Background and aim: The prevalence of typhoid fever is reportedly high, especially in Asia. When a pathogen enters the human body, there are markers in the form of molecules that will be known by the innate immune system. Specific molecular markers of gram negative bacteria, which are Lipopolysaccharides (LPS) and Toll-Like receptors-4 will interact with LPS. The binding between LPS and TLR-4 will give rise to activation signals that will activate innate immune cells. Immune cells will release a number of proinflammatory cytokines, such as TNF-α, IL-1, and IL-6. While Vitamin D Receptors (VDR) are expressed in large amounts in tumor tissue and infected cells. This study aimed to prove the role of IL-6, TNF-α, and VDR in inhibiting bacterial growth in mice that have been induced by S.Typhi. Methods: This research was a real experimental pre-post test design to investigate the level of IL-6, TNF-α and VDR in suppressing the growth of bacteria in the peritoneal fluid of S. Typhi, male, mice BALB/c. Mice were divided into three groups comprised of 10 mice each. All mice in groups A and B were intraperitoneally inoculated with S. Typhi strain Thy1 in study day 0. Group A was treated with antibiotic Levofloxacine, on study day 4th. Another study group, group B, was used as a placebo and received aquades on study day 4th. While group C as a control was not inoculated with S. Typhi. Blood samples from three groups for the calculation of serum Il-6, TNF-α, and VDR were collected. This examination was taken four times; at baseline, 4th day, 10th day, and 30th day. For the calculation of bacterial colony, peritoneal fluid retrieval was collected three times, which is on 4th day, 10th day, and 30th day. Results: A repeated measure ANOVA in group A (antibiotic) and group B (placebo) group showed that mean IL-6, TNF-α, and VDR level differed statistically significant between times (p-value 0.000). There was a strong negative correlation between bacterial colony count and VDR level, which was statistically significant in both groups (group A; r = -0.875, p-value = 0.000 vs group B; r = -0.470, p-value = 0.002). IL-6 and TNF-α didn't give significant statistical correlation with bacterial colony count. Conclusion: VDR, IL-6, and TNF-α play an important role in killing bacteria. From the results of this study, IL-6 level is related to the number of bacterial colonies, the lower the IL-6 level, the less the number of bacterial colonies. Similarly, TNF-α levels have a positive correlation with the number of bacterial colonies. While VDR levels are also related to the number of bacterial colonies, the higher the VDR level, the lower the number of bacterial colonies.
Background: Chronic Obstructive Pulmonary Disease (COPD) is a chronic inflammatory disease and disturbed bacterial clearance. Vitamin D deficiency is sometimes observed in COPD patients and as significant roles in increasing inflammation of airway obstruction and systemic obstruction, increasing proinflammatory cytokine including TNF-α, reduction of bacterial clearance and increase exacerbation risk due to infection. Also, vitamin D plays significant roles in the metabolism of calcium and mineralization of bones and regulation system of immune. TNF-α also has essential roles in pathogenesis and inflammation of COPD. Several studies that investigate the relationship between vitamin D level and serum TNF-α concentration in COPD patients are relatively uncommon, including in Indonesia. For that reason, this study aimed to assess the relationship between vitamin D level and TNF-α concentration in patients on the severity of the chronic obstructive pulmonary disease. Methods This study was a hospital-based descriptive cross-sectional study. Total samples were 50 COPD patients with the average age of older than 60 years during their enrollments at the Department of Pulmonology and Respiratory Medicine of the Dr.Wahidin Sudirohusodo General hospital Makassar in September 2018-January 2019. All procedures of the present study were reviewed and approved by the Research Ethics Committee of Medicine Faculty of Hasanuddin University. The severity of COPD was assessed according to the combination of COPD assessment stages that referred to the Global Initiative for Chronic Obstructive Lung Disease (GOLD) Guideline 2015 that consisted of the combination of scoring COPD Assessment Test (CAT), the modified Medical Research Council (mMRC) questionnaire and results of the spirometric measurement. Assessment of airway obstruction levels referred to the GOLD spirometric criteria. Determination of thoracic photographs was conducted to verify the COPD diagnosis of the severity of COPD. Determination of serum TNF-α concentration and vitamin D3 [1,25(OH)2D3] level used the ELISA method. Results The majority of COPD patients were observed in the category of older than 60 years old accounted for 34 COPD patients (68%), and the majority of COPD patients were males accounted for 47 males with COPD (94%). The majority of COPD patients were observed in the group of D (38%). All the study subjects observed in this study were smokers, and 82% of them were in the category of heavy smokers. 21 study subjects had higher concentration of serum TNF-α (tertile 3 = 0.21-1.83 pg/dl), 20 study subjects and lower level of vitamin D (tertile 1 = 182.1-364.5 pg/dl). The majority of the study subjects (38%) were in the category of severe COPD (category D of the severity of COPD at the tertile 3) according to the GOLD Combine Assessment. In view of the relationship between vitamin D level and serum TNF-α concentration on the airway obstruction, there were significant positive correlations between the increase of vitamin D levels and the increase of serum TNF-α concentrations on airway obstruction. In view of the relationship between vitamin D level and serum TNF-α concentration on the severity of COPD, there were significant positive correlations between the increase of vitamin D levels (tertiles 1, 2 and 3) and the increase of serum TNF-α concentrations on the severity of COPD at p-value<0.05. Overall, there were non-linear relationships between vitamin D level and serum TNF-α concentration on the severity of COPD. Conclusions: Serum TNF-α concentration was positively associated with airway obstruction level and severity of COPD. Low level of vitamin D was negatively associated with airway obstruction level and severity of COPD. Vitamin D3 level (1,25(OH)2D) was negatively associated with serum TNF-α concentration and airway obstruction level and severity of COPD.
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