PERAN EFEK IMUNOMODULASI VITAMIN D PADA TATALAKSANA COVID-19
DOI:
https://doi.org/10.29303/jku.v11i2.712Kata Kunci:
COVID-19, Vitamin D, Immunomodulation EffectAbstrak
Infeksi COVID-19 ditandai dengan masuknya virus SARS-CoV-2 yang berikatan dengan reseptor ACE-2. Selama proses ini, virus akan menghindari sistem imun tubuh, kemudian diikuti oleh badai sitokin pada beberapa pasien. Selain berperan untuk homeostasis kalsium dan metabolisme tulang, vitamin D juga berperan pada pengurangan proses inflammasi dan imunoregulasi yang dikenal sebagai efek imunomodulasi. Vitamin D berperan melawan patogen pada imunitas adaptif dan bawaan. Vitamin D memodulasi respon sel T-helper (Th) untuk menginduksi perpindahan respon dari Th1 ke Th2, meningkatkan perkembangan sel T regulatori (Treg) dan menyeimbangkan respon sel T-helper untuk melawan patogen dan menurunkan produksi sitokin proinflamasi. Vitamin D dapat menurunkan produksi sitokin proinflammasi seperti TNF-a, IL-6, IL-1b, IL-12, dan IFN-g, disebabkan oleh terhambatnya aktivasi faktor nuklear kB (NF-kB). Vitamin D juga dapat menginduksi vasorelaksan ACE2 yang merubah Angiotensin II menjadi Angiotensin VII yang bersifat vasodilator sehingga dapat mencegah terjadinya Acute Respiratory Distress Syndrome (ARDS). Beberapa data penelitian menunjukkan adanya kekurangan vitamin D pada penderita terinfeksi COVID-19. Satu penelitian meta-analisis mencakup 360.972 penderita COVID-19 mendapatkan defisiensi vitamin D 37,7% dan insufisiensi vitamin D 32,2%. Defisiensi vitamin D ini berkaitan dengan tingkat keparahan dan kematian penderita COVID-19. Data dari 42 penderita dengan gagal napas akut karena infeksi COVID-19 di Bari Italia menunjukkan penderita dengan kadar vitamin D < 10 ng/ml angka kematiannya 50% setelah 10 hari perawatan. Pemeriksaan kadar vitamin D sangat dianjurkan pada penderita COVID-19. Suplementasi Vitamin D dianjurkan menggunakan vitamin D3 dengan dosis pemberian 4000 IU/hari selama 7 hari selanjutnya dosis pemeliharaan 800-1000 IU/hari pada penderita dengan kekurangan vitamin D.
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