Vitamin D deficiencies among tuberculosis patients in Africa: A systematic review

Keflie, Tibebeselassie Seyoum; Nölle, Nils; Lambert, Christine; Nöhr, Donatus; Biesalski, Hans Konrad

doi:10.1016/j.nut.2015.05.003

Cited by 35 publications

(24 citation statements)

References 47 publications

(37 reference statements)

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Several studies conducted in patients infected with TB and taking the conventional 4 drug anti-TB regimen have suggested a very high prevalence of vitamin D deficiency in these populations [38], [39], [40], [41]. The association between TB and vitamin D deficiency suggests that several factors including the anti-TB therapy itself may have impacted the vitamin D status of the patients infected with TB.…”

Section: Discussionmentioning

confidence: 99%

The effects of first-line anti-tuberculosis drugs on the actions of vitamin D in human macrophages

Chesdachai

Zughaier

et al. 2016

Journal of Clinical & Translational Endocrinology

View full text Add to dashboard Cite

Tuberculosis (TB) is a major global health problem. Patients with TB have a high rate of vitamin D deficiency, both at diagnosis and during the course of treatment with anti-tuberculosis drugs. Although data on the efficacy of vitamin D supplementation on Mycobacterium tuberculosis (Mtb) clearance is uncertain from randomized controlled trials (RCTs), vitamin D enhances the expression of the anti-microbial peptide human cathelicidin (hCAP18) in cultured macrophages in vitro. One possible explanation for the mixed (primarily negative) results of RCTs examining vitamin D treatment in TB infection is that anti-TB drugs given to enrolled subjects may impact actions of vitamin D to enhance cathelicidin in macrophages. To address this hypothesis, human macrophage-like monocytic (THP-1) cells were treated with varying doses of first-line anti-tuberculosis drugs in the presence of the active form of vitamin D, 1N1,25-dihydroxyvitamin D3 (1,25(OH)2D3). The expression of hCAP18 was determined by quantitative reverse transcriptase polymerase chain reaction (qRT-PCR). 1,25(OH)2D3 strongly induced expression of hCAP18 mRNA in THP-1 cells (fold-change from control). The combination of the standard 4-drug TB therapy (isoniazid, rifampicin, pyrazinamide and ethambutol) in the cultured THP-1 cells demonstrated a significant decrease of hCAP18 mRNA at the dosage of 10 ug/mL. In 31 subjects with newly diagnosed drug-sensitive TB randomized to either high-dose vitamin D3 (1.2 million IU over 8 weeks, n=13) versus placebo (n=18), there was no change from baseline to week 8 in hCAP18 mRNA levels in peripheral blood mononuclear cells or in plasma concentrations of LL-37, the protein product of hCAP18.These data suggest that first-line anti-TB drugs may alter the vitamin D-dependent increase in hCAP18 and LL-37 human macrophages.

show abstract

Section: Discussionmentioning

confidence: 99%

The effects of first-line anti-tuberculosis drugs on the actions of vitamin D in human macrophages

Chesdachai

Zughaier

et al. 2016

Journal of Clinical & Translational Endocrinology

View full text Add to dashboard Cite

show abstract

“…According to the Food and Agriculture Organization/World Health Organization, two billion people worldwide have an inadequate iron supply, one billion have inadequate zinc and vitamin D supply, and one‐half billion have inadequate vitamin A . Poor vitamin D status is a global problem not only in the Northern Hemisphere because of low sun exposure and subsequent low synthesis of vitamin D in the skin, but also in countries with high sun exposure . Inadequate supply of vitamins A and D, as well as other micronutrients, might interfere with microbiota function and explain the relationship between dysbiosis and malnutrition.…”

Section: Malnutrition and The Microbiotamentioning

confidence: 99%

Nutrition meets the microbiome: micronutrients and the microbiota

Biesalski

2016

Annals of the New York Academy of Sciences

184

127

View full text Add to dashboard Cite

There is increasing evidence that food is an important factor that influences and shapes the composition and configuration of the gut microbiota. Most studies have focused on macronutrients (fat, carbohydrate, protein) in particular and their effects on the gut microbiota. Although the microbiota can synthesize different water-soluble vitamins, the effects of vitamins synthesized within the microbiota on systemic vitamin status are unclear. Few studies exist on the shuttling of vitamins between the microbiota and intestine and the impact of luminal vitamins on the microbiota. Studying the interactions between vitamins and the microbiota may help to understand the effects of vitamins on the barrier function and immune system of the intestinal tract. Furthermore, understanding the impact of malnutrition, particularly low micronutrient supply, on microbiota development, composition, and metabolism may help in implementing new strategies to overcome the deleterious effects of malnutrition on child development. This article reviews data on the synthesis of different micronutrients and their effects on the human microbiota, and further discusses the consequences of malnutrition on microbiota composition.

show abstract

“…Moreover, Stead et al have shown racial differences in the incidence of TB associated with the levels of 25-hydroxyvitamin D (25(OH)D). Recently, studies have reported that hypovitaminosis D results in lower antimycobacterial immunity [ 10 , 11 ] and is related to increased risk of TB [ 12 , 13 ]. In vitro studies have revealed that 1,25-dihydroxyvitamin D (1,25(OH) 2 D) enhances innate immunity by increasing the expression of antimicrobial peptides, including cathelicidin, and inducing the autophagy of infected cells, thus restricting the intracellular growth of M.tb in macrophages [ 14 ].…”

Section: Introductionmentioning

confidence: 99%

Vitamin D and the promoter methylation of its metabolic pathway genes in association with the risk and prognosis of tuberculosis

Wang

Kong

et al. 2018

Clin Epigenet

View full text Add to dashboard Cite

BackgroundA variety of abnormalities in vitamin D metabolism have been reported in patients with active tuberculosis. However, intervention trials have produced inconsistent results. We hypothesized that genetic and epigenetic changes in the key genes of the vitamin D metabolic pathway may partly explain the differences between studies.MethodsWe performed a case-control study followed by a prospective cohort study. We recruited 122 patients with pulmonary tuberculosis and 118 healthy controls. The serum 25-hydroxyvitamin D and 1,25-dihydroxyvitamin D levels were measured. The methylation of the promoter regions of key genes in the vitamin D metabolic pathway (CYP24A1, CYP27A1, CYP27B1, CYP2R1, and VDR) was detected using the Illumina MiSeq platform. The specific methylation profiles were examined as epigenetic biomarkers. The sensitivity, specificity, and receiver operating characteristic (ROC) curves were used to estimate the predictive value of the biomarkers.ResultsThe baseline serum 25-hydroxyvitamin D and 1,25-dihydroxyvitamin D concentrations in the cases were significantly lower than those in the controls (51.60 ± 27.25 nmol/L vs. 117.50 ± 75.50 nmol/L, Z = − 8.515, P < 0.001; 82.63 ± 51.43 pmol/L vs. 94.02 ± 49.26 pmol/L, Z = − 2.165, P = 0.03). We sequenced 310 CpG sites in five candidate genes. After Bonferroni correction, there were 55 differentially methylated CpG sites between cases and controls; 41.5% were in the CYP27B1 gene, 31.7% were in the CYP24A1 gene, 14.7% were in the VDR gene, and 12.3% were in the CYP27A1 gene. When we designated the CpG sites that remained significant after the Bonferroni correction as the biomarkers, the area under the curve (AUC) for the cumulative methylation was 0.810 (95% CI 0.754–0.866). There was an interaction between CYP27A1 methylation level and 1,25-dihydroxyvitamin D concentration associated with the risk of TB (ORinteraction = 4.11, 95% CI 1.26–13.36, P = 0.019). The serum 1,25-dihydroxyvitamin D concentration at the end of the intensive treatment stage was related to a patient’s prognosis (P = 0.008). There were 23 CpG sites that were individually related to the treatment outcomes, but the relationships were not significant after the Bonferroni correction.ConclusionBoth serum vitamin D concentrations and the methylation levels of key genes in the vitamin D metabolic pathway are related to the risk and prognosis of tuberculosis.Electronic supplementary materialThe online version of this article (10.1186/s13148-018-0552-6) contains supplementary material, which is available to authorized users.

show abstract

Vitamin D deficiencies among tuberculosis patients in Africa: A systematic review

Cited by 35 publications

References 47 publications

The effects of first-line anti-tuberculosis drugs on the actions of vitamin D in human macrophages

The effects of first-line anti-tuberculosis drugs on the actions of vitamin D in human macrophages

Nutrition meets the microbiome: micronutrients and the microbiota

Vitamin D and the promoter methylation of its metabolic pathway genes in association with the risk and prognosis of tuberculosis

Contact Info

Product

Resources

About