The addition of Curcuma Xanthorriza to Vitamin D3 supplementation did not affect fatigue and cytokines in lupus patients with hypovitaminosis D
DOI:
https://doi.org/10.36216/jpd.v3i2.98Keywords:
Fatigue, Hypovitaminosis D, VDR, Curcuma xanthorrizaAbstract
Background: Seventy percent of Lupus patients in Indonesia have hypovitaminosis D. Curcumin is a novel VDR ligand and has synergic effects with vitamin D.
Objective: This study aimed to determine the effect of Curcuma xanthorriza addition to vitamin D3 supplementation on fatigue, serum IL-6, TGF- ?1, and to study the correlation between fatigue, serum IL-6 and TGF-?1 in lupus patients with hypovitaminosis D.
Methods: This was a double blind randomized controlled trial involving 40 SLE patients with hypovitaminosis D (vitamin D<30 ng/ml). The first group consisted of 20 patients who received Cholecalciferol 1200 IU/day and placebo, and the other group received Cholecalciferol 1200 IU/day and Curcuma xanthorriza 60 mg/day. The subjects were followed up at the end of 3 months. Fatigue were measured by Fatigue Severity Scale (FSS) and Visual Analogue Scale-Fatigue (VAS-F). Vitamin D, serum IL-6 and TGF-?1 were measured by ELISA.
Result: There was no significant difference between the decrease of FSS (p = 0.300) and VAS-F score (p = 0.085) in curcuma Vs placebo groups, respectively. The decrease of IL-6 (p = 0.061) and increase of TGF-?1 (p = 0.261) in curcuma Vs placebo group also did not differ significantly. There was no correlation between fatigue and IL-6 [FSS, r=0.255, p=0.117], [VAS, r=0.086, p=0.625], also between fatigue and TGF-?1 [FSS, r=0.127, p=0.441], [VAS-F, r=0.510, p=0.109].
Conclusion: The addition of Curcuma xanthorriza had no significant effect on fatigue and alteration of IL-6, as well as TGF-?1 serum. There were no correlations between fatigue, IL-6 and TGF-?1 serum.
Downloads
References
2. Khajehdehi P, Zanjaninejad B, al AZe. Oral Supplementation of Turmeric Decreases Proteinuria, Hematuria, and Systolic Blood Pressure in Patients Suffering From Relapsing of Refarctory Lupus Nephritis: A Randomized and Placebo-controlled Study. Journal of Renal Nutrition. 2012;22(1):50-7.
3. Ana MB, Graciela SA. Epidemiology of Systemic Lupus Erythromatosus. A Companion of Rheumatology Systemic Lupus Erythromatosus first edition. United State of America: Mosby Inc; 2007.
4. Handono K, Puspitasari L, Rudijanto A, Wahono C, Kalim H. Vitamin D Serum Level And Disease Activity In Patients With Systemic Lupus Erythematosus. International Journal of Pharmaceutical Science Invention. 2013;2(2):35-40.
5. Zhou C, Assem M, Tay J, Watkins P, Blumberg B, Schuetz E, et al. Steroid and xenobiotic receptor and vitamin D receptor crosstalk mediates CYP24 expression and drug -induced osteomalacia J Clin Invest. 2006;116(6):1703-12.
6. Holick M, Chen T. Vitamin D deficiency: a worlwide problem with health consequences. Am J Clin Nutr. 2008;87:1080s-6s.
7. Cannell J, Hollis B, Zasloff M, Heaney R. Diagnosis and treatment of vitamin D deficiency. Informa Health Care. 2008.
8. Lorentzen K, Danielsen M, Kay S, Voss A. Validation of the Fatigue Severity Scale in Danish Patients with Systemic Lupus Erythematosus. Dan Med J. 2014;61(4):A4808.
9. Ceglia L. Vitamin D and Its Role in Skeletal Muscle. Curr Opin Clin Nutr Metab Care. 2009;12(6):628-33.
10. Rifai A, Kalim H, Kusworini, Wahono C. Validity and reliability fatigue severity scale in patients with Systemic Lupus Erythematosus (SLE) in Indonesia. IJR. 2016;8:4-8.
11. Kos D, Nagels G, Hooghe M, Duportail M, Kerckhofs E. A rapid screening tool for fatigue impact in multiple sclerosis. BMC Neurology. 2006.
12. Handono K, Hasanah D, Kalim H, Mawarti H. The associations among serum levels of vitamin D, TGF-?/IL-6 balance and Treg/Th17 balance in systemic lupus erythematosus patients in Indonesia. IJBB 2013;2(9):490-6.
13. Kimura A, Kishimoto T. Il-6: Regulator of Treg/Th17 Balance. Eur J Immunol. 2010;40:1830-5.
14. Bartik L ea. Curcumin: a novel nutritionally derived ligand of the vitamin D receptor with implications for colon cancer chemoprevention. J Nutr Biochem. 2010;12:1153-61.
15. Guo C, Rosoha E, Lowry M, Borregard N, Gombart A. Curcumin induces human cathelicidin antimicrobial peptide gene expression through a vitamin D receptor-independent pathway. J Nutr Biochem. 2013;24(5):754-9.
16. Haussler M, Haussler C, Bartik L, Whitfield G, Hsieh J, Slater S, et al. Vitamin D receptor: molecular signaling and actions of nutritional ligands in disease prevention. Nutrition Reviews. 2008;66(2):98-112.
17. Shoba G, et al. Influence of Piperine on the pharmacokinetics of Curcumin in Animals and Human Volunteers. Planta Medica 1998;64:353-6.
18. Liu W, Zhai Y, Heng X, Che FY, Chen W, Sun D, et al. Oral bioavailability of curcumin: problems and advancements. Journal of Drug Targeting. 2016;24(8):694-702.
19. Ahn G, Ramsey-Goldman R. Fatigue in SLE. Int J Clin Rheumtol. 2012;7(2):217-27.
20. Nishimura K, al e. Fatigue in Patient with Early-Stage Systemic Lupus Erythematosus Before Receiving Corticosteroid Therapy: A Prospective Cross-Sectional Study. Journal of Rheumatic Diseases adn Treatment. 2015;1(4).
21. Y W, H K. Brain Science on Chronic Fatigue. JMAJ. 2006;49(1):19-26.
22. Omdal R, Mellgren S, Koldingsnes W, Jacobsen E, Husby G. Fatigue in patients with systemic lupus erythematosus: lack of associations to serum cytokines, antiphospholipid antibodies, or other disease characteristics. The Journal of Rheumatology. 2002;29(3):482-6.
23. Nastaran G, Ansari N, Fetrosi S, Shamil A, Choobsaz H, Montazen H. Fatigue in Iranian Patients with Neurological Conditions: an assesment with Persian Fatigue Severity Scale. Health Science Journal. 2013;7(4):395-401.
Published
How to Cite
Issue
Section
Copyright (c) 2019 Jurnal Penyakit Dalam Udayana

This work is licensed under a Creative Commons Attribution 4.0 International License.
Copyright Notice
The copyright to this article is transferred to JPD (including without limitation, the right to publish the work in whole or in part in any and all forms of media, now or hereafter known) effective if and when the article is accepted for publication thus granting JPD all rights for the work so that both parties may be protected from the consequences of unauthorized use.
The copyright transfer covers the exclusive right to reproduce and distribute the article, including reprints, translations, photographic reproductions, microform, electronic form (offline,online) or any other reproductions of similar nature.
The authors warrant that their contribution is an original work not published elsewhere, that they have the full power to make this grant and that the article contains no matter unlawful or which invades the right to privacy or infringes any proprietary right.