Relationship between Cysteine, Interleukin (IL)-2, And Interleukin (IL)-10 in Children with Marasmus Type Malnutrition

Teguh Wahyudi, Anik Puryatni, Tinny Endang Hernowati


 Malnutrition is one of the health issues in developing countries. The most commonly found malnutrition is the marasmus type. Infection in marasmus patient is the main cause of morbidity and mortality in developing countries. In marasmus, there is a decrease in protein level such as cysteine which is one of the glutathione forming components that plays a significant role in immune system. In malnutrition, there is a disturbance of lymphocyte in the form of down-regulation of type 1 cytokine (IL-2 and IFN-γ) and up- regulation of type 2 cytokine (IL-4 and IL-10). IL-2 is needed for the development of regulatory T produced by thymus and for NK cell cytotoxicity which plays a role in infection process, while IL-10 inhibits activation of lymphocyte T so the cellular immunity reaction ends. Several studies about the relationship between cysteine, IL-2, and IL-10 have been done in malnutrition-patients, but there is no study focusing on patients with marasmus. This study is to find out the relationship between cysteine, IL-2, and IL-10 in patients with marasmus type malnutrition. This study was an observational analytic study using cross-sectional design consisting of 20 children with marasmus type malnutrition and 20 well-nourished children treated in Saiful Anwar Hospital Malang. The cysteine, IL-2, and IL-10 level then measured using Elisa method. Normality and the various test were done. The Pearson correlation test was done to find out the relationship between cysteine and IL-2 level, cysteine and IL-10 level, and IL-2 and IL-10. The standard of cysteine and IL-2 level in children with marasmus is significantly lower than the control group, which was 1.616 ± 1.039 vs 3.298 ± 0.519 pg/mL; p = 0.000 dan 12.38±4.94 vs. 16.58 ± 4.80 pg/mL;p = 0.010, respectively. IL-10 in children with marasmus was significantly higher than control group (19.08± 5.93 vs 10.46 ± 3.90 pg/mL; p = 0.000). The cysteine level was positively correlated to the IL-2 level (p = 0.000; r = 0.71), while the cysteine and IL-10, IL-2 and IL-10 was negatively correlated with p = 0.014; r= -0.53 and p=0.037; r= -0.46 in marasmus. There was a positive correlation between the cysteine and IL-2 level and negative correlation between IL-10 and IL-2 also IL-2 and IL-10 in children with marasmus.



Serum cysteine level; IL-2 level; IL-10 level; marasmus type malnutrition

Full Text:



Muller, O., Krawinkel, M., 2005. Malnutrition And Health In Developing Countries. CMAJ. 2:173.

Susanto JC, Mexitalia M, Nasar Sri S. 2011. Malnutrisi Akut Berat dan Terapi Nutrisi Berbasis Komunitas. Dalam: Buku Ajar Nutrisi Pediatrik dan Penyakit Metabolik. Jilid I. Jakarta: Badan Penerbit IDAI. h: 128-30.

Kementerian Kesehatan RI. 2013. Riset Kesehatan Dasar (RISKESDAS) 2013. Jakarta: Badan penelitian dan pengembangan kesehatan Kemenkes RI

Arif S, Indrawati R, Hidayat B, Netty E Pratono. 1984. Pola Defisiensi Protein Kalori pada Anak di RSUD Sutomo, Buku Abstrak KONIKA VII. Jakarta, h: 11-15.

Departemen Kesehatan Republik Indonesia Direktorat Jenderal Bina Kesehatan Masyarakat Direktorat Bina Gizi Masyarakat. 2011. Buku Bagan Tatalaksana Anak Gizi Buruk. Departemen Kesehatan RI.

Ambrus JL Sr, Ambrus JL Jr. 2004. Nutrition and infectious diseases in developing countries and problems of acquired immunodeficiency syndrome. Exp Biol Med (Maywood) (229): 464-72.

Ozkan H, Olgun N, Saşmaz E, Abacioğlu H, Okuyan M, Cevik N. 1993. Nutrition, immunity and infections: T lymphocyte subpopulations in protein--energy malnutrition. J Trop Pediatr (39): 257-60.

Fock RA, Borelli P, Nakajima K, et al. 2008. Protein-Energy Malnutrition Modifies the Production of IL-10 in Response to Lipopolysaccharide (LPS) in a Murine Model. Journal of Nutritional Science and Vitaminology; 54(5): 371-7.

Geng, R. Zhang, G. Yang, W. Jiang, C. Xu. 2012. Interleukin-2 and autoimmune disease occurrence and therapy. European Review for Medical and Pharmacological Sciences. 16: 1462-67

Kresno, S.B. 2001. Imunologi: Diagnosis dan Prosedur Laboratorium. Edisi ke-4. Jakarta: Balai Penerbit FKUI.

Dröge W. 1993. Cysteine and glutathione deficiency in AIDS patients: a rationale for the treatment with N-acetyl-cysteine. Pharmacology (46): 61-5.

Ranjit KC. 1997. Nutrition and The Immune System: An Introduction. Am J Clin Nutr; 66:460S-3S.

Badaloo et al. 2002. Cysteine supplementation improves the erythrocyte glutathione synthesis rate in children with severe edematous malnutrition. Am J Clin Nutr; 76(3): 646-52.

Hirani, S.A.A., 2012., Malnutrition In Young Pakistani Children. J Ayub Med Coll Abbottabad. 24:2.

Kandala, B., Madungu, T.P., Emina, J.B., Nzita, P., Cappuccio, F.P., 2011. Malnutrition Among Children Under The Age Of Five In The Democratic Republic Of Congo (DRC): Does Geographic Location Matter? BMC Public Health. 11:261.

Avram, M.A., Chattopadhyay, J., Fein, P.A., Mittman, M., 2006. Monitoring Albumin Level As An Indicator Of Nutrition In Uremia Therapy. Nefrologia I Dializoterapia Polska .10:163-5.

Gupta, D., Lis, C.G., 2010. Pretreatment serum albumin as a predictor of cancer survival: A systematic review of the epidemiological literature, Nutrition Journal . 9:1-16

Bhoite, R., Iyer, M., 2011. Magnitude of Malnutrition and Iron Deficiency Anemia Among Rural School Children: An Appraisal, Asian J. Exp Biol. 2:354-62

Yang, W., Li, X., Li Y., Zhang, S., Liu, L., Wang, X., Li, W., 2012. Anemia, Malnutrition And Their Correlations With Socio-Demographic Characteristics And Feeding Practices Among Infants Aged 0-18 Months In Rural Areas Of Shaanxi Province In Northwestern China: A Cross-Sectional Study. BMC Public Health. 12:1127-13.

Chowdhury, S.I., Rahman, Z., Haque, M., Nahar, N., Taher, A., 2007. Serum Aspartate Aminotransferase (AST) and Alanine Aminotransferase (ALT) Levels in Different Grades of Protein Energy Malnutrition, J Bangladesh Soc Physiol. 2:17-9.

Hary, P., Bagga, A., Mahajan, P., Lakshmy, R., 2007. Effect of Malnutrition on Serum Creatinine and cystatin C levels, Pediatric Nephrology. 22:1757-61.

Jahoor, F., Badaloo, A., Reid ., Forrester, T., 2006. Sulfur Amino Acid Metabolism In Children With Severe Childhood Undernutrition: Cysteine Kinetics, Ajcn.Nutrition.11:1393-9.

William, L. 2005. Amino Acid. Journal of Pediatric Gastroenterology and Nutrition. 41:12-8.

Martin, S.S., Qasim, A., Reilly, M.P., 2008. Leptin Resistance, J Am Coll Cardiol. 52:2101-10.

Breitkreutz R, Pittack N, Nebe CT, et al. 2000. Improvement of immune functions in HIV infection by sulfur supplementation: two randomized trials. J Mol Med (Berl) (78): 55-62.

Giordani L, et al. 2002. N-acetylcysteine inhibits the induction of an antigen-specific antibody response down-regulating CD40 and CD27 co-stimulatory molecules. Clin Exp Immunol; 129(2):254-64.


Copyright (c) 2016 Journal of Tropical Life Science