Abstract

Effect of curcuma xanthorrhiza suplementation in vitamin D3 administration towards proteinuria, serum anti-dsDNA and IL-17 levels on systemic lupus erythematosus (sle) patients with hypovitamin D

Author(s): Cesarius Singgih Wahono, Zoraida Dwi Wahyuni*, Handono Kalim

Background: Vitamin D is an immunomodulator that plays a role in immunoregulation. Curcumin is also a potential immunomodulator in several autoimmune diseases. Curcumin-vitamin D bonds in VDR have different positions, thus leading to a homologous function with vitamin D and is thought to have a synergic effect if given simultaneously.

Aims: To determine the effect of curcumin supplementation in vitamin D3 adminstration towards proteinuria, serum anti-dsDNA and IL-17 levels in SLE patients with hypovitamin D.

Method: This study is a double blind randomized controlled trial on active SLE patients with hypovitamin D in the Oupatient Clinic of Saiful Anwar General Hospital Malang. This study was held from January 2016-March 2017. Measurement of vitamin D, antidsDNA and IL-17 were carried out using ELISA, while proteinuria was assessed with protein-creatinine ratio (enzymatic-turbidimetric method). Data were analyzed using Spearman correlation test and several comparative tests with a significance of p <0.05; which were Wilcoxon, t-test, Saphiro-Wilk normality test, and Levene homogenity variance test.

Results: Total of 39 female subjects was divided into 2 groups; 19 in the treatment group (vitamin D+curcumin) and 20 in the control group (vitamin D + placebo). We observed a significant increase in vitamin D, decreased anti-dsDNA, protein-creatinine ratio and IL-17 levels in each group (p < 0,05), but no significant difference were found when the treatment and control groups were compared. Median of elevated vitamin D levels is of 8.6 (IQR: -0.4-15.2) vs 11.6 (IQR: 6.32-17.47) (P>0.05). Vitamin D increase have a significant correlation with anti-dsDNA and IL-17 decrease (R= 0,514; P=0,001 and R= -0,510; P=0,001)

Conclusion: Curcumin addition in vitamin D administration have no effect compared with singular vitamin D administration. The increase of vitamin D levels is correlated with anti-dsDNA and IL-17 decrease, which lead to a better improvement of proteinuria.