Tuberculosis and vitamin D

Yıl 2014, Cilt: 27 Sayı: 2, 85 - 88, 20.05.2014

Arzu Akşit İlki

Öz

Tuberculosis (TB) is still highly prevalent world-wide accounting
for over one million deaths annually. Especially the multi drugresistant Mycobacterium tuberculosis necessitates the development
of new agents to enhance the response to antimicrobial therapy for
active TB. In the pre-antibiotic era, vitamin D was used to treat
TB. However, after the development of antituberculosis agents, it
lost its importance. Recently, its active metabolite,
1,25-dihydoxyvitamin D, was shown to enhance the immune
response to mycobacteria. Vitamin D does not have a direct killing
effect but 1,25-dihydoxyvitamin D, is a modulater of the immune
system. The synthesis of 1,25-dihydroxyvitamin D promotes the
production of endogen defensin and cathelicidin. These products
have a direct lethal effect on bacteria and intracellular
microorganisms like M.tuberculosis.
In this review, the role of vitamin D in host resistance to
M.tuberculosis infection and its effect for supplementation therapy
is discussed.

Anahtar Kelimeler

Tuberculosis, Vitamin D, 1, 25-dihydoxyvitamin D, Immune response, Defensin, Cathelicidin

Tüberküloz ve D vitamini

Öz

Tüberküloz, hala tüm dünyada yılda bir milyondan fazla kişinin
ölümüne yol açan en yaygın hastalıklardan biridir. Özellikle çoklu
ilaca dirençli Mycobacterium tuberculosis enfeksiyonlarında
antimikrobiyal tedavi cevabını arttırmak için yeni ajanların
gelişimine ihtiyaç duyulmaktadır. Antibiyotik öncesi dönemde
tüberküloz tedavisinde kullanılan D vitamini, antitüberküloz
ilaçların gelişimiyle önemini yitirmiştir. Son zamanlarda D vitamini
aktif metaboliti, 1,25-dihydroxyvitamin D’nin mikobakterilerde
bağışık yanıtı arttırdığı bilinmektedir. D vitamininin direkt
öldürücü etkisi yoktur, ancak 1,25-dihydoxyvitamin D, bağışık
yanıt üzerinde modülator görevi yapar. 1,25-dihydroxyvitamin D
sentezi endojen defensin ve katelisidin sentezini arttırır. Bu
ürünlerin bakterilere ve M.tuberculosis gibi hücre içi yerleşimli
mikroorganizmalara direkt ölümcül etkileri vardır.
Bu derlemede, D vitamininin, M.tuberculosis enfeksiyonunda
konak direncindeki rolü ve destek tedavisi ile ilgili etkileri
tartışılmıştır. 

Anahtar Kelimeler

Tüberküloz, D Vitamini, 1, 25-dihydoxyvitamin D, Bağışık yanıt, Defensin, Katelisidin

Kaynakça

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