Effect of Immunomodulating Extract and Some Isolates from Etlingera rubroloba A.D. Poulsen Fruits on Diabetic Patients with Tuberculosis

Abstract

Diabetes mellitus (DM) is a disease easily complicated by tuberculosis (TB) due to impaired function of the innate immune response. The successes of the discovery of immunomodulatory compounds needs to be continued to introduce new insights into the innate immune response. In previous studies, plant compounds of Etlingera rubroloba A.D. Poulsen (E.rubroloba) were demonstrated to have potential as an immunomodulators. This study aims to isolate and identify the structure of the compounds of E.rubroloba fruit that could effectively improve the function of the innate immune response in individuals with DM infected with TB. The isolation and purification of the compounds of the E.rubroloba extract were carried out by radial chromatography (RC) and thin-layer chromatography (TLC). Identification of the isolated compound structures was determined by measuring the proton (1H) and carbon (13C) nuclear magnetic resonance (NMR). In vitro testing was performed on the immunomodulating activity of the extracts and isolated compounds on DM model macrophages infected with TB antigens. This study succeeded at isolating and identifying the structures of two isolate compounds, namely Sinaphyl alcohol diacetat (BER-1), and Ergosterol peroxide (BER-6). The two isolates were more effective as immunomodulators than the positive controls were, which differed significantly (* p < 0.05) at the reducing interleukin-12 (IL-12) levels and Toll-like receptor-2 (TLR-2) protein expression and increasing the human leucocyte antigen-DR (HLA-DR) protein expression in DM infected with TB. The isolated compound was discovered in E. rubroloba fruits, which has been reported to have the potential to be developed as an immunomodulatory agent. Follow-up testing to determine the mechanism and effectiveness of these compounds as immunomodulators for DM patients is required so that they are not susceptible to TB infection.

Recent research progress in the plant contribution to the management of tuberculosis

“…Likewise, the role of medicinal plants and their bioactive derivatives as alveolar NLRP3 inflammasome regulators during M. tuberculosis infection was explored, providing information about the mechanism in which they can inhibit excessive stimulation of the inflammasomes and its associated factors, and as a consequence reducing immunopathological response in the host (Mvubu & Chiliza, 2021). Later, the immunomodulatory activity of some diterpenes was confirmed in a human alveolar epithelial cell line infected with M. tuberculosis (Hernández‐Herrera et al, 2023), while sinaphyl alcohol diacetate and ergosterol peroxide were proved to reduce interleukin‐12 levels and Toll‐like receptor‐2 protein expression, and to increase the human leucocyte antigen‐DR protein expression in diabetic patients with tuberculosis (Ilyas et al, 2023). The general concept of immunomodulatory activity of plant extracts administration in tuberculosis is depicted in Figure 4.…”

Review Article : The Role of Cluster of Differentiation-8 (Cd8) in the Immune System

“…Mekanisme pertahanan tubuh (host defence mechanism) akan menentukan proses reaksi infeksi antara agen penyebab penyakit dan tubuh manusia sebagai hospes (virulensi dan patogenesitas) faktor yang mempengaruhi mekanisme pertahanan tubuh adalah usia, gender, etnis, genetik, dan status imun (M. Y. Ilyas et al, 2020;M. Y. Ilyas et al, 2023).…”

“…Selain memiliki kemampuan mengenali antigen secara spesifik, imfosit B bertanggung jawab membentuk antibodi humoral dalam darah yang juga dikenal sebagai immunoglobulin (M. Y. Ilyas et al, 2023). Sel limfosit B (bursal atau bone marrow) merupakan kumpulan populasi sel yang mengekspresikan berbagai reseptor immunoglobulin (Ig) di permukaan sel nya untuk mengenali berbagai macam epitop spesifik dari antigen.…”

“…Makrofag merupakan sel fagositik utama yang berperan menangkal serangan patogen melalui mekanisme fagositosis, berperan penting baik pada respon imun bawaan maupun respon imun adaptif (M. Y. Ilyas et al, 2020;M. Y. Ilyas et al, 2023).…”

“…Sistem kekebalan tubuh ini terdiri dari dua sistem yaitu imun alami (non spesifik) dan imun spesifik (M. Y. Ilyas et al, 2023).…”