Deficiency in Fat-soluble Vitamins A, D, E in Patients with Pulmonary Multidrug-Resistant Tuberculosis

Öz

Objective: The treatment management of Multidrug-Resistant Tuberculosis (MDR-TB) is a major global public health problem. The development of this form of tuberculosis increases immune deficiency and the production of free radicals in the body. Micronutrients, especially fat-soluble vitamins A, D, and E, play an essential role in the immune system by protecting and renewing cells. The objective of this study is to determine the profiles of vitamins A, D, and E in order to evaluate the performance of the immune defenses of MDR-TB under second-line anti-TB treatment. Methods: The analysis of vitamins A, D and E was carried out using an HPLC chain, in isocratic mode by UV-Visible detection after prior extraction of the lipid fraction from the serum in the hexane protected away from light. Results: MDR-TB showed a significant decrease in the concentration of vitamins A, D, and E (p˂0.05) with high reduction levels of 80%, 40% and 50%, respectively. Conclusion: The persistence of this deficit after six months of TB treatment highlights the need for corrective measures to be taken, such as the supplementation of vitamins A, D, and E. J Microbiol Infect Dis 2020; 10(4): 199-207.

Anahtar Kelimeler

• Micronutrients
• Multidrug resistant
• Tuberculosis
• HPLC
• Côte d’Ivoire

Kaynakça

1. 1- WHO: World Health Organization. Principes directeurs à l’intention des programmes antituberculeux pour la prise en charge des tuberculoses pharmacorésistantes. Genève, Suisse, 2008; WHO/HTM/TB/2008, p:402. 276.
2. 2- Edem VF, Ige O, Arinola OG. Plasma vitamins and essential trace elements in multi-drug resistant tuberculosis patients before and during chemotherapy. Egypt J Chest Dis Tuberc 2016; 65: 441–445.
3. 3- WHO: World Health Organization. Global tuberculosis report. Geneva, Switzerland 20th ed, 2015; http://www.who.int/iris/handle/10665/191102. Description. p 192.
4. 4- Schaaf H S, Moll A P, Dheda K. Multidrug and extensively drug-resistant tuberculosis in Africa and South America: epidemiology, diagnosis and management in adults and children. Clin Chest Med, 2009; 30: 667–683.
5. 5- Anonyme. Programme National de Lutte Contre la Tuberculose (PNLT), Plan Stratégique National 2012 – 2015 de lutte contre la Tuberculose, 2012; p: 65.
6. 6- UN: Union Nation- Projet de document final du Sommet des Nations Unies consacré à l’adoption du programme de développement pour l’après-2015. Soixante-neuvième session. New York, Etats Unis, 2015; http://www.adequations.org/spip.php?article2318, p: 38.
7. 7- Shah NS, Moodley P, Babaria P, et al. Rapid diagnosis of tuberculosis and multidrug resistance by the microscopic-observation drug-susceptibility assay, Am J Respir Crit Care Med 2011; 183:1427–33.
8. 8- Sharma M, Thibert L, Chedore P, et al. Canadian multicenter laboratory study for standardized second-line antimicrobial susceptibility testing of Mycobacterium tuberculosis. J Clin Microbiol 2011; 49: 4112–4116.

9. 9- Prasad AS. Zinc: role in immunity, oxidative stress and chronic inflammation. Clin Nutr Metab Care 2009; 12: 646–52.
10. 10- Russell DG, Cardona PJ, Kim MJ, Allain S, Altare F. Foamy macrophages and the progression of the human tuberculosis granuloma. Nat Immunol 2009; 10: 943–8.
11. 11- Simeone R, Sayes F, Song O, et al. Cytosolic Access of Mycobacterium tuberculosis: critical impact of phagosomal acidification control and demonstration of occurrence in vivo. PLoS Pathog 2015; 11:
12. 12- Eklund D, Persson HL, Larsson M, et al. Vitamin D enhances IL-1b secretion and restricts growth of mycobacterium tuberculosis in macrophages from TB patients. Int. J. Mycobacteriol 2013; 2: 18–25.
13. 13- Pawar BD, Suryakar AN, Khandelwal AS. Effect of micronutrients supplementation on oxidative stress and antioxidant status in pulmonary tuberculosis. Biomed Res 2011; 22: 455-459.
14. 14- Bhootra YM, Babu S. Malnutrition in Tuberculosis. In: Preedy V., Patel V. (eds) Handbook of Famine, Starvation, and Nutrient Deprivation. Springer, Cham 2018; 19 p.
15. 15- Steingart KR, Sohn H, Schiller I, et al. Xpert® MTB/RIF assay for pulmonary tuberculosis and rifampicin resistance in adults. Cochrane Database Systeme 2013; Review 1: CD 009593.
16. 16- N’Guessan KK, Alagna R, Dutoziet CC, et al. Genotyping of mutations detected with GeneXpert. Int J Mycobacteriol 2016; 5: 142–147.
17. 17- Zaman Z, Fielden P, Frost PG. Simultaneous determination of vitamins A and E and carotenoids in plasma by reversed-phase HPLC in elderly and younger subjects. Clin Chem 1993; 39: 2229–34.
18. 18- Beglinger Ch., Seibold F, Rogler G. Valeurs standard en laboratoire. http://www.gastro.medline.ch/Services_et_outils/Valeurs_standard_en_laboratoire/Valeurs_standard_en_laboratoire Biochimie.php, 2010, consulté le 02 Septembre 2013.
19. 19- Martineau AR, Timms PM, Bothamley GH, 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.
20. 20- Rajendra P, Irfan A, Ram ASK, Wahid A, Mahendra KG, Mohd S. Vitamin A and zinc alter the immune function in tuberculosis. Kuwait Med J 2012; 44:183–189.
21. 21- Irfan A, Srvasttava VK, Prasad M, Yusuf M, Safia, Saleen M, Wahid A. Deficiency of micronutrient status in pulmonary tubercolosis patients in North India. Biomed Res 2011; 22: 449–454.
22. 22- Edem VF, Ige O, Arinola OG, Plasma vitamins and essential trace elements in newly diagnosed pulmonary tuberculosis patients and at different durations of anti-tuberculosis chemotherapy. Egypt J Chest Dis Tuberc 2015; 64: 675–679.
23. 23- Pakasi TA, Karyadi E, Suratih DNM, et al. Zinc and vitamin A supplementation fails to reduce sputum conversion time in severely malnourished pulmonary tuberculosis patients in Indonesia. Nutr J 2010; 9: 41.
24. 24- Bahi GA, Boyvin L, Méité S, et al. Assessments of serum copper and zinc concentration, and the Cu/Zn ratio determination in patients with multidrug resistant pulmonary tuberculosis (MDR-TB) in Côte d’Ivoire. BMC Infectious Diseases 2017; 17: 257.
25. 25- Nelson CD, Renhardt TA, Beitz DC, Lippolis JD. In vivo activation of the intracrine vitamine D pathway in innate immune cells and mammary tissue during a bacterial infection. PLoS One 2010; 5: e15469.
26. 26- Landrier J F. Vitamine D: sources, métabolisme et mécanismes d’action. OCL 2014; 21: 302–309.
27. 27- Mallet E. Dossier Vitamine D: comment mieux comprendre le métabolisme de la vitamine D? Réalités Pédiatriques 2013; 181: 16–20.
28. 28- Murry E. Actualités sur la vitamine D et nouvelles perspectives thérapeutiques. Thèse de Doctorat en Pharmacie. Université Joseph Fourier de Grenoble, France 2011; p:125.
29. 29- Bhimrao DP, Adinath NS, Archana SK. Effect of micronutrients supplementation on oxidative stress and antioxidant status in pulmonary tuberculosis. Biomed Res 2011; 22: 455–459.