Adjunctive vitamin D for treatment of active tuberculosis in India: a randomised, double-blind, placebo-controlled trial

Daley, Peter; Jagannathan, Vijayakumar; John, Kevin; Sarojini, Joy; Latha, A; Vieth, Reinhold; Suzana, S; Jeyaseelan, Lakshmanan; Christopher, Devasahayam Jesudas; Śmieja, Marek; Mathai, Dilip

doi:10.1016/s1473-3099(15)70053-8

Cited by 121 publications

(114 citation statements)

References 15 publications

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“…Interestingly, decreased levels of serum vitamin D are associated with higher risk of active tuberculosis (65). Although recent clinical studies suggest that vitamin D supplementation does not significantly affect time to sputum culture conversion (66,67), it is also reported that vitamin D reduces time to sputum culture conversion in patients with vitamin D receptor polymorphism (67). The cocktail of isoniazid and pyrazinamide is the first-line standard drug for the treatment of tuberculosis.…”

Section: Mtb Infectionmentioning

confidence: 99%

Autophagy in Pulmonary Diseases

Nakahira

Porras

Choi

2016

Am J Respir Crit Care Med

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The pathogenesis of pulmonary diseases is often complex and characterized by multiple cellular events, including inflammation, cell death, and cell proliferation. The mechanisms by which these events are regulated in pulmonary diseases remain poorly understood. Autophagy is an essential process for cellular homeostasis and stress adaptation in eukaryotic cells. This highly conserved cellular process involves the sequestration of cytoplasmic components in double-membrane autophagosomes, which are delivered to lysosomes for degradation. The critical roles of autophagy have been demonstrated in a wide range of pathophysiological conditions. Emerging studies have identified that autophagy plays important roles in the pathogenesis of various lung diseases. In addition, autophagy has been shown to selectively degrade subcellular targets, including proteins, organelles, and pathogens. Here, we highlight the recent advances in the molecular regulation and function of autophagy in lung diseases.

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Section: Mtb Infectionmentioning

confidence: 99%

Autophagy in Pulmonary Diseases

Nakahira

Porras

Choi

2016

Am J Respir Crit Care Med

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“…The concentration in the vitamin D group increased significantly by 14.2 nmol/l (p-value 0.001) from baseline vs 6·66 nmol/l in the placebo group (pvalue 0·15), though, even the patients who received vitamin D were unable to achieve sufficiency. 17 Another double-blind randomized study conducted by Martineau et al where same dose was used as by Daley et al, but was given at 0, 2, 4 and 6 weeks along with ATT in test group vs placebo in control group; reported mean serum Vitamin D at 8 weeks to be 101.4 nmol/l vs. 22.8 nmol/l in intervention vs. placebo arms respectively (95% CI for difference 68.6-88.2 nmol/l, p-value <0.001). 20 On assessment of adverse effect profile, the patients of both the groups under study tolerated the drugs well and in none of the patients the adverse effects were serious enough to discontinue the drug therapy (Table 10).…”

Section: Discussionmentioning

confidence: 99%

A study of vitamin D supplementation with directly observed treatment short course for Pulmonary Tuberculosis

Randhawa¹,

Jindal²,

Rai³

et al. 2017

Int J Basic Clin Pharmacol

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Background: Tuberculosis remains one of major global health problems due to growing resistance in TB bacilli against anti-tubercular treatment (ATT). Vitamin D3 has been reported to have immunostimulatory effect. Aim was to study effect of Vitamin D3 on efficacy and safety of ATT / Directly Observed Treatment, short course regimen.Methods: Prospective, randomized and interventional study of 90 days was carried out in 60 newly diagnosed sputum positive pulmonary tuberculosis patients on DOTS strategy. Study was conducted in Government Medical College, Amritsar, Punjab, India. 30 patients each were randomly divided into two groups, A and B, with group A - vitamin D3 and DOTS regimen and Group B - DOTS alone. Patients were evaluated on day 0, 30, 60 and 90 by TB score, sputum microscopy, laboratory investigations, and adverse drug events. At the end of 90 days, results were tabulated and data analyzed statistically applying relevant tests.Results: Statistically non-significant improvement in symptoms, sputum conversion and decrease in mean TB scores was seen in Group A vs B at 90 days. Significant increase in mean Vitamin D levels was seen in Group A at end of study. Insignificant difference in safety profile was observed in group A which showed additional adverse events suspected to be due to Vitamin D. Equivocal hepatoprotective effect of Vitamin D was observed.Conclusions: Vitamin D as adjuvant to ATT does not confer additional benefit to newly diagnosed pulmonary tuberculosis patients. Large multi-centric trials are required to find any benefit of Vitamin D supplementation with ATT.

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“…(27) A study conducted in India by Peter Daley et al found that adjunctive vitamin D in the treatment of active tuberculosis did not reduce the time to sputum culture conversion. (28) In one published case report, simultaneous correction of vitamin D deficiency with ATT in an African-American female who presented with refractory, drug susceptible pulmonary tuberculosis resulted in clinical and microbiological improvement. (29) A meta-analysis was done by Lewis et al to assess the association of pulmonary TB with VDR FokI and TaqI polymorphisms.…”

Section: (Oh) Vitamin D Levelmentioning

confidence: 99%

A Study on Vitamin D Status in Tuberculosis

Rajamanickam¹,

Biswas²,

Kar³

2017

jemds

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BACKGROUNDIndia is a country with the highest burden of TB. Vitamin D can lead to activation of immune system and prevent the growth of intracellular Mycobacterium tuberculosis. Good number of studies show that there is deficiency of Vitamin D in tuberculosis patients, though there are limited number of studies to show result on the contrary.This study was done with an aim to evaluate for any association of vitamin D with tuberculosis. MATERIALS AND METHODSThe study was undertaken with 52 number of patients newly diagnosed with tuberculosis, diagnosed by clinical criteria and usual laboratory tests. Serum samples were collected and 25-hydroxy vitamin D level was estimated in all of them using chemiluminescent immunoassay technology and compared with that of normal healthy controls. RESULTSThe study population included 52 patients (34 males and 18 females) diagnosed as TB, and healthy controls. 28 patients had pulmonary and 24 patients had extrapulmonary TB. Our study confirmed a high prevalence of vitamin D deficiency, 69.23% in patients with TB as compared to 34% of the healthy controls. The difference between the means were statistically significant with t=-2.41731 and p=0.008 (p<0.05). BACKGROUND Tuberculosis (TB) is a global pandemic that mainly affects the low-and middle-income countries. India, followed by Indonesia, China, Nigeria, Pakistan and South Africa account for 60% of the total TB statistics in the world. Despite advances in diagnostic technology and invention of new antituberculous drugs, TB continues to remain a major public health concern. In May 2014, the World Health Assembly at Geneva endorsed "The End TB Strategy" with an aim to end the global TB epidemic by 2035 with targets to reduce TB deaths by 95% and cut down the new cases by 90% and ensure that no family is burdened with catastrophic expenses due to TB. India contributes to one-quarter of the global TB burden. WHO statistics for 2015 gives an estimated incidence and prevalence of 2.2 and 2.5 million respectively for TB in India. CONCLUSION(1) TB along with HIV remains as one of the leading causes of morbidity and mortality among general population.

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Adjunctive vitamin D for treatment of active tuberculosis in India: a randomised, double-blind, placebo-controlled trial

Cited by 121 publications

References 15 publications

Autophagy in Pulmonary Diseases

Autophagy in Pulmonary Diseases

A study of vitamin D supplementation with directly observed treatment short course for Pulmonary Tuberculosis

A Study on Vitamin D Status in Tuberculosis

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