{"id":3062,"date":"2021-03-24T09:00:00","date_gmt":"2021-03-24T02:00:00","guid":{"rendered":"https:\/\/ahligizi.id\/blog\/?p=3062"},"modified":"2021-03-22T17:15:52","modified_gmt":"2021-03-22T10:15:52","slug":"tuberkulosis-dan-vitamin-d","status":"publish","type":"post","link":"https:\/\/ahligizi.id\/blog\/2021\/03\/24\/tuberkulosis-dan-vitamin-d\/","title":{"rendered":"Tuberkulosis dan Vitamin D"},"content":{"rendered":"\n\n\n

Tanggal 24 Maret diperingati sebagai Hari Tuberkulosis Sedunia. Peran potensial vitamin D sebagai imunomodulator terapeutik pada tuberkulosis (TB) telah diakui selama lebih dari 150 tahun, tetapi baru-baru ini kembali ke pusat arena penelitian karena meningkatnya kesadaran akan kekurangan vitamin D global.<\/p>\n\n\n\n

Tuberkulosis<\/h2>\n\n\n\n

TB (Tuberkulosis) masih menjadi penyebab global utama morbiditas dan mortalitas. Tuberkulosis merupakan penyakit menular yang disebabkan oleh\u00a0Mycobacterium tuberculosis<\/em>. Bakteri tersebut dapat menimbulkan gangguan pada saluran nafas. Dapat menyerang organ mana pun di tubuh, organ yang paling sering terkena yaitu paru<\/strong>.<\/span> Oleh karena itu, hanya tuberkulosis paru yang menular.\u200b1\u200b<\/sup><\/span><\/p>\n\n\n\n

\"\"<\/figure>\n\n\n\n

Lebih Lanjut : Pengaturan Makan pada Tuberkulosis (TB)<\/a><\/strong><\/p>\n\n\n\n

Vitamin D pada Pasien TB<\/h2>\n\n\n\n

Metabolisme vitamin D berubah pada TB. Sejumlah penelitian telah menjelaskan defisiensi vitamin D pada TB aktif. Kekurangan vitamin D (konsentrasi 25-hidroksivitamin D [25D] plasma rendah) sering dilaporkan di tuberkulosis.<\/span><\/strong> Produksi ekstra-ginjal yang tinggi dari 1,25D terlihat pada tuberkulosis, termasuk di individu dengan 25D dalam kisaran defisit; namun, defisiensi 25D yang parah jarang terjadi. Peningkatan 1,25D, sebagai penanda aktivasi makrofag, dikaitkan dengan penambahan berat badan yang lebih baik tetapi peningkatan terus-menerus 1,25D dikaitkan dengan hasil radiologis dan indeks massa tubuh yang lebih buruk. 1,25D memerlukan pengujian dalam set data yang lebih besar termasuk pasien TB yang kurang responsif terhadap pengobatan, seperti TB yang resistan terhadap beberapa obat, untuk menguji kegunaannya sebagai penanda tuberkulosis keparahan dan respon pengobatan.<\/span><\/strong>\u200b2\u200b<\/sup><\/span><\/p>\n\n\n\n

Vitamin D memodulasi aktivitas monosit-makrofag dalam tubuh dan berperan dalam kekebalan bawaan manusia terhadap agen infeksi tertentu. Peran ini mungkin penting dalam pertahanan tubuh melawan tuberkulosis, di mana serangan makrofag merupakan langkah kunci dalam patogenesis. Vitamin D bekerja dengan mengikat reseptor inti pada sel target. Oleh karena itu, kadar vitamin yang rendah maupun kelainan pada struktur dan fungsi reseptor dapat menyebabkan gangguan kekebalan tubuh terhadap basil tuberkulum<\/span><\/strong>.\u200b3\u200b<\/sup><\/span><\/p>\n\n\n\n

Dua fakta dari sebuah studi menunjukkan hubungan rendahnya serum vitamin D ke tuberkulosis, bukan sebaliknya. Pertama, bentuk aktif vitamin D meningkatkan kemampuan makrofag untuk menekan pertumbuhan Mycobacterium tuberculosis<\/em> intraseluler. Kedua, saat memicu toll like receptor <\/em>oleh molekul basil tuberkulum, produksi katelisidin pembunuh mikroba terganggu karena tidak adanya serum vitamin D yang memadai.\u200b4\u200b<\/sup><\/span><\/p>\n\n\n\n

Artikel : Defisiensi Vitamin D<\/a><\/strong><\/p>\n\n\n\n

Defisiensi Vitamin D dan Tuberkulosis<\/h2>\n\n\n\n

Signifikansi hubungan antara defisiensi vitamin D<\/a> dan tuberkulosis adalah 2 kali lipat. Pertama, kadar vitamin D yang sudah rendah pada pasien tuberkulosis dapat menurun lebih lanjut saat pengobatan dimulai.<\/span><\/strong> Penurunan lebih lanjut dapat mempengaruhi keadaan kekurangan vitamin D lainnya. Terdapat peran potensial suplementasi vitamin D pada kasus tuberkulosis walaupun butuh evaluasi lebih lanjut terkait suplementasi vitamin D pada pasien tuberkulosis pada pengobatan.\u200b3\u200b<\/sup><\/span> <\/p>\n\n\n\n

Kedua, prevalensi diabetes mellitus (DM)<\/a> meningkat secara global dan orang dengan DM 4\u20135 kali lebih berisiko mengalami penyakit ginjal kronis. Pasien dialisis berisiko memiliki tingkat vitamin D yang rendah dibandingkan dengan mereka yang tidak memiliki penyakit ginjal. <\/span><\/strong>Insiden tuberkulosis tinggi pada penyakit ginjal kronis sebagian sebagai akibat dari gangguan imunitas yang diperantarai sel tetapi jika kadar serum vitamin D rendah juga cenderung tuberkulosis.\u200b3\u200b<\/sup><\/span> <\/p>\n\n\n\n

Pada gagal ginjal, suplementasi vitamin D menormalkan metabolisme tulang dengan mengoreksi peningkatan hormon paratiroid. Namun, sistem hidroksilase yang mengubah vitamin D menjadi bentuk aktif biologisnya menjadi substrat yang bergantung pada gagal ginjal (yaitu vitamin D dosis tinggi meningkatkan laju produksi bentuk aktifnya). Oleh karena itu, ada kemungkinan bahwa suplementasi vitamin D dapat mempengaruhi hasil klinis lain pada gagal ginjal, seperti pencegahan tuberkulosis aktif. Hal ini masih perlu dieksplorasi dengan studi yang sesuai.\u200b3\u200b<\/sup><\/span><\/p>\n\n\n\n

Baca : Pedoman Gizi untuk Penyakit Ginjal (Update)<\/a><\/strong><\/p>\n\n\n\n

Referensi<\/h2>\n\n\n\n
  1. \n
    1. <\/div>
    WHO W. Global Tuberculosis Report 2017<\/i>. WHO; 2017.<\/div>\n <\/div>\n<\/li>
  2. \n
    2. <\/div>
    Ralph AP, Rashid Ali MRS, William T, et al. Vitamin D and activated vitamin D in tuberculosis in equatorial Malaysia: a prospective clinical study. BMC Infect Dis<\/i>. Published online April 27, 2017. doi:10.1186\/s12879-017-2314-z<\/a><\/div>\n <\/div>\n<\/li>
  3. \n
    3. <\/div>
    Nnoaham KE, Clarke A. Low serum vitamin D levels and tuberculosis: a systematic review and meta-analysis. International Journal of Epidemiology<\/i>. Published online January 31, 2008:113-119. doi:10.1093\/ije\/dym247<\/a><\/div>\n <\/div>\n<\/li>
  4. \n
    4. <\/div>
    Liu PT. Toll-Like Receptor Triggering of a Vitamin D-Mediated Human Antimicrobial Response. Science<\/i>. Published online March 24, 2006:1770-1773. doi:10.1126\/science.1123933<\/a><\/div>\n <\/div>\n<\/li><\/ol><\/section>\n\n\n\n
      \n\n\n\n\n\n<\/ul>\n","protected":false},"excerpt":{"rendered":"

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