Association of Vitamin D Deficiency with Cathelicidin (LL-37) Level in Drug Resistant TB Patients

Abstract

Background Antimicrobial peptide LL-37 is produced in response to active vitamin D produces immunomodulatory effects and inhibits Mycobacterium tuberculosis replication in vitro. To date, no such clinical studies have been conducted to show the relationship between 25hydroxyvitamin D and drug-resistant tuberculosis patients in Pakistan. Objective: This study was conducted to find the association between insufficiencies of vitamin D and Cathelicidin LL-37 in drug-resistant tuberculosis patients and compare them with the control group. Methodology: Newly diagnosed drug-resistant TB patients and healthy controls ages 15-50 years old (mean 27.17, SD ± 10.37 years) were enrolled. Plasma LL-37 and serum 25 (OH) D levels were measured by ELISA technique in 46 patients and 94 controls. Results There was a significant difference (p-value <.001) in the level of Vitamin D in both case and control groups. Vitamin D insufficiency prevalence was 57.8% and 42.2% with the mean baseline concentrations of 34.39ng/mL (SD ± 15.28) and 39.41 ng/mL (SD ± 18.28) in cases and control respectively. In the mean serum concentrations 52.95 ng /mL (SD ± 19.67) and 39.00 ng /mL (SD ± 18.02) of LL-37 in cases and control respectively, there was a significant difference of P-value < 0.001 was found. However, concentrations of vitamin D were not associated with serum LL-37 concentrations (p-value > 0.05). Conclusion Cathelicidine LL-37 is a potential biomarker of TB disease. However, the relationship between vitamin D &  LL-37 requires further studies in TB patients. Keywords Vitamin D; Cathelicidin LL-37; Drug-resistant tuberculosis