Vitamin D Deficiency and Tuberculosis Progression

Talat, Najeeha; Perry, Sharon; Parsonnet, Julie; Dawood, Ghaffar; Hussain, Rabia

doi:10.3201/eid1605.091693

Cited by 218 publications

(174 citation statements)

References 12 publications

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“…Two studies have examined the influence of VDR genotype on response to antimicrobial therapy: Roth et al reported that the FF genotype of the FokI VDR polymorphism and the Tt genotype of the TaqI VDR polymorphism associated with faster sputum culture conversion in a cohort of pulmonary TB patients in Peru (53) , while Babb et al reported no difference in time to sputum culture conversion according to TaqI or FokI VDR genotype among South African TB patients (54) . Recently, a cohort study conducted in Pakistan (55) reported that profound vitamin D deficiency among healthy household TB contacts at baseline associated with increased risk of development of active TB over the subsequent 4 years: seven out of thirty contacts with baseline plasma 25(OH)D <17 . 5 nmol/l developed active TB during follow-up, compared with one of thirty-two with plasma 25(OH)D 17 .…”

Section: Prospective Observational Studiesmentioning

confidence: 99%

Old wine in new bottles: vitamin D in the treatment and prevention of tuberculosis

Martineau

2011

Proc. Nutr. Soc.

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Tuberculosis (TB) is a major cause of mortality, responsible for 1 . 68 million deaths worldwide in 2009. The global prevalence of latent Mycobacterium tuberculosis infection is estimated to be 32 %, and this carries a 5-20% lifetime risk of reactivation disease. The emergence of drug-resistant organisms necessitates the development of new agents to enhance the response to antimicrobial therapy for active TB. Vitamin D was used to treat TB in the pre-antibiotic era, and its active metabolite, 1,25-dihydoxyvitamin D, has long been known to enhance the immune response to mycobacteria in vitro. Vitamin D deficiency is common in patients with active TB, and several clinical trials have evaluated the role of adjunctive vitamin D supplementation in its treatment. Results of these studies are conflicting, reflecting variation between studies in baseline vitamin D status of participants, dosing regimens and outcome measures. Vitamin D deficiency is also recognised to be highly prevalent among people with latent M. tuberculosis infection in both high-and low-burden settings, and there is a wealth of observational epidemiological evidence linking vitamin D deficiency with increased risk of reactivation disease. Randomised controlled trials of vitamin D supplementation for the prevention of active TB have yet to be performed, however. The conduct of such trials is a research priority, given the safety and low cost of vitamin D supplementation, and the potentially huge public health consequences of positive results. Tuberculosis: Vitamin D: Immunomodulation: Clinical trialsTuberculosis (TB) is a major public health problem. The global prevalence of latent Mycobacterium tuberculosis (MTB) infection has been estimated at 32% (1) , and this carries a 5-20% lifetime risk of reactivation disease in people who are not infected with HIV (2) ; reactivation rates higher than 10% per annum have been reported in HIVinfected people (3) . The WHO estimates that in 2009 there were 9 . 4 million incident cases of active TB, 14 million prevalent cases of TB, 1 . 3 million deaths from TB in HIV-uninfected people and 0 . 38 million deaths from TB in HIV-infected people (4) . The development of new agents to prevent acquisition or reactivation of latent MTB infection and to allow shortening of antimicrobial therapy regimens for active TB without loss of efficacy is a research priority. This paper reviews the growing body of evidence from studies conducted both in vitro and in vivo suggesting that vitamin D might have a role in the prevention and treatment of TB.

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Section: Prospective Observational Studiesmentioning

confidence: 99%

Old wine in new bottles: vitamin D in the treatment and prevention of tuberculosis

Martineau

2011

Proc. Nutr. Soc.

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“…81 The influence of vitamin D on tuberculosis can be traced back to the predrug era, when exposure to sunlight was considered an important adjuvant treatment modality. Yesudian et al hypothesized that high-risk populations latently infected with the organism would develop full-fledged disease upon migrating from an area with high sun exposure to areas with diminished sunlight.…”

mentioning

confidence: 99%

Antimicrobial implications of vitamin D

Youssef

Miller

Elabbassi

et al. 2011

Dermato-Endocrinology

167

128

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“…In a cohort follow-up study from Pakistan, low vitamin D levels were associated with progression to active TB disease in healthy household contacts. The findings suggested also the higher susceptibility of women to the infection, because of their low socioeconomic status, poor nutrition, traditional/cultural traits, and little exposure to sunlight [52]. In Southeast Asian countries, TB is also a major public health issue.…”

Section: Vitamin D Deficiency and Tbmentioning

confidence: 99%

The potential role of vitamin D for prevention and treatment of tuberculosis and infectious diseases

Dini

Bianchi

2012

Annali Dell'Istituto Superiore Di Sanità

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Abstract.Introduction.Vitamin D deficiency (VDD) is a common condition among several populations in the world. VDD is associated with higher incidence of immune system disorders and faster progression of some infectious diseases. Vitamin D is known to be of physiological importance, it is considered an essential micronutrient for the bone health and plays a beneficial role in the prevention and/or treatment of a number of chronic diseases. Vitamin D has a complex action on the immune system. Results. Evidence that vitamin D protects against tuberculosis has been supported by in vitro, epidemiological and some preliminary clinical studies. Vitamin D has a potential effect on HIV (human immunodeficiency virus) and plays a crucial role in the defence against respiratory infections. Conclusions. Vitamin D supplementation could be a low-cost, practical method to protect groups of people with high incidence of those diseases. Public health education should stress the need for adequate dietary intake of vitamin D in those vulnerable groups.Key words: VDD, Vitamin D deficiency, tuberculosis, HIV, respiratory infections. Riassunto (Il ruolo potenziale della vitamina D nella prevenzione e terapia della tubercolosi e delle malattie infettive).Introduzione. La carenza di vitamina D è una condizione comune in numerosi gruppi di popolazione nel mondo. Essa risulta associata a un'elevata incidenza dei disturbi del sistema immunitario e a una più veloce progressione di alcune malattie infettive. Oltre ad essere un micronutriente essenziale per la salute dell'apparato scheletrico, la vitamina D riveste un ruolo importante nei processi fisiologici e nella prevenzione e/o terapia di numerose patologie croniche. Essa svolge un'azione complessa sul sistema immunitario. Risultati. La dimostrazione che la vitamina D protegge contro la tubercolosi è stata supportata da studi in vitro, epidemiologici e da alcuni dati clinici preliminari. La vitamina D ha un effetto potenziale sull'HIV (sindrome da immunodeficienza acquisita) e svolge un ruolo fondamentale nelle infezioni respiratorie. Conclusioni. La somministrazione di vitamina D può essere un metodo pratico, a basso costo per proteggere gruppi specifici di popolazione con elevata incidenza delle suddette malattie. L'educazione sanitaria pubblica dovrebbe mettere in risalto la necessità di una adeguata assunzione di vitamina D in tutti i gruppi vulnerabili.Parole chiave: carenza di vitamina D, tubercolosi, HIV, infezioni respiratorie.

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Vitamin D Deficiency and Tuberculosis Progression

Cited by 218 publications

References 12 publications

Old wine in new bottles: vitamin D in the treatment and prevention of tuberculosis

Old wine in new bottles: vitamin D in the treatment and prevention of tuberculosis

Antimicrobial implications of vitamin D

The potential role of vitamin D for prevention and treatment of tuberculosis and infectious diseases

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