Role of Adjunctive Vitamin D Therapy in Treatment of Tuberculosis

Abstract

The role of vitamin D in bone homeostasis and calcium metabolism is well documented but some evidences support its immunoregulatory role, particularly in cases of tuberculosis. For many years, vitamin D is being used as an adjunctive therapy in tuberculosis patients though definitive data regarding its importance is lacking. Lack of exposure to sunlight and dietary factors are the most important reasons responsible for vitamin D deficiency. Rifampicin and Isoniazid can also reduce serum vitamin D level. Modern researchers demonstrated probable antimycobacterial action of vitamin D by induction of antimicrobial peptide cathelicidin. But many studies all over the worldrevealed conflicting results. Mean serum vitamin D level is found to be low in tuberculosis patients in most of the studies but supplementation of vitamin D failed to conclusively prove the necessity of such supplementation. Controversies remained regarding the appropriate dosage of vitamin D andduration of this therapy. With the emergence of drug resistant tuberculosis, addition of vitamin D to antituberculous therapy may be considered to improve outcome as we have limited antituberculous drugs in hand. Further research needed for prevention and management of this vitamin deficiency and to improve outcome of Tuberculosis patients.