Wallis, RS;
Zumla, A;
(2016)
Vitamin D as Adjunctive Host-Directed Therapy in Tuberculosis: A Systematic Review.
Open Forum Infectious Diseases
, 3
(3)
, Article ofw151. 10.1093/ofid/ofw151.
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Abstract
Vitamin D plays an important role in innate defenses against intracellular pathogens. Seasonal vitamin D insufficiency (VDI) due to reduced sun exposure far from the equator increases tuberculosis risk. Eight randomized controlled trials examined vitamin D as adjunctive therapy during tuberculosis treatment. The studies varied substantially regarding patient genetic backgrounds, the extent of baseline VDI, the administered dose, the study endpoints, and the quality of the reported data. One carefully performed study in which moderately large vitamin D doses were given to markedly VDI patients found a benefit sufficient to support shortening treatment from 6 to 4 months, although other similar studies did not. Vitamin D is thought to have anti-inflammatory effects. However, 2 studies reported 3 vitamin D recipients with severe paradoxical inflammatory reactions. Future studies of vitamin D in tuberculosis in patients with specific genetic backgrounds must monitor these events closely to determine their risks and underlying mechanisms.
| Type: | Article |
|---|---|
| Title: | Vitamin D as Adjunctive Host-Directed Therapy in Tuberculosis: A Systematic Review |
| Open access status: | An open access version is available from UCL Discovery |
| DOI: | 10.1093/ofid/ofw151 |
| Publisher version: | http://dx.doi.org/10.1093/ofid/ofw151 |
| Language: | English |
| Additional information: | This is an Open Access article distributed under the terms of the Creative Commons Attribution-NonCommercial-NoDerivs licence (http://creativecommons.org/licenses/by-nc-nd/4.0/), which permits non-commercial reproduction and distribution of the work, in any medium, provided the original work is not altered or transformed in any way, and that the work is properly cited. For commercial re-use, please contact journals.permissions@oup.com. |
| Keywords: | Infectious Diseases, clinical trial, host-directed therapy, tuberculosis, vitamin D, MULTIDRUG-RESISTANT TUBERCULOSIS, RANDOMIZED CONTROLLED-TRIAL, PLACEBO-CONTROLLED TRIAL, HIGH-DOSE VITAMIN-D-3, DOUBLE-BLIND, PULMONARY TUBERCULOSIS, D DEFICIENCY, MYCOBACTERIA, CATHELICIDIN, LL-37 |
| UCL classification: | UCL UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Medical Sciences UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Medical Sciences > Div of Infection and Immunity |
| URI: | https://discovery-pp.ucl.ac.uk/id/eprint/10043543 |
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