25-Hydroxyvitamin D levels after recovery from tuberculosis: Insights into pathogenesis

Abstract

Objective 25-hydroxyvitamin D [25(OH)D] levels after recovery from tuberculosis (TB) may reflect pre-morbid levels and therefore provide insight into pathogenesis. We assessed 25(OH)D levels after recovery from TB disease, and compared to levels in persons without TB disease. Methods Case-control study. Cases were persons who had recovered from culture-confirmed Mycobacterium tuberculosis disease. Controls were persons without TB disease. Total 25(OH)D was measured from stored plasma specimens using liquid chromatography-mass spectrometry. Results 29 persons with prior TB disease and 36 controls were included. Median 25(OH)D levels were 24.7 ng/mL (IQR, 18.3–34.1) in prior TB disease, and 33.6 ng/mL (IQR, 26.2–42.4) in controls (Mann-Whitney; P=0.01). Multivariable linear regression analysis showed that black race (adjusted mean difference [β]=−8.3 ng/mL; 95% CI −14.5, −2.2; P<0.01), enrollment in winter (β=−10.4 ng/mL; 95% CI −17.0, −3.8; P<0.01) and prior TB disease (β=−5.8 ng/mL; 95% CI −11.4, −0.3; P=0.05) were associated with lower 25(OH)D levels. Conclusions Persons who had recovered from TB disease had lower 25(OH)D levels compared to controls without TB disease, after adjusting for important confounders. Larger, longitudinal studies are needed to further characterize the possible role of low 25(OH)D in the pathogenesis of TB disease and TB recurrence after recovery.

Changes in inflammatory protein and lipid mediator profiles persist after antitubercular treatment of pulmonary and extrapulmonary tuberculosis: A prospective cohort study

“…The common biosignature driving increased molecular perturbation in blood was composed by key mediators of anti-M. tuberculosis innate immune response, such as IL-1 β and TNF-α, as well as IL-4 [36,55]. Previous studies have also reported abnormal immune responses in individuals with prior EPTB, supporting our findings of long lasting changes in immune profile [42][43][44]. Importantly, our findings have multiple possible implications.…”

“…Studying plasma biomarkers in the context of TB may provide important insights into diagnosis, treatment efficacy and also disease pathogenesis [33]. Several prior studies have reported concentrations of cytokines, chemokines, acute phase proteins and lipid mediators in populations of pulmonary TB patients [30,[34][35][36][37][38][39][40][41], but less is known about extrapulmonary infection [42][43][44]. Here, we performed multiparametric analyses of plasma concentrations of several inflammatory cytokines, soluble cytokine receptors, receptor ligands, alongside with lipid mediators in a large set of active TB patients with pulmonary or extrapulmonary disease to characterize the systemic inflammatory profile of this disease.…”

Risk of Sarcopenia and Osteoporosis in Male Tuberculosis Survivors: Korea National Health and Nutrition Examination Survey

“…Physical inactivity, increased levels of systemic inflammation, hypoxia, poor nutrition, and use of corticosteroids have been implicated as major contributing factors 33 . Vitamin D deficiency is a risk factor of active TB and a sustained risk factor for TB recurrence even after recovery from active TB infection 34 , 35 . Vitamin D deficiency and compensatory rise in PTH may influence the pathogenesis of increased osteoporosis risk in patients with TB.…”

Increased vitamin D receptor expression from macrophages after stimulation with M. tuberculosis among persons who have recovered from extrapulmonary tuberculosis

“…[30] We found in a previous study that persons with treated TB had lower levels of 25-hydroxvitamin D compared to uninfected controls. [31] In our current study we found that persons with previous extrapulmonary TB had low but similar median serum levels of 25-hydroxyvitamin D (24.4 ng/mL; IQR 15.4, 39.5) compared to persons with previous pulmonary TB (19.9 ng/mL; IQR 16.4, 34.3), LTBI (22.9 ng/mL; IQR 13.8, 25.8), and uninfected TB contacts (18 ng/mL; IQR 10.9, 26.3) (Kruskal-Wallis p = 0.23). Vitamin D levels < 30 ng/mL were considered low according to standard commercial breakpoints (LabCorp).…”

“…In this study, there was no significant difference in 25-hydroxyvitamin D levels in participants with previous extrapulmonary TB and the three control groups, though median levels were low in all groups. In previous work, we demonstrated that 25-hydroxyvitamin D levels after recovery from TB were lower than in controls without TB disease, after controlling for important confounders—suggesting that low 25-hydroxyvitamin D levels could have been present prior to TB disease, and therefore contributed to TB risk [31]. However, there were no significant differences between those with previous extrapulmonary vs. pulmonary TB, [31] consistent with findings from other studies of persons with active TB disease [15, 45].…”