September 4, 2012
Tuberculosis Patients Have Speedy Recovery With Antibiotics And Vitamin D
Lawrence LeBlond for redOrbit.com - Your Universe Online
Recent studies have shown that vitamin D deficiencies can make people gain weight and also worsen lung function in smokers. And other research has shown that vitamin D intake can reduce the risk of respiratory infection in children. Now, researchers from Queen Mary University of London have found that the “sunshine” vitamin can also aid in a speedy recovery from tuberculosis (TB).
Vitamin D has been used to treat TB for decades before antibiotics became available, and many people would be sent to sanatoriums and health retreats where they could soak up the healing effects of the Sun, known as heliotherapy or phototherapy. And scientists are now showing why the vitamin D treatments of yore may have done some good in the treatment of TB.
In a collaboration with Medical Research Council's National Institute for Medical Research, study leaders have shown that high doses of the “sunshine” vitamin D, given in addition to antibiotic treatment, appear to help patients recover from TB more quickly.
Published online this week in the Proceedings of the National Academy of Sciences (PNAS), this is the first study to investigate the effect of vitamin D on the immune responses of patients receiving treatment for an infectious disease.
Findings of the study indicate that high doses of vitamin D can dampen down the body´s inflammatory response to infection, enabling the body to recover faster from infection, with less damage to the lungs. The researchers also believe, based on the aspects of their findings, that vitamin D supplementation may also lead to faster recovery times in a number of other diseases such as pneumonia.
“These findings are very significant. They indicate that vitamin D may have a role in accelerating resolution of inflammatory responses in tuberculosis patients,” said Dr. Adrian Martineau, senior lecturer in respiratory infection and immunity at Queen Mary´s Blizard Institute. “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 they may also suffer less lung damage.”
This could have broad-reaching implications for the medical field, as antibiotic treatments may fail over time.
The World Health Organization (WHO) estimates that 3.4 percent of all new TB cases are resistant to the two main drug treatments--known as multiple drug resistant tuberculosis. That figure rises to about 20 percent for people who have been infected multiple times in their lives. Estimates have gone as far to say that half of all cases in some countries were resistant to drug treatment.
Furthermore, there is also concern about extensively drug resistant TB, which is resistant to backup drugs as well. The WHO estimates that 9.4 percent of all drug-resistant TB is extensively drug resistant.
In Dr. Martineau´s study, he and his colleagues, from a number of different London-area hospitals and institutions, randomized 95 TB patients receiving standard antibiotic treatment into two groups. Group one, which included 44 patients, received additional high dose vitamin D over an eight week period. The remaining 51 received only a placebo with regular treatment.
Levels of the inflammatory markers in blood samples taken from the patients were analyzed by study coauthor Dr. Anna Coussens of the Medical Research Center to determine the effects vitamin D had on the first group´s immune response.
“We found that a large number of these inflammatory markers fell further and faster in patients receiving vitamin D,” said Coussens.
The analysis showed that recovery was nearly two weeks faster in the vitamin D group. Patients who completed the regimen cleared the infection in 23 days on average, while the placebo group took 36 days on average to clear the infection.
“This isn't going to replace antibiotics, but it may be a useful extra weapon,” Martineau told James Gallagher of BBC News. “It looks promising, but we need slightly stronger evidence.” He noted that trials in more patients, as well as studies looking at the best dose and if different forms of vitamin D appears to work by calming inflammation during infection. Inflammatory response is an important part of the body´s response to infection.
During TB infection, inflammatory response breaks down some of the scaffolding in the lungs, allowing more infection-fighting white blood cells in to do their job. However, this also creates tiny cavities in the lungs in which TB bacteria can hide out and strike again at a later time.
“If we can help these cavities to heal more quickly, then patients should be infectious for a shorter period of time, and they may also suffer less lung damage,” Martineau said. “We are hoping to do more work to evaluate the effects of higher doses and different forms of vitamin D to see if they have a more dramatic effect.”
Martineau also thought there could be an even greater role in preventing TB. About 33 percent of people have low levels of TB bacteria in their lungs and often show no symptoms (known as latent TB). However, this would turn to full blown TB in about 10 percent of people.
Professor Peter Davies, secretary of the charity TB Alert, believes that giving vitamin D supplements could prevent latent TB from developing. “That would be a massive revolution if it was shown to work,” he told the British news network.
The findings of the study were “excellent,” Davies said, adding that vitamin D could play “an important role in treating tuberculosis.”
“Drug-resistant TB is an increasing concern world-wide and so new treatments to reduce the length of TB treatment would be very welcome,” said Professor Alison Grant, from the London School of Hygiene and Tropical Medicine. “Vitamin D supplements are often given to patients who are short of vitamin D and these low doses are generally very safe.”
“In this study the researchers were giving higher doses of vitamin D, and I think we would need larger studies to be confident that there were no negative effects of this higher dose,” she cautioned.