Tuberculosis still associated with low vitamin D – 12th meta-analysis

Created June 2021

Impact of vitamin D status and cathelicidin antimicrobial peptide on adults with active pulmonary TB globally: A systematic review and meta-analysis

PLoS One. 2021 Jun 11;16(6):e0252762. doi: 10.1371/journal.pone.0252762. eCollection 2021.

Ester Lilian Acen 1, Irene Andia Biraro 2 3, William Worodria 4, Moses L Joloba 5, Bill Nkeeto 6, Joseph Musaazi 7, David Patrick Kateete 5

1. Overview Tuberculosis and Vitamin D has the following summary {include} - - - - - - - - * Tuberculosis recovery speeded up by single 450,000 IU dose of vitamin D – RCT Jan 2017 * Tuberculosis -100 percent cure rate with 10,000 IU of vitamin D daily – RCT 2006 * Every TB patient benefited from 2 doses of 600,000 IU of vitamin D – RCT Jan 2013 * TB arrested by cod-liver oil (containing vitamin D) in 1848 3X better than other treatments at the time * 📄 PDF 1. # Items in both categories TB and Meta-analysis are listed here: {category} --- 1. A Poor Vitamin D Receptor prevents Vitamin D in blood from getting to the cells * Vitamin D Receptor is associated in over 40 autoimmune studies The risk of 44 diseases at least double with poor Vitamin D Receptor as of Oct 2019 * Omega-3, Magnesium, Zinc, Quercetin, non-daily Vit D, Curcumin, intense exercise, Ginger, Essential oils, etc** Note: The founder of VitaminDWiki uses 10 of the 12 known VDR activators 1. # Items in both categories TB and Vitamin D Receptor: {category}

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Standard mean differences of Vitamin D and TB

Background: Tuberculosis remains a global threat and a public health problem that has eluded attempts to eradicate it. Low vitamin D levels have been identified as a risk factor for tuberculosis infection and disease. The human cathelicidin LL-37 has both antimicrobial and immunomodulatory properties and is dependent on vitamin D status. This systematic review attempts to compare vitamin D and LL-37 levels among adult pulmonary tuberculosis patients to non-pulmonary TB individuals between 16-75 years globally and to determine the association between vitamin D and cathelicidin and any contributing factor among the two study groups.

Methods/design: We performed a search, through PubMed, HINARI, Google Scholar, EBSCOhost, and databases. A narrative synthesis through evaluation of vitamin D and LL-37 levels, the association of vitamin D and LL-37, and other variables in individual primary studies were performed. A random-effect model was performed and weighted means were pooled at a 95% confidence interval. This protocol is registered under the International Prospective Register of Systematic Reviews (PROSPERO), registration number CRD42019127232.

Results: Of the 2507 articles selected 12 studies were eligible for the systematic review and of these only nine were included in the meta-analysis for vitamin D levels and six for LL-37 levels. Eight studies were performed in Asia, three in Europe, and only one study in Africa. The mean age of the participants was 37.3±9.9 yrs. We found low vitamin D and high cathelicidin levels among the tuberculosis patients compared to non-tuberculosis individuals to non-tuberculosis. A significant difference was observed in both vitamin D and LL-37 levels among tuberculosis patients and non-tuberculosis individuals (p = < 0.001).

Conclusion: This study demonstrated that active pulmonary tuberculosis disease is associated with hypovitaminosis D and elevated circulatory cathelicidin levels with low local LL-37 expression. This confirms that vitamin D status has a protective role against tuberculosis disease.

Tags: Meta-analysis Tuberculosis