Kadar 4-hidroksinonenal pada melasma lebih tinggi dibandingkan dengan kontrol dan berkorelasi positif dengan tingkat keparahan melasma

I Gusti Ngurah Ariwangsa Asbita; I Gusti Ayu Agung Elis  Indira; Ketut Kwartantaya Winaya; Luh Made Mas Rusyati; Nyoman Suryawati; Ni Made Dwi Puspawati

doi:10.15562/ism.v14i1.1622

Kadar 4-hidroksinonenal pada melasma lebih tinggi dibandingkan dengan kontrol dan berkorelasi positif dengan tingkat keparahan melasma

I Gusti Ngurah Ariwangsa Asbita ,

I Gusti Ayu Agung Elis Indira ,

Ketut Kwartantaya Winaya ,

Luh Made Mas Rusyati ,

Nyoman Suryawati ,

Ni Made Dwi Puspawati ,

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DOI: https://doi.org/10.15562/ism.v14i1.1622 |
Published: 2023-04-15

Abstract

Background: Melasma or chloasma is a condition of hyperpigmentation of the skin, especially the facial area which is commonly found in women due to exposure to ultraviolet (UV) and hormonal influences. The development of melasma disease is generally evaluated using oxidative parameters that reflect conditions of oxidative stress and accumulation of ROS in the skin. 4 Hydroxinonenal (4-HNE) is a photo-oxidation product that is more stable than other ROS groups and can represent the condition of cyanocytes and melanocytes in the skin.

Method: Analytical observational study with a cross-sectional approach. The research was carried out from October – December 2022 at the Dermatology and Venereology Polyclinic and Clinical Pathology Laboratory, Sanglah Hospital Denpasar. The sample consisted of 40 melasma samples and 20 non-melasma samples aged 18-65 years who were selected through consecutive sampling according to inclusion and exclusion criteria. The sample is taken by taking 3 milliliters of venous blood which will then be examined for 4-HNE with an ELISA kit. Data analysis was carried out using SPSS version 23 and the value of p <0.05 was significant.

Results: The results of the analysis showed that the group with melasma had significantly higher levels of 4-HNE (765.22±243.65 ng/mL) compared to the non-melasma group (347,68±110,99 ng/mL). The results of the correlation analysis showed that there was a significant correlation between 4-HNE levels and the MASI score with a correlation coefficient (r) of 0.955 and a p-value of 0.000.

Conclusion: The mean 4-HNE level in melasma group was significantly higher when compared to non-melasma group. 4-HNE levels were significantly correlated and directly proportional to the severity of melasma as measured by the MASI score.

Latar Belakang: Melasma atau chloasma merupakan suatu kondisi hiperpigmentasi pada kulit, khususnya daerah wajah yang umumnya ditemukan pada wanita akibat adanya paparan sinar ultraviolet (UV) dan pengaruh hormonal. Perkembangan penyakit melasma umumnya dievaluasi menggunakan parameter oksidatif yang mencerminkan kondisi stres oksidatif dan akumulasi ROS pada kulit. 4 Hidroksinonenal (4-HNE) merupakan photo-oxidation product yang bersifat lebih stabil dibandingkan golongan ROS lainnya dan dapat merepresentasikan kondisi keranosit dan melanosit pada kulit.

Metode: Studi observasional analitik dengan pendekatan potong lintang. Penelitian dilaksanakan mulai bulan Oktober - Desember 2022 di Poliklinik Kulit dan Kelamin dan Laboratorium Biomedik Terpadu Fakultas Kedokteran Universitas Udayana. Sampel terdiri dari 40 sampel melasma dan 20 sampel bukan melasma yang berusia 18-65 tahun yang dipilih melalui consecutive sampling sesuai kriteria inklusi dan eksklusi. Sampel dilakukan pengambilan 3 mililter darah vena yang kemudian akan diperiksa 4-HNE dengan kit ELISA. Analisis data dengan SPSS versi 23 dan nilai p<0.05 bermakna signifikan.

Hasil: Hasil analisis menunjukkan bahwa kelompok dengan melasma secara signifikan memiliki kadar 4-HNE yang lebih tinggi (765,22±243,65 ng/mL) dibandingkan dengan kelompok non-melasma (347,68±110,99 ng/mL). Hasil analisis korelasi menunjukkan bahwa korelasi yang signifikan antara kadar 4-HNE dengan skor melasma area and severity index (MASI) dengan nilai koefisien korelasi (r) sebesar 0,955 dan nilai p sebesar 0,000.

Kesimpulan: Rerata kadar 4-HNE pada kelompok melasma secara signifikan lebih tinggi jika dibandingkan dengan kelompok non-melasma. Kadar 4-HNE berkorelasi secara signifikan dan berbanding lurus dengan tingkat keparahan melasma yang diukur dengan skor MASI.

References

Suryantari SAA, Sweta NPTB, Veronica E, Hartawan IGNBRM, Karna NLPRV. Systematic review of melasma treatments: advantages and disadvantages. Bali Dermatology Venereol J. 2020;3(2):37–51.
Basit H, Godse K, Al Aboud A. Melasma. Treasure Island (FL): StatPearls Publishing; 2021. 1–12 p.
Pichardo R, Vallejos Q, Feldman SR, Schulz MR, Verma A, Quandt SA, et al. The prevalence of melasma and its association with quality of life in adult male Latino migrant workers. Int J Dermatol. 2009;48(1):22–6.
Sarkar R, Puri P, Jain R, Singh A, Desai A. Melasma in men: a clinical, aetiological and histological study. J Eur Acad Dermatology Venereol. 2010;24(7):768–72.
Rathi S, D’Souza P. Epidemiology of melasma. In: Lahiri K, Charttejee C, Sarkar R, editors. Pigmentary Disorders. New Delhi: Jaypee Brother Medical; 2014. p. 282–6.
Xing X, Dan Y, Xu Z, Xiang L. Implications of Oxidative Stress in the Pathogenesis and Treatment of Hyperpigmentation Disorders. Oxid Med Cell Longev. 2022;2022:1–12.
Zhang H, Forman H. 4-hydroxynonenal-mediated signaling and aging. Free Radic Biol Med. 2017;111:219–25.
Amrutha H, Rashmi A, Rajashekhar N, Biradar P. Melasma: a prospective study of clinico etiological and dermoscopic pattern in men. IJSRT. 2020;5(10):803–6.
Saputra I, Furqaani A, Hikmawati D. Hubungan Lama Paparan Radiasi Ultraviolet (UV) dengan Angka Kejadian Melasma pada Petani. Pros Pendidik Dr. 2021;7(1):167–9.
Martin M, Hameedullah A, Priya M. Unveiling the risk factors behind melasma: An observational study. Int Arch Med. 2017;4(11):85–9.
Batubara S, Amelia C, Yuneldi AD. Hubungan Lamanya Paparan Sinar Matahari dengan Kejadian Melasma pada Wanita Petugas Penyapu Jalan di Dinas Lingkungan Hidup Kota Batam. Zo Kedokt Progr Stud Pendidik Dr Univ Batam. 2021;11(3):76–82.
Guo L, Zhang X, Zhang Y, Huang X, Chi M. Association of 4-hydroxynonenal with classical adipokines and insulin resistance in a Chinese non-diabetic obese population. Nutr Hosp. 2017;34(2):363–8.
Mattson M. Roles of the lipid peroxidation product 4-hydroxynonenal in obesity, the metabolic syndrome, and associated vascular and neurodegenerative disorders. Exp Gerontol. 2009;44(10):625–33.
Hidalgo L. Dermatological complications of obesity. Am J Clin Dermatol. 2002;3(7):497–506.
Seçkin H, Kalkan G, Baş Y, Akbaş A, Önder Y, Özyurt H, et al. Oxidative stress status in patients with melasma. Cutan Ocul Toxicol. 2014;33(3):212–7.
Pandya A, Hynan L, Bhore R, Riley F, Guevara I, Grimes P, et al. Reliability assessment and validation of the Melasma Area and Severity Index (MASI) and a new modified MASI scoring method. J Am Acad Dermatol. 2011;64(1):78–83.
Gil L, Siems W, Mazurek B, Gross J, Schroeder P, Voss P, et al. Age-associated analysis of oxidative stress parameters in human plasma and erythrocytes. Free Radic Res. 2006;40(5):495–505.
Swiader A, Camaré C, Guerby P, Salvayre R, Negre-Salvayre A. 4-hydroxynonenal contributes to fibroblast senescence in skin photoaging evoked by UV-a radiation. Antioxidants. 2021;10(3):1–14.
Ayala A, Muñoz MF, Argüelles S. Lipid peroxidation: Production, metabolism, and signaling mechanisms of malondialdehyde and 4-hydroxy-2-nonenal. Oxid Med Cell Longev. 2014;2014:1–31.
Asano S, Rice KM, Kakarla S, Katta A, Desai DH, Walker EM, et al. Aging influences multiple indices of oxidative stress in the heart of the Fischer 344/NNia x Brown Norway/BiNia rat. Redox Rep. 2007;12(4):167–80.
Larroque-Cardoso P, Camaré C, Nadal-Wollbold F, Grazide MH, Pucelle M, Garoby-Salom S, et al. Elastin modification by 4-hydroxynonenal in hairless mice exposed to UV-A. role in photoaging and actinic elastosis. J Invest Dermatol. 2015;135(7):1873–81.
Li Y, Zhao T, Li J, Xia M. Oxidative Stress and 4-hydroxy-2-nonenal (4-HNE): Implications in the Pathogenesis and Treatment of Aging-related Diseases. J Immunol Res. 2022;2022(8):1–12.
Kobayashi E, Suzuki T, Yamamoto M. Roles nrf2 plays in myeloid cells and related disorders. Oxid Med Cell Longev. 2013;2013:1–7.
Luis H, Fridayantara WD, Mahariski PA, Wignall FS, Irwanto I, Gedela K. Evolving ART crisis for people living with HIV in Indonesia. Lancet HIV. 2020;7(6):E384–5.
Maiorino M, Conrad M, Ursini F. GPx4, lipid peroxidation, and cell death: discoveries, rediscoveries, and open issues. Antioxid Redox Signal. 2018;29(1):61–74.

[1] Suryantari SAA, Sweta NPTB, Veronica E, Hartawan IGNBRM, Karna NLPRV. Systematic review of melasma treatments: advantages and disadvantages. Bali Dermatology Venereol J. 2020;3(2):37–51.

[2] Basit H, Godse K, Al Aboud A. Melasma. Treasure Island (FL): StatPearls Publishing; 2021. 1–12 p.

[3] Pichardo R, Vallejos Q, Feldman SR, Schulz MR, Verma A, Quandt SA, et al. The prevalence of melasma and its association with quality of life in adult male Latino migrant workers. Int J Dermatol. 2009;48(1):22–6.

[4] Sarkar R, Puri P, Jain R, Singh A, Desai A. Melasma in men: a clinical, aetiological and histological study. J Eur Acad Dermatology Venereol. 2010;24(7):768–72.

[5] Rathi S, D’Souza P. Epidemiology of melasma. In: Lahiri K, Charttejee C, Sarkar R, editors. Pigmentary Disorders. New Delhi: Jaypee Brother Medical; 2014. p. 282–6.

[6] Xing X, Dan Y, Xu Z, Xiang L. Implications of Oxidative Stress in the Pathogenesis and Treatment of Hyperpigmentation Disorders. Oxid Med Cell Longev. 2022;2022:1–12.

[7] Zhang H, Forman H. 4-hydroxynonenal-mediated signaling and aging. Free Radic Biol Med. 2017;111:219–25.

[8] Amrutha H, Rashmi A, Rajashekhar N, Biradar P. Melasma: a prospective study of clinico etiological and dermoscopic pattern in men. IJSRT. 2020;5(10):803–6.

[9] Saputra I, Furqaani A, Hikmawati D. Hubungan Lama Paparan Radiasi Ultraviolet (UV) dengan Angka Kejadian Melasma pada Petani. Pros Pendidik Dr. 2021;7(1):167–9.

[10] Martin M, Hameedullah A, Priya M. Unveiling the risk factors behind melasma: An observational study. Int Arch Med. 2017;4(11):85–9.

[11] Batubara S, Amelia C, Yuneldi AD. Hubungan Lamanya Paparan Sinar Matahari dengan Kejadian Melasma pada Wanita Petugas Penyapu Jalan di Dinas Lingkungan Hidup Kota Batam. Zo Kedokt Progr Stud Pendidik Dr Univ Batam. 2021;11(3):76–82.

[12] Guo L, Zhang X, Zhang Y, Huang X, Chi M. Association of 4-hydroxynonenal with classical adipokines and insulin resistance in a Chinese non-diabetic obese population. Nutr Hosp. 2017;34(2):363–8.

[13] Mattson M. Roles of the lipid peroxidation product 4-hydroxynonenal in obesity, the metabolic syndrome, and associated vascular and neurodegenerative disorders. Exp Gerontol. 2009;44(10):625–33.

[14] Hidalgo L. Dermatological complications of obesity. Am J Clin Dermatol. 2002;3(7):497–506.

[15] Seçkin H, Kalkan G, Baş Y, Akbaş A, Önder Y, Özyurt H, et al. Oxidative stress status in patients with melasma. Cutan Ocul Toxicol. 2014;33(3):212–7.

[16] Pandya A, Hynan L, Bhore R, Riley F, Guevara I, Grimes P, et al. Reliability assessment and validation of the Melasma Area and Severity Index (MASI) and a new modified MASI scoring method. J Am Acad Dermatol. 2011;64(1):78–83.

[17] Gil L, Siems W, Mazurek B, Gross J, Schroeder P, Voss P, et al. Age-associated analysis of oxidative stress parameters in human plasma and erythrocytes. Free Radic Res. 2006;40(5):495–505.

[18] Swiader A, Camaré C, Guerby P, Salvayre R, Negre-Salvayre A. 4-hydroxynonenal contributes to fibroblast senescence in skin photoaging evoked by UV-a radiation. Antioxidants. 2021;10(3):1–14.

[19] Ayala A, Muñoz MF, Argüelles S. Lipid peroxidation: Production, metabolism, and signaling mechanisms of malondialdehyde and 4-hydroxy-2-nonenal. Oxid Med Cell Longev. 2014;2014:1–31.

[20] Asano S, Rice KM, Kakarla S, Katta A, Desai DH, Walker EM, et al. Aging influences multiple indices of oxidative stress in the heart of the Fischer 344/NNia x Brown Norway/BiNia rat. Redox Rep. 2007;12(4):167–80.

[21] Larroque-Cardoso P, Camaré C, Nadal-Wollbold F, Grazide MH, Pucelle M, Garoby-Salom S, et al. Elastin modification by 4-hydroxynonenal in hairless mice exposed to UV-A. role in photoaging and actinic elastosis. J Invest Dermatol. 2015;135(7):1873–81.

[22] Li Y, Zhao T, Li J, Xia M. Oxidative Stress and 4-hydroxy-2-nonenal (4-HNE): Implications in the Pathogenesis and Treatment of Aging-related Diseases. J Immunol Res. 2022;2022(8):1–12.

[23] Kobayashi E, Suzuki T, Yamamoto M. Roles nrf2 plays in myeloid cells and related disorders. Oxid Med Cell Longev. 2013;2013:1–7.

[24] Luis H, Fridayantara WD, Mahariski PA, Wignall FS, Irwanto I, Gedela K. Evolving ART crisis for people living with HIV in Indonesia. Lancet HIV. 2020;7(6):E384–5.

[25] Maiorino M, Conrad M, Ursini F. GPx4, lipid peroxidation, and cell death: discoveries, rediscoveries, and open issues. Antioxid Redox Signal. 2018;29(1):61–74.

Kadar 4-hidroksinonenal pada melasma lebih tinggi dibandingkan dengan kontrol dan berkorelasi positif dengan tingkat keparahan melasma

Abstract

References

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