1 and zinc levels.

Results: Mean serum zinc level before and after supplementation were 79.00±9.67 g/dl and 95.16±31.84 g/dl, mean difference 25.21±32.12 g/dl (p<0.001). IgM anti-PGL-1 mean level before and after supplementation were 843.21±878.51 u/ml and 465.68±735.21 u/ml, mean difference 377.52±309.62 u/ml (p<0.001). Correlation test of different mean levels of zinc with different mean levels of IgM anti-PGL-1 resulted with r=0.630 and p=0.004.

Conclusion: Forty mg elemental zinc per day for four weeks may increase serum zinc levels and reduce IgM anti-PGL-1 in close contact with multibacillary leprosy patients (p<0.05). Higher mean increase in serum zinc levels follower by higher mean decrease of IgM anti-PGL-1 levels.

 

Latar Belakang: Indonesia menduduki peringkat ketiga jumlah kasus baru kusta terbanyak setelah India dan Brazil. Keluarga yang tinggal serumah memiliki resiko yang paling tinggi untuk terkena infeksi. Saat ini ditemukan beberapa penelitian yang menghubungkan kadar PGL-1 dengan defisiensi mikronutrien, salah satunya yaitu seng. Penelitian ini bertujuan untuk meneliti efek pemberian suplementasi seng elemental 40 mg per hari selama 4 minggu terhadap kadar IgM anti PGL-1.

Metode: Penelitian eksperimental one group pre-test post-test design yang dilakukan pada Februari hingga Mei 2021. Sampel adalah seluruh individu narakontak dengan pasien kusta tipe multibasiler berusia 18-65 tahun yang berkunjung ke Poliklinik Kulit dan Kelamin RSUP Sanglah Denpasar selama periode penelitian berlangsung secara consecutive sampling. Anamnesis, pemeriksaan fisik, dan pengambilan sampel darah dilakukan untuk pemeriksaan IgM anti PGL-1 dan kadar serum seng.

Hasil: Rerata kadar serum seng sebelum dan sesudah diberikan suplementasi yaitu 79,00±9,67 µg/dl dan 95,16±31,84 µg/dl dengan beda rerata 25,21±32,12 µg/dl (p<0,001). Rerata kadar IgM anti PGL-1 sebelum dan sesudah diberikan suplementasi yaitu 843,21±878,51 u/ml dan 465,68 ± 735,21 u/ml dengan beda rerata 377,52±309,62 u/ml (p<0,001). Uji korelasi beda rerata kadar seng dengan beda rerata kadar IgM anti PGL-1 yaitu r=0,630 dan p=0,004.

Simpulan: Pemberian suplementasi seng elemental 40 mg perhari selama 4 minggu dapat meningkatkan kadar serum seng dan menurunkan kadar serum IgM anti PGL-1 pada narakontak pasien kusta tipe multibasiler (p<0,05). Semakin tinggi selisih rerata peningkatan kadar seng serum, semakin tinggi selisih rerata penurunan kadar IgM anti PGL-1.

References

  1. Nasution K, Nadeak K, Lubis S. Igm anti pgl-1 antibody level in patients with leprosy: A comparative study between ear lobes capillary and median cubital vein blood samples. Open Access Maced J Med Sci. 2018;6(8):1346–1348.
  2. WHO. Global leprosy update, 2018: moving towards a leprosy- free world (Weekly epidemiological record No. 94). 2018.
  3. Yudianto, Didik B, Boga H, Titu A. Pengendalian Penyakit. In: Profil Kesehatan Republik Indonesia Tahun 2014. Jakarta: Kementerian Kesehatan Republik Indonesia; 2015. p. 1340168.
  4. Dinas Kesehatan Provinsi Bali. Profil Kesehatan Propinsi Bali. Denpasar; 2015.
  5. Agusni I. Kusta Stadium Subklinis dan Kedudukannya Dalam Epidemiologi Penyakit Kusta. MKI. 2011;51(1):22–5.
  6. Pinho J, Rivas P, Mendes M. Presence of Mycobacterium leprae DNA and PGL-1 antigen in household contacts of leprosy patients from a hyperendemic area in Brazil. Genet Mol Res. 2015;14(4):1479–87.
  7. Job C, Ponnaiya J. Laboratory Diagnosis. In: IAL Textbook of Leprosy 1st ed. New Delhi: Jaypee Brothers Medical Publishers; 2010. p. 176–88.
  8. Dwivedi V, Banerjee A, Das I, Saha A, Dutta M. Diet and Nutrition: an Important Risk Factor in Leprosy. Microb Pathog. 2019;137:1–11.
  9. Maares M, Haase H. Zinc and immunity: An essential interrelation. Arch Biochem Biophys. 2016;611:58–65.
  10. Gammoh NZ, Rink L. Zinc in infection and inflammation. Nutrients. 2017;9(6):1–25.
  11. Wessels I, Maywald M, Rink L. Zinc as a gatekeeper of immune function. Nutrients. 2017;9(12):9–12.
  12. Pradhan T, Kumari S. Evaluation of oxidative stress level in leprosy patients after zinc dupplementation. Int J Biol Med Res. 2015;6(2):4984–7.
  13. Rahfiludin M, Wirjatmadi B, Agusni I, Dahlan YP. Zinc supplementation could modulate T cell to maintain interleukin-2 level in seropositive contact of leprosy patients. Med J Indones. 2011;20(3):201–4.
  14. Rahfiludin MZ, Ginandjar P, Pangestuti DR. Correlation of zinc plasma and IgM anti PGL-1 levels among close contact of leprosy. Med J Indones. 2012;21(3):166–9.
  15. Barnett JB, Dao MC, Hamer DH, Kandel R, Brandeis G, Wu D, et al. Effect of zinc supplementation on serum zinc concentration and T cell proliferation in nursing home elderly: a randomized, double-blind, placebo-controlled trial. Am J Clin Nutr. 2016;103(3):942–51.
  16. Raja Asean Saragih. Gambaran epidemiologi penyakit kusta di kecamatan sui kakap kabupaten kubu raya provinsi kalimantan barat tahun 2012. Universitas Tanjungpura; 2014.
  17. Apriani D, Rismayanti, Wahiduddin. Faktor risiko kejadian penyakit kusta di kota Makassar. Universitas Hasanuddin; 2018.
  18. Erliyati P. Perbandingan Faktor Risiko Terjadinya Stadium Subklinik di Kecamatan, Pesantren Syalaf dengan Pondok Pesantren Syalaf Modern di Surabaya, Pragaan Kabuapten Sumenep. Universitas Airlangga; 2007.
  19. Hannan M. Penularan Penyakit Kusta Berdasarkan Pengukuran Kadar Antibodi Anti Pgl-1 Pada Narakontak Di Kecamatan Pragaan. Pros Univ Wiraraja. 2018;134–48.
  20. Krismawati H, Oktavian A, Maladan Y, Wahyuni T. Risk factor for Mycobacterium leprae detection in household contact with leprosy patients: a study in Papua, East Indonesia. Med J Indones. 2020;29:64–70.
  21. Andarini F, Rusmawardiana, Kartowigno S, Bahar E. Comparison of Phenolic Glycolipid 1 Antibody Levels in Household Contact of Pausibacilary and Multibacilary Patients. Biosientia Med J Biomed Transl Res. 2020;4(4):24–8.
  22. Rahfiludin M, Saraswati L, Ginandjar P. Duration of contact, type of leprosy, and floor condition as risk factor for leprosy sero-positivity. J Kesehat Masy. 2017;13(2):169–77.
  23. Escobedo-Monge M, Torres-Hinojal M, Barrado E, Escobedo-Monge M, Marugan-Miguelsanz J. Zinc nutritional status in a series of children with chronic disease: a cross-sectional study. Nutrients. 2021;13(1121):1–16.
  24. Zaky D, Sultan E, Salim M, Dawod R. Zinc level and obesity. The Egyptian Journal of Internal Medicine. Egypt J Intern Med. 2013;25:209–12.
  25. Plum L, Rink L, Haase H. The Essential Toxin: Impact of Zinc on Human Health. Int J Env. 2010;7:1342–565.
  26. Hassan A, Khattab M, El Deib A, Salama H, Mohamed M. Effect of zinc suplementation on body mass index in type 2 diabetics, iterventional study, Ismailia-Egypt. Egypt Fam Med J. 2020;4(1):1–9.
  27. Thorat D, Sharma P. Epidemiology. In: Kumar K, Kumar B, editors. IAL Textbook of Leprosy 1st ed. New Delhi: Jaypee Brothers Medical Publishers; 2010. p. 24–31.
  28. Angeline D. Kadar IgM Anti PGL-1 yang Tinggi Merupakan Faktor Risiko Terjadinya Kusta Subklinis pada Narakontak Pasien Kusta Tipe Multibasiler. Fakultas Kedokteran Universitas Udayana; 2019.
  29. Khanam S. Impact of Zinc on Immune Response. Immunol Curr Res. 2018;2(1):1–3.
  30. Maywald M, Wessels I, Rink L. Zinc signals and immunity. Int J Mol Sci. 2017;18(10).
  31. Darmaputra IGN, Herwanto N, Rusyati LM, Riawan W, Endaryanto A, Prakoeswa CRS. Distribution of iNOS expressions and TNF neutrofil cells as well as PGE2 and S100 Schwann cell dermal nerves in the erythema nodosum leprosum patients. Bali Med J. 2018;7(1):262–6.

How to Cite

Wijaya, E., Rusyati, L. M. M., & Praharsini, I. G. A. A. (2021). Suplementasi seng (Zn) menurunkan kadar IgM anti PGL-1 pada narakontak serumah pasien kusta tipe multibasiler. Intisari Sains Medis, 12(3), 1043–1049. https://doi.org/10.15562/ism.v12i3.1122

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Elice Wijaya
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Luh Made Mas Rusyati
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I Gusti Ayu Agung Praharsini
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