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Alta dosis de vitamina D durante el tratamiento antimicrobiano de fase intensiva de la tuberculosis pulmonar: un
Adrian R Martineau1, Peter M Timms, Graham H Bothamley
1Queen Mary University of London, Barts and The London School of Medicine and Dentistry, London, UK. a.martineau@qmul.ac.uk
Lancet (London, England)
|January 11, 2011
Resumen
La suplementación con vitamina D no acortó significativamente la duración del tratamiento de la tuberculosis en todos los pacientes. Sin embargo, aceleró la conversión del cultivo de esputo en individuos con una variante genética específica del receptor de vitamina D (genotipo TaqI tt).
Área de la Ciencia:
- Medicina Pulmonar La medicina pulmonar es el tratamiento de las enfermedades pulmonares.
- Enfermedades infecciosas Enfermedades infecciosas.
- Ciencias de la Nutrición Ciencias de la Nutrición
Sus antecedentes:
- La vitamina D trató históricamente la tuberculosis y sus metabolitos muestran propiedades antimicobácterias in vitro.
- El efecto de la vitamina D adyuvante en la conversión del cultivo de esputo en ensayos clínicos sigue siendo poco investigado.
Objetivo del estudio:
- Evaluar la eficacia de la vitamina D3 adyuvante en la aceleración de la conversión de cultivos de esputo en adultos con tuberculosis pulmonar.
- Investigar la influencia de los polimorfismos genéticos del receptor de vitamina D (VDR) (TaqI y FokI) en la respuesta al tratamiento.
Principales métodos:
- Un ensayo controlado aleatorizado multicéntrico que involucró a 146 adultos con tuberculosis pulmonar positiva en el frotis de esputo.
- Los participantes recibieron el tratamiento estándar para la tuberculosis más vitamina D3 (2,5 mg de dosis) o placebo durante 42 días.
- Se realizó genotipización para los polimorfismos TaqI y FokI VDR para analizar los efectos del tratamiento específicos del genotipo.
Principales resultados:
- La suplementación con vitamina D3 aumentó significativamente los niveles séricos de 25-hidroxivitamina D en comparación con el placebo.
- No se observó una diferencia significativa en el tiempo medio de conversión al cultivo de esputo en la población general del estudio.
- Se observó una aceleración significativa de la conversión del cultivo de esputo en pacientes con el genotipo TaqI tt (p=0,02).
Conclusiones:
- La vitamina D3 adyuvante elevó efectivamente los niveles séricos de vitamina D durante el tratamiento de la tuberculosis.
- La suplementación de vitamina D no acortó universalmente el tiempo de conversión del cultivo de esputo, pero mostró un beneficio significativo en pacientes con el genotipo TaqI tt VDR.
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