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Zhou Y, Wu Q, Wang F, Chen S, Zhang Y, Wang W, Huang C, Liu K, Chen B. Association of variant vitamin statuses and tuberculosis development: a systematic review and meta-analysis. Ann Med 2024; 56:2396566. [PMID: 39221709 PMCID: PMC11370680 DOI: 10.1080/07853890.2024.2396566] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/27/2023] [Revised: 05/27/2024] [Accepted: 05/30/2024] [Indexed: 09/04/2024] Open
Abstract
BACKGROUND Several studies have suggested an association between vitamin deficiency and the development of tuberculosis; however, the precise impact remains unclear. This study aimed to elucidate the relationship between distinct vitamin statuses and the occurrence of tuberculosis. MATERIALS AND METHODS Retrieval was conducted using several databases without language restrictions to capture the eligible studies on tuberculosis and vitamin status. Pooled odds ratios (ORs), relative risks (RRs), and hazard ratios (HRs) were used with 95% confidence intervals (CIs) to clarify the relationship between the different vitamin statuses (A, B, D, and E) and the occurrence of tuberculosis. Subgroup analysis, sensitivity analysis, meta-regression analysis, and Galbraith plot were performed to determine sources of heterogeneity. Potential publication biases were detected using Begg's test, Egger's test, and the trim-and-fill test. RESULTS We identified 10,266 original records from our database searches, and 69 eligible studies were considered in this study. The random-effect model showed that people with tuberculosis may exhibit vitamin A deficiency (OR = 10.66, 95%CI: 2.61-43.63, p = .001), while limited cohort studies showed that vitamin A supplementation may reduce tuberculosis occurrence. Additionally, vitamin D deficiency was identified as a risk factor for tuberculosis development (RR = 1.69, 95%CI: 1.06-2.67, p = .026), and people with tuberculosis generally had lower vitamin D levels (OR = 2.19, 95%CI: 1.76-2.73, p < .001) compared to other groups. No publication bias was detected. CONCLUSIONS This meta-analysis indicated that people with tuberculosis exhibited low levels of vitamins A and D, while vitamin D deficiency was identified as a risk factor for tuberculosis. More randomized controlled interventions at the community levels should be recommended to determine the association between specific vitamin supplementation and tuberculosis onset.
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Affiliation(s)
- Yiqing Zhou
- School of Public Health, Hangzhou Medical College, Hangzhou, China
| | - Qian Wu
- Department of Tuberculosis Control and Prevention, Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou, China
| | - Fei Wang
- Department of Tuberculosis Control and Prevention, Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou, China
| | - Songhua Chen
- Department of Tuberculosis Control and Prevention, Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou, China
| | - Yu Zhang
- Department of Tuberculosis Control and Prevention, Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou, China
| | - Wei Wang
- Department of Tuberculosis Control and Prevention, Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou, China
| | - Chenxi Huang
- School of Public Health, Zhejiang Chinese Medical University, Hangzhou, China
| | - Kui Liu
- Department of Tuberculosis Control and Prevention, Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou, China
- National Centre for Tuberculosis Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Bin Chen
- Department of Tuberculosis Control and Prevention, Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou, China
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Murugesan H, Sampath P, A VK, R S, Veerasamy A, Ranganathan UD, Paramasivam S, Bethunaickan R. Association of CYP27B1 gene polymorphisms with pulmonary tuberculosis and vitamin D levels. Gene 2024; 927:148679. [PMID: 38876405 DOI: 10.1016/j.gene.2024.148679] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2024] [Revised: 05/08/2024] [Accepted: 06/10/2024] [Indexed: 06/16/2024]
Abstract
BACKGROUND AND OBJECTIVES Genetic factors are reported to be connected with tuberculosis (TB) infection. Studies have shown that genetic variations in genes involved in the vitamin D pathway influence the levels of vitamin D found in the bloodstream (serum). Cyp27b1 (1α-hydroxylase) is an enzyme that activates the synthesis of bioactive vitamin D3 by hydroxylation of 25(OH)D3.The in vitro studies reported rare gene variants of Cyp27b1 such as rs118204011 and rs118204012, associated with loss of Cyp27b1 function and lower serum vitamin D levels. Globally, a critical gap exists in understanding the link between these gene variants with TB and vitamin D levels. Hence, the study objective is to comprehend the association of Cyp27b1 rs118204009 (G/A), rs118204011 (C/T), and rs118204012 (A/G) with tuberculosis susceptibility/protection and to assess the influence of gene variants on vitamin D levels in both healthy controls (HCs) and those with pulmonary tuberculosis (PTB) in South India. METHODS Genomic DNA extraction was performed by salting-out procedure and subsequently genotyped through polymerase chain reaction and restriction fragment length polymorphism (PCR-RFLP) method. Vitamin D level was measured by Enzyme-Linked Immunosorbent Assay (ELISA). RESULTS In rs118204012 (A/G), a substantial association was found with PTB susceptibility in allele 'A' [Odds Ratio (OR): 1.52 (1.02-2.26); p = 0.044] and 'AA' genotype [OR: 1.69 (1.02-2.81); p = 0.040] through the dominant model. Allele 'G' [OR: 0.66 (0.44-0.98); p = 0.044) was found to be associated with protection against TB. Males were associated with increased susceptibility towards TB compared to females in the rs118204011 "CC" [OR: 3.94 (1.94-7.98); p = 0.002] and rs118204012 'AA' [OR: 4.57 (2.13-9.79); p = 0.0001] genotypes. Vitamin D insufficiency (<30 ng/ml) was more prevalent in PTB patients (66.67 %) with the rs118201012 'AA' genotype compared with healthy controls (57.14 %). This genotype was associated with disease susceptible odds ratio of 1.5. CONCLUSION Cyp27b1 rs118204012 'AA' genotype was found to have association with vitamin D insufficiency and TB susceptibility. In terms of gender, our findings suggest that male individuals are correlated with a higher TB risk. This suggest that the gene variants may be involved in the downstream processing of serum Vitamin D levels and its association with the disease.
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Affiliation(s)
- Harishankar Murugesan
- Department of Immunology, ICMR-National Institute for Research in Tuberculosis, Chennai, India
| | - Pavithra Sampath
- Department of Immunology, ICMR-National Institute for Research in Tuberculosis, Chennai, India
| | - Vamsi Kumar A
- Department of Immunology, ICMR-National Institute for Research in Tuberculosis, Chennai, India
| | - Srividhya R
- Department of Immunology, ICMR-National Institute for Research in Tuberculosis, Chennai, India
| | - Athikesavan Veerasamy
- Department of Immunology, ICMR-National Institute for Research in Tuberculosis, Chennai, India
| | - Uma Devi Ranganathan
- Department of Immunology, ICMR-National Institute for Research in Tuberculosis, Chennai, India
| | - Selvaraj Paramasivam
- Department of Immunology, ICMR-National Institute for Research in Tuberculosis, Chennai, India
| | - Ramalingam Bethunaickan
- Department of Immunology, ICMR-National Institute for Research in Tuberculosis, Chennai, India.
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Mamadapur VK, Nagaraju S, Prabhu MM. Comparative Study of Vitamin D Levels in Newly Diagnosed Tuberculosis and a Normal Population. MEDICINA (KAUNAS, LITHUANIA) 2024; 60:685. [PMID: 38792867 PMCID: PMC11122980 DOI: 10.3390/medicina60050685] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/02/2024] [Revised: 03/29/2024] [Accepted: 04/09/2024] [Indexed: 05/26/2024]
Abstract
Background and Objectives: Tuberculosis (TB) is an ancient disease caused by Mycobacterium tuberculosis, a member of the Mycobacterium tuberculosis complex. It contributes to significant morbidity and mortality. Treatment of TB poses a considerable challenge because of emerging drug resistance and the longer duration of therapy. Various past studies, both in vitro and in vivo, have established the role of vitamin D in the pathogenesis and treatment of TB. Results of in vivo studies are inconsistent, and this study aims to determine vitamin D levels and their association with newly diagnosed TB (pulmonary and extrapulmonary) cases and normal populations. Material and Methods: A Prospective Case-Control study with 116 subjects (58 cases and 58 controls) was conducted over two years. 29 cases of pulmonary TB and 29 cases of extrapulmonary TB constituted 58 cases of TB. Vitamin D levels were measured and compared in both the cases and controls. Data analysis was carried out using SPSS software 22.0. Results: The prevalence of vitamin D deficiency was 68.96% in the cases, while it was 51.72% in the controls. The reported median and quartile of serum vitamin D levels were 14.35 ng/mL (8.65, 25.48) in the TB group and 19.08 ng/mL (13.92, 26.17) in the control group. There was a significant statistical difference between the TB and non-TB populations with a p-value of 0.029 on the Mann-Whitney test. Conclusion: Vitamin D deficiency was more prevalent in individuals with TB than those without TB.
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Affiliation(s)
| | - Shreesha Nagaraju
- Department of General Medicine, Kasturba Medical College, Manipal, Manipal Academy of Higher Education, Manipal 576104, Karnataka, India;
| | - Mukhyaprana M. Prabhu
- Department of General Medicine, Kasturba Medical College, Manipal, Manipal Academy of Higher Education, Manipal 576104, Karnataka, India;
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Arifin J, Massi MN, Biakto KT, Bukhari A, Noor Z, Johan MP. Randomized controlled trial of vitamin d supplementation on toll-like receptor-2 (tlr-2) and toll-like receptor-4 (tlr-4) in tuberculosis spondylitis patients. J Orthop Surg Res 2023; 18:983. [PMID: 38129893 PMCID: PMC10740285 DOI: 10.1186/s13018-023-04445-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/25/2023] [Accepted: 12/05/2023] [Indexed: 12/23/2023] Open
Abstract
BACKGROUND Tuberculosis spondylitis accounts for approximately 50% of all cases of skeletal tuberculosis. Vitamin D plays a role in the immune system. Vitamin D helps in the activation of TLR-2 and TLR-4, which play a role in the process of tuberculosis infection. The objective of this study was to investigate the effect of oral supplementation with vitamin D on TLR-2 and TLR-4 levels in tuberculosis spondylitis patients. METHODS The true Experiment Design Pretest-Posttest with Control Group (Pretest-Posttest with Control Group) was used for this research. TLR-2 and TLR-4 were measured by ELISA. Repeated ANOVA, ANOVA tests, and Kolmogorov-Smirnov normality tests on the SPSS program were used to statistically analyze the results. RESULT In the dose groups of 10,000 IU and 5000 IU, significant increases in the levels of vitamin D, TLR-2, and TLR-4 were observed at weeks 4 and 8 (p < 0.05). In the control group, there was no significant increase. CONCLUSIONS Vitamin D supplements can significantly increase TLR-2 and TLR-4 levels. Supplementation with vitamin D 10,000 IU/day for 8 weeks can increase vitamin D levels > 50 ng/dl to optimally act as an immunomodulator.
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Affiliation(s)
- Jainal Arifin
- Orthopaedic and Traumatology Department, Faculty of Medicine, Hasanuddin University, Makassar, Indonesia
| | - Muhammad Nasrum Massi
- Clinical Microbiology Department, Faculty of Medicine, Hasanuddin University, Makassar, Indonesia.
| | - Karya Triko Biakto
- Orthopaedic and Traumatology Department, Faculty of Medicine, Hasanuddin University, Makassar, Indonesia
| | - Agussalim Bukhari
- Clinical Nutrition Department, Faculty of Medicine, Hasanuddin University, Makassar, Indonesia
| | - Zairin Noor
- Orthopaedic and Traumatology Department, Faculty of Medicine, Lambung Mangkurat University, Banjarmasin, Indonesia
| | - Muhammad Phetrus Johan
- Orthopaedic and Traumatology Department, Faculty of Medicine, Hasanuddin University, Makassar, Indonesia
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Ganmaa D, Chinbayar T, Khudaykov P, Nasantogtoh E, Ariunbuyan S, Enkhtsetseg T, Sarangua G, Chan A, Tserendagva D. Latent TB Infection, Vitamin D Status and COVID-19 Severity in Mongolian Patients. Nutrients 2023; 15:3979. [PMID: 37764763 PMCID: PMC10536319 DOI: 10.3390/nu15183979] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2023] [Revised: 09/07/2023] [Accepted: 09/08/2023] [Indexed: 09/29/2023] Open
Abstract
We aimed to determine potential risk factors for COVID-19 severity including serum vitamin D levels and latent TB infection among Mongolian inpatients diagnosed with COVID-19, and to study the effects of disease complications and treatment outcomes. This study included patients admitted to the Mongolian National Center for Communicable Disease, a main referral center for infectious disease in Mongolia, with COVID-19 ascertained by a positive PCR test. Patients' demographic, clinical, and laboratory data were analyzed. Of the 270 patients enrolled, 125 (46%) had mild-to-moderate illness, 86 (32%) had severe illness, and 59 (22%) had critical illness. Ten (91%) of the 11 patients who had active TB were hospitalized with severe or critical COVID-19, suggesting that they had a higher risk of falling into the severe category (OR = 10.6 [1.2; 92.0] 95% CI). Severe vitamin D deficiency (25(OH)D < 10 ng/mL) was present in 32% of the patients, but was not significantly associated with the severity of illness (p = 0.65). Older age, being male, having active TB and/or COPD were associated with greater COVID-19 severity, whereas a history of COVID-19 vaccination and the presence of a BCG vaccination scar were protective in terms of disease severity.
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Affiliation(s)
- Davaasambuu Ganmaa
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA 02115, USA
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA 02115, USA
| | - Tserendorj Chinbayar
- National Center for Communicable Disease, Ulaanbaatar 13335, Mongolia; (T.C.); (G.S.)
| | | | | | - Sukhbaatar Ariunbuyan
- Division of Oral and Maxillofacial Oncology and Surgical Sciences, Graduate School of Dentistry, Tohoku University, Sendai 980-8575, Japan;
- Laboratory of Biomedical Engineering for Cancer, Graduate School of Biomedical Engineering, Tohoku University, Sendai 980-8575, Japan
- Biomedical Engineering Cancer Research Center, Graduate School of Biomedical Engineering, Tohoku University, Sendai 980-8575, Japan
| | | | - Ganbold Sarangua
- National Center for Communicable Disease, Ulaanbaatar 13335, Mongolia; (T.C.); (G.S.)
| | - Andrew Chan
- Department of Medicine, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA 02115, USA;
| | - Dalkh Tserendagva
- International School of Mongolian Medicine, Mongolian National University of Medical Sciences, Ulaanbaatar 14210, Mongolia;
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Middelkoop K, Stewart J, Walker N, Delport C, Jolliffe DA, Coussens AK, Nuttall J, Tang JCY, Fraser WD, Griffiths CJ, Kumar GT, Filteau S, Hooper RL, Wilkinson RJ, Bekker LG, Martineau AR. Vitamin D supplementation to prevent tuberculosis infection in South African schoolchildren: multicenter phase 3 double-blind randomized placebo-controlled trial (ViDiKids). Int J Infect Dis 2023; 134:63-70. [PMID: 37211272 DOI: 10.1016/j.ijid.2023.05.010] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2023] [Revised: 05/09/2023] [Accepted: 05/09/2023] [Indexed: 05/23/2023] Open
Abstract
OBJECTIVES To determine whether weekly oral supplementation with 10,000 IU vitamin D3 for 3 years reduces the risk of sensitization to M. tuberculosis in South African schoolchildren aged 6-11 years with negative QuantiFERON-tuberculosis (TB) Gold Plus (QFT-Plus) assay results at baseline. METHODS We conducted a phase 3 randomized placebo-controlled trial in 1682 children attending 23 primary schools in Cape Town. The primary outcome was a positive end-trial QFT-Plus result, analyzed using a mixed effects logistic regression model with the school of attendance included as a random effect. RESULTS 829 vs. 853 QFT-Plus-negative children were randomized to receive vitamin D3 vs. placebo, respectively. Mean end-study 25(OH)D concentrations in participants randomized to vitamin D vs. placebo were 104.3 vs 64.7 nmol/l, respectively (95% confidence interval for difference, 37.6 to 41.9 nmol/l). A total of 76/667 (11.4%) participants allocated to vitamin D vs. 89/687 (13.0%) participants allocated to placebo tested QFT-Plus positive at 3-year follow-up (adjusted odds ratio 0.86, 95% confidence interval 0.62-1.19, P = 0.35). CONCLUSION Weekly oral supplementation with 10,000 IU vitamin D3 for 3 years elevated serum 25(OH)D concentrations among QFT-Plus-negative Cape Town schoolchildren but did not reduce their risk of QFT-Plus conversion.
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Affiliation(s)
- Keren Middelkoop
- Desmond Tutu HIV Centre, Institute of Infectious Diseases & Molecular Medicine, University of Cape Town, Observatory, South Africa; Department of Medicine, University of Cape Town, Cape Town, South Africa
| | - Justine Stewart
- Desmond Tutu HIV Centre, Institute of Infectious Diseases & Molecular Medicine, University of Cape Town, Observatory, South Africa; Department of Medicine, University of Cape Town, Cape Town, South Africa
| | - Neil Walker
- Wolfson Institute of Population Health, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London, UK
| | - Carmen Delport
- Desmond Tutu HIV Centre, Institute of Infectious Diseases & Molecular Medicine, University of Cape Town, Observatory, South Africa
| | - David A Jolliffe
- Blizard Institute, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London, UK
| | - Anna K Coussens
- Wellcome Centre for Infectious Diseases Research in Africa, Institute of Infectious Disease and Molecular Medicine, University of Cape Town, Cape Town, South Africa; Infectious Diseases and Immune Defense Division, Walter and Eliza Hall Institute of Medical Research, Parkville, Australia
| | - James Nuttall
- Paediatric Infectious Diseases Unit, Red Cross War Memorial Children's Hospital and the Department of Paediatrics and Child Health, University of Cape Town, Cape Town, South Africa
| | - Jonathan C Y Tang
- Norwich Medical School, University of East Anglia, Norwich Research Park, Norwich, UK; Departments of Laboratory Medicine, Clinical Biochemistry, and Departments of Diabetes and Endocrinology, Norfolk and Norwich University Hospital NHS Foundation Trust, Norwich, UK
| | - William D Fraser
- Norwich Medical School, University of East Anglia, Norwich Research Park, Norwich, UK; Departments of Laboratory Medicine, Clinical Biochemistry, and Departments of Diabetes and Endocrinology, Norfolk and Norwich University Hospital NHS Foundation Trust, Norwich, UK
| | - Christopher J Griffiths
- Wolfson Institute of Population Health, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London, UK
| | - Geeta Trilok Kumar
- Delhi School of Public Health, Institute of Eminence, University of Delhi, Delhi, India; Trivedi School of Biosciences, Ashoka University, Sonipat, India
| | - Suzanne Filteau
- Faculty of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, London, UK
| | - Richard L Hooper
- Wolfson Institute of Population Health, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London, UK
| | - Robert J Wilkinson
- Wellcome Centre for Infectious Diseases Research in Africa, Institute of Infectious Disease and Molecular Medicine, University of Cape Town, Cape Town, South Africa; The Francis Crick Institute, London, UK; Imperial College London, London, UK
| | - Linda-Gail Bekker
- Desmond Tutu HIV Centre, Institute of Infectious Diseases & Molecular Medicine, University of Cape Town, Observatory, South Africa
| | - Adrian R Martineau
- Blizard Institute, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London, UK.
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Al-Jaberi FAH, Crone CG, Lindenstrøm T, Arildsen NS, Lindeløv ES, Aagaard L, Gravesen E, Mortensen R, Andersen AB, Olgaard K, Hjaltelin JX, Brunak S, Bonefeld CM, Kongsbak-Wismann M, Geisler C. Reduced vitamin D-induced cathelicidin production and killing of Mycobacterium tuberculosis in macrophages from a patient with a non-functional vitamin D receptor: A case report. Front Immunol 2022; 13:1038960. [DOI: 10.3389/fimmu.2022.1038960] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2022] [Accepted: 10/18/2022] [Indexed: 11/06/2022] Open
Abstract
Tuberculosis (TB) presents a serious health problem with approximately a quarter of the world’s population infected with Mycobacterium tuberculosis (M. tuberculosis) in an asymptomatic latent state of which 5–10% develops active TB at some point in their lives. The antimicrobial protein cathelicidin has broad antimicrobial activity towards viruses and bacteria including M. tuberculosis. Vitamin D increases the expression of cathelicidin in many cell types including macrophages, and it has been suggested that the vitamin D-mediated antimicrobial activity against M. tuberculosis is dependent on the induction of cathelicidin. However, unraveling the immunoregulatory effects of vitamin D in humans is hampered by the lack of suitable experimental models. We have previously described a family in which members suffer from hereditary vitamin D-resistant rickets (HVDRR). The family carry a mutation in the DNA-binding domain of the vitamin D receptor (VDR). This mutation leads to a non-functional VDR, meaning that vitamin D cannot exert its effect in family members homozygous for the mutation. Studies of HVDRR patients open unique possibilities to gain insight in the immunoregulatory roles of vitamin D in humans. Here we describe the impaired ability of macrophages to produce cathelicidin in a HVDRR patient, who in her adolescence suffered from extrapulmonary TB. The present case is a rare experiment of nature, which illustrates the importance of vitamin D in the pathophysiology of combating M. tuberculosis.
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Wherry TLT, Dassanayake RP, Bannantine JP, Mooyottu S, Stabel JR. Vitamin D3 alters macrophage phenotype and endosomal trafficking markers in dairy cattle naturally infected with Mycobacterium avium subsp. paratuberculosis. Front Cell Infect Microbiol 2022; 12:1021657. [PMID: 36275033 PMCID: PMC9579537 DOI: 10.3389/fcimb.2022.1021657] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2022] [Accepted: 09/20/2022] [Indexed: 11/22/2022] Open
Abstract
Macrophages are important host defense cells in ruminant paratuberculosis (Johne’s Disease; JD), a chronic enteritis caused by Mycobacterium avium subsp. paratuberculosis (MAP). Classical macrophage functions of pathogen trafficking, degradation, and antigen presentation are interrupted in mycobacterial infection. Immunologic stimulation by 25-hydroxyvitamin D3 (25(OH)D3) and 1,25-dihydroxyvitamin D3 (1,25(OH)2D3) enhances bovine macrophage function. The present study aimed to investigate the role of vitamin D3 on macrophage phenotype and endosomal trafficking of MAP in monocyte-derived macrophages (MDMs) cultured from JD-, JD+ subclinical, and JD+ clinically infected cattle. MDMs were pre-treated 100 ng/ml 25(OH)D3 or 4 ng/ml 1,25(OH)2D3 and incubated 24 hrs with MAP at 10:1 multiplicity of infection (MOI). In vitro MAP infection upregulated pro-inflammatory (M1) CD80 and downregulated resolution/repair (M2) CD163. Vitamin D3 generally decreased CD80 and increased CD163 expression. Furthermore, early endosomal marker Rab5 was upregulated 140× across all stages of paratuberculosis infection following in vitro MAP infection; however, Rab5 was reduced in MAP-activated MDMs from JD+ subclinical and JD+ clinical cows compared to healthy controls. Rab7 expression decreased in control and clinical cows following MDM infection with MAP. Both forms of vitamin D3 reduced Rab5 expression in infected MDMs from JD- control cows, while 1,25(OH)2D3 decreased Rab7 expression in JD- and JD+ subclinical animals regardless of MAP infection in vitro. Vitamin D3 promoted phagocytosis in MDMs from JD- and JD+ clinical cows treated with either vitamin D3 analog. Results from this study show exogenous vitamin D3 influences macrophage M1/M2 polarization and Rab GTPase expression within MDM culture.
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Affiliation(s)
- Taylor L. T. Wherry
- Infectious Bacterial Diseases, National Animal Disease Center, United States Department of Agriculture - Agricultural Research Service (USDA-ARS), Ames, IA, United States
- Department of Veterinary Pathology, College of Veterinary Medicine, Iowa State University, Ames, IA, United States
| | - Rohana P. Dassanayake
- Ruminant Diseases and Immunology, National Animal Disease Center, United States Department of Agriculture - Agricultural Research Service (USDA-ARS), Ames, IA, United States
| | - John P. Bannantine
- Infectious Bacterial Diseases, National Animal Disease Center, United States Department of Agriculture - Agricultural Research Service (USDA-ARS), Ames, IA, United States
| | - Shankumar Mooyottu
- Department of Veterinary Pathology, College of Veterinary Medicine, Iowa State University, Ames, IA, United States
| | - Judith R. Stabel
- Infectious Bacterial Diseases, National Animal Disease Center, United States Department of Agriculture - Agricultural Research Service (USDA-ARS), Ames, IA, United States
- *Correspondence: Judith R. Stabel,
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Association between vitamin D and insulin resistance in adults with latent tuberculosis infection: Results from the National Health and Nutrition Examination Survey (NHANES) 2011-2012. J Infect Public Health 2022; 15:930-935. [PMID: 35878516 DOI: 10.1016/j.jiph.2022.07.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2022] [Revised: 07/10/2022] [Accepted: 07/15/2022] [Indexed: 11/22/2022] Open
Abstract
BACKGROUND Evidence demonstrated that vitamin D insufficiency was involved in insulin resistance (IR) pathogenesis and associated with tuberculosis. However, the association of vitamin D and IR in patients with latent tuberculosis infection (LTBI) remains unclear. This study aims to evaluate the association between vitamin D and insulin resistance in US adults with LTBI. METHOD National Health and Nutrition Examination Survey (NHANES) participants ≥ 20 years during the years 2011-2012 with positive QuantiFERON®-TB Gold-In-Tube (QFT) or tuberculin skin testing (TST) were enrolled in present study. Participants with LTBI were divided into 2 groups: (1) vitamin D insufficiency group (n = 267), and (2) vitamin D sufficiency group (n = 437). RESULTS Weighted analysis of all the population in the study showed that serum 25(OH)D inversely correlated with HOMA-IR (r = -0.14, P = 0.008). The vitamin D insufficiency group had higher fasting insulin (17.5 (1.38) vs. 15.29 (3.1), respectively, P = 0.0013) and HOMA-IR (5.0 (0.4) vs. 4.5 (1), respectively, P = 0.013) than the vitamin D sufficiency group. In adjusted analysis, vitamin D levels was independently associated with insulin resistance (adjusted OR [aOR] 2.74; 95% CI, 1.01-7.48, p = 0.0489). CONCLUSIONS Taken together, our study suggested that serum 25(OH) D concentrations were inversely and independently associated with HOMA-IR in LTBI.
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Cai L, Hou S, Huang Y, Liu S, Huang X, Yin X, Jiang N, Tong Y. The Potential Role of Vitamin D in the Development of Tuberculosis in Chinese Han Population: One Case-Control Study. Front Med (Lausanne) 2022; 9:849651. [PMID: 35957850 PMCID: PMC9358990 DOI: 10.3389/fmed.2022.849651] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2022] [Accepted: 06/14/2022] [Indexed: 11/13/2022] Open
Abstract
Background and aims:Spinal serum 25-hydroxyvitamin D [25[OH]D] status plays an important role in mediating innate immune responses by acting as a cofactor for induction of antimycobacterial activity and is thus involved in the development of Tuberculosis (TB). Results reported regarding the association of vitamin D with TB remained controversial. We aimed to identify any common association between 25[OH]D status and TB in the Chinese Han population.Methods280 subjects (70 TB patients and 210 matched controls) were recruited. TB cases were diagnosed based on the presence of acid-fast bacilli on smears from sputum and MTB isolation. Healthy controls were randomly selected from four local community-based populations. 25[OH]D was detected by electrochemiluminescence immunoassay (ECLIA) on Roche Elecsys before the initial treatment. Multivariable logistic regression analysis was used to examine the association of Vitamin D with TB.ResultsThere was no significant difference in the serum vitamin D level between total cases and controls, but we found a strong tendency toward a higher serum vitamin D level in male population (P < 0.05) with TB but not in females. High serum vitamin D increased the risk of TB in the Chinese Han population (OR = 1.035, 95%CI: 1.001–1.070, P < 0.05). The serum vitamin D level was significantly decreased with age increasing in cases and controls (all P < 0.001).ConclusionsHigh serum vitamin D may be an independent risk factor for TB in the Chinese Han population.
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Affiliation(s)
- Li Cai
- Wuhan Center for Disease Control and Prevention, Wuhan, China
- School of Public Health, Wuhan University, Wuhan, China
| | - Shuangyi Hou
- Center for Disease Control and Prevention, Wuhan, China
| | - Yadong Huang
- Center for Disease Control and Prevention, Wuhan, China
| | - Shuang Liu
- Center for Disease Control and Prevention, Wuhan, China
| | - Xibao Huang
- Center for Disease Control and Prevention, Wuhan, China
| | - Xiaoxv Yin
- School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Nan Jiang
- School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
- Nan Jiang
| | - Yeqing Tong
- Center for Disease Control and Prevention, Wuhan, China
- *Correspondence: Yeqing Tong
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11
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Belur K, Arunachalam P, Raveendran JR. An Association Between Serum Vitamin D Levels and Serum Cathelicidin Antimicrobial Peptide (CAMP) Levels Among Tuberculosis Patients in Comparison with Control Subjects. J Pharmacol Pharmacother 2022. [DOI: 10.1177/0976500x221105760] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Objectives: The objective of this study is to compare the serum vitamin D and serum cathelicidin antimicrobial peptide (CAMP) levels among tuberculosis patients and healthy subjects and to determine the association between serum vitamin D and cathelicidin in tuberculosis. Materials and Methods: This is a case-control study carried out at the pulmonary medicine and pediatrics departments of a tertiary care hospital in Chengalpattu. The study included 180 tuberculosis cases and 90 control subjects of both sexes between the age group of 1 to 80 years. Serum was used to estimate vitamin D and CAMP. The study was analyzed using SPSS version 21 (IBM Corp. Armonk, New York). The results were evaluated using the chi-square test at a 95% confidence interval, and P value <.05 was considered highly significant. Results: This study observed vitamin D deficiency, vitamin D insufficiency, and optimum vitamin D among 55%, 41%, and 3.89% tuberculosis cases, respectively. Similarly, vitamin D deficiency, vitamin D insufficiency, and optimum vitamin D were seen in 40%, 50%, and 10% healthy controls, respectively. Conclusion: This study found no association between serum vitamin D and serum CAMP levels in tuberculosis patients and healthy controls.
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Affiliation(s)
- Kiran Belur
- Department of Pharmacology, SRM MCH and RC, Potheri, Chengalpattu, Tamil Nadu, India
| | - Prema Arunachalam
- Department of Paediatrics, SRM MCH and RC, Potheri, Chengalpattu, Tamil Nadu, India
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Tanaka H, Asakura T, Suzuki S, Okamori S, Kusumoto T, Ogawa T, Uno S, Morita A, Lee H, Namkoong H, Kamata H, Sato Y, Uwamino Y, Nishimura T, Ishii M, Fukunaga K, Hasegawa N. Osteoporosis in nontuberculous mycobacterial pulmonary disease: a cross-sectional study. BMC Pulm Med 2022; 22:202. [PMID: 35596169 PMCID: PMC9123794 DOI: 10.1186/s12890-022-01991-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2021] [Accepted: 05/05/2022] [Indexed: 11/29/2022] Open
Abstract
Background Since nontuberculous mycobacterial pulmonary disease (NTM-PD) is common in middle-aged/elderly slender women at risk of osteoporosis, we hypothesized that NTM-PD could be associated with osteoporosis. The study aimed to evaluate the prevalence of osteoporosis in patients with NTM-PD compared with that in the general population and determine the factors associated with osteoporosis in the subjects, including the serum estradiol (E2) and 25-hydroxyvitamin D (25OHD) levels. Methods We have recruited 228 consecutive adult patients with NTM-PD from a prospective cohort study at the Keio University Hospital, who had no history of osteoporosis or osteoporosis-associated bone fracture but underwent dual-energy X-ray absorptiometry-based bone mineral density (BMD) evaluation from August 2017–September 2019. The E2 and 25OHD levels were measured in 165 patients with available stored serum samples. We performed multivariable logistic regression analyses for osteopenia and osteoporosis. Results Osteoporosis (T-score ≤ − 2.5) and osteopenia (T-score − 1 to − 2.5) were diagnosed in 35.1% and 36.8% of patients with NTM-PD, respectively. Compared with the general population, the proportion of osteoporosis was significantly higher in 50–59-, 60–69-, and 70–79-year-old women with NTM-PD. Multivariable analysis revealed that older age (adjusted odds ratio [aOR] for 1-year increase = 1.12; 95% confidence interval [CI] = 1.07–1.18), female sex (aOR = 36.3; 95% CI = 7.57–174), lower BMI (aOR for 1 kg/m2 decrease = 1.37; 95% CI = 1.14–1.65), and chronic Pseudomonas aeruginosa (PA) infection (aOR = 6.70; 95% CI = 1.07–41.8) were independently associated with osteoporosis. Additionally, multivariable analysis in 165 patients whose serum E2 and 25OHD levels were measured showed that both low E2 levels (< 10 pg/mL) and lower 25OHD levels were independently associated with osteoporosis. Conclusions Middle-aged/elderly women with NTM-PD have a higher prevalence of osteoporosis than the general population. BMD screening should be considered in NTM-PD, especially in older females with severe diseases such as chronic PA infection and lower BMI, and low serum E2 and 25OHD levels. Supplementary Information The online version contains supplementary material available at 10.1186/s12890-022-01991-3.
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Affiliation(s)
- Hiromu Tanaka
- Division of Pulmonary Medicine, Department of Medicine, Keio University School of Medicine, 35 Shinanomachi, Shinjuku, Tokyo, 160-8582, Japan
| | - Takanori Asakura
- Division of Pulmonary Medicine, Department of Medicine, Keio University School of Medicine, 35 Shinanomachi, Shinjuku, Tokyo, 160-8582, Japan.
| | - Shoji Suzuki
- Division of Pulmonary Medicine, Department of Medicine, Keio University School of Medicine, 35 Shinanomachi, Shinjuku, Tokyo, 160-8582, Japan
| | - Satoshi Okamori
- Division of Pulmonary Medicine, Department of Medicine, Keio University School of Medicine, 35 Shinanomachi, Shinjuku, Tokyo, 160-8582, Japan
| | - Tatsuya Kusumoto
- Division of Pulmonary Medicine, Department of Medicine, Keio University School of Medicine, 35 Shinanomachi, Shinjuku, Tokyo, 160-8582, Japan
| | - Takunori Ogawa
- Division of Pulmonary Medicine, Department of Medicine, Keio University School of Medicine, 35 Shinanomachi, Shinjuku, Tokyo, 160-8582, Japan
| | - Shunsuke Uno
- Department of Infectious Diseases, Keio University School of Medicine, 35 Shinanomachi, Shinjuku, Tokyo, 160-8582, Japan
| | - Atsuho Morita
- Division of Pulmonary Medicine, Department of Medicine, Keio University School of Medicine, 35 Shinanomachi, Shinjuku, Tokyo, 160-8582, Japan
| | - Ho Lee
- Division of Pulmonary Medicine, Department of Medicine, Keio University School of Medicine, 35 Shinanomachi, Shinjuku, Tokyo, 160-8582, Japan
| | - Ho Namkoong
- Department of Infectious Diseases, Keio University School of Medicine, 35 Shinanomachi, Shinjuku, Tokyo, 160-8582, Japan
| | - Hirofumi Kamata
- Division of Pulmonary Medicine, Department of Medicine, Keio University School of Medicine, 35 Shinanomachi, Shinjuku, Tokyo, 160-8582, Japan
| | - Yasunori Sato
- Department of Preventive Medicine and Public Health, Keio University School of Medicine, 35 Shinanomachi, Shinjuku, Tokyo, 160-8582, Japan
| | - Yoshifumi Uwamino
- Department of Laboratory Medicine, Keio University School of Medicine, 35 Shinanomachi, Shinjuku, Tokyo, 160-8582, Japan
| | | | - Makoto Ishii
- Division of Pulmonary Medicine, Department of Medicine, Keio University School of Medicine, 35 Shinanomachi, Shinjuku, Tokyo, 160-8582, Japan
| | - Koichi Fukunaga
- Division of Pulmonary Medicine, Department of Medicine, Keio University School of Medicine, 35 Shinanomachi, Shinjuku, Tokyo, 160-8582, Japan
| | - Naoki Hasegawa
- Department of Infectious Diseases, Keio University School of Medicine, 35 Shinanomachi, Shinjuku, Tokyo, 160-8582, Japan
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Buonsenso D, Pata D, Turriziani Colonna A, Ferrari V, Salerno G, Valentini P. Vitamin D and tuberculosis in children: a role in the prevention or treatment of the disease? Monaldi Arch Chest Dis 2022; 92. [PMID: 35352542 DOI: 10.4081/monaldi.2022.2112] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2021] [Accepted: 03/24/2022] [Indexed: 11/23/2022] Open
Abstract
Despite the growing number of published studies, the role of vitamin D in the prevention or treatment of tuberculosis remains unclear. In this review we analyze current scientific literature to provide evidence about the relationship between vitamin D and TB, with a special focus on the pediatric population. While in vitro studies have shown relevant antimycobacterial immune-stimulatory and immunosuppressive effects of vitamin D, this has not panned out in vivo with active TB. On the contrary, there is some evidence that this tool could work as prevention - both against TB infection as well as progression from latent to active infection. However, only a few studies have evaluated this correlation in children. The potential link between tuberculosis and vitamin D levels is promising. If effective, vitamin D supplementation of at-risk populations would be an affordable public health intervention, particularly in light of the worldwide increase in identified TB cases and drug-resistance. Vitamin D might represent a new, affordable, safe and easy to access drug for the prevention and treatment of TB. For stronger evidence, considering the features of infection (relative low incidence of reactivation of latent infection in immunocompetent patients) we need clinical trials with large numbers of participants conducted in endemic regions with a prolonged follow-up time.
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Affiliation(s)
- Danilo Buonsenso
- Department of Woman and Child Health and Public Health, Fondazione Policlinico Universitario "Agostino Gemelli", Rome.
| | - Davide Pata
- Institute of Pediatrics, Catholic University of Sacred Heart, Rome.
| | | | - Vittoria Ferrari
- Institute of Pediatrics, Catholic University of Sacred Heart, Rome.
| | - Gilda Salerno
- Institute of Pediatrics, Catholic University of Sacred Heart, Rome.
| | - Piero Valentini
- Department of Woman and Child Health and Public Health, Fondazione Policlinico Universitario "Agostino Gemelli", Rome; Institute of Pediatrics, Catholic University of Sacred Heart, Rome.
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14
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Acen EL, Biraro IA, Bbuye M, Kateete DP, Joloba ML, Worodria W. Hypovitaminosis D among newly diagnosed pulmonary TB patients and their household contacts in Uganda. Sci Rep 2022; 12:5296. [PMID: 35351933 PMCID: PMC8964708 DOI: 10.1038/s41598-022-09375-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2021] [Accepted: 03/22/2022] [Indexed: 11/29/2022] Open
Abstract
An estimated one billion people globally live with hypovitaminosis D. Studies have indicated that vitamin D deficiency is a risk factor for active tuberculosis (TB) disease. The aim of this study was to determine the association between vitamin D deficiency and TB status among patients with active TB, latent TB infection (LTBI) and those without TB infection. In a cross-sectional study of active TB patients, LTBI, QuantiFERON GOLD testpositive and (QFN+TST+) household contact and controls QuantiFERON GOLD testnegative (QFN-TST-) samples vitamin D levels were compared. Vitamin D status was determined by measurement of total vitamin D levels with 56 samples of active TB patients, 17 with LTBI, and 22 without TB infection using electrochemiluminescence. The median interquartile range (IQR) age of the study participants was 28 (20-35) years, and the majority (63%) were females. The median (IQR) vitamin D levels were 18 ng/ml (14-24). All groups had vitamin D hypovitaminosis with significantly lower levels among active TB patients (17 ng/ml, 13, 2) than among LTBI individuals (23 ng/ml 16-29) and those without TB infection (22 ng/ml, 17-28).
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Affiliation(s)
- Ester Lilian Acen
- Department of Physiology, School of Biomedical Sciences, College of Health Sciences, Makerere University, Kampala, Uganda.
| | - Irene Andia Biraro
- Department of Internal Medicine, School of Medicine, College of Health Sciences Unit Makerere University, Kampala, Uganda
- Medical Research Council/Uganda Virus Research Institute and London School of Hygiene and Tropical Medicine Uganda Research Unit, Entebbe, Uganda
| | - Mudarshiru Bbuye
- Makerere Lung Institute College of Health Sciences Makerere University, Kampala, Uganda
| | - David Patrick Kateete
- Department of Immunology and Molecular Biology, School of Biomedical Sciences, College of Health Sciences, Makerere University, Kampala, Uganda
| | - Moses L Joloba
- Department of Immunology and Molecular Biology, School of Biomedical Sciences, College of Health Sciences, Makerere University, Kampala, Uganda
| | - William Worodria
- Pulmonary Division, Department of Medicine, Mulago National Referral Hospital, Kampala, Uganda
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15
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Cao Y, Wang X, Liu P, Su Y, Yu H, Du J. Vitamin D and the risk of latent tuberculosis infection: a systematic review and meta-analysis. BMC Pulm Med 2022; 22:39. [PMID: 35045861 PMCID: PMC8772077 DOI: 10.1186/s12890-022-01830-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2021] [Accepted: 01/07/2022] [Indexed: 11/23/2022] Open
Abstract
Objective Latent tuberculosis infection (LTBI) may be a risk of developing tuberculosis (TB) and thus a health hazard. The aim of this meta-analysis is to explore the association between vitamin D and LTBI. Methods Databases including PubMed, Embase, Scopus, and ProQuest were electronically searched to identify observational or interventional studies that reported the association between vitamin D and LTBI. The retrieval time is limited from inception to 30 September 2021. Two reviewers independently screened literature, extracted data, and assessed risk bias of included studies. Meta-analysis was performed by using STATA 12.0 software. Results A total of 5 studies involving 2 case–control studies and 3 cohort studies were included. The meta-analysis result showed that the risk of LTBI among individuals was not associated with high vitamin D level (OR 0.51, 95% CI 0.05–5.65, P = 0.58). The result from cohort studies also suggested that relatively high vitamin D level was not a protective factor for LTBI (RR = 0.56, 95%CI 0.19–1.67, P = 0.300). Conclusions Our meta-analysis suggested that serum vitamin D levels were not associated with incidence of LTBI, and relatively high serum vitamin D level was not a protective factor for LTBI. Further RCTs are needed to verify whether sufficient vitamin D levels and vitamin D supplementation reduces the risk of LTBI. Supplementary Information The online version contains supplementary material available at 10.1186/s12890-022-01830-5.
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Niu Z, Qi Y, Zhao P, Li Y, Tao Y, Peng L, Qiao M. Short-term effects of ambient air pollution and meteorological factors on tuberculosis in semi-arid area, northwest China: a case study in Lanzhou. ENVIRONMENTAL SCIENCE AND POLLUTION RESEARCH INTERNATIONAL 2021; 28:69190-69199. [PMID: 34291414 DOI: 10.1007/s11356-021-15445-6] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/14/2021] [Accepted: 07/10/2021] [Indexed: 05/21/2023]
Abstract
To investigate the short-term effects of ambient air pollution and meteorological factors on daily tuberculosis (TB), semi-parametric generalized additive model was used to assess the impacts of ambient air pollutants and meteorological factors on daily TB case from 2005 to 2010 in Chengguan District, Lanzhou, China. Then a non-stratification parametric model and a stratification parametric model were applied to study the interactive effect of air pollutants and meteorological factors on daily TB. The results show that sulfur dioxide (SO2), nitrogen dioxide (NO2), and particulate matter with aerodynamic diameter less than 10μm (PM10) were positively correlated with daily TB case; the excess risk (ER) and 95% confidence interval (CI) were 1.79% (0.40%, 3.20%), 3.86% (1.81%, 5.96%), and 0.32% (0.02%, 0.62%), respectively. Daily TB case was positively correlated with maximum temperature, minimum temperature, average temperature, vapor pressure, and relative humidity, but negatively correlated with atmospheric pressure, wind speed, and sunshine duration. The association with average temperature was the strongest, whose ER and 95% CI were 4.43% (3.15%, 5.72%). In addition, there were significant interaction effects between air pollutants and meteorological factors on daily TB case.
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Affiliation(s)
- Zhaocheng Niu
- Gansu Key Laboratory for Environmental Pollution Prediction and Control, College of Earth and Environmental Sciences, Lanzhou University, 222 South Tianshui Road, Chengguan District, Lanzhou, 730000, Gansu Province, People's Republic of China
- Key Laboratory of Western China's Environmental Systems (Ministry of Education), College of Earth and Environmental Sciences, Lanzhou University, 222 South Tianshui Road, Chengguan District, Lanzhou, 730000, Gansu Province, People's Republic of China
| | - Yuejun Qi
- Lanzhou Municipal Health Service Center, Lanzhou, 730030, China
| | - Puqiu Zhao
- Gansu Key Laboratory for Environmental Pollution Prediction and Control, College of Earth and Environmental Sciences, Lanzhou University, 222 South Tianshui Road, Chengguan District, Lanzhou, 730000, Gansu Province, People's Republic of China
- Key Laboratory of Western China's Environmental Systems (Ministry of Education), College of Earth and Environmental Sciences, Lanzhou University, 222 South Tianshui Road, Chengguan District, Lanzhou, 730000, Gansu Province, People's Republic of China
| | - Yidu Li
- Gansu Key Laboratory for Environmental Pollution Prediction and Control, College of Earth and Environmental Sciences, Lanzhou University, 222 South Tianshui Road, Chengguan District, Lanzhou, 730000, Gansu Province, People's Republic of China
- Key Laboratory of Western China's Environmental Systems (Ministry of Education), College of Earth and Environmental Sciences, Lanzhou University, 222 South Tianshui Road, Chengguan District, Lanzhou, 730000, Gansu Province, People's Republic of China
| | - Yan Tao
- Gansu Key Laboratory for Environmental Pollution Prediction and Control, College of Earth and Environmental Sciences, Lanzhou University, 222 South Tianshui Road, Chengguan District, Lanzhou, 730000, Gansu Province, People's Republic of China.
- Key Laboratory of Western China's Environmental Systems (Ministry of Education), College of Earth and Environmental Sciences, Lanzhou University, 222 South Tianshui Road, Chengguan District, Lanzhou, 730000, Gansu Province, People's Republic of China.
| | - Lu Peng
- Gansu Key Laboratory for Environmental Pollution Prediction and Control, College of Earth and Environmental Sciences, Lanzhou University, 222 South Tianshui Road, Chengguan District, Lanzhou, 730000, Gansu Province, People's Republic of China
- Key Laboratory of Western China's Environmental Systems (Ministry of Education), College of Earth and Environmental Sciences, Lanzhou University, 222 South Tianshui Road, Chengguan District, Lanzhou, 730000, Gansu Province, People's Republic of China
| | - Mingli Qiao
- Gansu Key Laboratory for Environmental Pollution Prediction and Control, College of Earth and Environmental Sciences, Lanzhou University, 222 South Tianshui Road, Chengguan District, Lanzhou, 730000, Gansu Province, People's Republic of China
- Key Laboratory of Western China's Environmental Systems (Ministry of Education), College of Earth and Environmental Sciences, Lanzhou University, 222 South Tianshui Road, Chengguan District, Lanzhou, 730000, Gansu Province, People's Republic of China
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Li CH, Chen HJ, Chen WC, Tu CY, Hsia TC, Hsu WH, Chang CT, Huang CC, Bau DT, Chou CY. The Risk of Tuberculosis Infection in Non-dialysis Chronic Kidney Disease Patients. Front Med (Lausanne) 2021; 8:715010. [PMID: 34485344 PMCID: PMC8409506 DOI: 10.3389/fmed.2021.715010] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2021] [Accepted: 07/23/2021] [Indexed: 12/11/2022] Open
Abstract
Background: Patients with chronic kidney disease (CKD) receiving maintenance renal replacement therapy are at higher risk of tuberculosis (TB) infection. The risk of TB infection in CKD patients not receiving dialysis is unknown. Aim: We conduct this study to test the hypothesis that TB infection is negatively correlated to renal function. Design: Non-dialysis CKD stage 1–5 patients, admitted in China Medical University Hospital from January of 2003 to May of 2014, were enrolled in this study and were prospectively followed up to the diagnosis of TB, death, loss to follow-up, or December 2014. The risk factors of TB infection were analyzed using competing-risks regression analysis with time-varying covariates. The initiation of dialysis and patients' death were considered as competing events. Patients' estimated glomerular filtration rate (eGFR) and body mass index (BMI) were recorded at enrollment. Results: They were followed-up for a median duration of 1.4 years. Of the 7221 patients, TB infection was identified in 114 patients. Higher eGFR was associated with lower risk of TB infection (P < 0.01). The adjusted subdistribution hazard ratio (aSHR) was 0.82 [95% confidence interval (CI), 0.72 to 0.94] for every 5 ml/min/1.73 m2 increase in eGFR. In addition, higher BMI (p = 0.01) was associated with a lower risk of TB infection and the aSHR was 0.91 (95% CI, 0.85 to 0.98) for every 1 kg/m2 increase in BMI. Conclusion: Renal function and body mass index are independently associated with the risk of tuberculosis infection in patients with chronic kidney disease not receiving dialysis.
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Affiliation(s)
- Chia-Hsiang Li
- Graduate Institute of Biomedical Science, China Medical University, Taichung, Taiwan.,School of Medicine, China Medical University, Taichung, Taiwan.,Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, China Medical University Hospital, Taichung, Taiwan
| | - Hung-Jen Chen
- School of Medicine, China Medical University, Taichung, Taiwan.,Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, China Medical University Hospital, Taichung, Taiwan
| | - Wei-Chun Chen
- School of Medicine, China Medical University, Taichung, Taiwan.,Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, China Medical University Hospital, Taichung, Taiwan
| | - Chih-Yen Tu
- School of Medicine, China Medical University, Taichung, Taiwan.,Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, China Medical University Hospital, Taichung, Taiwan
| | - Te-Chun Hsia
- Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, China Medical University Hospital, Taichung, Taiwan.,School of Nursing, China Medical University, Taichung, Taiwan
| | - Wu-Huei Hsu
- School of Medicine, China Medical University, Taichung, Taiwan.,Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, China Medical University Hospital, Taichung, Taiwan
| | - Chiz-Tzung Chang
- School of Medicine, China Medical University, Taichung, Taiwan.,Division of Nephrology and Kidney, Department of Internal Medicine, China Medical University Hospital, Taichung, Taiwan
| | - Chiu-Ching Huang
- School of Medicine, China Medical University, Taichung, Taiwan.,Division of Nephrology and Kidney, Department of Internal Medicine, China Medical University Hospital, Taichung, Taiwan
| | - Da-Tian Bau
- School of Medicine, China Medical University, Taichung, Taiwan.,Terry Fox Cancer Research Laboratory, Department of Medical Research, China Medical University Hospital, Taichung, Taiwan.,Department of Bioinformatics and Medical Engineering, Asia University, Taichung, Taiwan
| | - Che-Yi Chou
- Division of Nephrology and Kidney, Department of Internal Medicine, China Medical University Hospital, Taichung, Taiwan.,Division of Nephrology, Asia University Hospital, Taichung, Taiwan.,Department of Post-baccalaureate Veterinary Medicine, Asia University, Taichung, Taiwan
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19
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Association of Vitamin D Deficiency and Newly Diagnosed Pulmonary Tuberculosis. Pulm Med 2021; 2021:5285841. [PMID: 33510909 PMCID: PMC7826226 DOI: 10.1155/2021/5285841] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2020] [Revised: 01/01/2021] [Accepted: 01/05/2021] [Indexed: 01/16/2023] Open
Abstract
Introduction Vitamin D has a significant role in host immune defense against Mycobacterium tuberculosis. It has been suggested that pulmonary tuberculosis may be associated with lower levels of vitamin D. Present study was therefore undertaken to identify the association between vitamin D deficiency and pulmonary tuberculosis. Methods A case-control study was conducted in a tertiary care hospital from 2014 to 2016, including 50 adult newly diagnosed sputum positive pulmonary tuberculosis patients as cases and 50 age and sex-matched healthy participants as control groups. All participants in the study group had undergone detailed clinical examination and routine laboratory investigations, including vitamin D, calcium, and sputum for AFB. The clinical characteristics, X-ray findings, sputum AFB, and vitamin D levels were analyzed and compared with data obtained from healthy controls. Results In both groups, the majority were men (88%). BMI was significantly (<0.0001∗) lower in the tuberculosis group (19.40 (17.20, 22.0) vs. 24.00 (22.50, 25.47)). Serum vitamin D levels were significantly lower (P = 0.012) in the tuberculosis group (19 (7.75, 27.25) ng/dl) as compared to the control group (25 (19.75, 32.00) ng/dl). Out of 50 TB patients, 27 (54%) had vitamin D deficiency, while among healthy controls, only 13 (26%) had vitamin D deficiency. Among vitamin D deficient PTB patients, 44% had 3+/hpf AFB in sputum smear examination. Conclusion The prevalence of vitamin D deficiency in pulmonary tuberculosis cases is very high. Hypovitaminosis D was associated with more severe clinical symptoms, higher sputum smear positivity, and extensive lesions in chest radiograph among pulmonary tuberculosis patients.
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Wang R, DeGruttola V, Lei Q, Mayer KH, Redline S, Hazra A, Mora S, Willett WC, Ganmaa D, Manson JE. The vitamin D for COVID-19 (VIVID) trial: A pragmatic cluster-randomized design. Contemp Clin Trials 2021; 100:106176. [PMID: 33045402 PMCID: PMC7547023 DOI: 10.1016/j.cct.2020.106176] [Citation(s) in RCA: 43] [Impact Index Per Article: 14.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2020] [Revised: 10/03/2020] [Accepted: 10/06/2020] [Indexed: 12/27/2022]
Abstract
OBJECTIVES To determine the effect of vitamin D supplementation on disease progression and post-exposure prophylaxis for COVID-19 infection. We hypothesize that high-dose vitamin D3 supplementation will reduce risk of hospitalization/death among those with recently diagnosed COVID-19 infection and will reduce risk of COVID-19 infection among their close household contacts. METHODS We report the rationale and design of a planned pragmatic, cluster randomized, double-blinded trial (N = 2700 in total nationwide), with 1500 newly diagnosed individuals with COVID-19 infection, together with up to one close household contact each (~1200 contacts), randomized to either vitamin D3 (loading dose, then 3200 IU/day) or placebo in a 1:1 ratio and a household cluster design. The study duration is 4 weeks. The primary outcome for newly diagnosed individuals is the occurrence of hospitalization and/or mortality. Key secondary outcomes include symptom severity scores among cases and changes in the infection (seroconversion) status for their close household contacts. Changes in vitamin D 25(OH)D levels will be assessed and their relation to study outcomes will be explored. CONCLUSIONS The proposed pragmatic trial will allow parallel testing of vitamin D3 supplementation for early treatment and post-exposure prophylaxis of COVID-19. The household cluster design provides a cost-efficient approach to testing an intervention for reducing rates of hospitalization and/or mortality in newly diagnosed cases and preventing infection among their close household contacts.
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Affiliation(s)
- Rui Wang
- Department of Population Medicine, Harvard Pilgrim Health Care Institute and Harvard Medical School, Boston, MA, USA; Department of Biostatistics, Harvard T. H. Chan School of Public Health, Boston, MA, USA.
| | - Victor DeGruttola
- Department of Biostatistics, Harvard T. H. Chan School of Public Health, Boston, MA, USA
| | | | - Kenneth H Mayer
- Fenway Health, and Department of Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA
| | - Susan Redline
- Division of Sleep Medicine and Circadian Disorders, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA
| | - Aditi Hazra
- Division of Preventive Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA
| | - Samia Mora
- Division of Preventive Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA; Division of Cardiovascular Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA
| | - Walter C Willett
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA, USA; Channing Division of Network Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA
| | - Davaasambuu Ganmaa
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA, USA; Channing Division of Network Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA
| | - JoAnn E Manson
- Division of Preventive Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA; Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA
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21
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Harishankar M, Sampath P, Athikesavan V, Chinnaiyan P, Velayutham B, Putcha UK, Tripathy SP, Ranganathan UD, Selvaraj P, Bethunaickan R. Association of rs7041 and rs4588 polymorphisms of vitamin D binding protein gene in pulmonary tuberculosis. Meta Gene 2020. [DOI: 10.1016/j.mgene.2020.100822] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023] Open
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Lin SY, Chiu YW, Yang HR, Chen TC, Hsieh MH, Wang WH, Chen YH. Association of vitamin D levels and risk of latent tuberculosis in the hemodialysis population. JOURNAL OF MICROBIOLOGY, IMMUNOLOGY, AND INFECTION = WEI MIAN YU GAN RAN ZA ZHI 2020; 54:680-686. [PMID: 32593557 DOI: 10.1016/j.jmii.2020.06.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/13/2020] [Revised: 05/04/2020] [Accepted: 06/02/2020] [Indexed: 01/06/2023]
Abstract
BACKGROUND Vitamin D is essential in the host defense against tuberculosis (TB). Suboptimal vitamin D status is common in the hemodialysis population. Hemodialysis patients have an increased risk compared to the general population latent tuberculosis infection (LTBI). However, the association between vitamin D deficiency and LTBI in this population remains unclear. MATERIALS AND METHODS We conducted a cross-sectional study between March and May 2017. Interferon-gamma release assay (IGRA) through QuantiFERON-TB Gold In-Tube was used to assess LTBI. Plasma 25-hydroxycholecalciferol (25-OHD) levels were measured by Elecsys Vitamin D Total assay. Suboptimal vitamin D levels included vitamin D insufficiency 20-29 ng/mg and vitamin D deficiency <20 ng/mL. Predictors for LTBI were analyzed. RESULTS A total of 287 participants were enrolled. The suboptimal vitamin D level was 31.4% (90/287), which including the vitamin D deficiency was 13.9% (40/287). A total of 49.1% (141/287) people received nutritional vitamin D supplementation. The prevalence of IGRA positivity in this study was 25.1% (72/287). There was no significant difference in vitamin D concentrations or the proportion of vitamin D supplementation among the IGRA-positive and IGRA-negative groups (p = 0.789 and 0.496, respectively). In multivariate analysis, age >65 years old (odds ratio (OR), 1.89; 95% CI, 1.08-3.31; p = 0.026) and TB history (OR, 3.51; 95% CI, 1.38-8.91; p = 0.008) were independent predictors of IGRA positivity. CONCLUSION This is the first study to report that vitamin D deficiency was not associated with IGRA positivity in a hemodialysis population. Aging and TB history were both independent predictors for LTBI.
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Affiliation(s)
- Shang-Yi Lin
- Division of Infectious Diseases, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan; Graduate Institute of Clinical Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan; Sepsis Research Center, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan; Department of Laboratory Medicine, Kaohsiung Medical University Hospital, Taiwan
| | - Yi-Wen Chiu
- Division of Nephrology, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan; Department of Renal Care, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Hui-Ru Yang
- Department of Laboratory Medicine, Kaohsiung Medical University Hospital, Taiwan
| | - Tun-Chieh Chen
- Division of Infectious Diseases, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan; Department of Internal Medicine, Kaohsiung Municipal Ta-Tung Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Min-Han Hsieh
- Department of Internal Medicine, Kaohsiung Municipal Ta-Tung Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Wen-Hung Wang
- Division of Infectious Diseases, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan; Center for Tropical Medicine and Infectious Disease, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Yen-Hsu Chen
- Division of Infectious Diseases, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan; Department of Internal Medicine, Kaohsiung Municipal Ta-Tung Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan; Center for Tropical Medicine and Infectious Disease, Kaohsiung Medical University, Kaohsiung, Taiwan; Department of Biological Science and Technology, College of Biological Science and Technology, National Chiao Tung University, Hsinchu, Taiwan.
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23
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Xu P, Gao QL, Wang YJ, Guo CF, Tang MX, Liu SH, Deng A, Wang YX, Li YB, Zhang HQ. rs6127698 polymorphism in the MC3R gene and susceptibility to multifocal tuberculosis in southern Chinese Han population. INFECTION GENETICS AND EVOLUTION 2020; 82:104292. [PMID: 32240798 DOI: 10.1016/j.meegid.2020.104292] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/13/2019] [Revised: 02/15/2020] [Accepted: 03/19/2020] [Indexed: 11/17/2022]
Abstract
OBJECTIVE To investigate the relationship between melanocortin-3 receptor (MC3R) gene polymorphism and tuberculosis (TB) susceptibility in Han population in southern China. METHODS A total of 341 patients with TB (173 with pulmonary TB and 168 with multifocal TB) and 359 healthy controls were enrolled. Genotyping was performed by PCR and DNA sequencing, and detection of protein was performed by western blot. RESULTS The distributions of genotype and allele frequencies of rs6127698 differed significantly between the pulmonary and multifocal TB groups, and between the multifocal TB and control groups. The GG genotype was significantly more common among multifocal TB patients than among pulmonary TB patients (P = .009) and those in the control group (P = .001) under the recessive model. GG+GT genotype was more common in multifocal TB than in pulmonary TB (P < .01) and control group (P < .01) under the dominant model. G allele was more common in multifocal TB than in pulmonary TB (P < .0167) and control group (P < .0167). Patients with multifocal TB had an increased expression of MC3R protein than healthy controls (P < .05). CONCLUSIONS In the southern Chinese Han population, the MC3R rs6127698 polymorphism, which accompanying an increased expression of MC3R protein,was associated with susceptibility to multifocal TB. Presence of the G allele increased the risk of developing multifocal TB.
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Affiliation(s)
- Peng Xu
- Department of Spine Surgery, Xiangya Spinal Surgery Center, Xiangya Hospital, Central South University, Changsha 410008, People's Republic of China
| | - Qi-le Gao
- Department of Spine Surgery, Xiangya Spinal Surgery Center, Xiangya Hospital, Central South University, Changsha 410008, People's Republic of China
| | - Yun-Jia Wang
- Department of Spine Surgery, Xiangya Spinal Surgery Center, Xiangya Hospital, Central South University, Changsha 410008, People's Republic of China.
| | - Chao-Feng Guo
- Department of Spine Surgery, Xiangya Spinal Surgery Center, Xiangya Hospital, Central South University, Changsha 410008, People's Republic of China
| | - Ming-Xing Tang
- Department of Spine Surgery, Xiangya Spinal Surgery Center, Xiangya Hospital, Central South University, Changsha 410008, People's Republic of China
| | - Shao-Hua Liu
- Department of Spine Surgery, Xiangya Spinal Surgery Center, Xiangya Hospital, Central South University, Changsha 410008, People's Republic of China
| | - Ang Deng
- Department of Spine Surgery, Xiangya Spinal Surgery Center, Xiangya Hospital, Central South University, Changsha 410008, People's Republic of China
| | - Yu-Xiang Wang
- Department of Spine Surgery, Xiangya Spinal Surgery Center, Xiangya Hospital, Central South University, Changsha 410008, People's Republic of China
| | - Yan-Bing Li
- Department of Clinical Laboratory, Xiangya Hospital, Central South University, Changsha 410008, People's Republic of China
| | - Hong-Qi Zhang
- Department of Spine Surgery, Xiangya Spinal Surgery Center, Xiangya Hospital, Central South University, Changsha 410008, People's Republic of China
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Chokuda E, Reynolds C, Das S. Association of Low Vitamin D with Complications of HIV and AIDS: A literature Review. Infect Disord Drug Targets 2020; 20:122-142. [PMID: 30574856 DOI: 10.2174/1871526519666181221122731] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2018] [Revised: 12/13/2018] [Accepted: 12/14/2018] [Indexed: 06/09/2023]
Abstract
With the advent of combination antiretroviral therapy (cART), the survival of HIV patients has improved dramatically, but the complications of the disease and treatment have become an important issue in the management of HIV patients. Vitamin-D deficiency is common in HIV patients. Low vitamin-D is associated with different comorbidities in the HIV uninfected general population. In this review, we first briefly describe vitamin D synthesis and mechanism of action and we focus on the epidemiological and clinical data dealing with the relationship between vitamin D deficiency in HIV infection with several comorbidities which has been found to be increasingly common in patients living with HIV infection. We searched the PubMed database using the keywords "HIV," "vitamin D" and other common disorders or conditions that are relatively common in HIV infection. The other conditions included in the search were osteoporosis and fracture, cardiovascular disease, diabetes and insulin resistance, active tuberculosis, hepatitis-C co-infection, and HIV disease progression. Articles presenting original data as well as systematic reviews and met analysis related to HIV population were included in our analysis. Vitamin-D deficiency seems to be associated with several adverse outcomes in HIV patients but a definite cause and effect relationship with vitamin-D is yet to be confirmed in most of the cases. However, the literature supporting the efficacy of vitamin-D supplementation is lacking.
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Affiliation(s)
- Evelyn Chokuda
- Department of HIV Medicine, Coventry & Warwickshire Partnership Trust, Coventry, United Kingdom
| | - Chris Reynolds
- Department of HIV Medicine, Coventry & Warwickshire Partnership Trust, Coventry, United Kingdom
| | - Satyajit Das
- Department of HIV Medicine, Coventry & Warwickshire Partnership Trust, Coventry, United Kingdom
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25
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Martín Giménez VM, Ferder L, Inserra F, García J, Manucha W. Differences in RAAS/vitamin D linked to genetics and socioeconomic factors could explain the higher mortality rate in African Americans with COVID-19. Ther Adv Cardiovasc Dis 2020; 14:1753944720977715. [PMID: 33283618 PMCID: PMC7724257 DOI: 10.1177/1753944720977715] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/20/2020] [Accepted: 11/06/2020] [Indexed: 12/13/2022] Open
Abstract
COVID-19 is said to be a pandemic that does not distinguish between skin color or ethnic origin. However, data in many parts of the world, especially in the United States, begin to show that there is a sector of society suffering a more significant impact from this pandemic. The Black population is more vulnerable than the White population to infection and death by COVID-19, with hypertension and diabetes mellitus as probable predisposing factors. Over time, multiple disparities have been observed between the health of Black and White populations, associated mainly with socioeconomic inequalities. However, some mechanisms and pathophysiological susceptibilities begin to be elucidated that are related directly to the higher prevalence of multiple diseases in the Black population, including infection and death by COVID-19. Plasma vitamin D levels and evolutionary adaptations of the renin-angiotensin-aldosterone system (RAAS) in Black people differ considerably from those of other races. The role of these factors in the development and progression of hypertension and multiple lung diseases, among them SARS-CoV-2 infection, is well established. In this sense, the present review attempts to elucidate the link between vitamin D and RAAS ethnic disparities and susceptibility to infection and death by COVID-19 in Black people, and suggests possible mechanisms for this susceptibility.
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Affiliation(s)
- Virna Margarita Martín Giménez
- Instituto de Investigaciones en Ciencias
Químicas, Facultad de Ciencias Químicas y Tecnológicas, Universidad Católica
de Cuyo, San Juan, Argentina
| | - León Ferder
- Universidad Maimónides, Buenos Aires,
Argentina
| | | | - Joxel García
- AMBITNA, Ambitious Solutions for Health Cures,
Chevy Chase, MD, USA
| | - Walter Manucha
- Instituto de Medicina y Biología Experimental de
Cuyo (IMBECU), Consejo Nacional de Investigaciones Científicas y
Tecnológicas (CONICET), Mendoza, Argentina
- Departamento de Patología, Facultad de Ciencias
Médicas, Área de Farmacología, Universidad Nacional de Cuyo, Libertador 80,
Mendoza, 5500, Argentina
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26
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Yang H, Zhang H, Li Y, Xiang L, Liu J. BCG stimulation promotes dendritic cell proliferation and expression of VDR and CYP27B1 in vitamin D‑deficient mice. Mol Med Rep 2019; 20:5265-5271. [PMID: 31702812 DOI: 10.3892/mmr.2019.10780] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2018] [Accepted: 06/12/2019] [Indexed: 11/05/2022] Open
Abstract
Vitamin D deficiency may lead to an increased risk of tuberculosis. In the present study, the effects of Mycobacterium tuberculosis (Mtb) infection on dendritic cells (DCs) derived from vitamin D‑deficient mice or normal control mice were investigated. A vitamin D‑deficient mouse model was established, and bone marrow‑derived DCs (BMDCs) were isolated and treated with GM‑CSF and interleukin (IL)‑4 for 6 days, followed by an additional 24 h of treatment with Bacillus Calmette‑Guérin (BCG). The expression levels of surface molecules of DCs, including integrin alpha‑X and T‑lymphocyte activation antigen CD86, were significantly increased by BCG in the vitamin D‑deficient mice model group compared with the control group, while those of T‑lymphocyte activation antigen CD80, major histocompatibility complex class I and major histocompatibility complex class II were significantly decreased. These changes were BCG concentration‑dependent. In addition, the levels of IL‑4, IL‑6 and IL‑10 in the BMDCs from the vitamin D‑deficient mice were significantly decreased compared with the control mice, while the levels of tumor necrosis factor‑α, IL‑5, IL‑2, IL‑12 and interferon‑γ were significantly increased. Furthermore, the expression levels of vitamin D receptor (VDR) and CYP27B1 protein in the BMDCs from the vitamin D‑deficient mice were decreased compared with the control. BCG significantly increased the expression levels of VDR and CYP27B1 in the BMDCs. The DCs treated with BCG significantly induced the viability of CD4+ T lymphocytes. Therefore, BCG increases DCs and may enhance immunofunction, which may assist in preventing the risk of tuberculosis in patients with a vitamin D deficiency.
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Affiliation(s)
- Huifeng Yang
- Department of Orthopedics, General Hospital of Northern Theater Command, Shenyang, Liaoning 110015, P.R. China
| | - Haocong Zhang
- Department of Orthopedics, General Hospital of Northern Theater Command, Shenyang, Liaoning 110015, P.R. China
| | - Yu Li
- Department of Orthopedics, General Hospital of Northern Theater Command, Shenyang, Liaoning 110015, P.R. China
| | - Liangbi Xiang
- Department of Orthopedics, General Hospital of Northern Theater Command, Shenyang, Liaoning 110015, P.R. China
| | - Jun Liu
- Department of Orthopedics, General Hospital of Northern Theater Command, Shenyang, Liaoning 110015, P.R. China
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Ganmaa D, Khudyakov P, Buyanjargal U, Jargalsaikhan B, Baigal D, Munkhjargal O, Yansan N, Bolormaa S, Lkhagvasuren E, Sempos CT, Bromage S, Wu Z, Ochirbat B, Gunchin B, Martineau AR. Prevalence and Determinants of QuantiFERON-Diagnosed Tuberculosis Infection in 9810 Mongolian Schoolchildren. Clin Infect Dis 2019; 69:813-819. [PMID: 30481273 PMCID: PMC6695506 DOI: 10.1093/cid/ciy975] [Citation(s) in RCA: 25] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2018] [Accepted: 11/26/2018] [Indexed: 12/18/2022] Open
Abstract
BACKGROUND There is controversy regarding the potential influence of vitamin D deficiency, exposure to environmental tobacco smoke, BCG vaccination, season, and body habitus on susceptibility to Mycobacterium tuberculosis (MTB) infection. METHODS We conducted a cross-sectional analysis to identify determinants of a positive QuantiFERON-TB Gold (QFT) assay result in children aged 6-13 years attending 18 schools in Ulaanbaatar, Mongolia. Data relating to potential risk factors for MTB infection were collected by questionnaire, physical examination, and determination of serum 25-hydroxyvitamin D (25[OH]D) concentrations. Risk ratios (RRs) were calculated with adjustment for potential confounders, and population attributable fractions (PAFs) were calculated for modifiable risk factors identified. RESULTS Nine hundred forty-six of 9810 (9.6%) participants had a positive QFT result. QFT positivity was independently associated with household exposure to pulmonary tuberculosis (adjusted RR [aRR], 4.75 [95% confidence interval {CI}, 4.13-5.46, P < .001]; PAF, 13.1% [95% CI, 11.1%-15.0%]), vitamin D deficiency (aRR, 1.23 [95% CI, 1.08-1.40], P = .002; PAF, 5.7% [95% CI, 1.9%-9.3%]), exposure to environmental tobacco smoke (1 indoor smoker, aRR, 1.19 [95% CI, 1.04-1.35]; ≥2 indoor smokers, aRR, 1.30 [95% CI, 1.02-1.64]; P for trend = .006; PAF, 7.2% [95% CI, 2.2%-12.0%]), and increasing age (aRR per additional year, 1.14 [95% CI, 1.10-1.19], P < .001). No statistically significant independent association was seen for presence of a BCG scar, season of sampling, or body mass index. CONCLUSIONS Vitamin D deficiency and exposure to environmental tobacco smoke are potentially modifiable risk factors for MTB infection.
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Affiliation(s)
- Davaasambuu Ganmaa
- Harvard T. H. Chan School of Public Health, Boston, Massachusetts
- Mongolian Health Initiative, Ulaanbaatar
| | - Polyna Khudyakov
- Harvard T. H. Chan School of Public Health, Boston, Massachusetts
| | - Uyanga Buyanjargal
- Office of Dietary Supplements, National Institutes of Health, Bethesda, Maryland
| | | | | | | | | | | | - Enkhsaikhan Lkhagvasuren
- Mongolian Health Initiative, Ulaanbaatar
- Mongolian National Health Sciences University, Ulaanbaatar
| | - Christopher T Sempos
- Office of Dietary Supplements, National Institutes of Health, Bethesda, Maryland
| | | | - Zhenqiang Wu
- School of Population Health, University of Auckland, New Zealand
| | | | - Batbaatar Gunchin
- Mongolian Health Initiative, Ulaanbaatar
- Mongolian National Health Sciences University, Ulaanbaatar
| | - Adrian R Martineau
- Blizard Institute, Barts and London School of Medicine and Dentistry, Queen Mary University of London, United Kingdom
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Teixeira HC, Dias LDS, Bizarro HDDS, Castro JMDA. Efeitos contrastantes da vitamina D sobre a resposta imune inata e adquirida e seu impacto na recuperação da tuberculose. HU REVISTA 2019. [DOI: 10.34019/1982-8047.2018.v44.22232] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
A vitamina D é um hormônio essencial para o organismo, podendo ser obtida da dieta ou, principalmente, gerada pela pele após exposição à luz solar ultravioleta B. Na sua forma ativa (1,25(OH)2D) ela controla a absorção de cálcio e fósforo do intestino para a corrente sanguínea e participa de diversos processos celulares e fisiológicos. A ligação da 1,25(OH)2D ao receptor da vitamina D (VDR) presente em diversas células, como as células do sistema imunológico, induz a transcrição de genes que podem, por exemplo, modular a resposta imune inata e adquirida. A deficiência de vitamina D ou do VDR é associada a problemas de saúde como desordens esqueléticas, hipertensão, doenças cardiovasculares, diabetes mellitus, dislipidemias, doenças autoimunes e doenças infecciosas. Neste sentido, a suplementação com vitamina D tem sido proposta como uma possível medida preventiva, podendo ser aplicada em muitas patologias, em especial na tuberculose. Principal causa de morte por um único agente infeccioso, a tuberculose é responsável por cerca de 1,3 milhões de óbitos por ano no mundo. Publicações recentes apontam efeitos diversos da vitamina D na resposta imune inata e adquirida. A 1,25(OH)2D3 na presença do interferon (IFN)-γ é capaz de aumentar a atividade bactericida do macrófago contra o M. tuberculosis, aumentando a produção de peptídios antimicrobianos e estimulando a autofagia, favorecendo assim a lise de bacilos localizados em fagossomos. Por outro lado, a vitamina D em linfócitos T mostra efeito tolerogênico que favorece o controle de respostas inflamatórias excessivas. Neste trabalho de revisão são apresentados estudos recentes envolvendo efeitos da vitamina D na resposta imune inata e adquirida. Além disso, considerações sobre deficiência de vitamina D e maior risco de contrair tuberculose, e efeitos contrastantes da suplementação com vitamina D na prevenção e tratamento da TB, são discutidos.
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29
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Manabe T, Takasaki J, Kudo K. Seasonality of newly notified pulmonary tuberculosis in Japan, 2007-2015. BMC Infect Dis 2019; 19:497. [PMID: 31170932 PMCID: PMC6555020 DOI: 10.1186/s12879-019-3957-8] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2018] [Accepted: 04/08/2019] [Indexed: 12/15/2022] Open
Abstract
BACKGROUND The seasonality of pulmonary tuberculosis (TB) incidence may indicate season-specific risk factors that could be controlled if they were better understood. The aims of this study were to elucidate how the incidence of TB changes seasonally and to determine the factors influencing TB incidence, to reduce the TB burden in Japan. METHODS We assessed the seasonality of newly notified TB cases in Japan using national surveillance data collected between 2007 and 2015. To investigate age and sex differences, seasonal variation was analyzed according to sex for all cases and then by stratified age groups (0-4, 5-14, 15-24, 25-44, 45-64, 65-74, and ≥ 75 years). We used Roger's test to analyze the cyclic monthly trends in seasonal variation of TB incidence. RESULTS A total of 199,856 newly notified TB cases (male, 62.2%) were reported over the past 9-year period. Among them, 60.6% involved patients aged ≥65 years. Overall, the peak months of TB incidence occurred from April to October, excluding September. In the analysis stratified by age group, a significant seasonal variation in TB cases was observed for age groups ≥15 years, whereas no seasonal variation was observed for age groups ≤14 years. For female patients aged ≥25 years, the peak TB epidemic period was seen from June to December, excluding November. Male patients in the same age groups exhibited declining TB incidence from September to March. CONCLUSIONS TB incidence exhibits seasonality in Japan for people aged > 15 years and peaks in summer to fall. Monthly trends differ according to age and sex. For age groups ≥25 years, cases in women showed longer peaks from June to December whereas cases in men declined from September to December. These results suggest that the seasonality of TB incidence in Japan might be influenced by health checkups in young adults, reactivation of latent TB infection with aging, and lifestyle habits in older adults. These findings can contribute to establishing the potential determinants of TB seasonality in Japan.
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Affiliation(s)
- Toshie Manabe
- Division of Community and Family Medicine, Center for Community Medicine, Jichi Medical University, 333-1 Yakushiji, Shimotsuke, Tochigi, Japan. .,Waseda University Organization of Regional and Inter-Regional Studies, Tokyo, Japan. .,Department of Hygiene and Public Health, Teikyo University School of Medicine, Tokyo, Japan.
| | - Jin Takasaki
- Department of Respiratory Medicine, National Center for Global Health and Medicine, Tokyo, Japan
| | - Koichiro Kudo
- Waseda University Organization of Regional and Inter-Regional Studies, Tokyo, Japan
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Khan A, Rebhan A, Seminara D, Szerszen A. Enduring Challenge of Latent Tuberculosis in Older Nursing Home Residents: A Brief Review. J Clin Med Res 2019; 11:385-390. [PMID: 31143304 PMCID: PMC6522238 DOI: 10.14740/jocmr3763] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2019] [Accepted: 03/04/2019] [Indexed: 12/17/2022] Open
Abstract
Tuberculosis (TB) kills almost 4,000 people a day and is competing with human immunodeficiency virus/acquired immune deficiency syndrome (HIV/AIDS) as the most deadly infectious disease in the world. The gold standards of detection and management of latent tuberculosis infection (LTBI) have not been successful in complete eradication of the disease. Current screening modalities of TB include tuberculin skin testing (TST) and/or interferon-γ release assay (IGRA). However, these screening tests have been heavily studied in healthy populations but not in the elderly who are more likely to have multiple risk factors for progression to active TB from LTBI. The largest population that is harboring LTBI is the elderly, specifically those residing in nursing homes. Yet, unfortunately, guidelines for standards of detection and treatment for this specific group are lacking. In this review, we look at TST versus IGRA screening for LTBI in the elderly living in nursing homes. We review a cross-sectional study done at Staten Island University Hospital, and several other assessments of the sensitivity and accuracy of both screening tools. Furthermore, this review looks at the appropriateness of current LTBI treatment and prophylaxis in elderly patients residing in close quarters. The reviews point to the superiority of IGRA testing in the elderly for screening LTBI. The IGRA has been shown to be more sensitive to the detection of LTBI than TST. Additionally, medical complexities that the elderly population possesses may present challenges and resistance to standard treatments of LTBI. It is recommended via the literature that the addition of vitamin D, or alternative therapies (e.g. rifampin) could produce better outcomes for elderly patients with LTBI than the current 9 months of isoniazid (INH). As the older adults represent the fastest growing segment of our population and the largest LTBI reservoir in the USA, revisiting screening and treatment of LTBI in the elderly living in nursing homes may prove to lead to a path of TB eradication once and for all.
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Affiliation(s)
- Asif Khan
- Department of Internal Medicine, Staten Island University Hospital, Staten Island, NY, USA
| | - Anh Rebhan
- Department of Internal Medicine, Staten Island University Hospital, Staten Island, NY, USA
| | - Donna Seminara
- Department of Internal Medicine, Staten Island University Hospital, Staten Island, NY, USA
| | - Anita Szerszen
- Department of Internal Medicine, Staten Island University Hospital, Staten Island, NY, USA
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Kayomo MK, Hasker E, Aloni M, Nkuku L, Kazadi M, Kabengele T, Muteteke D, Kapita F, Lufulwabo A, Mukadi YD, Muyembe-Tamfum JJ, Ieven M, de Jong BC, Boelaert M. Outbreak of Tuberculosis and Multidrug-Resistant Tuberculosis, Mbuji-Mayi Central Prison, Democratic Republic of the Congo. Emerg Infect Dis 2019; 24:2029-2035. [PMID: 30334730 PMCID: PMC6199999 DOI: 10.3201/eid2411.180769] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
After an alert regarding ≈31 tuberculosis (TB) cases, 3 of which were rifampin-resistant TB cases, in Mbuji-Mayi Central Prison, Democratic Republic of the Congo, we conducted an outbreak investigation in January 2015. We analyzed sputum of presumptive TB patients by using the Xpert MTB/RIF assay. We also assessed the Mycobacterium tuberculosis isolates' drug-susceptibility patterns and risk factors for TB infection. Among a prison population of 918 inmates, 29 TB case-patients were already undergoing treatment. We found an additional 475 presumptive TB case-patients and confirmed TB in 170 of them. In March 2015, the prevalence rate of confirmed TB was 21.7% (199/918 inmates). We detected an additional 14 cases of rifampin-resistant TB and initiated treatment in all 14 of these case-patients. Overcrowded living conditions and poor nutrition appeared to be the driving factors behind the high TB incidence in this prison.
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Buonsenso D, Sali M, Pata D, Masiello E, Salerno G, Ceccarelli M, Delogu G, Valentini P. Vitamin D Levels in Active TB, Latent TB, Non-TB Pneumonia and Healthy Children: A Prospective Observational Study. Fetal Pediatr Pathol 2018; 37:337-347. [PMID: 30260729 DOI: 10.1080/15513815.2018.1509407] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Abstract
BACKGROUND Growing evidence suggests that vitamin D deficiency might be implicated in the development of active tuberculosis (TB). We evaluated vitamin D levels in children with active TB compared to children with latent TB infection (LTBI), non-TB pneumonia (NTBP) and healthy controls to determine if there was a difference. METHODS In this prospective study, vitamin D levels were measured and compared between the four groups and adjusted for age, ethnicity, gender and season of sample collection. RESULTS Fifty-seven children were included: 24.6% active TB, 28.1% LTBI, 22.8% NPTB and 24.6% healthy controls. 36.8% of all children tested had an insufficient or deficient vitamin D level. Vitamin D level was significantly lower in active TB compared to other groups (p = 0.004). CONCLUSIONS Our study showed a correlation between hypovitaminosis D and active pulmonary TB.
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Affiliation(s)
- Danilo Buonsenso
- a Department of Pediatrics, Fondazione Policlinico Universitario A. Gemelli, IRCCS , Roma , Italy
| | - Michela Sali
- b Institute of Microbiology, Catholic University of Rome, A. Gemelli Hospital , Roma , Italy
| | - Davide Pata
- a Department of Pediatrics, Fondazione Policlinico Universitario A. Gemelli, IRCCS , Roma , Italy
| | - Enrico Masiello
- c Department of Pediatrics , Catholic University of Rome, A. Gemelli Hospital , Roma , Italy
| | - Gilda Salerno
- c Department of Pediatrics , Catholic University of Rome, A. Gemelli Hospital , Roma , Italy
| | - Manuela Ceccarelli
- c Department of Pediatrics , Catholic University of Rome, A. Gemelli Hospital , Roma , Italy
| | - Giovanni Delogu
- b Institute of Microbiology, Catholic University of Rome, A. Gemelli Hospital , Roma , Italy
| | - Piero Valentini
- a Department of Pediatrics, Fondazione Policlinico Universitario A. Gemelli, IRCCS , Roma , Italy
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Updates on the Status of Vitamin D as a Risk Factor for Respiratory Distress Syndrome. Adv Pharmacol Sci 2018; 2018:8494816. [PMID: 30364026 PMCID: PMC6186338 DOI: 10.1155/2018/8494816] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2018] [Accepted: 09/05/2018] [Indexed: 11/17/2022] Open
Abstract
To update the guidelines regarding vitamin D status in respiratory distress syndrome, we reviewed recent human and animal studies on the benefits of vitamin D in respiratory distress. We searched PubMed and ProQuest for studies on the use of vitamin D from 2009 to 2017. The common parameters in these studies included the use of lung tissue, phospholipids, blood, and plasma to assess the effects of vitamin D on respiratory syndrome. The metabolized form of vitamin D used in these studies was 1,25(OH)2D3 in animal studies and 25(OH)D in human studies. Vitamin D supplementation decreases the risk of respiratory distress syndrome, improves the quality of life, and is relatively effective and safe for preterm neonates as well as during lung maturation. However, although vitamin D supplementation may offer benefits for respiratory distress syndrome, the optimal dosing strategies for specific types of risk factors in the lungs must be clarified to confirm the therapeutic efficacy.
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Fujita K, Ito Y, Oguma T, Mio T, Niimi A, Hirai T. Association between Mycobacterium avium complex lung disease and serum vitamin D status, antimicrobial peptide levels, and bone mineral density. Medicine (Baltimore) 2018; 97:e12463. [PMID: 30235737 PMCID: PMC6160122 DOI: 10.1097/md.0000000000012463] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
Abstract
Vitamin D maintains calcium balance and has immunomodulatory effects. Only few studies have revealed the relationship between vitamin D and its associated factors in Mycobacterium avium complex (MAC) infection. This study aimed to investigate the effects of MAC infection on serum vitamin D, human cationic antimicrobial protein 18, its C-terminal 37 amino acid fragment (hCAP18/LL-37) levels, and bone mineral density (BMD).We enrolled 58 patients with MAC lung disease and 15 control participants. Serum 25-hydroxyvitamin D and hCAP18/LL-37 levels were measured via enzyme-linked immunosorbent assay. Lastly, computed tomography scan density readings of the BMD of the thoracic and lumbar vertebral bones (Th4, Th7, Th10, and L1) were assessed.No significant differences in patient characteristics and serum vitamin D levels were observed. Patients with MAC lung disease had significantly low serum hCAP18/LL-37 levels (P = .049). Moreover, low BMD of the mean thoracic and lumbar vertebrae was observed (mean Th, P = .012; L1, P = .48, respectively). A higher prevalence of scoliosis (P = .031) was observed in the participants with low BMD compared with the control participants. Based on a multivariate analysis, patients with MAC lung disease had significantly lower body mass index [odds ratio (OR), 19.1; 95% confidence interval (CI), 2.0-419.0; P < .01] and vertebral BMD (OR, 12.4; 95% CI, 1.7-160.6; P = .012) than control participants.Serum hCAP18/LL-37 level and BMD were significantly decreased in patients with MAC lung disease without relation to serum vitamin D level. The vitamin D-independent pathway might affect the waning of antimicrobial peptides and decrease in BMD.
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Affiliation(s)
- Kohei Fujita
- Division of Respiratory Medicine, Center for Respiratory Diseases, National Hospital Organization Kyoto Medical Center, Kyoto
| | - Yutaka Ito
- Department of Respiratory Medicine, Allergy and Clinical Immunology, School of Medical Sciences, Nagoya City University, Nagoya
| | - Tsuyoshi Oguma
- Department of Respiratory Medicine, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Tadashi Mio
- Division of Respiratory Medicine, Center for Respiratory Diseases, National Hospital Organization Kyoto Medical Center, Kyoto
| | - Akio Niimi
- Department of Respiratory Medicine, Allergy and Clinical Immunology, School of Medical Sciences, Nagoya City University, Nagoya
| | - Toyohiro Hirai
- Department of Respiratory Medicine, Graduate School of Medicine, Kyoto University, Kyoto, Japan
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Harishankar M, Selvaraj P, Bethunaickan R. Influence of Genetic Polymorphism Towards Pulmonary Tuberculosis Susceptibility. Front Med (Lausanne) 2018; 5:213. [PMID: 30167433 PMCID: PMC6106802 DOI: 10.3389/fmed.2018.00213] [Citation(s) in RCA: 47] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2018] [Accepted: 07/10/2018] [Indexed: 12/11/2022] Open
Abstract
Tuberculosis (TB) is still remains the major threat for human health worldwide. Several case-control, candidate-gene, family studies and genome-wide association studies (GWAS) suggested the association of host genetic factors to TB susceptibility or resistance in various ethnic populations. Moreover, these factors modulate the host immune responses to tuberculosis. Studies have reported genetic markers to predict TB development in human leukocyte antigen (HLA) and non-HLA genes like killer immunoglobulin-like receptor (KIR), toll-like receptors (TLRs), cytokine/chemokines and their receptors, vitamin D receptor (VDR) and SLC11A1 etc. Highly polymorphic HLA loci may influence antigen presentation specificities by modifying peptide binding motifs. The recent meta-analysis studies revealed the association of several HLA alleles in particular class II HLA-DRB1 with TB susceptibility and valuable marker for disease development especially in Asian populations. Case-control studies have found the association of HLA-DR2 in some populations, but not in other populations, this could be due to an ethnic specific association of gene variants. Recently, GWAS conducted in case-control and family based studies in Russia, Chinese Han, Morocco, Uganda and Tanzania revealed the association of genes such as ASAP1, Alkylglycerol monooxygenase (AGMO), Forkhead BoxP1 (FOXP1), C-terminal domain phosphatase 1 (UBLCP1) and intergenic SNP rs932347C/T with TB. Whereas, SNP rs10956514A/G were not associated with TB in western Chinese Han and Tibetan population. In this review, we summarize the recent findings of genetic variants with susceptibility/resistance to TB.
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Affiliation(s)
- Murugesan Harishankar
- Department of Immunology, National Institute of Research in Tuberculosis, Chennai, India
| | - Paramasivam Selvaraj
- Department of Immunology, National Institute of Research in Tuberculosis, Chennai, India
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Kim EH, Bae JM. Vitamin D supplementation as a control program against latent tuberculosis infection in Korean high school students. Epidemiol Health 2018; 40:e2018035. [PMID: 30056639 PMCID: PMC6232659 DOI: 10.4178/epih.e2018035] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2018] [Accepted: 07/25/2018] [Indexed: 12/16/2022] Open
Abstract
The prevalence of latnet Mycobacterium tuberculosis infection (LTBI) in the first-grade high school students in South Korea was 2.1%, which was the lowest level at congregated settings in 2017. For LTBI cases refusing anti-tuberculosis (TB) medication or having poor compliance, additional support should be considered. Eight systematic reviews concluded that vitamin D (VD) deficiency is a risk factor for TB. While three of four South Korean adolescents were VD deficiency, VD supplementation could be a practical remedy to protect LTBI students of refusing anti-TB medication or having poor compliance.
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Affiliation(s)
- Eun Hee Kim
- Department of Preventive Medicine, Jeju National University School of Medicine, Jeju, Korea
| | - Jong-Myon Bae
- Department of Preventive Medicine, Jeju National University School of Medicine, Jeju, Korea
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Study of IL-6 and vitamin D3 in patients of pulmonary tuberculosis. Indian J Tuberc 2018; 66:337-345. [PMID: 31439177 DOI: 10.1016/j.ijtb.2018.05.018] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2018] [Revised: 04/24/2018] [Accepted: 05/24/2018] [Indexed: 12/13/2022]
Abstract
BACKGROUND Mycobacterium tuberculosis can grow in hostile intracellular environment of macrophages by actively evading macrophage-associated antibacterial activities. The stress response factor contributes this process by releasing inflammatory cytokine Interleukin 6 (IL-6). IL-6 screening of patients with TB may be useful to monitor the progress of infection and to infer the risk of progression to active disease. Vitamin D has a critical role in the innate immune system, in the circulating metabolite and supports induction of pleiotropic antimicrobial responses, through the production of antimicrobial peptides, particularly cathelicidin and its active metabolite. 1,25-dihydoxyvitamin D, has long been known to enhance immune response to mycobacteria. In this study, we have studied the role of IL-6 and Vitamin D3 in M. tuberculosis. MATERIALS AND METHODS Three groups involved in this study are Control, Category I (newly diagnosed TB) and MDR TB patients. The serum levels of IL-6 and vitamin D3 were measured using chemiluminescence and fully-automated enzyme-linked immunosorbent assay respectively. RESULTS The serum levels of IL-6 were significantly increased, whereas vitamin D3 decreased in TB multidrug-resistant group of patients compared to the newly diagnosed TB patients. CONCLUSION IL-6 appears to be the major cytokine elaborated by mycobacteria infection as well as play a role in the clinical manifestations and pathological events and hence may function as a potent biomarker of tuberculosis. Since, Vitamin D increases activity of cell-mediated immunity; it can be used as a supplementation during tuberculosis therapy.
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Abstract
Tuberculosis (TB) has troubled mankind for millennia, but current treatment strategies are long and complicated and the disease remains a major global health problem. The risk of Mycobacterium tuberculosis (Mtb) infection or progression of active TB disease is elevated in individuals with vitamin D deficiency. High-dose vitamin D was used to treat TB in the preantibiotic era, and in vitro experimental data show that vitamin D supports innate immune responses that restrict growth of Mtb. Several randomized controlled trials have tested whether adjunctive vitamin D supplementation enhances the clinical and microbiological response to standard antimicrobial chemotherapy for pulmonary TB. The effects have been modest at best, and attention is turning to the question of whether vitamin D supplementation might have a role in preventing acquisition or reactivation of latent Mtb infection. In this article, we describe the effects of vitamin D on host immune responses to Mtb in vitro and in vivo and review the results of clinical trials in the field. We also reflect on the findings of clinical trials of vitamin D supplementation for the prevention of acute respiratory tract infections, and discuss how these findings might influence the design of future trials to evaluate the role of vitamin D in the prevention and treatment of TB.
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Affiliation(s)
- S Brighenti
- Department of Medicine, Center for Infectious Medicine (CIM), Karolinska Institutet, Karolinska University Hospital Huddinge, Stockholm, Sweden
| | - P Bergman
- Department of Laboratory Medicine (LABMED), Clinical Microbiology, Karolinska Institutet, Karolinska University Hospital Huddinge, Stockholm, Sweden
| | - A R Martineau
- Blizard Institute, Centre for Immunobiology, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London, UK
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Hayward S, Harding RM, McShane H, Tanner R. Factors influencing the higher incidence of tuberculosis among migrants and ethnic minorities in the UK. F1000Res 2018; 7:461. [PMID: 30210785 PMCID: PMC6107974 DOI: 10.12688/f1000research.14476.2] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 08/09/2018] [Indexed: 12/17/2022] Open
Abstract
Migrants and ethnic minorities in the UK have higher rates of tuberculosis (TB) compared with the general population. Historically, much of the disparity in incidence between UK-born and migrant populations has been attributed to differential pathogen exposure, due to migration from high-incidence regions and the transnational connections maintained with TB endemic countries of birth or ethnic origin. However, focusing solely on exposure fails to address the relatively high rates of progression to active disease observed in some populations of latently infected individuals. A range of factors that disproportionately affect migrants and ethnic minorities, including genetic susceptibility, vitamin D deficiency and co-morbidities such as diabetes mellitus and HIV, also increase vulnerability to infection with
Mycobacterium tuberculosis (M.tb) or reactivation of latent infection. Furthermore, ethnic socio-economic disparities and the experience of migration itself may contribute to differences in TB incidence, as well as cultural and structural barriers to accessing healthcare. In this review, we discuss both biological and anthropological influences relating to risk of pathogen exposure, vulnerability to infection or development of active disease, and access to treatment for migrant and ethnic minorities in the UK.
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Affiliation(s)
- Sally Hayward
- St John's College, University of Oxford, Oxford, OX1 3JP, UK
| | | | - Helen McShane
- The Jenner Institute, University of Oxford, Oxford, OX1 3PS, UK
| | - Rachel Tanner
- The Jenner Institute, University of Oxford, Oxford, OX1 3PS, UK
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Hayward S, Harding RM, McShane H, Tanner R. Factors influencing the higher incidence of tuberculosis among migrants and ethnic minorities in the UK. F1000Res 2018; 7:461. [PMID: 30210785 PMCID: PMC6107974 DOI: 10.12688/f1000research.14476.1] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 08/09/2018] [Indexed: 09/04/2023] Open
Abstract
Migrants and ethnic minorities in the UK have higher rates of tuberculosis (TB) compared with the general population. Historically, much of the disparity in incidence between UK-born and migrant populations has been attributed to differential pathogen exposure, due to migration from high-incidence regions and the transnational connections maintained with TB endemic countries of birth or ethnic origin. However, focusing solely on exposure fails to address the relatively high rates of progression to active disease observed in some populations of latently infected individuals. A range of factors that disproportionately affect migrants and ethnic minorities, including genetic susceptibility, vitamin D deficiency and co-morbidities such as diabetes mellitus and HIV, also increase vulnerability to infection with Mycobacterium tuberculosis (M.tb) or reactivation of latent infection. Furthermore, ethnic socio-economic disparities and the experience of migration itself may contribute to differences in TB incidence, as well as cultural and structural barriers to accessing healthcare. In this review, we discuss both biological and anthropological influences relating to risk of pathogen exposure, vulnerability to infection or development of active disease, and access to treatment for migrant and ethnic minorities in the UK.
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Affiliation(s)
- Sally Hayward
- St John’s College, University of Oxford, Oxford, OX1 3JP, UK
| | | | - Helen McShane
- The Jenner Institute, University of Oxford, Oxford, OX1 3PS, UK
| | - Rachel Tanner
- The Jenner Institute, University of Oxford, Oxford, OX1 3PS, UK
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Current therapies in alleviating liver disorders and cancers with a special focus on the potential of vitamin D. Nutr Metab (Lond) 2018; 15:13. [PMID: 29449867 PMCID: PMC5807831 DOI: 10.1186/s12986-018-0251-5] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2017] [Accepted: 01/30/2018] [Indexed: 02/06/2023] Open
Abstract
Background Liver dysfunction is a topic of global concern with many advancing therapies being researched. Though vitamin D takes a center place, other therapies especially nutritional are also gaining ground. Vitamin D has gone beyond its role in skeletal disorders by showcasing its associations in other metabolic dysfunctions too. Result Epidemiological evidences show a correlation between the status of vitamin D and different forms of cancer. Vitamin D receptors and alterations in gene expression appear decisive in the development of chronic liver disorders. Nutritional status therefore plays a significant role in avoiding the complications related to liver dysfunctions, making it mandatory in maintaining vitamin D sufficiency in the body. Therapies with omega-3 fatty acids, antioxidants, amino acids, steroids also render benefits which could be further explored. Recent research on the progression of certain forms of liver cancer using vitamin D analogs like Seocalcitol EB 1089 has shown good promise. Conclusion The anti-inflammatory and immuno- regulatory properties of vitamin D makes its analogs, suitable candidates of better choice for the prevention and treatment of liver disorders and cancer.
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Hoan NX, Tong HV, Song LH, Meyer CG, Velavan TP. Vitamin D deficiency and hepatitis viruses-associated liver diseases: A literature review. World J Gastroenterol 2018; 24:445-460. [PMID: 29398866 PMCID: PMC5787780 DOI: 10.3748/wjg.v24.i4.445] [Citation(s) in RCA: 32] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/28/2017] [Revised: 01/08/2018] [Accepted: 01/16/2018] [Indexed: 02/06/2023] Open
Abstract
The secosteroid hormone vitamin D has, in addition to its effects in bone metabolism also functions in the modulation of immune responses against infectious agents and in inhibiting tumorigenesis. Thus, deficiency of vitamin D is associated with several malignancies, but also with a plethora of infectious diseases. Among other communicable diseases, vitamin D deficiency is involved in the pathogenesis of chronic liver diseases caused by hepatitis B and C viruses (HBV, HCV) and high prevalence of vitamin D deficiency with serum levels below 20 mg/mL in patients with HBV and HCV infection are found worldwide. Several studies have assessed the effects of vitamin D supplementation on the sustained virological response (SVR) to interferon (IFN) plus ribavirin (RBV) therapy in HBV and HCV infection. In these studies, inconsistent results were reported. This review addresses general aspects of vitamin D deficiency and, in particular, the significance of vitamin D hypovitaminosis in the outcome of HBV- and HCV-related chronic liver diseases. Furthermore, current literature was reviewed in order to understand the effects of vitamin D supplementation in combination with IFN-based therapy on the virological response in HBV and HCV infected patients.
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Affiliation(s)
- Nghiem Xuan Hoan
- Institute of Clinical Infectious Diseases, 108 Military Central Hospital, Hanoi 10004, Vietnam
- Molecular Genetics of Infectious Diseases, Institute of Tropical Medicine, University of Tübingen, Tübingen 72074, Germany
- Vietnamese-German Center of Medical Research (VG-CARE), Hanoi 10004, Vietnam
| | - Hoang Van Tong
- Vietnamese-German Center of Medical Research (VG-CARE), Hanoi 10004, Vietnam
- Institute of Biomedicine and Pharmacy, Vietnam Military Medical University, Hanoi 10004, Vietnam
| | - Le Huu Song
- Institute of Clinical Infectious Diseases, 108 Military Central Hospital, Hanoi 10004, Vietnam
- Vietnamese-German Center of Medical Research (VG-CARE), Hanoi 10004, Vietnam
| | - Christian G Meyer
- Molecular Genetics of Infectious Diseases, Institute of Tropical Medicine, University of Tübingen, Tübingen 72074, Germany
- Vietnamese-German Center of Medical Research (VG-CARE), Hanoi 10004, Vietnam
- Medical Faculty, Duy Tan University, Da Nang, Vietnam
| | - Thirumalaisamy P Velavan
- Molecular Genetics of Infectious Diseases, Institute of Tropical Medicine, University of Tübingen, Tübingen 72074, Germany
- Vietnamese-German Center of Medical Research (VG-CARE), Hanoi 10004, Vietnam
- Medical Faculty, Duy Tan University, Da Nang, Vietnam
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Aleteng Q, Zhao L, Lin H, Xia M, Ma H, Gao J, Pan B, Gao X. Optimal Vitamin D Status in a Middle-Aged and Elderly Population Residing in Shanghai, China. Med Sci Monit 2017; 23:6001-6011. [PMID: 29255137 PMCID: PMC5745892 DOI: 10.12659/msm.904495] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022] Open
Abstract
BACKGROUND The aim of this study was to investigate the optimal vitamin D status in the middle-aged and elderly population residing in Shanghai, China. MATERIAL AND METHODS A total of 1,829 males and postmenopausal females older than 45 years of age in the Changfeng community of Shanghai were included in this study. The optimal vitamin D level was determined according to the suppression of parathyroid hormone (PTH) and the highest bone mineral density (BMD). Locally weighted scatter plot smoothing (LOWESS) was performed to study the correlations of 25(OH)D with PTH and BMD in the lumbar spine and total hip, adjusting for gender, age, weight, use of calcium and vitamin D supplements, eGFR, smoking status, and alcohol consumption. RESULTS The mean serum 25(OH)D concentration was 48.0±19.2 nmol/L for the whole study population. The circulating PTH was maximally suppressed by the serum 25(OH)D of 55 nmol/L in the total population (60 nmol/L for males and 50 nmol/L for females). The 25(OH)D concentrations corresponding to the highest BMD at lumbar spine (L1-L4) and total hip were 53 nmol/L and 75 nmol/L, respectively, for the whole population. These values were also higher in males than females. CONCLUSIONS The optimal 25(OH)D concentration of 55 nmol/L is sufficient to maintain the bone health and metabolic status in middle-aged and elderly individuals living in Shanghai. Males probably need higher vitamin D concentration than females. There are differences between vitamin D status based on lumbar spine BMD and total hip BMD.
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Affiliation(s)
- Qiqige Aleteng
- Department of Endocrinology and Metabolism, ZhongShan Hospital, Fudan University, Shanghai, China (mainland)
| | - Lin Zhao
- Department of Endocrinology and Metabolism, ZhongShan Hospital, Fudan University, Shanghai, China (mainland)
| | - Huandong Lin
- Department of Endocrinology and Metabolism, ZhongShan Hospital, Fudan University, Shanghai, China (mainland)
| | - Mingfeng Xia
- Department of Endocrinology and Metabolism, ZhongShan Hospital, Fudan University, , China (mainland)
| | - Hui Ma
- Department of Endocrinology and Metabolism, ZhongShan Hospital, Fudan University, Shanghai, China (mainland).,Department of Geriatrics, ZhongShan Hospital, Fudan University, Shanghai, China (mainland)
| | - Jian Gao
- Department of Clinical Nutrition, ZhongShan Hospital, Fudan University, Shanghai, China (mainland)
| | - Baishen Pan
- Department of Laboratory Medicine, ZhongShan Hospital, Fudan University, Shanghai, China (mainland)
| | - Xin Gao
- Department of Endocrinology and Metabolism, Zhongshan Hospital, Fudan University, Shanghai, China (mainland)
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Gautam S, Jain A, Akhtar S, Priyadarshini A, Jaiswar SP. Serum Vitamin D Level as a Risk Factor for Female Genital Tuberculosis (FGTB). J Clin Diagn Res 2017; 11:DC18-DC20. [PMID: 29207705 DOI: 10.7860/jcdr/2017/30084.10636] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2017] [Accepted: 08/01/2017] [Indexed: 02/01/2023]
Abstract
Introduction Vitamin D is now known to be essential to Mycobacterium tuberculosis containment and killing through activation of 25-hydroxyvitamin-D receptors (VDRs) present on all immune cells or obtained from dietary food stuffs as either vitamin D3 or vegetable vitamin D2 (also known as ergocalciferol). Aim To evaluate the association of serum vitamin D level between the Female Genital Tuberculosis (FGTB) cases and healthy controls. Materials and Methods Total 120 cases and 120 controls enrolled for the study following inclusion and exclusion criteria. Detailed clinical history was taken from each subjects. Total of 3 ml of the blood was collected in EDTA vial from each subject (case and control). Quantification of serum vitamin D level was measured by active human vitamin D ELISA kit using an ELISA reader. Statistical analysis was done using Statistical Package for Social Science (SPSS) version 21.0. A p-value <0.05 was considered as significant. Results A total of 120 confirmed FGTB cases and 120 healthy control enrolled for study. Out of 120 women 97.5%, 10.0%, 3.3%, 3.3% were detected positive for M. tuberculosis respectively. Comparing the mean demographic value of age and BMI were (29.03±3.127, 28.03±3.00) and (22.92±3.33, 24.15±3.97) respectively with the p=0.012* and p=0.010* found to be significant among cases and controls. The mean serum vitamin D level was 14.96±8.81 in cases and 23.00±8.83 in controls with p-value<0.001. There was a significant positive association found in low serum vitamin D level among FGTB cases than controls. Conclusion Vitamin D is important for normal immune cell function, as well as regression of FGTB disease. FGTB may be controlled by regulating the serum vitamin D level concentration. This study suggests that, vitamin D deficiency and BMI is strongly associated with the progression of active FGTB disease which alters the expression of antimicrobial peptide and lead to the persistence of TB infection. Therefore, serum vitamin D level may play an important role in treatment of FGTB.
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Affiliation(s)
- Swati Gautam
- PhD Scholar, Department of Biosciences, Integral University, and Department of Microbiology, King George's Medical University, Lucknow, Uttar Pradesh, India
| | - Amita Jain
- Professor, Department of Microbiology, King George's Medical University, Lucknow, Uttar Pradesh, India
| | - Salman Akhtar
- Assistant Professor, Department of Bioengineering, Integral University, Lucknow, Uttar Pradesh, India
| | - Apala Priyadarshini
- Senior Resident, Department of Obstetrics and Gynaecology, King George's Medical University, Lucknow, Uttar Pradesh, India
| | - Shyam Pyari Jaiswar
- Professor, Department of Obstetrics and Gynaecology, King George's Medical University, Lucknow, Uttar Pradesh, India
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Qrafli M, Najimi M, Elaouad R, Sadki K. Current immunogenetic predisposition to tuberculosis in the Moroccan population. Int J Immunogenet 2017; 44:286-304. [PMID: 29057608 DOI: 10.1111/iji.12340] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2017] [Revised: 08/06/2017] [Accepted: 08/27/2017] [Indexed: 11/30/2022]
Abstract
Tuberculosis (TB) is a serious infectious disease that kills approximately two million people per year, particularly in low- and middle-income countries. Numerous genetic epidemiology studies have been conducted of many ethnic groups worldwide and have highlighted the critical impact of the genetic environment on TB distribution. Many candidate genes associated with resistance or susceptibility to TB have been identified. In Morocco, where TB is still a major public health problem, various observations of clinical, microbiological and incidence distribution are heavily affected by genetic background and external environment. Morocco has almost the same clinical profile as do other North African countries, mainly the increase in more extrapulmonary than pulmonary forms of the diseases, when compared to European, Asian or American populations. In addition, a linkage analysis study that examined Moroccan TB patients identified a unique chromosome region that had a strong association with the risk of contracting TB. Other genes in the Moroccan population that were found to be associated seem to be involved predominantly in modulating the innate immunity. In this review, we appraise the major candidate genes that have been reported in Moroccan immunogenetic studies and discuss their updated role in TB, particularly during the first phase of the immune response to Mycobacterium tuberculosis (Mtb) infection.
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Affiliation(s)
- M Qrafli
- Physiopathology Team, Immunogenomic and Bioinformatic Unit, Faculty of Sciences, Genomic Center of Human Pathologies, Mohammed V University, Rabat, Morocco
| | - M Najimi
- Laboratory of Pediatric Hepatology and Cell Therapy, Institut de Recherche Expérimentale et Clinique (IREC), Université Catholique de Louvain, Brussels, Belgium
| | - R Elaouad
- School of Medicine and Pharmacy Sciences, Mohammed V University of Rabat, Rabat, Morocco
| | - K Sadki
- Physiopathology Team, Immunogenomic and Bioinformatic Unit, Faculty of Sciences, Genomic Center of Human Pathologies, Mohammed V University, Rabat, Morocco
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Vitamin A and D Deficiencies Associated With Incident Tuberculosis in HIV-Infected Patients Initiating Antiretroviral Therapy in Multinational Case-Cohort Study. J Acquir Immune Defic Syndr 2017; 75:e71-e79. [PMID: 28169875 DOI: 10.1097/qai.0000000000001308] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
INTRODUCTION Numerous micronutrients have immunomodulatory roles that may influence risk of tuberculosis (TB), but the association between baseline micronutrient deficiencies and incident TB after antiretroviral therapy (ART) initiation in HIV-infected individuals is not well characterized. METHODS We conducted a case-cohort study (n = 332) within a randomized trial comparing 3 ART regimens in 1571 HIV treatment-naive adults from 9 countries. A subcohort of 30 patients was randomly selected from each country (n = 270). Cases (n = 77; main cohort = 62, random subcohort = 15) included patients diagnosed with TB by 96 weeks post-ART initiation. We determined pretreatment concentrations of vitamin A, carotenoids, vitamin B6, vitamin B12, vitamin D, vitamin E, and selenium. We measured associations between pretreatment micronutrient deficiencies and incident TB using Breslow-weighted Cox regression models. RESULTS Median pretreatment CD4 T-cell count was 170 cells/mm; 47.3% were women; and 53.6% Black. In multivariable models after adjusting for age, sex, country, treatment arm, previous TB, baseline CD4 count, HIV viral load, body mass index, and C-reactive protein, pretreatment deficiency in vitamin A (adjusted hazard ratio, aHR 5.33, 95% confidence interval, CI: 1.54 to 18.43) and vitamin D (aHR 3.66, 95% CI: 1.16 to 11.51) were associated with TB post-ART. CONCLUSIONS In a diverse cohort of HIV-infected adults from predominantly low- and middle-income countries, deficiencies in vitamin A and vitamin D at ART initiation were independently associated with increased risk of incident TB in the ensuing 96 weeks. Vitamin A and D may be important modifiable risk factors for TB in high-risk HIV-infected patients starting ART in resource-limited highly-TB-endemic settings.
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Hassanien AE, Tharwat A, Own HS. Computational model for vitamin D deficiency using hair mineral analysis. Comput Biol Chem 2017; 70:198-210. [PMID: 28923545 DOI: 10.1016/j.compbiolchem.2017.08.015] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2017] [Revised: 08/09/2017] [Accepted: 08/22/2017] [Indexed: 01/03/2023]
Abstract
Vitamin D deficiency is prevalent in the Arabian Gulf region, especially among women. Recent studies show that the vitamin D deficiency is associated with a mineral status of a patient. Therefore, it is important to assess the mineral status of the patient to reveal the hidden mineral imbalance associated with vitamin D deficiency. A well-known test such as the red blood cells is fairly expensive, invasive, and less informative. On the other hand, a hair mineral analysis can be considered an accurate, excellent, highly informative tool to measure mineral imbalance associated with vitamin D deficiency. In this study, 118 apparently healthy Kuwaiti women were assessed for their mineral levels and vitamin D status by a hair mineral analysis (HMA). This information was used to build a computerized model that would predict vitamin D deficiency based on its association with the levels and ratios of minerals. The first phase of the proposed model introduces a novel hybrid optimization algorithm, which can be considered as an improvement of Bat Algorithm (BA) to select the most discriminative features. The improvement includes using the mutation process of Genetic Algorithm (GA) to update the positions of bats with the aim of speeding up convergence; thus, making the algorithm more feasible for wider ranges of real-world applications. Due to the imbalanced class distribution in our dataset, in the second phase, different sampling methods such as Random Under-Sampling, Random Over-Sampling, and Synthetic Minority Oversampling Technique are used to solve the problem of imbalanced datasets. In the third phase, an AdaBoost ensemble classifier is used to predicting the vitamin D deficiency. The results showed that the proposed model achieved good results to detect the deficiency in vitamin D.
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Affiliation(s)
- Aboul Ella Hassanien
- Faculty of Computers and Information, Cairo University, Egypt; Scientific Research Group in Egypt (SRGE), Egypt1.
| | - Alaa Tharwat
- Faculty of Engineering, Suez Canal University, Egypt; Faculty of Computer Science and Engineering, Frankfurt University of Applied Sciences, 60318 Frankfurt am Main, Germany; Scientific Research Group in Egypt (SRGE), Egypt1.
| | - Hala S Own
- Department of Solar and Space Research, National Research Institute of Astronomy and Geophysics, El-Marsad Street, P.O. Box 11421 Helwan, Egypt.
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Wubuli A, Li Y, Xue F, Yao X, Upur H, Wushouer Q. Seasonality of active tuberculosis notification from 2005 to 2014 in Xinjiang, China. PLoS One 2017; 12:e0180226. [PMID: 28678873 PMCID: PMC5497978 DOI: 10.1371/journal.pone.0180226] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2017] [Accepted: 06/12/2017] [Indexed: 12/26/2022] Open
Abstract
OBJECTIVES Xinjiang is one of the highest TB-burdened provinces of China. A time-series analysis was conducted to evaluate the trend, seasonality of active TB in Xinjiang, and explore the underlying mechanism of TB seasonality by comparing the seasonal variations of different subgroups. METHODS Monthly active TB cases from 2005 to 2014 in Xinjiang were analyzed by the X-12-ARIMA seasonal adjustment program. Seasonal amplitude (SA) was calculated and compared within the subgroups. RESULTS A total of 277,300 confirmed active TB cases were notified from 2005 to 2014 in Xinjiang, China, with a monthly average of 2311±577. The seasonality of active TB notification was peaked in March and troughed in October, with a decreasing SA trend. The annual 77.31% SA indicated an annual mean of additional TB cases diagnosed in March as compared to October. The 0-14-year-old group had significantly higher SA than 15-44-year-old group (P<0.05). Students had the highest SA, followed by herder and migrant workers (P<0.05). The pleural TB cases had significantly higher SA than the pulmonary cases (P <0.05). Significant associations were not observed between SA and sex, ethnic group, regions, the result of sputum smear microcopy, and treatment history (P>0.05). CONCLUSION TB notification in Xinjiang shows an apparent seasonal variation with a peak in March and trough in October. For the underlying mechanism of TB seasonality, our results hypothesize that winter indoor crowding increases the risk of TB transmission, and seasonality was mainly influenced by the recent exogenous infection rather than the endogenous reactivation.
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Affiliation(s)
- Atikaimu Wubuli
- Department of Epidemiology and Biostatistics, School of Public Health, Xinjiang Medical University, Urumqi, Xinjiang, China
| | - Yuehua Li
- Center for Tuberculosis Control and Prevention, Xinjiang Uygur Autonomous Region Center for Disease Control and Prevention, Urumqi, Xinjiang, China
| | - Feng Xue
- Center for Tuberculosis Control and Prevention, Xinjiang Uygur Autonomous Region Center for Disease Control and Prevention, Urumqi, Xinjiang, China
| | - Xuemei Yao
- Department of Epidemiology and Biostatistics, School of Public Health, Xinjiang Medical University, Urumqi, Xinjiang, China
| | - Halmurat Upur
- Department of Traditional Uygur Medicine, Xinjiang Medical University, Urumqi, Xinjiang, China
| | - Qimanguli Wushouer
- Department of Respiratory Medicine, The First Teaching Hospital of Xinjiang Medical University, Urumqi, Xinjiang, China
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Farazi A, Didgar F, Sarafraz A. The effect of vitamin D on clinical outcomes in tuberculosis. EGYPTIAN JOURNAL OF CHEST DISEASES AND TUBERCULOSIS 2017. [DOI: 10.1016/j.ejcdt.2017.01.004] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022] Open
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Workineh M, Mathewos B, Moges B, Gize A, Getie S, Stendahl O, Schon T, Abate E. Vitamin D deficiency among newly diagnosed tuberculosis patients and their household contacts: a comparative cross-sectional study. ACTA ACUST UNITED AC 2017. [PMID: 28638616 PMCID: PMC5474861 DOI: 10.1186/s13690-017-0195-7] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
Background Recent studies suggest that the incidence and severity of tuberculosis is associated with low levels of vitamin D. Even though individuals living in Ethiopia have a high exposure to sunlight which is a source of vitamin D, tuberculosis is still one of the major causes of morbidity and mortality in the country. Therefore, this study aimed to determine the prevalence and associated factors of vitamin D deficiency in newly diagnosed tuberculosis patients, household contacts and community controls in Gondar, Ethiopia. Methods A comparative cross-sectional study design was conducted. Blood samples were collected from newly diagnosed smear positive pulmonary TB patients, their household contacts and community controls. Serum 25(OH)-vitamin D3 was determined by an Enzyme Linked Immunosorbent Assay. A serum level of 25(OH)-vitamin D3 below < 50 nmol/L was defined as vitamin D deficiency and <25 nmol/L as severe vitamin D deficiency. Results A total of 126 newly diagnosed smear positive TB patients, 57 house hold contacts and 70 apparently community controls were included in the study. The mean ± SD age (years) of TB patients, house hold contacts and community controls was 29.8 ± 11.9, 24.3 ± 14.7 and 27.3 ± 7.6 respectively. Ninety out of 126 (71.4%) TB patients were underweight with a BMI of < 18.5 kg/m2. The mean 25(OH)-vitamin D3 level of TB patients (30.1 ± 19.3 nmol/L) was significantly lower than community controls (38.5 ± 20.9 nmol/L, P = 0.005 and household contacts (37.7 ± 12.8 nmol/L, P =0.031).). The prevalence of vitamin D deficiency was higher in TB patients (83.3%) than in community controls (67.1%, P = 0.009). The prevalence of vitamin D deficiency was also found higher in household contacts (80.7%). Severe vitamin D deficiency was observed in 53%(67/126), 30% (21/70), 19.3%(11/57) of TB patients, community controls and household contacts respectively. Low BMI (AOR = 2.13; 95%CI: 1.02, 3.28) and being positive for tuberculosis (AOR = 1.93; 95%CI: 1.06, 2.86) were significant predictors of severe vitamin D deficiency. Conclusion High prevalence of vitamin D deficiency was found among newly diagnosed TB patients and in their household contacts. The present study warrants further studies to determine the role of vitamin D supplementation in the prevention and treatment of tuberculosis in Ethiopia.
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Affiliation(s)
- Meseret Workineh
- Department of Immunology & Molecular Biology, School of Biomedical and Laboratory Sciences, University of Gondar, Gondar, Ethiopia
| | - Biniam Mathewos
- Department of Immunology & Molecular Biology, School of Biomedical and Laboratory Sciences, University of Gondar, Gondar, Ethiopia
| | - Beyene Moges
- Department of Immunology & Molecular Biology, School of Biomedical and Laboratory Sciences, University of Gondar, Gondar, Ethiopia
| | - Adissu Gize
- St. Paul's Millennium Medical College, Addis Ababa, Ethiopia
| | - Sisay Getie
- Department of Medical Parasitology, School of Biomedical and Laboratory Sciences, University of Gondar, Gondar, Ethiopia
| | - Olle Stendahl
- Department of Medical Microbiology, Linkoping University, Linköping, Sweden
| | - Thomas Schon
- Department of Medical Microbiology, Linkoping University, Linköping, Sweden.,Department of Clinical Microbiology and Infectious Diseases, Kalmar county Hospital, Kalmar, Sweden
| | - Ebba Abate
- Department of Immunology & Molecular Biology, School of Biomedical and Laboratory Sciences, University of Gondar, Gondar, Ethiopia
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