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

基本信息

批准号：
8534237
负责人：
Ganmaa Davaasambuu
金额：
$ 19.27万
依托单位：
HARVARD SCHOOL OF PUBLIC HEALTH
依托单位国家：
美国
项目类别：
财政年份：
2011
资助国家：
美国
起止时间：
2011-09-01 至 2016-07-31
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/8534237
关键词：
Antitubercular Agents Award Back Body Weight Changes CD3 Antigens CD8B1 gene Cause of Death Cell Count Cells Cessation of life Child Clinical Consent Developed Countries Developing Countries Development Epidemiology Evaluation Goals Health Benefit Health Professional Immune Immune response Immunology Infection Interleukin-12 Interleukin-17 Interleukin-2 Interleukin-4 Lead Measures Mediating Mentors Mongolia Outcome Patients Pharmaceutical Preparations Pharmacotherapy Pilot Projects Plasma Prevention Production Public Health Recruitment Activity Regimen Relapse Schools Specimen Sputum Supplementation TNF gene Testing Tuberculosis United States Vitamin D Vitamin D Deficiency Work antimicrobial cytokine disorder prevention follow-up global health immune function improved in vitro testing lymphocyte proliferation macrophage meetings monocyte nutrition nutritional epidemiology protective effect randomized trial tuberculosis drugs

项目摘要

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体现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。我的近期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。凭借这个奖项，我打算成功完成拟议的目标，并开始将自己打造成一名专注于营养相关疾病预防的全球健康专业人士。我计划参加正式的课程作业，定期与我的导师互动，对进展进行正式评估，并每年参加全国会议。预计结核病将成为 1990 年至 2020 年间最大的单一传染病死亡原因。估计的结核病病例和结核病死亡的 95% 以上发生在发展中国家。我们建议研究蒙古结核病营养、免疫学和流行病学的相互关系。具体来说，我们提出了一项试点研究，以测试每日补充维生素 D 对受试者控制结核感染的能力的影响。我们还将针对补充维生素 D 对免疫参数的影响进行推论研究。目标 1：A. 招募受试者、获得同意、向学校儿童分发维生素 D 补充剂、获取生物标本并将这些标本完好无损地运回美国。 B. 检验每日补充维生素 D 会增加 25(OH)D 血浆水平并恢复体外测试的单核细胞/巨噬细胞中 TLR 诱导的抗菌活性的假设。目标 2：确定维生素 D 补充剂作为多种药物治疗的辅助手段在增强结核病抗微生物免疫反应方面的功效。开始维生素 D 治疗后，细菌学治愈将通过确定痰培养转阴性来确定。临床结果包括痰培养转化、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；和细胞因子的产生。相关性：结核病是全球卫生领域的优先事项之一。维生素 D 缺乏症几乎在所有地方都很普遍，无论是在发达国家还是发展中国家，维生素 D 的全部潜力尚不清楚，但积极的结果意味着一种廉价、无毒的方法，并可能具有其他健康益处，可以控制世界上的一个主要杀手。