Vitamin D aids TB recovery

Scientists have discovered that adding high doses of vitamin D to standard antibiotic treatment can help people with tuberculosis (TB) recover more quickly and reduce lung damage.

For many years vitamin D was only thought to be important for bone health. More recently, researchers have found that it might have a range of other functions in our bodies, including a possible role in preventing cancer, type 2 diabetes and autoimmune diseases - conditions like multiple sclerosis where a person's immune system mistakenly attacks healthy cells.

There is also growing speculation about the benefits of vitamin D in preventing and treating lung infections including TB, and there is some evidence from laboratory studies that the vitamin may help TB recovery. In fact, in the days before antibiotics, vitamin D from sunlight was a recommended treatment for TB patients in sanatoria.

This is the first study to assess the effect of the vitamin on immune responses in patients being treated for the often fatal lung disease, which was responsible for 1.4 million deaths in 2010.

The researchers, led by Dr Adrian Martineau of Queen Mary University of London and the MRC's National Institute for Medical Research (NIMR; now part of the Francis Crick Institute) randomly allocated 95 TB patients at clinics across London to receive either high doses of vitamin D or a placebo in addition to the standard antibiotics for the first eight weeks of their treatment. Dr Anna Coussens of  NIMR's Division of Mycobacterial Research measured levels of various immune molecules and markers of inflammation in the patients' blood every two weeks during treatment.

"A large number of these inflammatory markers fell further and faster in patients receiving vitamin D than those given the placebo," explained Dr Martineau.

He added: "Our findings indicate that vitamin D may have a role in accelerating resolution of inflammatory responses. This is important, because sometimes these inflammatory responses can cause tissue damage, leading to the development of cavities in the lung. If we can help these cavities to heal more quickly, then patients should be infectious for a shorter period of time, and may also suffer less lung damage."

The scientists suggest that vitamin D might also be useful as an addition to treatment for other lung infections, including pneumonia, where inflammatory responses have been shown to be damaging.

The researchers worked with colleagues from Guy's and St Thomas' NHS Foundation Trust, Newham Chest Clinic, Homerton University NHS Foundation Trust, Whipps Cross University Hospital, Northwick Park Hospital, Lewisham Hospital and King's College Hospital. The work was jointly funded by the MRC and the British Lung Foundation.

The paper, 'Vitamin D accelerates resolution of inflammatory responses during tuberculosis treatment,' is published in the Proceedings of the National Academy of Sciences.

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