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CORRESPONDENCE
Year : 2015  |  Volume : 141  |  Issue : 6  |  Page : 840-841

Role of genetic variants of vitamin D immunomodulation genes in clinical response to treatment of tuberculosis


1 BioMedical Genomics Centre, PG Polyclinic Buliding (3[rd] Floor), 5- Suburban Hospital Road, Kolkata 700 020; F-140, Rail Vihar, 480, Madurdaha, Kolkata 700 107, West Bengal, India
2 Department of Biochemistry, KPC Medical College & Hospital, Jadavpur, Kolkata 700 032, West Bengal, India

Date of Web Publication14-Jul-2015

Correspondence Address:
Soumyadeep Bhaumik
BioMedical Genomics Centre, PG Polyclinic Buliding (3[rd] Floor), 5- Suburban Hospital Road, Kolkata 700 020; F-140, Rail Vihar, 480, Madurdaha, Kolkata 700 107, West Bengal
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/0971-5916.160726

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How to cite this article:
Bhaumik S, Hazra N. Role of genetic variants of vitamin D immunomodulation genes in clinical response to treatment of tuberculosis. Indian J Med Res 2015;141:840-1

How to cite this URL:
Bhaumik S, Hazra N. Role of genetic variants of vitamin D immunomodulation genes in clinical response to treatment of tuberculosis. Indian J Med Res [serial online] 2015 [cited 2020 Apr 5];141:840-1. Available from: http://www.ijmr.org.in/text.asp?2015/141/6/840/160726

Sir,

We read with great interest the recently published study [1] on the role of vitamin D on the type and clinical outcome of tuberculosis (TB). The authors did not find any role of baseline vitamin D levels with either the type or clinical outcome but they reported that children with sufficient levels of vitamin D were more likely to have sputum smear conversion at two months than those who did not have sufficient levels. A faster (or higher proportion of patients achieving) sputum smear conversion is an important outcome from the point of view of TB control since even a modest change would significantly alter the risk of transmission of the bacilli within the community.

We wish to point out that host gene polymorphisms for genes involved in vitamin D immunomodulation [2] are a potential clinically relevant factor which needs to be further investigated. The first study [3] which investigated this was from Lima, Peru and reported a faster sputum smear conversion among study participants with Taq1 Tt genotype (VDR-vitamin D receptor) compared to those with Taq TT genotype. Another randomized controlled trial [4 ] has also demonstrated that vitamin D supplementation significantly hastened sputum culture conversion in only the participants with TaqI tt genotype (VDR) (8.09, 95% CI 1.36-48.01; p0 =0.02) [4] . Genome-wide analysis has also underlined the role played by CYP27B1 (1-alpha hydroxylase) as a key mediator of innate immune function and adaptive immunity [5] , but this has not yet been clinically studied. Genetic polymorphisms of other genes which are responsible for vitamin D immunomodulation [2],[5] like toll-like receptor (TLR), vitamin D binding protein (VDBP) might also be related to therapeutic response to vitamin D supplementation in TB. There is a need to study the role of genetic variants of these genes in studies such as this and it might pave the way for "population stratification" strategies for TB control in future.

We suggest that an ad-hoc analysis on various genetic polymorphisms related to vitamin D immunomodulation mechanism should be undertaken to better understand the clinical relevance of vitamin D as a therapeutic agent for TB.

 
   References Top

1.
Khandelwal D, Gupta N, Mukherjee A, Lodha R, Singh V, Grewal HM, et al & Delhi Pediatric TB Study Group. Vitamin D levels in Indian children with intrathoracic tuberculosis. Indian J Med Res 2014; 140 : 531-7.  Back to cited text no. 1
    
2.
Liu PT, Stenger S, Li H, Wenzel L, Tan BH, Krutzik SR, et al. Toll-like receptor triggering of a vitamin D-mediated human antimicrobial response. Science 2006; 311 : 1770-3.  Back to cited text no. 2
    
3.
Roth DE, Soto G, Arenas F, Bautista CT, Ortiz J, Rodriguez R, et al. Association between vitamin D receptor gene polymorphisms and response to treatment of pulmonary tuberculosis. J Infect Dis 2004; 190 : 920-7.  Back to cited text no. 3
    
4.
Martineau AR, Timms PM, Bothamley GH, Hanifa Y, Islam K, Claxton AP, et al. High-dose vitamin D(3) during intensive-phase antimicrobial treatment of pulmonary tuberculosis: a double-blind randomised controlled trial. Lancet 2011; 377 : 242-50.  Back to cited text no. 4
    
5.
Chun RF, Liu PT, Modlin RL, Adams JS, Hewison M. Impact of vitamin D on immune function: lessons learned from genome-wide analysis. Front Physiol 2014; 5 : 151.  Back to cited text no. 5
    




 

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