Serious adverse events attributable to vitamin D supplementation were rare across all studies .
On the basis of studies review ed to date , the strongest evidence supports further research into adjunctive vitamin D therapy for tuberculosis , influenza , and viral upper respiratory tract illnesses .
OBJECTIVE To review the existing human controlled intervention studies of vitamin D as adjunctive therapy in setting s of infection and provide recommendations for design and implementation of future studies in this field on the basis of the evidence review ed .
Effects of calcitriol on eosinophil activity and antibody responses in patients with schistosomiasis
Abstract Objective : Parasitic infestations are known to elicit T-helper lymphocyte type 2 ( Th-2 ) reactions , characterized by a pronounced eosinophila and high IgE levels . In humans both elevated specific IgE levels and eosinophil counts are associated with resistance to reinfection with schistosomiasis . This study aim ed to establish whether the Th-2 reaction could be enhanced with calcitriol ( vitamin D3 ) . Calcitriol has been shown to cause a shift from Th-1 to Th-2 type reactions when applied locally to the skin . Methods : Fifty-nine patients with Schistostomahaematobium infection were r and omized to one of four treatment modalities , i.e. ( a ) praziquantel ( PZQ ) 60 mg · kg−1orally on day 1 , ( b ) PZQ 60 mg · kg−1 on day 1 plus calcitriol 1 μg per day orally for 5 consecutive days , ( c ) calcitriol 1 μg per day for 5 consecutive days or ( d ) placebo . Blood for differential counts , eosinophil cationic protein ( ECP ) , specific IgE and IgG to whole-worm antigen , as well as urine sample s for egg counts , were collected on days 0 and 21 . Results : Baseline values did not differ significantly between the groups . Calcitriol alone result ed in significant increases in circulating lymphocytes ( median increase of 5.5 % ) and the percentage of eosinophil vacuolization ( mean increase 28 % ) . It , however , significantly decreased ECP levels ( mean decrease 46 % ) . PZQ in combination with calcitriol significantly enhanced production of specific IgE ( mean increase 213 % ) and IgG ( mean increase of 170 % ) and tended to increase eosinophil vacuolization ( mean increase 22 % ) . All these changes also differed significantly from those in the placebo group . The specific IgE and IgG levels were also significantly higher than the already increased levels seen with PZQ treatment only . ECP levels were , however , not significantly affected by combination therapy , whereas PZQ alone significantly enhanced ECP production ( mean increase 93 % ) . Conclusions : The increases in specific IgE responses and percentage of eosinophil vacuolization favour a Th-2 type of reaction . The ECP values viewed in isolation may , paradoxically , indicate a Th-1 response ; this could , however , have been an artefact due to the method of ECP detection ex vivo . Finally , it would seem that calcitriol does cause some immune augmentation when combined with PZQ therapy in patients with schistosomiasis . However , long-term follow-up is needed to prove that these findings would translate into resistance against reinfection
Serious adverse events attributable to vitamin D supplementation were rare across all studies .
On the basis of studies review ed to date , the strongest evidence supports further research into adjunctive vitamin D therapy for tuberculosis , influenza , and viral upper respiratory tract illnesses .
OBJECTIVE To review the existing human controlled intervention studies of vitamin D as adjunctive therapy in setting s of infection and provide recommendations for design and implementation of future studies in this field on the basis of the evidence review ed .