Vitamin D accelerates resolution of inflammatory responses during tuberculosis treatment
Coussens AK, Wilkinson RJ, Hanifa Y, Nikolayevskyy V, Elkington PT, Islam K, Timms PM, Venton TR, Bothamley GH, Packe GE, Darmalingam M, Davidson RN, Milburn HJ, Baker LV, Barker RD, Mein CA, Bhaw-Rosun L, Nuamah R, Young DB, Drobniewski FA, Griffiths CJ, Martineau AR
Proceedings of the National Academy of Sciences of the United States of America · 218 citas
Cómo se estudió
- Diseño
- Ensayo controlado aleatorizado (indexado por PubMed)
- Estudiado en
- Personas
- Resultado principal
- Marcadores de salud y funcionamiento
Quién lo pagó
- Financiación
- Financiación independiente
- Organización sin fines de lucro
- Wellcome Trust
- Gobierno
- National Institute for Health and Care Research
- Gobierno
- National Institute for Health Research (NIHR)
- Gobierno
- Medical Research Council
- Subvenciones
- Wellcome Trust (088316); National Institute for Health and Care Research (DHCS/06/05/012); Wellcome Trust (84323)
Según 4 financiadores declarados.
Publicación
- Publicado
- 2012-09-04 · Proc Natl Acad Sci U S A · vol. 109 · número 38 · págs. 15449–15454
- Editorial
- National Academy of Sciences
- Citado
- 310 citas · más que el 100% de estudios similares · 22.0× el promedio de su campo
- Impacto
- Entre el 10 % más citado de su campo
- Referencias
- 44 trabajos
- Acceso
- Acceso abierto (copia en repositorio)
- Áreas de investigación
- Vitamin D Research Studies · Tuberculosis Research and Epidemiology · Immune responses and vaccinations
- Palabras clave
- vitamin D supplementation, 25-hydroxyvitamin D, pulmonary tuberculosis, adjunctive therapy, sputum smear conversion, lymphopenia, monocytosis, inflammatory cytokines, IL-4, RANTES, interferon-alpha, antimicrobial therapy, immunomodulation, inflammation resolution
- MeSH
- immune system, humans, tuberculosis, inflammation, steroids, vitamin d, antimicrobial cationic peptides, antitubercular agents, risk, regression analysis, gene expression regulation, kinetics, genotype, polymorphism, genetic, time factors, adult, middle aged, female, male
22 autores
- Anna K. Coussens🇬🇧Medical Research Council
- Robert John Wilkinson🇬🇧Imperial College London; Medical Research Council
- Yasmeen Hanifa🇬🇧Queen Mary University of London; Blizard Institute
- Vladyslav Nikolayevskyy🇬🇧Queen Mary University of London
- Paul T. Elkington🇬🇧Imperial College London
- Kamrul Islam🇬🇧Queen Mary University of London; Blizard Institute
- Peter M. Timms🇬🇧Homerton University Hospital
- Timothy R Venton🇬🇧Homerton University Hospital
- Graham Henry Bothamley🇬🇧Homerton University Hospital
- Geoffrey E. Packe
- Mathina Darmalingam🇬🇧Whipps Cross University Hospital
- Robert N. Davidson🇬🇧Northwick Park Hospital
- Heather June Milburn🇬🇧Guy's Hospital; St Thomas' Hospital; Guy's and St Thomas' NHS Foundation Trust
- Lucy V. Baker🇬🇧University Hospital Lewisham
- Richard D. Barker🇬🇧King's College Hospital
- Charles A. Mein🇬🇧Queen Mary University of London
- Leena Bhaw🇬🇧Queen Mary University of London
- Rosamond A. Nuamah🇬🇧Queen Mary University of London
- Douglas B. Young🇬🇧Medical Research Council
- Francis A. Drobniewski🇬🇧Queen Mary University of London
- Chris Griffiths🇬🇧Queen Mary University of London; Blizard Institute
- Adrian R. Martineau🇬🇧Queen Mary University of London; Blizard Institute; Imperial College London; Medical Research Council
Resumen
El texto original del estudio, en el idioma en que se publicó.
Calcidiol, the major circulating metabolite of vitamin D, supports induction of pleiotropic antimicrobial responses in vitro. Vitamin D supplementation elevates circulating calcidiol concentrations, and thus has a potential role in the prevention and treatment of infection. The immunomodulatory effects of administering vitamin D to humans with an infectious disease have not previously been reported. To characterize these effects, we conducted a detailed longitudinal study of circulating and antigen-stimulated immune responses in ninety-five patients receiving antimicrobial therapy for pulmonary tuberculosis who were randomized to receive adjunctive high-dose vitamin D or placebo in a clinical trial, and who fulfilled criteria for per-protocol analysis. Vitamin D supplementation accelerated sputum smear conversion and enhanced treatment-induced resolution of lymphopaenia, monocytosis, hypercytokinaemia, and hyperchemokinaemia. Administration of vitamin D also suppressed antigen-stimulated proinflammatory cytokine responses, but attenuated the suppressive effect of antimicrobial therapy on antigen-stimulated secretion of IL-4, CC chemokine ligand 5, and IFN-α. We demonstrate a previously unappreciated role for vitamin D supplementation in accelerating resolution of inflammatory responses during tuberculosis treatment. Our findings suggest a potential role for adjunctive vitamin D supplementation in the treatment of pulmonary infections to accelerate resolution of inflammatory responses associated with increased risk of mortality.
Resumen vía Europe PMC. Los derechos de autor siguen siendo de los autores o la editorial.
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