Tuberculosis (TB) is one of the deadliest infectious disease in the world that is brought on by the bacteria Mycobacterium tuberculosis.
By Ishrat Fatima
Introduction
According to the most recent estimates, M. tuberculosis has infected around one-fourth of all individuals on Earth, and it kills 1.4 million people annually. However, nearly 2 billion people worldwide are currently infected with tuberculosis, which has very old origins. The lungs are typically affected by tuberculosis (TB), however other organs such as the kidneys, intestines, brain, and spine may also be distressed thus developing pulmonary and extra pulmonary tuberculosis. For the control of the illness in a given region, it is crucial to comprehend the molecular epidemiology of TB. Numerous epidemiological studies demonstrate the link between a vitamin D deficiency and TB susceptibility.
Tuberculosis (TB)
Tuberculosis (TB) is a contagious ancient chronic condition that is caused by the bacteria Mycobacterium tuberculosis. Mycobacterium that is aerobic bacilli belongs to actinomycetes. . One-fourth of the worldwide TB burden is primarily borne by India. Nearly 2 billion people worldwide are currently infected with tuberculosis, which has very old origins. In 80–90% of instances, these aerobic bacteria cause pulmonary tuberculosis, which affects the lungs. While 5 to 20% cases of extra-pulmonary tuberculosis, which mostly affects bones, lymph nodes, joints, and the central nervous system. To focus on preventive measures, it is necessary to understand the risk factors for tuberculosis, such as vitamin D insufficiency.
The Drug Resistance
A large number of antibiotics were used in the treatment of TB. However antibiotics are more expensive and more likely to cause antibiotic resistance with the increasing rate of multiple drug resistant. Streptomycin, created by Waksman in 1943, has been used to treat TB ever since. Many other drugs have been used for its treatment such as isoniazid, rifampicin etc. Many new drugs have been added to this list. The drug resistance risk is increasing, with the increasing list of drugs. By strengthening the host immune system along with overpowering the organism, we can better compete with Tuberculosis. Vitamin D can be used for this approach.
Vitamin D
Vitamin D is a fat soluble vitamin and in the pre antibiotic era it was one of the effective adjuncts in the TB treatment. Previous reports showed that the consistent effectiveness of vitamin D in treating tuberculosis infections, irrespective of whether the vitamin D was produced in the skin from the effects of sunshine, taken orally as cod-liver oil, or put into solution and injected directly into the body and vitamin D increases the cure rate of TB. Vitamin D is well recognized for its role in bone metabolism and calcium homeostasis. Vitamin D increases the immunity in host system Vitamin D enhances the antimicrobial activity of monocytes and macrophage.
Vitamin D Role in Treatment of Tuberculosis (TB):
Prior studies showed that, a comprehensive range of antibiotics were used in the treatment of TB as the conventional treatment. But the use of vitamin D in TB treatment somewhat ignored. Vitamin D regulates the immune system in a significant way and affects the pathogenesis of TB by a variety of ways. Vitamin D possess immunomodulatory activity and it activates the expression of cathelicidin. Cathelicidin is involved in release of cytokines and activates the macrophages which show antibacterial and antiviral activity Vitamin D plays a role in interferon gamma mediated action against mycobacterium at the level of macrophages. This activity involves the generation of oxidative species and the encouragement of phagolysosome fusion, which results in the destruction of mycobacteria. Higher immunological activity and less severe tissue damage are associated with tuberculosis patients with increased vitamin D levels. So, low vitamin D levels cause pulmonary and extra pulmonary TB, which can be treated with vitamin D supplements.
Conclusion
Anti-TB drugs are limited due to increasing resistance and longer duration of treatment. So newer strategies use vitamin D in the treatment of TB. Low vitamin D levels are associated with progression to TB. Higher vitamin D deficiency causes severe TB disease. It can be cured by taking vitamin D supplements. So, it has encouraged to use vitamin D supplementation in the treatment of tuberculosis