肺結核の集中期抗菌剤治療中の高用量ビタミンD ((3)):ダブルブラインドランダム化対照試験
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
まとめ
ビタミンDサプリメントは,すべての患者で結核治療期間を大幅に短縮することはありませんでした. しかし,特定のビタミンD受容体遺伝子変異体 (TaqI tt遺伝子型) を有する個体において,唾液培養の変換を加速させた.
科学分野:
- 肺内医学 肺内医学 肺内医学
- 感染症 感染症は感染症です.
- 栄養科学とは,栄養科学である.
背景:
- ビタミンDは,過去に治療された結核およびその代謝産物には,インビトロ抗菌特性があります.
- 臨床試験における培養の変換に対する補助的なビタミンDの効果は,まだ十分に調査されていない.
研究 の 目的:
- 肺結核を患った成人における唾液培養の変換を加速させるための補助ビタミンD3の有効性を評価する.
- 治療反応に対するビタミンD受容体 (VDR) 遺伝子ポリモルフィズム (TaqIとFokI) の影響を調査する.
主な方法:
- 146人の大人を対象とした多センターランダム化対照試験で,唾液検査で陽性肺結核を発症した.
- 参加者は,標準的な結核治療とビタミンD3 (2.5mg投与量) またはプラセボを42日間投与された.
- TaqIとFokIのVDRポリモルフィズムに対する遺伝子型決定は,遺伝子型特異的な治療効果を分析するために行われました.
主要な成果:
- ビタミンD3のサプリメントは,プラセボと比較して,血清の25-ヒドロキシビタミンD濃度を有意に増加させた.
- 唾液培養の変換までの平均時間の有意な違いは,全体的な研究集団では観察されなかった.
- TaqI tt遺伝子型 (p=0.02) の患者では,唾液培養の変換の有意な加速が認められた.
結論:
- 添加ビタミンD3は,結核治療中に血清ビタミンDのレベルを効果的に上昇させた.
- ビタミンDのサプリメントは,培養の変換時間を普遍的に短縮することはなかったが,TaqI tt VDR遺伝子型を有する患者に有意な利点を示した.
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