Efektivitas Suplementasi Vitamin C Terhadap Penurunan Kadar Il-6 Serum dan Aktivitas Penyakit Pasien Lupus Eritematosus Sistemik

Abstract: Systemic lupus erythematosus (SLE) is a chronic autoimmune disease and its activity is related to interleukin-6 (IL-6) level. Lowering IL-6 levels can help to achieve remission. Vitamin C has antioxidant and immunomodulatory properties that have the potential to lower IL-6 level. However, research on vitamin C in SLE patients, especially in Indonesia, is still very limited. This study aimed to determine the effectiveness of vitamin C supplementation in reducing serum IL-6 levels and disease activity in SLE patients. This was a double-blind randomized controlled trial conducted on 34 patients with mild–moderate SLE at Dr. Mohammad Hoesin General Hospital. Subjects were divided into two groups namely intervention (vitamin C 2 x 500 mg/day) and control (placebo) groups, for eight weeks. Serum IL-6 levels and disease activity scores (Mex-SLEDAI) were measured before and after the intervention. The results showed that the vitamin C group had a significant decrease in serum IL-6 levels compared to placebo group, from a median of 6.46 (3.5–14.4) to 3.5 (3.5–8.36) pg/mL (p=0.001), while in the placebo group decreased from 3.7 (3.5–6.45) to 3.9 (3.5–14) pg/mL (p=0.136). The decrease in Mex-SLEDAI scores was statistically more significant in the vitamin C group compared to the placebo group (p=0.048). In conclusion, vitamin C 2x500 mg/day supplementation for eight weeks effectively reduces serum IL-6 levels and disease activity in mild–moderate SLE patients. Keywords: systemic lupus erythematosus; MEX-SLEDAI; vitamin C supplementation; interleukin 6 Abstrak: Lupus eritematosus sistemik (LES) merupakan penyakit autoimun kronik yang derajat aktivitasnya berkaitan dengan kadar interleukin-6 (IL-6). Penurunan kadar IL-6 dapat membantu dalam mencapai remisi. Vitamin C memiliki sifat antioksidan dan imunomodulator yang berpotensi menurunkan kadar IL-6, namun, penelitian mengenai vitamin C pada pasien LES khususnya di Indonesia masih sangat terbatas. Penelitian ini bertujuan untuk mengetahui efektivitas suplementasi vitamin C terhadap penurunan kadar IL-6 serum dan aktivitas penyakit pada pasien LES. Penelitian ini menggunakan uji klinis acak tersamar ganda dilakukan pada 34 pasien LES derajat ringan–sedang di RSUP Dr. Mohammad Hoesin. Subjek dibagi menjadi dua kelompok: intervensi (vitamin C 2x500 mg/hari) dan kontrol (plasebo), selama delapan minggu. Kadar IL-6 serum dan skor aktivitas penyakit (Mex-SLEDAI) diukur sebelum dan sesudah intervensi. Hasil penelitian mendapatkan bahwa kelompok vitamin C menunjukkan penurunan bermakna kadar IL-6 serum dibandingkan placebo dari median 6,46 (3,5–14,4) menjadi 3,5 (3,5–8,36) pg/mL (p=0,001), sedangkan kelompok plasebo dari 3,7 (3,5–6,45) menjadi 3,9 (3,5–14) pg/mL (p=0,136). Penurunan skor Mex-SLEDAI secara statistik lebih bermakna pada kelompok vitamin C dibandingkan plasebo (p=0,048). Simpulan penelitian ini ialah suplementasi vitamin C 2x500 mg/hari selama delapan minggu efektif menurunkan kadar IL-6 serum dan aktivitas penyakit lupus eritematosus sistemik derajat ringan–sedang. Kata kunci: lupus eritematosus sistemik; Mex-SLEDAI; suplementasi vitamin C; interleukin 6