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1994-08-27
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Document 0679
DOCN M9480679
TI [The relationship between tuberculosis, vitamin D, potassium and AIDS. A
message for South Africa?]
DT 9410
AU Lochner JD; Schneider DJ; Departement Geneeskundige Fisiologie en
Biochemie, Universiteit; van Stellenbosch, Tygerberg.
SO S Afr Med J. 1994 Feb;84(2):79-82. Unique Identifier : AIDSLINE
MED/94317066
AB The converging epidemics of tuberculosis and acquired immunodeficiency
syndrome (AIDS) in the RSA and their expected catastrophic interaction
afford an ideal opportunity for well-planned and essential research by
clinicians, molecular biologists, epidemiologists and other health
workers. The enigmatic relationship between tuberculosis, vitamin D and
calcium is a field of study which should be considered urgently. An
optimal vitamin D status not only assures sound calcium-phosphorus
homeostasis, but is also essential for maximal immune competency.
Hypovitaminosis D probably predisposes towards vulnerability to
tuberculosis due to deficient monocyte-macrophage function. In contrast,
hypervitaminosis D can correct this deficiency, but would do so at the
cost of both B- and T-lymphocyte efficiency. One example of such a state
is the endogenous over-production of activated vitamin D by
gamma-interferon-activated monocytes, tissue macrophages and
granulomatous tissue in tuberculosis. This would not only cause the
coincidental hypercalcaemia, but may also complicate the effective
co-ordination of monocyte-lymphocyte interaction and consequently
compromise an appropriate immune response. It can reasonably be expected
that the raised plasma interferon levels in the AIDS patient may trigger
similar vitamin D-related pathophysiological processes. It is proposed
that the ideal situation for enhanced vulnerability to tuberculosis in
the AIDS patient will have been created if the known destructive effects
of the human immunodeficiency virus on CD4-positive lymphocytes act
synergistically with the vitamin D-mediated complications listed above.
DE *Acquired Immunodeficiency Syndrome/DRUG THERAPY/EPIDEMIOLOGY English
Abstract Human *Potassium/PHARMACOLOGY/THERAPEUTIC USE South
Africa/EPIDEMIOLOGY *Tuberculosis/DRUG THERAPY/EPIDEMIOLOGY *Vitamin
D/PHARMACOLOGY/THERAPEUTIC USE JOURNAL ARTICLE
SOURCE: National Library of Medicine. NOTICE: This material may be
protected by Copyright Law (Title 17, U.S.Code).