Title of article :
Sunlight–derived vitamin D affects interleukin-4 level, T helper 2 serum cytokines, in patients with Graves’ disease: a prospective cohort study
Author/Authors :
Purnamasari, Dyah Department of Internal Medicine - Faculty of Medicine - Universitas Indonesia , Soewondo, Pradana Department of Internal Medicine - Faculty of Medicine - Universitas Indonesia , Djauzi, Samsuridjal Department of Internal Medicine - Faculty of Medicine - Universitas Indonesia
Abstract :
Background: Graves’ disease (GD) is the most common autoimmune disease leading to hyperthyroidism. The role of Th1/Th2 pathways balance in GD is still controversial. Vitamin D is reported to have an effect on those pathways. This study aims to examine the effect of sunlight exposure on vitamin D 25(OH) level and Th1 and Th2 pathway-derived cytokines in GD patients. Methods: A prospective cohort study was conducted on 32 GD patients to compare the effect of sunlight exposure on vitamin D level and cytokines of Th1 and Th2 pathways between exposed and unexposed groups. Exposed group received sunlight exposure three times a week for 30 minutes each between 9–11 a.m for 1 month. Thyroid stimulating hormone (TSH), free thyroxin (fT4), vitamin D 25(OH), interferon-γ (IFN-γ) and interleukin-4 (IL-4) serum levels, were investigated before and after one month of sunlight exposure. Paired t-test or Mann Whitney test were used to analyze the difference between exposed and unexposed GD groups before and after sun exposure. Results: One month of sunlight exposure increased vitamin D 25(OH) level by 27.90% among exposed GD group (15.34 ng/mL to 19.62 ng/mL, p<0.001). Meanwhile, unexposed GD group’s vitamin D 25(OH) level decreased from 20.48 ng/mL to 18.86 ng/mL (p<0.001). Increased vitamin D 25(OH) level in exposed group was not accompanied by the increase of IL-4 level after sunlight exposure. Conclusion: Sunlight exposure increases vitamin D 25(OH) serum level and may affect the level of IL-4, Th2 pathway-derived cytokine, in patients with GD. However, the role of sunlight-derived vitamin D on IFN-γ in GD patients can not be concluded in this study.
Other languages abstract :
Latar belakang: Penyakit Graves (GD) merupakan penyakit
autoimun paling sering dijumpai yang menyebabkan
hipertiroidisme. Peran keseimbangan jalur T helper 1 (Th1)/T
helper 2 (Th2) pada GD masih diperdebatkan. Vitamin D
dilaporkan memiliki efek terhadap kedua jalur tersebut.
Studi ini bertujuan mengetahui efek pajanan sinar matahari
terhadap kadar vitamin D 25(OH) dan kadar sitokin jalur
Th1/Th2 pada pasien GD.
Metode: Studi ini menggunakan desain kohort prospektif
untuk membandingkan efek pajanan matahari terhadap
kadar vitamin D 25(OH) dan sitokin jalur Th1 serta Th2
pada 32 pasien GD yang belum pernah remisi, yang dibagi
menjadi 2 kelompok: kelompok GD pajanan dan non-pajanan.
Kelompok pajanan mendapatkan intervensi berupa pajanan
sinar matahari 3 kali seminggu dengan durasi 30 menit/kali,
pukul 09.00–11.00 WIB, selama satu bulan. Data laboratorium
berupa kadar thyroid stimulating hormone (TSH), free
thyroxin (fT4), vitamin D 25(OH), interferon-γ (IFN-γ), dan
interleukin-4 (IL-4) dinilai sebelum dan sesudah pajanan.
Analisis data menggunakan uji t berpasangan atau uji Mann
Whitney.
Hasil: Pajanan sinar matahari selama satu bulan
meningkatkan kadar vitamin D 25(OH) sebanyak 27,90%
pada kelompok GD pajanan (15,34 ng/mL ke 19,62 ng/mL,
p<0,001), sementara kadar vitamin D kelompok GD nonpajanan
turun dari 20,48 ng/mL menjadi 18,86 ng/mL
(p<0,001). Dari dua kelompok, kenaikan kadar vitamin
D 25(OH) kelompok GD pajanan tidak diiringi dengan
peningkatan kadar IL-4 setelah pajanan matahari.
Kesimpulan: Pajanan sinar matahari meningkatkan kadar
vitamin D 25(OH) serum dan mempengaruhi kadar IL-4,
sitokin jalur Th2, pada pasien GD. Peran vitamin D yang
berasal dari pajanan sinar matahari pada kadar IFN-γ pasien
GD tidak dapat disimpulkan dalam studi ini.
Keywords :
Graves’ disease , IFN-γ , IL-4 , sunlight exposure , Th1 and Th2 pathway , vitamin D
Journal title :
Astroparticle Physics
