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Abstrak :
Salah satu peran sistem imunitas terhadap infeksi M.leprae adalah respons makrofag melalui interaksinya dengan vitamin D dan reseptor vitamin D (RVD). Interaksi vitamin D dengan RVD pada berbagai sel imun akan menstimulasi ekspresi katelisidin. Penelitian ini bertujuan untuk menganalisis kadar serum 25-hydroxyvitamin D (25(OH)D) dan kadar plasma RVD serta hubungannya dengan IB pada pasien kusta. Penelitian ini berupa observasional-analitik dengan desain potong lintang. Sebanyak 28 subjek penelitian (SP) menjalani pemeriksaan slit-skin smear kemudian diagnosis kusta ditegakkan berdasarkan tanda kardinal kusta. Penelitian ini juga menilai kecukupan pajanan matahari menggunakan kuesioner pajanan matahari mingguan. Kadar serum 25(OH)D diperiksa dengan metode chemiluminescent immunoassay (CLIA) dan kadar plasma RVD dilakukan dengan metode enzyme linked immunosorbent assay (ELISA). Median kadar serum 25(OH)D adalah 12,68 ng/ml (4,88 – 44,74). Median kadar plasma RVD adalah 1,36 ng/ml (0,26 – 8,04). Berdasarkan analisis regresi multivariat, tidak terdapat hubungan antara IB dengan kadar serum 25(OH)D dan kadar plasma RVD (R square = 0,055). Tedapat korelasi positif kuat antara kadar serum 25(OH)D dengan skor pajanan sinar matahari (r = 0,863; p < 0,001). ......One of many immunity system’s roles against M. leprae infection is macrophage response through its interaction with vitamin D and vitamin D receptor (VDR). The interaction between vitamin D and VDR in various immune cells will stimulate the expression of cathelicidin. The objective is to analyze the serum level of 25-hydroxyvitamin D₃ (25(OH)D) and plasma level of VDR as well as their association with IB in leprosy patients. This observational analytic study was performed with cross-sectional design. A total of 28 subjects underwent a slit-skin smear examination and then the diagnosis of leprosy was made based on the cardinal signs. This study also assessed the patient’s sun exposure with weekly sun exposure questionnaire. Serum 25(OH)D level was assessed with chemiluminescent immunoassay (CLIA) method and RVD plasma level was measured by enzyme linked immunosorbent assay (ELISA). Median serum level of 25(OH)D was 12.68 ng/ml (4.88 – 44.74). Median plasma level of VDR was 1.36 ng/ml (0.26 – 8.04). Based on multivariate regression analysis, there was no significant association between BI and serum level of 25(OH)D and plasma level of VDR (R square = 0.055). There was strong positive correlation between serum level of 25(OH)D and sun exposure score (r = 0.863; p < 0.001).

Abstrak :
Latar belakang: Saat ini, peran vitamin D dalam berbagai penyakit kronis banyak diteliti. Vitamin D dianggap memiliki efek imunomodulator sehingga diduga berkaitan dengan beberapa penyakit alergi dan autoimun, termasuk urtikaria kronik. Terdapat laporan kadar vitamin D yang rendah pada pasien urtikaria kronik dan suplementasi vitamin D terbukti memperbaiki gejala urtikaria kronik yang dinilai dengan kuesioner yang sudah tervalidasi Urticaria activity score 7 (UAS7). Namun, penelitian mengenai korelasi kadar vitamin D serum dengan aktivitas penyakit urtikaria masih terbatas, terutama di Indonesia. Tujuan: Menganalisis korelasi kadar vitamin D (25[OH]D) serum dengan aktivitas penyakit pada pasien urtikaria kronik. Metode: Penelitian deskriptif-analitik dengan desain potong lintang. Tiga puluh pasien urtikaria kronik usia 18–59 tahun yang memenuhi kriteria penerimaan dan penolakan direkrut dalam penelitian ini. Penilaian aktivitas penyakit menggunakan UAS7 dan dilakukan pengukuran kadar 25(OH)D serum. Korelasi kadar 25(OH)D serum dan aktivitas penyakit dilakukan dengan menggunakan analisis Spearman. Penelitian ini juga menilai kecukupan pajanan matahari menggunakan kuesioner pajanan matahari mingguan. Hasil: Rerata skor UAS7 adalah 14,63±7,8, median durasi penyakit adalah 12 (2–120) bulan, median skor pajanan matahari mingguan adalah 8 (2–34), dan median kadar 25(OH)D serum adalah 12,10 ng/mL (6,85–29.87). Mayoritas subjek mengalami defisiensi vitamin D (80%). Tidak terdapat korelasi antara kadar 25(OH)D serum dengan aktivitas penyakit (r=0,151; p=0,425), tetapi didapatkan korelasi negatif kuat yang bermakna pada kelompok defisiensi vitamin D berat (r=-0,916; p=0,001). Terdapat korelasi positif sedang bermakna antara aktivitas penyakit dan durasi penyakit (r=0,391; p=0,033). Pada kuesioner pajanan sinar matahari mingguan, didapatkan perbedaan bermakna skor bagian tubuh yang terpajan matahari antar kelompok insufisiensi dan defisiensi vitamin D (p=0,031). Kesimpulan: Tidak terdapat korelasi kadar 25(OH)D serum dengan aktivitas penyakit pasien urtikaria kronik, namun terdapat kecenderungan peningkatan aktivitas penyakit pada kelompok defisiensi berat vitamin D. ......Background: Nowadays, the role of vitamin D in various chronic diseases is a matter of great interest. Vitamin D is thought to have an immunomodulatory effect so it is thought to be associated with several allergic and autoimmune diseases, including chronic urticaria. There have been reports of low vitamin D levels in patients with chronic urticaria and vitamin D supplementations has been shown to improve symptoms of chronic urticaria which was assessed by a validated questionnaire Urticaria activity score 7 (UAS7). However, data on the correlation between serum vitamin D levels and disease activity in chronic urticaria are still limited, especially in Indonesia. Objective: To analyze the correlation between vitamin D (25[OH]D) serum and disease activity in chronic urticaria patients. Methods: This is an analytic-descriptive cross-sectional study. Thirty chronic urticaria patients age 18 – 59 years old who meet all inclusion and exclusion criterias were recruited in this study. Assessment of disease activity using UAS7 and measurement of 25(OH)D serum levels were performed. Correlation of 25(OH)D serum levels and disease activity was done using Spearman analysis. In this study, an assessment of sun exposure adequacy was carried out using a weekly sunlight exposure questionnaire. Results: The mean of UAS7 was 14.63±7.8, median duration of illness was 12 (2 – 120) month, median weekly sunlight exposure score was 8 (2 – 34), and the median serum 25(OH)D was 12.10 ng/mL (6.85 – 29.87). The majority of subjects had vitamin D deficiency (80%). There was no correlations between serum 25(OH)D levels and disease activity (r=0.151; p=0.425). However, a significant negative correlation was found in severe deficiency vitamin D group (r=-0.916; p=0.001). There was also significant moderate correlation between disease activity and duration of illness (r=0.391; p=0.033). In weekly sunlight exposure questionnaire, we found that body surface area score was significantly different between insufficiency and deficiency vitamin D groups (p=0,031). Conclusion: There was no correlation between serum 25(OH)D levels and disease activity in chronic urticaria patients, however there was a tendency of increasing disease activity in severe deficiency vitamin D group