MedicalResearch.com Interview with:
Professor Adrian Martineau, B Med Sci DTM&H MRCP PhD FRSB
Clinical Professor of Respiratory Infection and Immunity
University of London
MedicalResearch.com: What is the background for this study? What are the main findings?
Response: The World Health Organisation estimates that 10.0 million people developed active tuberculosis in 2017, and that 1.6 million people died of this disease. Multi-drug resistant (MDR) TB is caused by bacteria that are resistant to treatment with at least two of the most powerful first-line anti-TB drugs, causing around 500,000 cases and 150,000 deaths per year worldwide. Existing antibiotic treatments for MDR TB are lengthy, costly and often toxic due to their serious side effects.
One novel approach to treating MDR TB is to complement antibiotic treatment by using therapies that boost the immune system’s ability to kill TB bacteria. Vitamin D – the sunshine vitamin – is known to help white blood cells to make natural antibiotic substances (antimicrobial peptides) that can punch holes in the cell membranes of TB bacteria. Several clinical trials have investigated the effects of adding vitamin D to antibiotic treatment for TB.
In this study we pooled data from 8 of these studies (1850 participants) and analysed them to see if some TB patients benefited more from adding vitamin D to their treatment regimen than others. We found that vitamin D accelerated clearance of TB bacteria from the lungs of patients who had MDR TB; this benefit was not seen in patients who had ‘standard’ drug-sensitive TB.
MedicalResearch.com: What should readers take away from your report?
Response: Addition of vitamin D to antibiotic treatment for MDR TB may accelerate recovery from this disease.
MedicalResearch.com: What recommendations do you have for future research as a result of this work?
Response: A new clinical trial is needed, focusing exclusively on patients with MDR-TB, to see whether addition of vitamin D to antibiotic treatment really can benefit patients.
MedicalResearch.com: Is there anything else you would like to add?
Response: It’s important to emphasise that we are talking about addition of vitamin D to antibiotic treatment here i.e. vitamin D should not replace antibiotics.
Disclosures: I receive funding from the UK Medical Research Council and the US National Institutes of Health in support of clinical trials of vitamin D supplementation for the prevention of tuberculosis.
David A. Jolliffe, Davaasambuu Ganmaa, Christian Wejse, Rubhana Raqib, Md. Ahsanul Haq, Nawal Salahuddin, Peter K. Daley, Anna P. Ralph, Thomas R. Ziegler, Adrian R. Martineau. Adjunctive vitamin D in tuberculosis treatment: meta-analysis of individual participant data. European Respiratory Journal, 2019; 1802003 DOI: 10.1183/13993003.02003-2018
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