Common and Rare Hematological Manifestations and Adverse Drug Events during Treatment of Active TB: A State of Art

Minardi, Maria Letizia; Fato, Ilenia; Gennaro, Francesco Di; Mosti, Silvia; Mastrobattista, Annelisa; Cerva, Carlotta; Libertone, Raffaella; Saracino, Annalisa; Goletti, Delia; Girardi, Enrico; Andreoni, Massimo; Palmieri, Fabrizio; Gualano, Gina

doi:10.3390/microorganisms9071477

Cited by 23 publications

(26 citation statements)

References 89 publications

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“…However, it is unclear whether VD deficiency is a possible cause or consequence of the disease. Numerous in vitro studies have demonstrated the role and potential benefit of VD in TB, showing that VD suppresses the replication of MTB in vitro [ 82 , 83 ]; few clinical trials have been performed to evaluate the efficacy of VD supplementation in preventing the development of the disease, failing to show a reduction in the risk of infection and development of disease [ 84 , 85 ].…”

Section: Resultsmentioning

confidence: 99%

Potential Role of Vitamins A, B, C, D and E in TB Treatment and Prevention: A Narrative Review

et al. 2021

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(1) Background: Tuberculosis (TB) is one of the world’s top infectious killers, in fact every year 10 million people fall ill with TB and 1.5 million people die from TB. Vitamins have an important role in vital functions, due to their anti-oxidant, pro-oxidant, anti-inflammatory effects and to metabolic functions. The aim of this review is to discuss and summarize the evidence and still open questions regarding vitamin supplementation as a prophylactic measure in those who are at high risk of Mycobacterium tuberculosis (MTB) infection and active TB; (2) Methods: We conducted a search on PubMed, Scopus, Google Scholar, EMBASE, Cochrane Library and WHO websites starting from March 1950 to September 2021, in order to identify articles discussing the role of Vitamins A, B, C, D and E and Tuberculosis; (3) Results: Supplementation with multiple micronutrients (including zinc) rather than vitamin A alone may be more beneficial in TB. The WHO recommend Pyridoxine (vitamin B6) when high-dose isoniazid is administered. High concentrations of vitamin C sterilize drug-susceptible, MDR and extensively drug-resistant MTB cultures and prevent the emergence of drug persisters; Vitamin D suppresses the replication of mycobacterium in vitro while VE showed a promising role in TB management as a result of its connection with oxidative balance; (4) Conclusions: Our review suggests and encourages the use of vitamins in TB patients. In fact, their use may improve outcomes by helping both nutritionally and by interacting directly and/or indirectly with MTB. Several and more comprehensive trials are needed to reinforce these suggestions.

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Section: Resultsmentioning

confidence: 99%

Potential Role of Vitamins A, B, C, D and E in TB Treatment and Prevention: A Narrative Review

et al. 2021

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“…In particular, the half-life of 25(OH)D 2 is lower than that of 25(OH)D 3 , due to the lower affinity of the former for VDBP. The half-life of vitamin D is reduced when there are low levels of VDBP, such as in the case of increased loss in nephrotic syndrome [ 12 ]. In the kidney, 25(OH)D is further hydroxylated by an oxidase and then transformed into the active hormone: 1,25 dihydroxy vitamin D [1,25(OH) 2 D] or calcitriol.…”

Section: Metabolism Of Vitamin Dmentioning

confidence: 99%

“…This oxidase is expressed in the cells of the proximal convoluted tubule and subjected to strict regulation: it is stimulated by parathyroid hormone and hypophosphatemia and inhibited by calcium, FGF23 and 1,25(OH) 2 D itself. The active hormone acts on intracellular VDR and influences gene transcription [ 12 , 13 ]. Figure 1 shows metabolism of vitamin D.…”

Section: Metabolism Of Vitamin Dmentioning

confidence: 99%

Impact of Vitamin D in Prophylaxis and Treatment in Tuberculosis Patients

Papagni

Pellegrino

Gennaro

et al. 2022

IJMS

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Vitamin D plays a crucial role in many infectious diseases, such as tuberculosis (TB), that remains one of the world’s top infectious killers with 1.5 million deaths from TB in 2021. Vitamin D suppresses the replication of Mycobacterium tuberculosis in vitro and showed a promising role in TB management as a result of its connection with oxidative balance. Our review encourages the possible in vivo benefit of a joint administration with other vitamins, such as vitamin A, which share a known antimycobacterial action with vitamin D. However, considering the low incidence of side effects even at high dosages and its low cost, it would be advisable to assess vitamin D level both in patients with active TB and high-risk groups and administer it, at least to reach sufficiency levels.

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“…Most patients have low B6 vitamin serum levels. The state is reversible a few weeks after withdrawing the drug or after starting supplementation with pyridoxine [ 70 , 71 ].…”

Section: Non-clonal or Metabolic Acquired Sideroblastic Anemiasmentioning

confidence: 99%

Causes and Pathophysiology of Acquired Sideroblastic Anemia

Rodríguez‐Sevilla

Calvo

Arenillas

2022

Genes

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The sideroblastic anemias are a heterogeneous group of inherited and acquired disorders characterized by anemia and the presence of ring sideroblasts in the bone marrow. Ring sideroblasts are abnormal erythroblasts with iron-loaded mitochondria that are visualized by Prussian blue staining as a perinuclear ring of green-blue granules. The mechanisms that lead to the ring sideroblast formation are heterogeneous, but in all of them, there is an abnormal deposition of iron in the mitochondria of erythroblasts. Congenital sideroblastic anemias include nonsyndromic and syndromic disorders. Acquired sideroblastic anemias include conditions that range from clonal disorders (myeloid neoplasms as myelodysplastic syndromes and myelodysplastic/myeloproliferative neoplasms with ring sideroblasts) to toxic or metabolic reversible sideroblastic anemia. In the last 30 years, due to the advances in genomic techniques, a deep knowledge of the pathophysiological mechanisms has been accomplished and the bases for possible targeted treatments have been established. The distinction between the different forms of sideroblastic anemia is based on the study of the characteristics of the anemia, age of diagnosis, clinical manifestations, and the performance of laboratory analysis involving genetic testing in many cases. This review focuses on the differential diagnosis of acquired disorders associated with ring sideroblasts.

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Common and Rare Hematological Manifestations and Adverse Drug Events during Treatment of Active TB: A State of Art

Cited by 23 publications

References 89 publications

Potential Role of Vitamins A, B, C, D and E in TB Treatment and Prevention: A Narrative Review

Potential Role of Vitamins A, B, C, D and E in TB Treatment and Prevention: A Narrative Review

Impact of Vitamin D in Prophylaxis and Treatment in Tuberculosis Patients

Causes and Pathophysiology of Acquired Sideroblastic Anemia

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