Pemanfaatan Suplemen Makanan Secara Tepat Guna untuk Menjaga dan Meningkatkan Daya Tahan Tubuh

Nuzul Wahyuning Diyah (1), Hadi Poerwono (2), Kholis Amalia Nofianti (3), Achmad Toto Poernomo (4), Shabrina Wahyu Hidayati (5), Isnaeni Isnaeni (6)
(1) Universitas Airlangga,
(2) Fakultas Farmasi Universitas Airlangga, Surabaya, Indonesia,
(3) Fakultas Farmasi Universitas Airlangga, Surabaya, Indonesia,
(4) Fakultas Farmasi Universitas Airlangga, Surabaya, Indonesia,
(5) Fakultas Kedokteran Universitas Lambung Mangkurat, Banjarmasin, Indonesia,
(6) Program Studi Farmasi Fakultas Ilmu Kesehatan, Universitas Muhammadiyah Surabaya, Indonesia

Abstrak

Komponen makanan telah dikenal memberikan fungsi perlindungan terhadap benda asing yang mengakibatkan masalah kesehatan bagi masyarakat. Mikronutrien seperti vitamin dan mineral sangat penting bagi tubuh manusia dan kebutuhan hariannya harus dipenuhi melalui sumber makanan. Jika kebutuhan harian tidak terpenuhi karena beberapa kondisi, maka diperlukan tambahan suplemen makanan. Beberapa vitamin dan mineral berfungsi sebagai imunomodulator dan melindungi respons imun inang, sehingga mencegah penurunan daya tahan tubuh akibat serangan patogen. Berdasarkan acuan berbagai penelitian, artikel ini membahas fungsi suplemen vitamin dan mineral sebagai imunomodulator dalam meningkatkan daya tahan tubuh melalui sistem imun dan mekanisme kerja yang memperantarai fungsi ini. Kekurangan vitamin dan mineral dapat menyebabkan penurunan kinerja sistem imun, yang menjadi penyebab utama keadaan patologis dan imunologis yang tidak menguntungkan. Dari berbagai hasil penelitian secara in vitro dan in vivo dapat disimpulkan bahwa mikronutrien utama yang berperan dalam respons imun, yaitu: vitamin A, C, D, E, B6, B12, folat, dan mineral seng, zat besi, tembaga, dan selenium, dapat meningkatkan daya tahan tubuh terhadap infeksi.  Kekurangan asupan harian mikronutrien dari makanan dapat diatasi dengan memanfaatkan suplemen makanan.

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Referensi

Acácio, S., Nhampossa, T., Quintó, L., Vubil, D., Sacoor, C., Kotloff, K., Dilruba, N., Macete, E., Levine, M. M., Alonso, P., Mandomando, I., & Bassat, Q. (2018). The role of HIV infection in the etiology and epidemiology of diarrheal disease among children aged 0-59 months in Manhiça District, Rural Mozambique. International Journal of Infectious Diseases, 73, 10–17. https://doi.org/10.1016/j.ijid.2018.05.012

Agoro, R., Taleb, M., Quesniaux, V. F. J., & Mura, C. (2018). Cell iron status influences macrophage polarization. PloS One, 13(5). https://doi.org/10.1371/JOURNAL.PONE.0196921

Alpert, P. T. (2017). The Role of Vitamins and Minerals on the Immune System. Http://Dx.Doi.Org/10.1177/1084822317713300, 29(3), 199–202. https://doi.org/10.1177/1084822317713300

Aribi, M., D Mennechet, F. J., Touil-Boukoffa, C., & Bassaganya-Riera, J. (2023). Editorial: The role of vitamin D as an immunomodulator OPEN ACCESS EDITED AND REVIEWED BY. Front. Immunol, 14, 1186635. https://doi.org/10.3389/fimmu.2023.1186635

Belkaid, Y., & Hand, T. W. (2014). Role of the Microbiota in Immunity and inflammation. Cell, 157(1), 121. https://doi.org/10.1016/J.CELL.2014.03.011

Besold, A. N., Culbertson, E. M., & Culotta, V. C. (2016). The Yin and Yang of copper during infection. Journal of Biological Inorganic Chemistry : JBIC : A Publication of the Society of Biological Inorganic Chemistry, 21(2), 137–144. https://doi.org/10.1007/S00775-016-1335-1

Biesalski, H. K. (2016). Nutrition meets the microbiome: micronutrients and the microbiota. Annals of the New York Academy of Sciences, 1372(1), 53–64. https://doi.org/10.1111/NYAS.13145

Bscheider, M., & Butcher, E. C. (2016). Vitamin D immunoregulation through dendritic cells. Immunology, 148(3), 227. https://doi.org/10.1111/IMM.12610

Buchmann, K. (2014). Evolution of Innate Immunity: Clues from Invertebrates via Fish to Mammals. Frontiers in Immunology, 5(SEP). https://doi.org/10.3389/FIMMU.2014.00459

BPOM RI. (2018). Laporan Tahunan BPOM 2017. Jakarta.

BPOM RI. (2019). Peraturan Badan Pengawas Obat Dan Makanan Nomor 17 Tahun 2019 tentang Persyaratan Mutu Suplemen Kesehatan.

Carr, A. C., & Maggini, S. (2017). Vitamin C and Immune Function. Nutrients, 9(11). https://doi.org/10.3390/NU9111211

Carrillo, J. L. M., García, F. P. C., Coronado, O. G., García, M. A. M., Cordero, J. F. C., Carrillo, J. L. M., García, F. P. C., Coronado, O. G.,

García, M. A. M., & Cordero, J. F. C. (2017). Physiology and Pathology of Innate Immune Response Against Pathogens. Physiology and Pathology of Immunology. https://doi.org/10.5772/INTECHOPEN.70556

Carvalho, J. T. G., Schneider, M., Cuppari, L., Grabulosa, C. C., Aoike, D. T., Redublo, B. M. Q., Batista, M. C., Cendoroglo, M., Moyses, R. M., & Dalboni, M. A. (2017). Cholecalciferol decreases inflammation and improves vitamin D regulatory enzymes in lymphocytes in the uremic environment: A randomized controlled pilot trial. PLoS ONE, 12(6), e0179540. https://doi.org/10.1371/JOURNAL.PONE.0179540

Cavaillon, J.-M. (2018). Historical links between toxinology and immunology. 76, 19. https://doi.org/10.1093/femspd/fty019

Clark, A., & Mach, N. (2016). Role of Vitamin D in the Hygiene Hypothesis: The Interplay between Vitamin D, Vitamin D Receptors, Gut Microbiota, and Immune Response. Frontiers in Immunology, 7(DEC). https://doi.org/10.3389/FIMMU.2016.00627

Dlozi, P. N., Gladchuk, A., Crutchley, R. D., Keuler, N., Coetzee, R., & Dube, A. (2022). Cathelicidins and defensins antimicrobial host defense peptides in the treatment of TB and HIV: Pharmacogenomic and nanomedicine approaches towards improved therapeutic outcomes. Biomedicine & Pharmacotherapy = Biomedecine & Pharmacotherapie, 151. https://doi.org/10.1016/J.BIOPHA.2022.113189

Dutra, F. F., & Bozza, M. T. (2014). Heme on innate immunity and inflammation. Frontiers in Pharmacology, 5. https://doi.org/10.3389/FPHAR.2014.00115

Fritsche, S., Wang, X., & Jung, C. (2017). Recent Advances in our Understanding of Tocopherol Biosynthesis in Plants: An Overview of Key Genes, Functions, and Breeding of Vitamin E Improved Crops. Antioxidants (Basel, Switzerland), 6(4). https://doi.org/10.3390/ANTIOX6040099

Gao, X., Zhang, Z., Li, Y., Shen, P., Hu, X., Cao, Y., & Zhang, N. (2016). Selenium Deficiency Facilitates Inflammation Following S. aureus Infection by Regulating TLR2-Related Pathways in the Mouse Mammary Gland. Biological Trace Element Research, 172(2), 449–457. https://doi.org/10.1007/S12011-015-0614-Y

Gombart, A. F., Pierre, A., & Maggini, S. (2020). A Review of Micronutrients and the Immune System–Working in Harmony to Reduce the Risk of Infection. Nutrients 2020, Vol. 12, Page 236, 12(1), 236. https://doi.org/10.3390/NU12010236

Goodman and Gilman’s The Pharmacological Basis of Therapeutics, 13th Edition: 9781259584732: Medicine & Health Science Books @ Amazon.com. (2017). Retrieved December 23, 2024, from https://www.amazon.com/Goodman-Gilmans-Pharmacological-Basis-Therapeutics/dp/1259584739?tag=googhydr-20&hvqmt=&hvbmt=%7BBidMatchType%7D&hvdev=c&ref=pd_sl_1ehi8sny9z_e

Haiqing Cai, Chen, L., Yin, C., Liao, Y., Meng, X., Lu, C., Tang, S., Li, X., & Wang, X. (2020). The effect of micro-nutrients on malnutrition, immunity and therapeutic effect in patients with pulmonary tuberculosis: A systematic review and meta-analysis of randomised controlled trials. Tuberculosis (Edinburgh, Scotland), 125. https://doi.org/10.1016/J.TUBE.2020.101994

Haryanto, B.; Suksmasari, T.; Wintergerst, E.; Maggini, S. (2015). Multivitamin supplementation supports immune function and ameliorates conditions triggered by reduced air quality. Vitam. Miner. 4, 1–15. - Google Search. (n.d.). Retrieved December 23, 2024, from https://www.google.com/search?client=safari&rls=en&q=Haryanto%2C+B.%3B+Suksmasari%2C+T.%3B+Wintergerst%2C+E.%3B+Maggini%2C+S.+2015.+Multivitamin+supplementation+supports+immune+function+and+ameliorates+conditions+triggered+by+reduced+air+quality.+Vitam.+Miner.+4%2C+1%E2%80%9315.&ie=UTF-8&oe=UTF-8

Hu, T., Xu, H., Wang, C., Qin, H., & An, Z. (2018). Magnesium enhances the chondrogenic differentiation of mesenchymal stem cells by inhibiting activated macrophage-induced inflammation. Scientific Reports 2018 8:1, 8(1), 1–13. https://doi.org/10.1038/s41598-018-21783-2

Huang, Z.; Liu, Yu.; Qi, G. Brand, D. Zheng, S.G. (2018). Role of Vitamin A in the Immune System. J. Clin. Med. 7, 258.Haryanto, B.; Suksmasari, T.; Wintergerst, E.; Maggini, S. 2015. Multivitamin supplementation supports immune function and ameliorates conditions triggered by reduced air quality. Vitam. Miner. 4, 1–15. - Google Search. Retrieved December 23, 2024, from https://www.google.com/search?client=safari&rls=en&q=Huang%2C+Z.%3B+Liu%2C+Yu.%3B+Qi%2C+G.+Brand%2C+D.+Zheng%2C+S.G.+2018.+Role+of+Vitamin+A+in+the+Immune+System.+J.+Clin.+Med.+7%2C+258.Haryanto%2C+B.%3B+Suksmasari%2C+T.%3B+Wintergerst%2C+E.%3B+Maggini%2C+S.+2015.+Multivitamin+supplementation+supports+immune+function+and+ameliorates+conditions+triggered+by+reduced+air+quality.+Vitam.+Miner.+4%2C+1%E2%80%9315.&ie=UTF-8&oe=UTF-8

Humas BPOM RI. (2020). Bijak Manfaatkan Obat Herbal dan Suplemen Kesehatan untuk Daya Tahan Tubuh menghadapi Pandemi COVID-19. https://www.pom.go.id/new/.Diakses tanggal 14 Februari 2021.

Imdad, A.; Ahmed, Z.; Bhutta, Z.A. (2016). Vitamin A supplementation for the prevention of morbidity and mortality in infants one to six months of age. Cochrane Database Syst Rev. 2016(9): CD007480. doi: 10.1002/14651858.CD007480.pub3

Iwasaki, A., & Medzhitov, R. (2015). Control of adaptive immunity by the innate immune system. Nature Immunology, 16(4), 343–353. https://doi.org/10.1038/NI.3123

Jarosz, M., Olbert, M., Wyszogrodzka, G., Młyniec, K., & Librowski, T. (2017). Antioxidant and anti-inflammatory effects of zinc. Zinc-dependent NF-κB signaling. Inflammopharmacology, 25(1), 11–24. https://doi.org/10.1007/S10787-017-0309-4

Jirillo, E., José Pérez-Cano, F., Wu, D., Lewis, E. D., Pae, M., & Meydani, S. N. (2019). Nutritional Modulation of Immune Function: Analysis of Evidence, Mechanisms, and Clinical Relevance. Frontiers in Immunology | Www.Frontiersin.Org, 1, 3160. https://doi.org/10.3389/fimmu.2018.03160

Julier, Z., Park, A. J., Briquez, P. S., & Martino, M. M. (2017). Promoting tissue regeneration by modulating the immune system. Acta Biomaterialia, 53, 13–28. https://doi.org/10.1016/J.ACTBIO.2017.01.056

Khor, B. H., Tiong, H. C., Tan, S. C., Wong, S. K., Chin, K. Y., Karupaiah, T., Ima-Nirwana, S., & Gafor, A. H. A. (2021). Effects of tocotrienols supplementation on markers of inflammation and oxidative stress: A systematic review and meta-analysis of randomized controlled trials. PLOS ONE, 16(7), e0255205. https://doi.org/10.1371/JOURNAL.PONE.0255205

Kieliszek, M. (2019). Selenium−Fascinating Microelement, Properties and Sources in Food. Molecules (Basel, Switzerland), 24(7). https://doi.org/10.3390/MOLECULES24071298

Lee, G. Y., & Han, S. N. (2018). The Role of Vitamin E in Immunity. Nutrients, 10(11). https://doi.org/10.3390/NU10111614

Lewis, E. D., Meydani, S. N., & Wu, D. (2019). Regulatory role of vitamin E in the immune system and inflammation. IUBMB Life, 71(4), 487–494. https://doi.org/10.1002/IUB.1976

Lidyana, V. (2020). Berita Ekonomi Bisnis. Penjualan Obat dan Suplemen Naik, BPOM 'Patroli' di Toko Online. https://finance.detik.com/berita-ekonomi-bisnis/d-5020951/. Diakses tanggal 19 Februari 2021

Lu, L., Lan, Q., Li, Z., Zhou, X., Gu, J., Li, Q., Wang, J., Chen, M., Liu, Y., Shen, Y., Brand, D. D., Ryffel, B., Horwitz, D. A., Quismorio, F. P.,

Liu, Z., Li, B., Olsen, N. J., & Zheng, S. G. (2014). Critical role of all-trans retinoic acid in stabilizing human natural regulatory T cells under inflammatory conditions. Proceedings of the National Academy of Sciences of the United States of America, 111(33). https://doi.org/10.1073/PNAS.1408780111

Maggini, S., Pierre, A., & Calder, P. C. (2018). Immune Function and Micronutrient Requirements Change over the Life Course. Nutrients, 10(10). https://doi.org/10.3390/NU10101531

Marshall, J. S., Warrington, R., Watson, W., & Kim, H. L. (2018). An introduction to immunology and immunopathology. Allergy, Asthma, and Clinical Immunology : Official Journal of the Canadian Society of Allergy and Clinical Immunology, 14(Suppl 2). https://doi.org/10.1186/S13223-018-0278-1

Maywald, M., Wang, F., & Rink, L. (2018). Zinc supplementation plays a crucial role in T helper 9 differentiation in allogeneic immune reactions and non-activated T cells. Journal of Trace Elements in Medicine and Biology : Organ of the Society for Minerals and Trace Elements (GMS), 50, 482–488. https://doi.org/10.1016/J.JTEMB.2018.02.004

Mène-Saffrané, L. (2017). Vitamin E Biosynthesis and Its Regulation in Plants. Antioxidants (Basel, Switzerland), 7(1). https://doi.org/10.3390/ANTIOX7010002

Mihajlovic, M., Fedecostante, M., Oost, M. J., Steenhuis, S. K. P., Lentjes, E. G. W. M., Maitimu-Smeele, I., Janssen, M. J., Hilbrands, L. B., & Masereeuw, R. (2017). Role of Vitamin D in Maintaining Renal Epithelial Barrier Function in Uremic Conditions. International Journal of Molecular Sciences, 18(12), 2531. https://doi.org/10.3390/IJMS18122531

Mikkelsen, K., & Apostolopoulos, V. (2019). Vitamin B12, Folic Acid, and the Immune System. Nutrition and Immunity, 103–114. https://doi.org/10.1007/978-3-030-16073-9_6

Moore, A., & Khanna, D. (2023). The Role of Vitamin C in Human Immunity and Its Treatment Potential Against COVID-19: A Review Article. Cureus, 15(1). https://doi.org/10.7759/CUREUS.33740

Mousavi, S., Bereswill, S., & Heimesaat, M. M. (2019). Immunomodulatory and Antimicrobial Effects of Vitamin C. European Journal of Microbiology & Immunology, 9(3), 73–79. https://doi.org/10.1556/1886.2019.00016

Nicholson, L. B. (2016). The immune system. Essays in Biochemistry, 60(3), 275–301. https://doi.org/10.1042/EBC20160017

Nkengfack, G., Englert, H., & Haddadi, M. (2019). Selenium and Immunity. Nutrition and Immunity, 159–165. https://doi.org/10.1007/978-3-030-16073-9_9

(PDF) A Concise Review of Immune System and Natural Immune Modulators. (n.d.-a). Retrieved December 23, 2024, from https://www.researchgate.net/publication/352678457_A_Concise_Review_of_Immune_System_and_Natural_Immune_Modulators

(PDF) A Concise Review of Immune System and Natural Immune Modulators. (n.d.-b). Retrieved December 23, 2024, from https://www.researchgate.net/publication/352678457_A_Concise_Review_of_Immune_System_and_Natural_Immune_Modulators

Peterson, C. T., Rodionov, D. A., Peterson, S. N., & Osterman, A. L. (2020). B Vitamins and Their Role in Immune Regulation and Cancer. Nutrients, 12(11), 1–23. https://doi.org/10.3390/NU12113380

Raederstorff, D., Wyss, A., Calder, P. C., Weber, P., & Eggersdorfer, M. (2015). Vitamin E function and requirements in relation to PUFA. The British Journal of Nutrition, 114(8), 1113–1122. https://doi.org/10.1017/S000711451500272X

Rautiainen, S., Manson, JE., Lichtenstein, AH., Sesso, HD. (2016). Dietary supplements and disease prevention: a global overview. Nat Rev endocrinol 12(7): 407-420

Riera Romo, M., Pérez-Martínez, D., & Castillo Ferrer, C. (2016). Innate immunity in vertebrates: an overview. Immunology, 148(2), 125–139. https://doi.org/10.1111/IMM.12597

Rink, L., & Gabriel, P. (2000). Zinc and the immune system. The Proceedings of the Nutrition Society, 59(4), 541–552. https://doi.org/10.1017/S0029665100000781

Romano, M., Fanelli, G., Albany, C. J., Giganti, G., & Lombardi, G. (2019). Past, Present, and Future of Regulatory T Cell Therapy in Transplantation and Autoimmunity. Frontiers in Immunology, 10(JAN). https://doi.org/10.3389/FIMMU.2019.00043

Roy, S., & Awasthi, A. (2019). Vitamin A and the Immune System. Nutrition and Immunity, 53–73. https://doi.org/10.1007/978-3-030-16073-9_3

Sassi, F., Tamone, C., & D’amelio, P. (2018). Vitamin D: Nutrient, Hormone, and Immunomodulator. Nutrients, 10(11). https://doi.org/10.3390/NU10111656

Shah, K., Varna, V. P., Sharma, U., & Mavalankar, D. (2022). Does vitamin D supplementation reduce COVID-19 severity?: a systematic review. QJM : Monthly Journal of the Association of Physicians, 115(10), 665–672. https://doi.org/10.1093/QJMED/HCAC040

Shahidi, F., & De Camargo, A. C. (2016). Tocopherols and Tocotrienols in Common and Emerging Dietary Sources: Occurrence, Applications, and Health Benefits. International Journal of Molecular Sciences, 17(10), 1745. https://doi.org/10.3390/IJMS17101745

Stach, K., Stach, W., & Augoff, K. (2021). Vitamin B6 in Health and Disease. Nutrients, 13(9). https://doi.org/10.3390/NU13093229

Takiishi, T., Fenero, C. I. M., & Câmara, N. O. S. (2017). Intestinal barrier and gut microbiota: Shaping our immune responses throughout life. Tissue Barriers, 5(4). https://doi.org/10.1080/21688370.2017.1373208

Todorova, T. T., Ermenlieva, N., Tsankova, G., Todorova, T. T., Ermenlieva, N., & Tsankova, G. (2017). Vitamin B12: Could It Be a Promising Immunotherapy? Immunotherapy - Myths, Reality, Ideas, Future. https://doi.org/10.5772/65729

Wang, Z., Zeng, Y., Jia, H., Yang, N., Liu, M., Jiang, M., & Zheng, Y. (2022). Bioconversion of vitamin D3 to bioactive calcifediol and calcitriol as high-value compounds. Biotechnology for Biofuels and Bioproducts, 15(1), 1–12. https://doi.org/10.1186/S13068-022-02209-8/FIGURES/4

Ward E. (2014). Addressing nutritional gaps with multivitamin and mineral supplements. Nutr J. 13(72); 1-10.

Wessels, I., & Rink, L. (2020). Micronutrients in autoimmune diseases: possible therapeutic benefits of zinc and vitamin D. The Journal of Nutritional Biochemistry, 77. https://doi.org/10.1016/J.JNUTBIO.2019.108240

Wessels, I., Rolles, B., & Rink, L. (2020). The Potential Impact of Zinc Supplementation on COVID-19 Pathogenesis. Frontiers in Immunology, 11. https://doi.org/10.3389/FIMMU.2020.01712

Weyh, C., Krüger, K., Peeling, P., & Castell, L. (2022). The Role of Minerals in the Optimal Functioning of the Immune System. Nutrients, 14(3). https://doi.org/10.3390/NU14030644

Widasari, L., Chalid, M. T., Jafar, N., Thaha, A. R., & Dirpan, A. (2020). The Role of Multimicronutrients on Improving Better Pregnancy Outcomes: A literature review. Systematic Reviews in Pharmacy, 11(8), 550–553. https://doi.org/10.31838/SRP.2020.8.78

Wishart, K. (2017). Increased Micronutrient Requirements during Physiologically Demanding Situations: Review of the Current Evidence.

Wiysonge, C. S., Ndze, V. N., Kongnyuy, E. J., & Shey, M. S. (2017a). Vitamin A supplements for reducing mother‐to‐child HIV transmission. The Cochrane Database of Systematic Reviews, 2017(9), CD003648. https://doi.org/10.1002/14651858.CD003648.PUB4

Wiysonge, C. S., Ndze, V. N., Kongnyuy, E. J., & Shey, M. S. (2017b). Vitamin A supplements for reducing mother‐to‐child HIV transmission. The Cochrane Database of Systematic Reviews, 2017(9), CD003648. https://doi.org/10.1002/14651858.CD003648.PUB4

Woodruff, T. J., Janssen, S. J., Guillette, L. J., & Giudice Frontmatter, L. C. (2024). Assessment 978-0-521-51952-6-Environmental Impacts on Reproductive Health and Fertility Edited. Retrieved December 23, 2024, from www.cambridge.org

Xie, Z., Chen, J., Zheng, C., Wu, J., Cheng, Y., Zhu, S., Lin, C., Cao, Q., Zhu, J., & Jin, T. (2017). 1,25-dihydroxyvitamin D3 -induced dendritic cells suppress experimental autoimmune encephalomyelitis by increasing proportions of the regulatory lymphocytes and reducing T helper type 1 and type 17 cells. Immunology, 152(3), 414–424. https://doi.org/10.1111/IMM.12776

Yoshii, K., Hosomi, K., Sawane, K., & Kunisawa, J. (2019). Metabolism of Dietary and Microbial Vitamin B Family in the Regulation of Host Immunity. Frontiers in Nutrition, 6. https://doi.org/10.3389/FNUT.2019.00048

Penulis

Nuzul Wahyuning Diyah
nuzul-w-d@ff.unair.ac.id (Kontak utama)
Hadi Poerwono
Kholis Amalia Nofianti
Achmad Toto Poernomo
Shabrina Wahyu Hidayati
Isnaeni Isnaeni

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