Effect of Moringa Leaves Oral Supplementation on Pro-Inflammatory Cytokines in PEM Conditions

  • Nita Aquarista Politeknik Kesehatan Kemenkes Semarang
  • Melyana Nurul Widyawati Politeknik Kesehatan Kemenkes Semarang
  • Kurnianingsih Kurnianingsih Politeknik Kesehatan Kemenkes Semarang
Keywords: cytokines, il-6, moringa oleifera leaf, pro-inflammatory, PEM

Abstract

Protein-Energy Malnutrition (PEM) is a nutritional problem resulting from protein or energy deficiency, often associated with the occurrence of infections. Infections due to weakened immune systems caused by protein deficiency can lead to inflammation. The flavonoid content in moringa oleifera leaf (MOL) has anti-inflammatory that can be utilized as an alternative treatment for PEM. Objective: To  identified the potential of MOL as an anti-inflammatory in PEM conditions. Method: This study is a systematic literature review that were obtained through Google Scholar, ScienceDirect and PubMed databases for the last 10 years from 2012 to 2022 with a total 80 articles found based on keyword searches. References then re-selected using PICOS method, resulting in 9 articles be reviewed. The review process involves gathering pertinent information that is applicable to the study objectives and analyzing it based on population/problems, intervention or management to the case, comparating the similarities and differences, study the outcome and study design of the previous articles. Then the information will be synthesized to conclude the review. Results: The findings indicate that MOL can be used effectively for patient with PEM as an anti-inflammatory agent by reducing the secretion of pro-inflammatory cytokines such as IL-1, IL-6 and TNF-α Conclusions: Administration of oral supplementation of MOL has a positive impact as an anti-inflamatory in PEM condition.

References

Abdel-Daim, M. M., Khalil, S. R., Awad, A., Zeid, E. H. A., El-Aziz, R. A., & El-Serehy, H. A. (2020). Ethanolic Extract of Moringa oleifera Leaves Influences NF-κB Signaling Pathway to Restore Kidney Tissue from Cobalt-Mediated Oxidative Injury and Inflammation in Rats. Nutrients. 12(4): 1–20. DOI: 10.3390/nu12041031

Abou-Zeid, S. M., Ahmed, A. I., Awad, A., Mohammed, W. A., Metwally, M. M. M., Almeer, R., Abdel-Daim, M. M., & Khalil, S. R. (2021). Moringa oleifera ethanolic extract attenuates tilmicosin-induced renal damage in male rats via suppression of oxidative stress, inflammatory injury, and intermediate filament proteins mRNA expression. Biomedicine and Pharmacotherapy.Vol 133. DOI: 10.1016/j.biopha.2020.110997

Alaaraj, N., Soliman, A., & Rogol, A. D. (2021). Growth of malnourished infants and children: how is inflammation involved?. Expert Review of Endocrinology and Metabolism. 16(5), 213–216. DOI: 10.1080/17446651.2021.1956903

Cheng, Y., Zak, O., Aisen, P., Harrison, S. C., & Walz, T. (2004). Structure of the human transferrin receptor-transferrin complex. Cell, 116(4), 565–576. https://doi.org/10.1016/s0092-8674(04)00130-8

Depkes RI. (2018). Riset Kesehatan Dasar (RISKESDAS) 2018.

Dwi, A., Sujuti, H., & Endang, T. (2012). Serbuk Daun Kelor Menurunkan Derajat Perlemakan Hati dan Ekspresi Interleukin-6 Hati Tikus dengan Kurang Energi Protein Moringa oleifera Leaf Powder Decrease Fatty Liver Degree and Liver Interleukin-6 Expression of Rat with Protein Energy Malnutrition. Jurnal Kedokteran Brawijaya. 26(3), 125–130. DOI: 10.21776/ub.jkb.2011.026.03.1

Fontinele, L. L., Heimfarth, L., Pereira, E. W. M., Rezende, M. M., Lima, N. T., Barbosa Gomes de Carvalho, Y. M., Afonso de Moura Pires, E., Guimarães, A. G., Bezerra Carvalho, M. T., de Souza Siqueira Barreto, R., Campos, A. R., Antoniolli, A. R., Antunes de Souza Araújo, A., Quintans-Júnior, L. J., & de Souza Siqueira Quintans, J. (2019). Anti-hyperalgesic effect of (-)-α-bisabolol and (-)-α-bisabolol/β-Cyclodextrin complex in a chronic inflammatory pain model is associated with reduced reactive gliosis and cytokine modulation. Neurochemistry International. 131, 104530. DOI: 10.1016/j.neuint.2019.104530

Gwela, A., Mupere, E., & Berkley, J. . (2019). Undernutrition, host immunity and vulnerability to infection among young children. Pediatric Infection Disease. 38(8), 175–177.

Helmy, S. A., Morsy, N. F. S., Elaby, S. M., & Ghaly, M. A. A. (2017). Hypolipidemic Effect of Moringa oleifera Lam Leaf Powder and its Extract in Diet-Induced Hypercholesterolemic Rats. Journal of Medicinal Food. 20(8), 755–762. DOI: 10.1089/jmf.2016.0155

Hojjatoleslami, S., & Jamshidi, L. (2016). Relationship Between C-Reactive Protein and Obesity in Adults. Journal of Medical Science. 16(5), e6662. DOI: 10.17795/zjrms-6662

Hong, Z.-S., Xie, J., Wang, X.-F., Dai, J.-J., Mao, J.-Y., Bai, Y.-Y., Sheng, J., & Tian, Y. (2022). Moringa oleifera Lam. Peptide Remodels Intestinal Mucosal Barrier by Inhibiting JAK-STAT Activation and Modulating Gut Microbiota in Colitis. Frontiers in Immunology. 13, 924178. DOI: doi.org/10.3389/fimmu.2022.924178

Kemenkes RI. (2023). Buku Saku Hasil Survei Status Gizi Indonesia (SSGI) 2022. Jakarta: Kemenkes.

Kooltheat, N., Pankla Sranujit, R., Chumark, P., Potup, P., Laytragoon-Lewin, N., & Usuwanthim, K. (2014). An ethyl acetate fraction of Moringa oleifera Lam. inhibits human macrophage cytokine production induced by cigarette smoke. Nutrients. 6(2), 697–710. DOI: 10.3390/nu6020697

Koruk, M., Taysi, S., Savas, M. ., Yilmaz, O., Akcay, F., & Karakok, M. (2004). Oxydative Stress and Enzymatic Antioxidant Status in Patients with Nonalkohlic Teatohepatitis. Annals of Clinical and Laboratory Science. 34(1), 57–62.

Kundu, J. K., & Surh, Y.-J. (2012). Emerging avenues linking inflammation and cancer. Free Radical Biology & Medicine. 52(9), 2013–2037. DOI: 10.1016/j.freeradbiomed.2012.02.035

Marcilla, A., Martínez, I., Berenguer, D., Gómez-Siurana, A., & Beltrán, M. I. (2012). Comparative study of the main characteristics and composition of the mainstream smoke of ten cigarette brands sold in Spain. Food and Chemical Toxicology. 50(5), 1317–1333. DOI: 10.1016/j.fct.2012.01.046

Methley, A. M., Campbell, S., Chew-Graham, C., McNally, R., & Cheraghi-Sohi, S. (2014). PICO, PICOS and SPIDER: a comparison study of specificity and sensitivity in three search tools for qualitative systematic reviews. BMC Health Services Research. 14(1), 579. DOI: 10.1186/s12913-014-0579-0

Moenadjat, Y. (2023). Seri Inflamasi. In Sindrom Respon Inflamasi Sistemik (1st ed., pp. 1–43). Departemen Klinik Ilmu Bedah Fakultas Kedokteran Universitas Indonesia.

Mohamed Husien, H., Peng, W. L., Su, H., Zhou, R. G., Tao, Y., Huang, J. J., Liu, M. J., Bo, R. N., & Li, J. G. (2022). Moringa oleifera leaf polysaccharide alleviates experimental colitis by inhibiting inflammation and maintaining intestinal barrier. Frontiers in Nutrition. 9, 1–14. DOI: 10.3389/fnut.2022.1055791

Okinarum, G., & Zakiyah, Z. (2019). Pemanfaatan Herbal Dalam Kebidanan (1st ed.). Pustaka Panasea.

Purkis, S. W., Mueller, C., & Intorp, M. (2011). The fate of ingredients in and impact on cigarette smoke. Food and Chemical Toxicology : An International Journal Published for the British Industrial Biological Research Association. 49(12), 3238–3248. DOI: 10.1016/j.fct.2011.09.028

Putra, A. I. Y. D., Setiawan, N. B. W., Sanjiwani, M. I. D., Wahyuniari, I. A. I., & Indrayani, A. W. (2021). Nutrigenomic and biomolecular aspect of moringa oleifera leaf powder as supplementation for stunting children. Journal of Tropical Biodiversity and Biotechnology. 6(1), 1–15. DOI: 10.22146/jtbb.60113

Ratliff, B. B., Abdulmahdi, W., Pawar, R., & Wolin, M. S. (2016). Oxidant Mechanisms in Renal Injury and Disease. Antioxidants & Redox Signaling. 25(3), 119–146. DOI: 10.1089/ars.2016.6665

Rose-John, S. (2012). IL-6 Trans-Signaling via Soluble IL-6 Receptor: Importance for the Pro-Inflammatory Activities of IL-6. International Journal of Biological Sciences. 8(9), 1237–1247. DOI: 10.7150/ijbs.4989

Rupiasa, W. J. P., Fatimah-Muis, S., Syauqy, A., Tjahjono, K., & Anjani, G. (2021). Manfaat pemberian tepung daun kelor (Moringa oleifera) terhadap kadar IL-6 dan kolesterol LDL tikus Sprague Dawley dislipidemia. AcTion: Aceh Nutrition Journal. 6(2), 173. DOI: 10.30867/action.v6i2.596

Santosa, W. N., & Baharuddin. (2020). Penyakit Jantung Koroner dan Antioksidan. Keluwih: Jurnal Kesehatan Dan Kedokteran. 1(2), 95–100. DOI: 10.24123/kesdok.V1i2.2566

Sudargo, T., Astuti, I., Sholikhah, E. N., Amelia, R., Maknunah, L., Risnhukathulistiwi, M., & Pranoto, Y. A. (2017). The Effect of Kersen Juice on Lipid Profile of Spargue Dawley Rats: A Randomized Controlled Trial. Asian Journal of Clinical Nutrition. 9, 97–103. DOI: 10.3923/ajcn.2017.97.103

Sulistyowati, E., Julia, A. R., & Mudita, D. (2015). Pemberian Tepung Daun Kelor terhadap Kadar Transferin Darah Tikus Putih Model KEP. Indonesian Journal of Human Nutrition. 2(2), 108–116. DOI: doi.org/10.21776/ub.ijhn.2015.002.02.6

Tamimi, A., Serdarevic, D., & Hanania, N. A. (2012). The effects of cigarette smoke on airway inflammation in asthma and COPD: therapeutic implications. Respiratory Medicine. 106(3), 319–328. DOI: 10.1016/j.rmed.2011.11.003

UNICEF. (2013). The State of The World’s Children 2013 : Children with Disabilities. United Nations Children’s Fund.

UNICEF Indonesia. (2022). Laporan Tahunan UNICEF Indonesia 2022. In UNICEF Laporan Tahunan Indonesia 2022.

Victoria, C., de Onis, M., Hallal, P., Blossner, M., & Shrimpton, R. (2010). Worldwide Timing of Growth Faltering: Revisiting Implications for Interventions Using the World Health Organization Growth Standards. Pediatrics. 125(3). DOI: 10.1542/peds.2009-1519

Weckman, A. M., McDonald, C. R., Ngai, M., Richard-Greenblatt, M., Leligdowicz, A., Conroy, A. L., Kain, K. C., Namasopo, S., & Hawkes, M. T. (2023). Inflammatory profiles in febrile children with moderate and severe malnutrition presenting at-hospital in Uganda are associated with increased mortality. EBioMedicine. 94. DOI: 10.1016/j.ebiom.2023.104721

WHO. (2012). Global Nutrition Targets 2025: Stunting Policy Brief (WHO/NMH/NHD/14.3) (Issue 9).

Zeeshan, M., Murugadas, A., Ghaskadbi, S., Ramaswamy, B. R., & Akbarsha, M. A. (2017). Ecotoxicological assessment of cobalt using Hydra model: ROS, oxidative stress, DNA damage, cell cycle arrest, and apoptosis as mechanisms of toxicity. Environmental Pollution (Barking, Essex : 1987). 224, 54–69. DOI: 10.1016/j.envpol.2016.12.042

Zhang, X., Zhu, J., Yang, B., Chen, B., Wu, J., Sha, J., & Bao, E. (2020). Transcriptomic investigation reveals toxic damage due to tilmicosin and potential resistance against tilmicosin in primary chicken myocardial cells. Poultry Science. 99(12), 6355–6370. DOI: 10.1016/j.psj.2020.08.080

Zhang, Y., Peng, L., Li, W., Dai, T., Nie, L., Xie, J., Ai, Y., Li, L., Tian, Y., & Sheng, J. (2020). Polyphenol extract of Moringa oleifera leaves alleviates colonic inflammation in dextran sulfate sodium-treated mice. Evidence-Based Complementary and Alternative Medicine. DOI: 10.1155/2020/6295402

Published
2024-05-07
How to Cite
Aquarista, N., Widyawati, M. N., & Kurnianingsih, K. (2024). Effect of Moringa Leaves Oral Supplementation on Pro-Inflammatory Cytokines in PEM Conditions. Indonesian Journal of Global Health Research, 6(4), 1963-1974. https://doi.org/10.37287/ijghr.v6i4.3256