Effect of Iron Supplementation in Anti-Tuberculosis Drug Treatment on Interferon-γ Level in Tuberculosis Spondylitis Patients

M. F. Nanda Perdana, Hermawan Nagar Rasyid, Ahmad Ramdan, Yoyos Dias Ismiarto

Abstract


Tuberculosis (TB) is still one of the major health problems in the community. Micronutrients, including iron, are crucial in the body's defense mechanism. Iron modulates the activation of IFN-γ, which in turn will activate the macrophages. This study explores the effect of iron supplementation given with anti-tuberculosis drug therapy on the IFN-γ level in tuberculosis spondylitis patients. This was a single-blind randomized control trial study at Dr. Hasan Sadikin General Hospital Bandung, from December 2018 to March 2019, using the consecutive sampling approach. Thirty-four respondents with category 1 TB spondylitis and an sTfR level of> 21.7 pg /µL were recruited and randomized into control and experimental groups. The control group (n=17) was treated with 2 RHZE for 2 months while the experimental group (n=17) received 2 RHZE and iron tablet for 2 months. An increase in the IFN-γ level of the experimental group was observed from an average of 21.7 pg/ml before therapy to an average of 72.39 pg/mL after therapy. Meanwhile, the IFN-γ level in the control group increases from an average of 22.5 pg/mL to an average of 35.35 pg/mL. This difference was statistically significant based on the analysis using the independent t-test (p-value <0.05). Therefore, the administration of anti-tuberculosis drugs with the addition of iron can increase the body's immune response, which is indicated by the increasing level of IFN-γ.


Pengaruh Penambahan Zat Besi Pada Pengobatan Obat Anti Tuberkulosis Terhadap Kadar Interferon-γ Pada Pasien Spondilitis Tuberkulosis

Tuberkulosis (TB) masih merupakan salah satu masalah kesehatan yang cukup besar di masyarakat. Gangguan imunitas tubuh penderita berperan dalam proses terjadinya infeksi tuberculosis. Mikronutrient yang penting dalam pertahanan tubuh salah satunya adalah zat besi. Pada penelitian ini akan dipelajari mengenai pengaruh penambahan zat besi pada terapi OAT terhadap kadar IFN-γ pada pasien spondilitis tuberkulosis. Penelitian ini merupakan penelitian dengan metode single blind randomized control trial di Rumah Sakit Dr. Hasan Sadikin Bandung pada Desember 2018 hingga Maret 2019, dengan metode pengambilan sampel consecutive sampling. Dilakukan randomisasi pada 34 responden. Responden yaitu: penderita spondilitis TB kategori 1 dengan kadar sTfR >21,7 pg/µL. Kelompok kontrol 17 responden diterapi 2 RHZE. Kelompok eksperimen 17 responden diterapi 2 RHZE dengan tablet besi selama 2 bulan. Pada penelitian ini didapatkan peningkatan kadar IFN-γ rata-rata kelompok eksperimen (pemberian obat anti tuberkulosis dengan penambahan zat besi) dari 21,7 pg/mL sebelum dilakukan pemberian terapi menjadi rata-rata 72,39 pg/mL setelah dilakukan pemberian terapi diuji dengan uji t sampel independen (nilai p<0,05), secara statistik berbeda signifikan dengan kelompok kontrol (pemberian obat anti tuberkulosis), yaitu dari 22,5 pg/mL sebelum dilakukan pemberian terapi menjadi rata-rata 35,35 pg/mL setelah dilakukan pemberian terapi.  Simpulan, pemberian obat anti tuberkulosis dengan penambahan zat besi dapat meningkatkan respon imun tubuh, yang ditandai dengan meningkatnya kadar IFN-γ.


Keywords


nterferon-γ, iron supplementation, spondylitis TB

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DOI: https://doi.org/10.15395/mkb.v52n3.1712

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