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Vitamin D3 as an anti tuberculosis supplement in spinal tuberculosis treatment

Fajar Yulianto Karna Rajasa, Hermawan Nagar Rasyid, Bambang Tiksnadi, Ahmad Ramdan, Yoyos Dias Ismiarto, Ramco Abtiza.

Abstract
Background: Tuberculous infection susceptibility emerges in individuals with low levels of vitamin D. C-reactive protein (CRP) and erythrocyte sediment rate (ESR) are low during the intensive phase of anti-tuberculous drug (ATD) therapy. Cathelicidin, which is induced by vitamin D, has been proven to reduce the inflammatory process. Methods: This single-blind randomized control trial compared the efficacy of vitamin D in lowering CRP and ESR. The research was conducted at the Hasan Sadikin Hospital Outpatient Clinic and the Clinical Pathology Laboratory from March 2017 through August 2017. Tuberculous infected patients enrolled in the study were assigned to one of two groups; one received vitamin D supplementation, the other didnít received. The Willcoxon statistical test was used to examine the value of CRP in two groups, and the unpaired t-test was used to evaluate ESR values for both groups. Results: The CRP and ESR values in the group receiving vitamin D were significantly lower than in the placebo group (p < 0.05), indicating that vitamin D is beneficial in treating tuberculous infection. Discussion: Vitamin D can increase macrophage activation by increasing cathelicidin, Nitrogen Oxide (NO), and Reactive Oxygen Species (ROS) production. Conclusions: Giving vitamin D3 800 International Units (IU) supplementation increases the efficacy of ATDs in spine tuberculosis treatment.

Key words: CRP and ESR, Spine tuberculosis, Vitamin D3



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