Vitamin D accelerates clinical recovery from tuberculosis: results of the SUCCINCT Study [Supplementary Cholecalciferol in recovery from tuberculosis]. A randomized, placebo-controlled, clinical trial of vitamin D supplementation in patients with pulmonary tuberculosis'.
Vitamin D accelerates clinical recovery from tuberculosis: results of the SUCCINCT Study [Supplementary Cholecalciferol in recovery from tuberculosis]. A randomized, placebo-controlled, clinical trial of vitamin D supplementation in patients with pulmonary tuberculosis'.
复制标题
DOI：
10.1186/1471-2334-13-22
复制
发表时间：
2013-01-19
影响因子：
3.7
通讯作者：
Mahmood F
中科院分区：
文献类型：
--
作者：
Salahuddin N;Ali F;Hasan Z;Rao N;Aqeel M;Mahmood F
维生素D通过抑制干扰素γ (IFN-g)和减少宿主疾病相关炎症来增强宿主对结核分枝杆菌的保护性免疫反应。本研究的目的是确定补充维生素D是否会影响结核病患者的康复。259名肺结核患者随机接受60万IU肌内维生素D3或安慰剂两剂。分别于4周、8周和12周进行评估。在0周和12周时测定早期分泌和T细胞活化的6kda （ESAT6）和结核分枝杆菌（MTBs）抗原诱导的全血刺激IFN-g反应。采用学生t检验和Chi2检验对0周和12周结局变量进行统计学比较。12周后，通过胸片检查，维生素D补充组的平均体重增加（kg） (+ 3.75, (3.16 - 4.34) vs . + 2.61 (95% CI 1.99 - 3.23) p 0.009，残留疾病较少；涉及的区数为1.35 v/s 1.82 p 0.004 (95% CI 0.15, 0.79)，空腔大小减少50%或更多106 (89.8%)v/s 111 (94.8%), p 0.035。维生素D补充导致基线25-羟基维生素D“缺乏”的患者mtbs诱导的IFN-g分泌显著增加（p 0.021）。补充高剂量维生素D加速了所有结核病患者的临床和放射学改善，并增加了血清维生素D基线“缺乏”患者的宿主免疫激活。这些结果表明维生素D在治疗结核病方面具有治疗作用。ClinicalTrials.gov;否。NCT01130311;URL: clinicaltrials.gov
Vitamin D enhances host protective immune responses to Mycobacterium tuberculosis by suppressing Interferon-gamma (IFN-g) and reducing disease associated inflammation in the host. The objectives of this study were to determine whether vitamin D supplementation to patients with tuberculosis (TB) could influence recovery. Two hundred and fifty nine patients with pulmonary TB were randomized to receive either 600,000 IU of Intramuscular vitamin D3 or placebo for 2 doses. Assessments were performed at 4, 8 and 12 weeks. Early secreted and T cell activated 6 kDa (ESAT6) and Mycobacterium tuberculosis sonicate (MTBs) antigen induced whole blood stimulated IFN-g responses were measured at 0 and 12 weeks. Statistical comparisons between outcome variables at 0 and 12 weeks were performed using Student’s t-test and Chi2 tests. After 12 weeks, the vitamin D supplemented arm demonstrated significantly greater mean weight gain (kg) + 3.75, (3.16 – 4.34) versus + 2.61 (95% CI 1.99 – 3.23) p 0.009 and lesser residual disease by chest radiograph; number of zones involved 1.35 v/s 1.82 p 0.004 (95% CI 0.15, 0.79) and 50% or greater reduction in cavity size 106 (89.8%) v/s 111 (94.8%), p 0.035. Vitamin D supplementation led to significant increase in MTBs-induced IFN-g secretion in patients with baseline ‘Deficient’ 25-hydroxyvitamin D serum levels (p 0.021). Supplementation with high doses of vitamin D accelerated clinical, radiographic improvement in all TB patients and increased host immune activation in patients with baseline ‘Deficient’ serum vitamin D levels. These results suggest a therapeutic role for vitamin D in the treatment of TB. ClinicalTrials.gov; No. NCT01130311; URL: clinicaltrials.gov