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Calcitriol supplementation accelerates the recovery of patients with tuberculosis who have vitamin D deficiency: a randomized, single-blind, controlled clinical trial

BACKGROUND: This study aimed to evaluate whether calcitriol supplementation enhances CD4(+) T cell count and prognosis in patients with tuberculosis and low 25(OH)D levels. METHODS: This randomized controlled clinical trial enrolled treatment-naïve patients with tuberculosis admitted to Zigong First...

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Autores principales: Wen, Youli, Li, Lian, Deng, Zhiping
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9074353/
https://www.ncbi.nlm.nih.gov/pubmed/35513795
http://dx.doi.org/10.1186/s12879-022-07427-x
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author Wen, Youli
Li, Lian
Deng, Zhiping
author_facet Wen, Youli
Li, Lian
Deng, Zhiping
author_sort Wen, Youli
collection PubMed
description BACKGROUND: This study aimed to evaluate whether calcitriol supplementation enhances CD4(+) T cell count and prognosis in patients with tuberculosis and low 25(OH)D levels. METHODS: This randomized controlled clinical trial enrolled treatment-naïve patients with tuberculosis admitted to Zigong First People’s Hospital (June 2016 to April 2017). The patients were grouped as the serum 25(OH)D ≥ 75 nmol/L (Normal-25(OH)D) and 25(OH)D < 75 nmol/L (Low-25(OH)D) groups. The Low-Vit-D group was randomized to the Low-25(OH)D and Low-25(OH)D-Calcitriol groups. All patients were treated with the 2HRZE/4HR regimen. The patients in the Low-25(OH)D-Calcitriol group received calcitriol 0.25 µg bid. The main endpoints were CD4(+) T cell count during treatment, time to sputum culture conversion, time to 50% lesion absorption, and a 6-month cure rate. RESULTS: This study included 30 patients in each group. Baseline 25-(OH) D levels and CD4(+) T cell counts were higher in the Normal-25(OH)D group than in the Low-25(OH)D and Low-25(OH)D-Calcitriol groups (25(OH)D: 79.3 ± 3.4 vs. 37.8 ± 13.4 vs. 11.9 nmol/L, P < 0.05; 671 ± 287 vs. 200 ± 110 vs. 194 ± 119 cell/µL, P < 0.05). 25-(OH) D levels and CD4(+) T cell counts increased in the Low-25(OH)D-Calcitriol group during treatment to reach higher levels than in the Low-25(OH)D group at 1, 4, 8, and 24 weeks (all P < 0.05). Compared with the Low-25(OH)D group, the Low-25(OH)D-Calcitriol group showed shorter time to sputum culture conversion (3.2 ± 1.4 vs. 5.9 ± 2.5 days, P < 0.001) and time to 50% lesion absorption (7.4 ± 1.5 vs. 10.9 ± 4.0 days, P = 0.014) and similar to those in the Normal-25(OH)D group (3.1 ± 1.2 and 7.3 ± 1.5 days, respectively. The cure rate was 86.7% in the Low-25(OH)D group and 96.7% in the two other groups. CONCLUSIONS: Calcitriol supplementation can elevate CD4(+) T cell levels, shorten the time to sputum culture conversion, and accelerate lesion absorption in patients with tuberculosis and 25(OH)D deficiency. Trial registration The study is registered at the Chinese Clinical Trial Registry (ChiCTR2000039832)
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spelling pubmed-90743532022-05-07 Calcitriol supplementation accelerates the recovery of patients with tuberculosis who have vitamin D deficiency: a randomized, single-blind, controlled clinical trial Wen, Youli Li, Lian Deng, Zhiping BMC Infect Dis Research BACKGROUND: This study aimed to evaluate whether calcitriol supplementation enhances CD4(+) T cell count and prognosis in patients with tuberculosis and low 25(OH)D levels. METHODS: This randomized controlled clinical trial enrolled treatment-naïve patients with tuberculosis admitted to Zigong First People’s Hospital (June 2016 to April 2017). The patients were grouped as the serum 25(OH)D ≥ 75 nmol/L (Normal-25(OH)D) and 25(OH)D < 75 nmol/L (Low-25(OH)D) groups. The Low-Vit-D group was randomized to the Low-25(OH)D and Low-25(OH)D-Calcitriol groups. All patients were treated with the 2HRZE/4HR regimen. The patients in the Low-25(OH)D-Calcitriol group received calcitriol 0.25 µg bid. The main endpoints were CD4(+) T cell count during treatment, time to sputum culture conversion, time to 50% lesion absorption, and a 6-month cure rate. RESULTS: This study included 30 patients in each group. Baseline 25-(OH) D levels and CD4(+) T cell counts were higher in the Normal-25(OH)D group than in the Low-25(OH)D and Low-25(OH)D-Calcitriol groups (25(OH)D: 79.3 ± 3.4 vs. 37.8 ± 13.4 vs. 11.9 nmol/L, P < 0.05; 671 ± 287 vs. 200 ± 110 vs. 194 ± 119 cell/µL, P < 0.05). 25-(OH) D levels and CD4(+) T cell counts increased in the Low-25(OH)D-Calcitriol group during treatment to reach higher levels than in the Low-25(OH)D group at 1, 4, 8, and 24 weeks (all P < 0.05). Compared with the Low-25(OH)D group, the Low-25(OH)D-Calcitriol group showed shorter time to sputum culture conversion (3.2 ± 1.4 vs. 5.9 ± 2.5 days, P < 0.001) and time to 50% lesion absorption (7.4 ± 1.5 vs. 10.9 ± 4.0 days, P = 0.014) and similar to those in the Normal-25(OH)D group (3.1 ± 1.2 and 7.3 ± 1.5 days, respectively. The cure rate was 86.7% in the Low-25(OH)D group and 96.7% in the two other groups. CONCLUSIONS: Calcitriol supplementation can elevate CD4(+) T cell levels, shorten the time to sputum culture conversion, and accelerate lesion absorption in patients with tuberculosis and 25(OH)D deficiency. Trial registration The study is registered at the Chinese Clinical Trial Registry (ChiCTR2000039832) BioMed Central 2022-05-05 /pmc/articles/PMC9074353/ /pubmed/35513795 http://dx.doi.org/10.1186/s12879-022-07427-x Text en © The Author(s) 2022 https://creativecommons.org/licenses/by/4.0/Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) . The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/ (https://creativecommons.org/publicdomain/zero/1.0/) ) applies to the data made available in this article, unless otherwise stated in a credit line to the data.
spellingShingle Research
Wen, Youli
Li, Lian
Deng, Zhiping
Calcitriol supplementation accelerates the recovery of patients with tuberculosis who have vitamin D deficiency: a randomized, single-blind, controlled clinical trial
title Calcitriol supplementation accelerates the recovery of patients with tuberculosis who have vitamin D deficiency: a randomized, single-blind, controlled clinical trial
title_full Calcitriol supplementation accelerates the recovery of patients with tuberculosis who have vitamin D deficiency: a randomized, single-blind, controlled clinical trial
title_fullStr Calcitriol supplementation accelerates the recovery of patients with tuberculosis who have vitamin D deficiency: a randomized, single-blind, controlled clinical trial
title_full_unstemmed Calcitriol supplementation accelerates the recovery of patients with tuberculosis who have vitamin D deficiency: a randomized, single-blind, controlled clinical trial
title_short Calcitriol supplementation accelerates the recovery of patients with tuberculosis who have vitamin D deficiency: a randomized, single-blind, controlled clinical trial
title_sort calcitriol supplementation accelerates the recovery of patients with tuberculosis who have vitamin d deficiency: a randomized, single-blind, controlled clinical trial
topic Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9074353/
https://www.ncbi.nlm.nih.gov/pubmed/35513795
http://dx.doi.org/10.1186/s12879-022-07427-x
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