Vitamin D supplementations as adjunct to anti-tuberculosis drugs in Mongolia

蒙古将维生素 D 补充剂作为抗结核药物的辅助药物

• 批准号: 8416711
• 负责人: Ganmaa Davaasambuu
• 金额: $ 22.98万
• 依托单位: HARVARD SCHOOL OF PUBLIC HEALTH
• 依托单位国家: 美国
• 财政年份: 2011
• 资助国家: 美国
• 起止时间: 2011-09-01 至 2014-07-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8416711
• 关键词: Vitamin; supplementations; adjunct; anti; tuberculosis

DESCRIPTION (provided by applicant): Our enthusiasm for this project reflects our commitment to Mongolian public health sector development as well as our sense of urgency to resolve the vitamin D crisis and tuberculosis in Mongolia. My immediate and long term goals are to broaden my expertise in global health and nutritional epidemiology. With this award I intend to successfully complete the proposed aims and begin to establish myself as a global health professional with a focus in nutrition-related disease prevention. I plan to take formal course works, interact regularly with my mentors with formal evaluations of the progress and attend national meetings annually. Tuberculosis is predicted to be the largest single infectious cause of death between 1990 and 2020. More than 95% of the estimated TB cases and deaths due to TB occur in developing countries. We propose to examine the inter-relationships of nutrition, immunology, and epidemiology with respect to TB in Mongolia. Specifically, we propose a pilot study to test the effect of a daily vitamin D supplementation on the ability of subjects to control TB infection. We will also perform corollary studies on the effect of vitamin D supplementation on immune parameters. Aim 1: A. To recruit subjects, obtain consent, distribute vitamin D supplements to the children in the schools, obtain biologic specimens and to transport those specimens intact back to the United States. B. To test the hypothesis that daily vitamin D supplementation will increase plasma levels of 25(OH) D, and restore TLR-induced antimicrobial activity in monocytes/macrophages tested in vitro. Aim 2: To determine the efficacy of vitamin D supplement as an adjunct to multi drug therapy in enhancing the anti-microbial immune response to TB. Bacteriologic cure after the start of vitamin D therapy will be determined by ascertaining conversion of sputum culture to negative. The clinical outcomes include sputum culture conversion, relapse, or death. Cell-mediated immune endpoints will be measured including CD4+, CD8+, and CD3+ cell counts; ex vivo lymphocyte proliferation; and cytokine production. Relevance: Tuberculosis is one of the priorities in global health. Vitamin D deficiency is prevalent almost everywhere, both in developed and developing countries, the full potential of vitamin D is unknown but positive results would mean an inexpensive, non-toxic means, with possible other health benefits, to control a major killer in the world.

描述（由申请人提供）： 我们对该项目的热情反映了我们对蒙古公共卫生部门发展的承诺，以及解决蒙古维生素D危机和结核病的紧迫感。我的直接和长期目标是扩大我在全球健康和营养流行病学方面的专业知识。有了这个奖项，我打算成功完成拟议的目标，并开始将自己确立为全球卫生专业人员，重点是与营养有关的疾病预防。我计划参加正式的课程工作，定期与导师进行正式评估，并每年参加全国会议。预计结核病是1990年至2020年之间最大的单一感染原因。估计的结核病病例中有95％以上是在发展中国家发生的结核病。我们建议研究蒙古在结核病方面的营养，免疫学和流行病学的关系。具体而言，我们提出了一项试验研究，以测试补充维生素D对受试者控制结核病感染能力的影响。我们还将对补充维生素D对免疫参数的影响进行推论研究。目标1：A。要招募受试者，获得同意，向学校的儿童分发维生素D补充剂，获取生物标本，并将这些标本完好地运回美国。 B.为了测试以下假设：补充每日维生素D将增加25（OH）D的血浆水平，并恢复在体外测试的单核细胞/巨噬细胞中TLR诱导的抗菌活性。目标2：确定维生素D补充剂作为多药治疗增强抗微生物免疫反应的辅助性。维生素D治疗开始后的细菌学治疗将通过确定痰培养为阴性的转化来确定。临床结果包括痰培养，复发或死亡。将测量细胞介导的免疫终点，包括CD4+，CD8+和CD3+细胞计数；离体淋巴细胞增殖；和细胞因子产生。相关性：结核病是全球健康的优先事项之一。在发达国家和发展中国家，维生素D缺乏症几乎在任何地方都普遍存在，维生素D的全部潜力尚不清楚，但积极的结果将意味着一种廉价的，无毒的手段，具有其他健康益处，可以控制世界上的主要杀手。