Trinity scientists working alongside St James’ Hospital have made a significant breakthrough in the study of drug-resistant tuberculosis (TB) treatment. The breakthrough shows how vitamin A drives the human lung’s immune system to control TB.
The advances help us to understand how vitamin A works to support the lung’s immunity from TB. It outlines vitamin A as a therapeutic option to treat TB. The vitamin works to support the recycling and waste disposal functions of the human immune system, known as autophagy. This allows for better clearance of the bacteria which causes TB. The finding is significant as it is not believed that TB can become resistant to vitamin A.
Vitamin A deficiencies are commonly observed in patients with TB, and this results in a ten fold increase in the risk of contracting the disease.
The research has shown how white cells known as macrophages are strengthened in controlling bacteria associated with TB when supported with vitamin A. The scientists had previously demonstrated that this vitamin could also drive anti-inflammatory signals in the human lung. They noted that this combination of anti-inflammatory properties and the controlling of white cells was a particularly attractive therapeutic option.
The Trinity scientists have also made advances in showing how vitamin A supports the immune system in treating and curing other serious lung infections such as whooping cough. This welcomed development comes at a time where the incidence of whooping cough is increasing, with the Health Service Executive (HSE) recording 117 cases of the disease in 2015.
The research was funded by the Health Research Board (HRB), the Royal City of Dublin Hospital Trust, and the Irish Research Council, and was conducted at the Trinity Translational Medicine Institute at St James’s Hospital. Trinity Professor of Medicine Joseph Keane was the senior author on the paper. The findings have been published in a top respiratory journal, the American Journal of Respiratory Cell and Molecular Biology.
While this study outlines the value of vitamin A in combating TB, it cannot be synthesised by the body, and must be obtained from a person’s diet. It is noted that this can be difficult to obtain based on the individual’s socio-economic background. The study goes on to find that this is a reason why the deficiency is prevalent in under-developed and developing countries.
In outlining the significance of the findings and her satisfaction with the advances, Dr Sharee Basdeo stated: “TB remains a pressing global issue affecting millions worldwide. The high prevalence of vitamin A deficiency is a major driver in the global TB epidemic. Our next step will be to translate our research from the laboratory bench to the bedside. If this works out, we would plan to add vitamin A to the existing drug therapies to improve the outcome for our patients.”
TB is the largest infectious killer in the world, and has multiple drug resistant forms, which do not respond to common antibiotics. In 2016, the disease killed 1.7 million people worldwide. Its resistance to traditional drugs and antibiotics require additional strategies to treat the disease.
TB is a disease which spreads through the inhaling of infected droplets made when a TB sufferer coughs. It is a disease associated to malnutrition and its susceptibility is generally related to the general health of those infected. It is also common amongst people taking immuno-suppressant drugs, smokers, or those who have diabetes or HIV.