Vitamin D and TB treatment

Clinical trial of 95 pts being treated with 8wk course of antibiotics for TB with added high-dose vit d (100K units q2wk x 4 wk) vs placebo (see Coussens AK, PNAS. 2012; 109 (38):15449) showed that those on vitamin d had:

--faster sputum smear conversion to normal
--faster resolution of lymphopenia, monocytosis and high circulating cytokines
--decreased antigen-stimulated proinflammatory cytokines, in particular.  Raises issue that some of TB mortality during treatment (not found in this small study) is related to an exaggerated immune/inflammatory response.  In this study there seemed to be an improved clinical response and the immune modulation actually decreased cytokines associated with increased inflammation.

So, small trial but reinforces positive role of vit d in immune function.  However, important to note that no real clinical outcome differences in this study (other than about a 2 week earlier clearance of the sputum)

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