ABSTRACT
It has been suggested that some micronutrients have antioxidant and immunomodulating effects on the treatment of mycobacterial disease. In this study, we investigated the effect of vitamin E and selenium supplementation on clinical responses in tuberculosis patients. Thirty-five patients with pulmonary tuberculosis diagnosed on the basis of a positive sputum smear for acid fast bacilli or culture for Mycobacterium tuberculosis were selected. Serial sputum examinations were performed before the diagnosis and at the end of every 15 days, during two months of therapy; chest X-ray of all patients were also evaluated. In a setting of double-blind, placebo-controlled trial, the patients were divided into two groups. Group I[n=17] received combination of vitamin E and selenium which composed of 140 mg of +-TE and 200 ?g selenium per day, and group II received placebo. All patients in both groups received the same antituberculosis standard therapy. Clinical examination and assessment of micronutrient levels were carried out before and after 2 months of intervention. In group I, elimination of tubercle bacilli from sputum occurred earlier than in group II [6 weeks versus 8 weeks, respectively; p= 0.001]. At the end of the 2[nd] and 6[th] month of therapy, the median reduction in cavity surface area on chest X-ray in group I was significantly more than group II [2[nd] month: 1.5[0.0-4.5 versus 9.0[4.0-18.0];p= 0.03, and 6[th] month: 0.0[0.0-2.3] versus 6.3[1.0-15.8]; p < 0.05, respectively]. Vitamin E plus selenium supplementation may improve the microbiological and radiological outcomes of the treatment in patients with pulmonary tuberculosis
Subject(s)
Humans , Male , Female , Vitamin E , Selenium , Treatment OutcomeABSTRACT
The effects of vitamins on human immune system have been well studied. Vitamin A deficiency and its effects on immune system in pulmonary tuberculosis [TB] patients have been established. This study was carried out to evaluate vitamin A supplementary effect on immunologic profile of tuberculosis patients. In a double-blind clinical trial, thirty-five patients with confirmed pulmonary tuberculosis were included. The case group received vitamin A injection, 50000 lU, every 10 days for two months along with standard treatment of TB; the control group received only anti-TB drugs. Immunologic profiles including CD3+, CD4+, CD8+, CD4+/CD8+, CD19+, HLA-DR, CD16+56+, and plasma vitamin A as well as nutritional status were assessed in both groups primarily and two months after above-mentioned treatments. Data were analysed using SPSS software version 10. The study showed that there were not significant differences in mean[ +/- SD] of age, body weight, height, body mass index [BMI], fat thickness and vitamin A plasma level between the vit A-receiving and control groups. The mean of peripheral blood CD3+ showed significant increase in patient-control group [71.8 +/- 7.9% lymphocytes [after supplementation] compared with 68.3 +/- 10.7% [before supplementation]; p= 0.014.]. This was also true about CD4+ [p= 0.001]. CD4+ to CD8+ ratio and the mean of CD19+ showed significant decrease in the patient control group and the vit A-receiving group, respectively [p= 0.002 and p= 0.04, respectively]. In contrast, there was an increased significant difference for CD+16+56+ mean in the above-mentioned groups which was more prominent in the vit A- receiving group [p=0.038]. The means of HLA-DR and CD8+ did not show significant differences in both groups before and after supplementation. It seems that vitamin A supplementary effects on the quality of lymphocytic markers are remarkable. However, further studies should be performed regarding immunologic response quality