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

A meeting of the Nutrition Society hosted by the Irish Section jointly with the American Society for Nutrition was held at University College Cork, Republic of Ireland on 15–17 June 2011

Adrian R. Martineau

2011

Scholarcy highlights

  • A meeting of the Nutrition Society hosted by the Irish Section jointly with the American Society for Nutrition was held at University College Cork, Republic of Ireland on 15–17 June 2011
  • The emergence of drug-resistant organisms necessitates the development of new agents to enhance the response to antimicrobial therapy for active TB
  • 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
  • The observation that increased risk of TB reactivation was almost exclusively confined to individuals with profound vitamin D deficiency is interesting, when taken together with reports from case–control studies that profound vitamin D deficiency is most strongly associated with susceptibility to TB: the implication is that, if vitamin D deficiency does predispose to active TB, relatively modest elevations of serum 25(OH)D might be effective for the prevention of active disease
  • Investigations of the potential role of vitamin D as an adjunct to antimicrobial therapy are more advanced, but results from clinical trials published to date have shown little if any benefit in drug-sensitive disease
  • A pre-planned subgroup analysis revealed that adjunctive vitamin D significantly hastened sputum culture conversion by more than 17 d in participants with the tt genotype of the TaqI vitamin D receptor polymorphism
  • On-going investigations from a recently completed trial reveal that administration of adjunctive vitamin D is associated with favourable immunomodulatory activity; this observation raises the possibility that individuals with multi-drug resistant TB, in whom antimicrobial therapy is less effective, might derive a clinical benefit from enhancement of their antimycobacterial immune response using adjunctive vitamin D therapy

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