A single dose of vitamin D enhances immunity to mycobacteria.
BACKGROUND
Vitamin D was used to treat tuberculosis (TB) in the preantibiotic era. Prospective studies to evaluate the effect of vitamin D supplementation on antimycobacterial immunity have not previously been performed.


OBJECTIVE
To determine the effect of vitamin D supplementation on antimycobacterial immunity and vitamin D status.


METHODS
A double-blind randomized controlled trial was conducted in 192 healthy adult TB contacts in London, United Kingdom. Participants were randomized to receive a single oral dose of 2.5 mg vitamin D or placebo and followed up at 6 weeks.


RESULTS
The primary outcome measure was assessed with a functional whole blood assay (BCG-lux assay), which measures the ability of whole blood to restrict luminescence, and thus growth, of recombinant reporter mycobacteria in vitro; the readout is expressed as a luminescence ratio (luminescence postinfection/baseline luminescence). IFN-gamma responses to the Mycobacterium tuberculosis antigens early secretory antigenic target-6 and culture filtrate protein 10 were determined with a second whole blood assay. Vitamin D supplementation significantly enhanced the ability of participants' whole blood to restrict BCG-lux luminescence in vitro compared with placebo (mean luminescence ratio at follow-up, 0.57, vs. 0.71, respectively; 95% confidence interval for difference, 0.01-0.25; p=0.03) but did not affect antigen-stimulated IFN-gamma secretion.


CONCLUSIONS
A single oral dose of 2.5 mg vitamin D significantly enhanced the ability of participants' whole blood to restrict BCG-lux luminescence in vitro without affecting antigen-stimulated IFN-gamma responses. Clinical trials should be performed to determine whether vitamin D supplementation prevents reactivation of latent TB infection. Clinical trial registered with www.clinicaltrials.gov (NCT 00157066).
Martineau
Adrian R
AR
Centre for Health Sciences, Queen Mary's School of Medicine and Dentistry, Barts and The London, and Department of Clinical Biochemistry, North West London Hospitals NHS Trust, Northwick Park Hospital, Harrow, E1 2AT, UK. a.martineau@qmul.ac.uk
Wilkinson
Robert J
RJ
Wilkinson
Katalin A
KA
Newton
Sandra M
SM
Kampmann
Beate
B
Hall
Bridget M
BM
Packe
Geoffrey E
GE
Davidson
Robert N
RN
Eldridge
Sandra M
SM
Maunsell
Zoë J
ZJ
Rainbow
Sandra J
SJ
Berry
Jacqueline L
JL
Griffiths
Christopher J
CJ
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D019587:Dietary Supplements; D004311:Double-Blind Method; D004334:Drug Administration Schedule; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007113:Immunity, Innate / Q000187:drug effects*; D008297:Male; D008875:Middle Aged; D014376:Tuberculosis / Q000276:immunology*; D014807:Vitamin D / Q000008:administration & dosage / Q000494:pharmacology*; D014815:Vitamins / Q000008:administration & dosage / Q000494:pharmacology*
D014815:Vitamins; D014807:Vitamin D