Vitamin D and solar ultraviolet radiation in the risk and treatment of tuberculosis
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Ralph, Anna P; Norval, M; Lucas, Robyn
Description
Improved understanding of the association between tuberculosis and vitamin D is needed to inform clinical practice. Vitamin D has both immunostimulatory and immunosuppressive effects relevant to human antimycobacterial responses. Ultraviolet radiation, the main source of vitamin D, also induces immunomodulation and could affect the relation between vitamin D and tuberculosis. Clinical trials of vitamin D supplementation in patients with tuberculosis have produced largely negative results,...[Show more]
dc.contributor.author | Ralph, Anna P | |
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dc.contributor.author | Norval, M | |
dc.contributor.author | Lucas, Robyn | |
dc.date.accessioned | 2015-12-13T23:01:46Z | |
dc.identifier.issn | 1473-3099 | |
dc.identifier.uri | http://hdl.handle.net/1885/84577 | |
dc.description.abstract | Improved understanding of the association between tuberculosis and vitamin D is needed to inform clinical practice. Vitamin D has both immunostimulatory and immunosuppressive effects relevant to human antimycobacterial responses. Ultraviolet radiation, the main source of vitamin D, also induces immunomodulation and could affect the relation between vitamin D and tuberculosis. Clinical trials of vitamin D supplementation in patients with tuberculosis have produced largely negative results, prompting the review of dosing regimens-an explanation for low 25-hydroxyvitamin D status in patients with active tuberculosis is also needed. The reporting of vitamin D deficiency needs to address assay inaccuracies, rising thresholds to define sufficiency, and scarce knowledge of the concentrations needed for optimum immune responses. Future research to measure the effect of the inflammatory setting on serum concentrations of 25-hydroxyvitamin D, at tuberculosis diagnosis and during recovery, could help to account for 25-hydroxyvitamin D changes in these concentrations in patients with tuberculosis. Studies into the role of vitamin D supplementation in latent tuberculosis justify clinical trials in this population, but pose methodological challenges. Vitamin D trials in patients with active tuberculosis should be done in well selected populations using adequate vitamin D doses, although such doses remain undefined. | |
dc.publisher | Lancet Publishing Group | |
dc.source | The Lancet Infectious Diseases | |
dc.subject | Keywords: 25 hydroxyvitamin D; antimycobacterial agent; vitamin D; adaptive immunity; clinical practice; disease association; genetic polymorphism; human; hypothesis; immunostimulation; immunosuppressive treatment; innate immunity; observational study; priority jou | |
dc.title | Vitamin D and solar ultraviolet radiation in the risk and treatment of tuberculosis | |
dc.type | Journal article | |
local.description.notes | Imported from ARIES | |
local.identifier.citationvolume | 13 | |
dc.date.issued | 2013 | |
local.identifier.absfor | 111700 - PUBLIC HEALTH AND HEALTH SERVICES | |
local.identifier.ariespublication | f5625xPUB12860 | |
local.type.status | Published Version | |
local.contributor.affiliation | Ralph, Anna P, Charles Darwin University | |
local.contributor.affiliation | Lucas, Robyn, College of Medicine, Biology and Environment, ANU | |
local.contributor.affiliation | Norval, M, University of Edinburgh Medical School | |
local.description.embargo | 2037-12-31 | |
local.bibliographicCitation.issue | 1 | |
local.bibliographicCitation.startpage | 77 | |
local.bibliographicCitation.lastpage | 88 | |
local.identifier.doi | 10.1016/S1473-3099(12)70275-X | |
dc.date.updated | 2016-02-24T08:43:00Z | |
local.identifier.scopusID | 2-s2.0-84871096851 | |
Collections | ANU Research Publications |
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