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Cathelidicin, Vitamin D isoforms levels during the first month of anti-tuberculosis therapy

D Sambrano(1) K Salazar(1,2) F Acosta(1) P Patel(1) M Morán(1) D Candanedo(1,2) J Ortega(6) I Martínez(5) Y Cuadra(4) S Hawkins(4) A Michel de Chávez(5) O Luque(5) J Jurado(4) A Goodridge(1)

1:Instituto de Investigaciones Científicas y Servicios de Alta Tecnología, Ciudad del Saber, Panamá; 2:Universidad Latina de Panamá, Ciudad de Panamá; 3:Laboratorio Regional de Tuberculosis de Colón, Colón Panamá; 4:Caja de Seguro Social, Colón, Panama; 5:Programa de Control de Tuberculosis, Ministerio de Salud, Colón, Panamá.; 6:Universidad Interamericana de Panamá; 7:Universidad de Panamá

Vitamin D has preventive functions against infectious diseases, including tuberculosis. The active form acts as an immunomodulator against Mycobacterium tuberculosis infections. Here, we aim to correlate the vitamin D and isoforms levels and receptor genetics with the dietary patterns of patients on the first month of anti-tuberculosis therapy in Colón, Panama. A total of 80 tuberculosis patients and 50 healthy controls were recruited. A total of 25(OH)D and the Fok1, Tak1, and Bsm1 haplotypes of the vitamin D receptors were determined by ELISA and RFLP-PCR, respectively. Levels of values of isoforms 25(OH)D, 25(OH)D2, 25(OH)D3, and 24,25(OH)2 were obtained by LC-MS/MS.  Our results show that 63% (50/80) of tuberculosis patients have sufficient levels of total vitamin D, compared with 54% (27/50) of healthy controls. We observed a significantly higher level of total vitamin D in tuberculosis patients (41.7 ng/mL) compared to healthy controls (32.8 ng/mL) (Wilcoxon test p<0.005) in the first month of anti-TB therapy.  When looking at vitamin D isoforms 25(OH)D2, 25(OH)D3, and 24,25(OH)D2, we found 0.22, 55.94, and 5.75 ng/mL, respectively, during the first month of anti-tuberculosis therapy. No significant differences were observed in cathelicidin levels between tuberculosis patients (58.7 ng/ml) and healthy controls (53.4 ng/ml). Only the Bsm1 homozygote BB haplotype resulted in a significantly lower total vitamin D level when compared to healthy controls (32.0 vs 53.3 mg/mL p<0.001), respectively. We recommend a complete evaluation of the patient's nutritional and vitamin biochemistry before using vitamin D supplementation during anti-tuberculosis therapy treatment to enhance treatment outcomes.

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