Impact of Vitamin D in Prophylaxis and Treatment in Tuberculosis Patients

Papagni, Roberta; Pellegrino, Carmen; Gennaro, Francesco Di; Patti, Giulia; Ricciardi, Aurelia; Novara, Roberta; Cotugno, Sergio; Musso, Maria; Guido, Giacomo; Ronga, Luigi; Stolfa, Stefania; Bavaro, Davide Fiore; Romanelli, Federica; Totaro, Valentina; Lattanzio, Rossano; Iaco, Giulia De; Palmieri, Fabrizio; Saracino, Annalisa; Gualano, Gina

doi:10.3390/ijms23073860

Cited by 20 publications

(17 citation statements)

References 55 publications

(68 reference statements)

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“…Previous studies suggested that multivitamin supplementation is beneficial to the prognosis of TB patients, and its effect may be through inhibiting growth, even killing Mycobacterium TB, and improving the internal environment of oxidative stress. 30 , 31 Therefore, BMI may not provide a comprehensive assessment of nutritional levels in TB patients. The parameters of GNRI include height, weight, and albumin, and are also improved by NRI recommended by PNNs.…”

Section: Discussionmentioning

confidence: 99%

Malnutrition is Associated with an Increased Risk of Death in Hospitalized Patients with Active Pulmonary Tuberculosis: A Propensity Score Matched Retrospective Cohort Study

Xu¹,

Zhu²,

Cai³

et al. 2022

IDR

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Background This study aimed to investigate whether nutrition levels in patients with active pulmonary tuberculosis (TB) affect their risk of all-cause mortality during hospitalization and to further evaluate the predictive ability of Geriatric Nutritional Risk Index (GNRI) and Body Mass Index (BMI) for risk of all-cause mortality. Methods Patients from January 1, 2020 to December 31, 2021 were retrieved, and a total of 1847 were included. The primary outcome was all-cause mortality. Propensity score matching (PSM) was performed for risk adjustment, and receiver operating characteristic (ROC) curve analysis was performed to assess the predictive ability of GNRI and BMI for all-cause mortality. Results Malnourished TB patients were older, had more congestive heart failure, and had more chronic obstructive pulmonary disease or asthma. Under the nutrition level grouping defined by GNRI, the all-cause mortality in the malnourished group did not appear to reach a statistical difference compared with the nonmalnourished group (P = 0.078). When grouped by level of nutrition as defined by BMI, the all-cause mortality was higher in the malnourished group (P = 0.009), and multivariate logistic regression analysis revealed that malnutrition was an independent risk factor for all-cause mortality. After propensity score matching, the results showed that the all-cause mortality was higher in the malnutrition group, regardless of BMI or GNRI defined nutrition level grouping, compared with the control group (both P < 0.001). The ROC curve analysis revealed that the area under the curve (AUC) was 0.811 ([95% confidence interval (CI) 0.701–0.922], P < 0.001) for GNRI and 0.728 ([95% CI 0.588–0.869], P = 0.001) for BMI. Conclusion In the clinical treatment of patients with active TB, more attention should be paid to the management of nutritional risk. GNRI may be a highly effective and easy method for predicting short-term outcomes in patients with active pulmonary TB.

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Section: Discussionmentioning

confidence: 99%

Malnutrition is Associated with an Increased Risk of Death in Hospitalized Patients with Active Pulmonary Tuberculosis: A Propensity Score Matched Retrospective Cohort Study

Xu¹,

Zhu²,

Cai³

et al. 2022

IDR

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“…The low toxicity of vitamin K in humans may ease such attempts. The possible in vivo benefit of a joint administration with vitamin D shown to be protective in other infectious diseases is encouraged to be investigated [ 59 ].…”

Section: Discussionmentioning

confidence: 99%

Dramatic Decrease of Vitamin K2 Subtype Menaquinone-7 in COVID-19 Patients

et al. 2022

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(1) Background: Vitamin K (VK) is a fat-soluble compound with a common chemical structure, a 2-methyl-1,4-naphthoquinone ring, and a variable aliphatic side-chain. VK is involved in the synthesis of blood-clotting proteins, bone stability, anti-oxidative, and immune inflammatory-modulatory functions. Vitamin K also activates protein S, which acts as an antioxidant and anti-inflammatory. The fact that cytokine overproduction, oxidative stress, and disturbed microcirculation by thrombogenicity play a central role in severe COVID-19 prompted us to analyze this vitamin. (2) Methods: We analyzed by a validated liquid-chromatography tandem mass-spectrometry method serum vitamin K1, MK4, MK7, and VK epoxide levels in 104 healthy controls, 77 patients with non-COVID-19 pneumonia, and 135 hospitalized COVID-19 patients with potentially fatal outcomes admitted to our University Hospital between April and November 2020. We included the quotient between VK and triglyceride (TG, nmol/mmol/L) values in the analyses with respect to the TG transporter function for all VK subtypes. Additionally, we assessed anthropometric, routine laboratory, and clinical data from the laboratory and hospital information systems. (3) Results: The COVID-19 patients had significantly lower MK7 levels than non-COVID-19 pneumonia patients and healthy controls. COVID-19 and non-COVID-19 pneumonia patients had significantly lower vitamin K1 and significantly higher MK4 compared to healthy controls, but did not differ significantly from each other. Between COVID-19 non-survivors (n = 30) and survivors (n = 105) no significant differences were seen in all vitamin K subtypes, despite the fact that non-survivors had higher peak concentrations of IL-6, CRP, d-dimer, and higher oxygen needs, respectively. (4) Conclusions: The present data identified significantly decreased vitamin K1, K2 (MK7), and increased MK4 levels in patients with COVID-19 compared to healthy controls. Vitamin K2 (MK7) was lowest in COVID-19 patients irrespective of potentially fatal courses, indicating consumption of this VK subtype by COVID-19 immanent effects, most probably inflammatory and oxidative stress factors.

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“…It seems that prevention and treatment of different conditions require different concentrations of vitamin D. Cutoff values in vitamin D concentration supported by high-level evidence studies are still not available. However, it appears that for interventions in bone mineral density, dental health, fracture risk, or tumorigenesis, benefits are obtained starting at 25OHD concentrations of 30 ng/mL [ 114 ]. For tuberculosis prevention, in vitro studies have indicated a cholecalciferol concentration of 4 µg/mL as adequate to slow proliferation in culture.…”

Section: Current Clinical Trials Using Vitamin D In Autoimmune Diseasesmentioning

confidence: 99%

“…This is a much higher concentration, but potentially achievable due to local hydroxylation performed by macrophages. At the same time, in vivo studies did not provide a clear conclusion [ 114 , 115 ]. A number of research and review papers, including those cited in this paper, point to the need for robust randomized controlled trials on large groups of patients to determine a dose of vitamin D supplementation that would demonstrate long-term benefits with a safety profile in ADs.…”

Section: Current Clinical Trials Using Vitamin D In Autoimmune Diseasesmentioning

confidence: 99%

Vitamin D as a Nutri-Epigenetic Factor in Autoimmunity—A Review of Current Research and Reports on Vitamin D Deficiency in Autoimmune Diseases

2022

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Epigenetics is a series of alterations regulating gene expression without disrupting the DNA sequence of bases. These regulatory mechanisms can result in embryogenesis, cellular differentiation, X-chromosome inactivation, and DNA-protein interactions. The main epigenetic mechanisms considered to play a major role in both health and disease are DNA methylation, histone modifications, and profiling of non-coding RNA. When the fragile balance between these simultaneously occurring phenomena is disrupted, the risk of pathology increases. Thus, the factors that determine proper epigenetic modeling are defined and those with disruptive influence are sought. Several such factors with proven negative effects have already been described. Diet and nutritional substances have recently been one of the most interesting targets of exploration for epigenetic modeling in disease states, including autoimmunity. The preventive role of proper nutrition and maintaining sufficient vitamin D concentration in maternal blood during pregnancy, as well as in the early years of life, is emphasized. Opportunities are also being investigated for affecting the course of the disease by exploring nutriepigenetics. The authors aim to review the literature presenting vitamin D as one of the important nutrients potentially modeling the course of disease in selected autoimmune disorders.

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Impact of Vitamin D in Prophylaxis and Treatment in Tuberculosis Patients

Cited by 20 publications

References 55 publications

Malnutrition is Associated with an Increased Risk of Death in Hospitalized Patients with Active Pulmonary Tuberculosis: A Propensity Score Matched Retrospective Cohort Study

Malnutrition is Associated with an Increased Risk of Death in Hospitalized Patients with Active Pulmonary Tuberculosis: A Propensity Score Matched Retrospective Cohort Study

Dramatic Decrease of Vitamin K2 Subtype Menaquinone-7 in COVID-19 Patients

Vitamin D as a Nutri-Epigenetic Factor in Autoimmunity—A Review of Current Research and Reports on Vitamin D Deficiency in Autoimmune Diseases

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