Variation in vitamin D deficiency among tuberculosis patients by ethnic group and geographical region of birth: evidence from a diverse south London population

Pilarski, Adam M.; Penn, Nicole; Ratnakumar, Sharenja; Barker, Richard D.; Milburn, Heather

doi:10.1183/13993003.00057-2016

Cited by 9 publications

(4 citation statements)

References 15 publications

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“…The question arises of why then is there a variation in vitamin D status if they are from a homogenous social setting? Genetic susceptibility to vitamin D deficiency has been suggested by Pilarski et al, 9 and Sita-Lumsden et al 18 The genetic variation may explain our finding. We advocate further exploration of this observation.…”

Section: Discussionsupporting

confidence: 61%

A comparison of vitamin D and cathelicidin (LL-37) levels between patients with active TB and their healthy contacts in a high HIV prevalence setting: a prospective descriptive study

Lungu

Kilembe

Lakhi

et al. 2021

Transactions of the Royal Society of Tropical Medicine and Hygiene

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Background Studies from Asia and Europe indicate an association between vitamin D deficiency and susceptibility to TB. We performed an observational case-control study to determine vitamin D and cathelicidin (LL-37) levels and their association with active TB in newly diagnosed and microbiologically confirmed adult TB patients in Zambia, a high HIV prevalence setting. Methods Both total vitamin D and LL-37 were measured using ELISA from serum and supernatant isolated from cultured whole blood that was stimulated with heat-killed Mycobacterium tuberculosis. Statistical analysis was performed using STATA statistical software version 12. Results The median vitamin D in TB patients and healthy contacts was 28.7 (19.88–38.64) and 40.8 (31.2–49.44) ng/ml, respectively (p<0.001). The median LL-37 in TB patients compared with healthy contacts was 1.87 (2.74–8.93) and 6.73 (5.6–9.58) ng/ml, respectively (p=0.0149). Vitamin D correlation with LL-37 in healthy contacts was R2=0.7 (95% CI 0.566 to 0.944), p<0.0001. Normal vitamin D significantly predicted a healthy status (OR 4.06, p=0.002). Conclusions Significantly lower levels of vitamin D and LL-37 are seen in adults with newly diagnosed active TB. Longitudinal studies across various geographical regions are required to accurately define the roles of vitamin D and LL-37 in preventive and TB treatment outcomes.

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Section: Discussionsupporting

confidence: 61%

A comparison of vitamin D and cathelicidin (LL-37) levels between patients with active TB and their healthy contacts in a high HIV prevalence setting: a prospective descriptive study

Lungu

Kilembe

Lakhi

et al. 2021

Transactions of the Royal Society of Tropical Medicine and Hygiene

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“…The number of subjects experiencing the outcome of interest in previous studies was limited, however, ranging from 3 to 18 over follow-up periods 2 to 4 years. These studies have been found to vary with study design, geographical location 8 , as well as ethnicities 30 and gender 24 of subjects. Thus, studies with larger sample sizes in different populations are needed to help clarify whether the association between vitamin D and susceptibility to TB infection or disease is causal in nature.…”

Section: Discussionmentioning

confidence: 99%

Serum vitamin D levels and risk of prevalent tuberculosis, incident tuberculosis and tuberculin skin test conversion among prisoners

Maceda

Gonçalves

Andrews

et al. 2018

Sci Rep

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Poor vitamin D status has been associated with tuberculosis (TB); whether poor status is cause or consequence of disease is uncertain. We conducted a case-control study and two nested case-control studies to determine whether vitamin D levels were associated with active TB, tuberculin skin test (TST) conversion, and risk of progression to the active TB in prisoners in Brazil. In multivariable conditional logistic regression, subnormal vitamin D levels (OR, 3.77; 95% CI, 1.04-13.64) were more likely in prisoners with active TB. In contrast, vitamin D was not found to be a risk factor for either TST conversion ( Tuberculosis (TB) is a major global public health problem, causing approximately 1.4 million deaths annually 1 . The World Health Organization estimates that one-third of the world's population has latent TB 1 , of which approximately 10% will develop active disease 2 . Understanding which individuals will progress to TB and which will maintain lifelong immune control or achieve clearance, remains an important scientific question with substantial public health implications. This high-risk group also provides the opportunity to examine host factors that currently lack complete understanding in the disease pathway for active TB.One of the prominent host factors that has been implicated in TB risk is vitamin D levels 3 . Nutritional deficiency, low exposure to sunlight due to spending only short periods of time outdoors, and seasonal changes resulting in reduced ultraviolet radiation type B (UVB) may be associated with subnormal vitamin D levels 4 . Vitamin D levels of <30 ng/ml, which are characterized clinically as either insufficient (29-20 ng/ml) or deficient (<20 ng/ml). Vitamin D is composed of a group of secosteroid molecules that are predominantly synthesized

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“…Having dark skin when living permanently at northern latitudes would have caused vitamin D 3 deficiency, resulting in reduced bone strength and a defective immune system. For example, nowadays, the tuberculosis rate of individuals with dark skin living distant from the equator is significantly higher than that of people with light skin [20].…”

Section: Vitamin D and Human Genetic Adaptationmentioning

confidence: 99%

Nutrigenomics of Vitamin D

2019

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Nutrigenomics studies how environmental factors, such as food intake and lifestyle, influence the expression of the genome. Vitamin D3 represents a master example of nutrigenomics, since via its metabolite 1α,25-dihydroxyvitamin D3, which binds with high-affinity to the vitamin D receptor, the secosteroid directly affects the epigenome and transcriptome at thousands of loci within the human genome. Vitamin D is important for both cellular metabolism and immunity, as it controls calcium homeostasis and modulates the response of the innate and adaptive immune system. At sufficient UV-B exposure, humans can synthesize vitamin D3 endogenously in their skin, but today’s lifestyle often makes the molecule a true vitamin and micronutrient that needs to be taken up by diet or supplementation with pills. The individual’s molecular response to vitamin D requires personalized supplementation with vitamin D3, in order to obtain optimized clinical benefits in the prevention of osteoporosis, sarcopenia, autoimmune diseases, and possibly different types of cancer. The importance of endogenous synthesis of vitamin D3 created an evolutionary pressure for reduced skin pigmentation, when, during the past 50,000 years, modern humans migrated from Africa towards Asia and Europe. This review will discuss different aspects of how vitamin D interacts with the human genome, focusing on nutritional epigenomics in context of immune responses. This should lead to a better understanding of the clinical benefits of vitamin D.

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Variation in vitamin D deficiency among tuberculosis patients by ethnic group and geographical region of birth: evidence from a diverse south London population

Cited by 9 publications

References 15 publications

A comparison of vitamin D and cathelicidin (LL-37) levels between patients with active TB and their healthy contacts in a high HIV prevalence setting: a prospective descriptive study

A comparison of vitamin D and cathelicidin (LL-37) levels between patients with active TB and their healthy contacts in a high HIV prevalence setting: a prospective descriptive study

Serum vitamin D levels and risk of prevalent tuberculosis, incident tuberculosis and tuberculin skin test conversion among prisoners

Nutrigenomics of Vitamin D

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