Friday, January 1, 2010

Will vitamin D stop the new killer strain of drug-resistant tuberculosis, or is sunlight the cure?

It appears that the first case of drug-resistant TB has arrived in the US from Peru.[1] It is nearly 100% resistant to antibiotics, and does not bode well for the country, since it could cause an immense killer epidemic. There seems to be no answer to the “superbug” that causes it. Or is there an answer? Could sunlight and its skin-produced hormone, vitamin D, provide answers to this latest health threat?

Sunlight has a long history of treatment for tuberculosis. Much of the following discussion of TB comes from Dr. Fielder’s history of heliotherapy.[2]

As early as 1857 Madame Duhamel of France exposed children with TB to sunshine because it hastened their recovery. Many doctors of that same era used heliotherapy (sunlight treatments) with great success, and as Dr. Fielder states, “As a general rule, the experience of all the Hygienists in their use of sunbathing was so successful that all question of doubt as to its place in the Hygienic System was ensured.”

Madame Duhamel was correct about sunbathing healing tuberculosis (TB). Later on, a disillusioned physician, Dr. Rollier, gave up a promising surgical practice and moved to the mountains of the Swiss countryside to practice medicine there. However, he discovered that the people needed little help, as they were seldom sick. People were always telling him, “Where the sun is, the doctor ain’t [sic].” In fact, Dr. Rollier’s fiancĂ©e had TB and would have died without intervention. He brought her to the Alpine area, exposed her regularly to sunshine, and she completely recovered.

Dr. Rollier opened a sanatorium in 1903 that was really just an extremely large solarium (sunbathing facility) with patient living quarters. There were 2,167 patients under Dr. Rollier’s care for TB following World War One. Of these, 1,746 completely recovered their health. Only those in the most advanced stages of the disease failed to recover.

In 1895, Dr. Niels Finsen made use of the first artificial UV light in treating patients with a particularly virulent form of TB known as lupus vulgaris (a skin disease). Though the disease was considered incurable, 41 of every 100 patients under his care recovered. Finsen’s work earned the Nobel Prize in medicine in 1903.

These researchers and physicians were not alone in their observations of the therapeutic power of sunlight. In 1877 two scientists, Arthur Downes and Thomas Blunt, discovered that sunlight was bactericidal. In 1890, the German microbiologist Robert Koch (who had isolated and described the tuberculosis bacterium in 1882), showed that sunlight killed TB bacteria.[3]

Recently, the interest in Vitamin D to thwart TB is being revisited.[4] [5] [6] and it has been shown that Black immigrants to Australia have much lower vitamin D levels than the general population and a much higher risk of TB.[7] Moreover, the effectiveness of vitamin D was demonstrated against the TB bacteria in an experiment in which a single dose of vitamin D (100,000 IU) significantly increased immunity to the TB bacterium.[8] The effectiveness of vitamin D against TB is determined by the production of cathelicidin,[9] an antibacterial peptide, which we could call the “body’s natural antibiotic.”

Further corroborating vitamin D’s essential role is that people who lack vitamin D receptors (VDR) are three times more likely to contract TB as those with normal VDR.[10] Vitamin D also inhibits the body’s inflammatory response to TB infection in the lungs.[11] [12] Considering the efficacy of sunlight therapy and vitamin D in inhibiting or even curing tuberculosis, doesn’t it seem that it’s time to return to the sun? Remember that you should never burn yourself in the sunlight.

[2] Fielder, J. Heliotherapy: the principles & practice of sunbathing. Soil and Health Library (online)
[3] Hobday, R. The Healing sun. Findhorn Press 1999:132
[4] Martineau, A. Effect of vitamin D supplementation on anti-mycobacterial immunity: a double-blind randomized placebo-controlled trial in London tuberculosis contacts. Int J Tuberculosis Lung Dis 2005;9:S173.
[5] Martineau, A. et al. Vitamin D status of tuberculosis patients and healthy blood donors in Samara City, Russia. Int J Tuberculosis Lung Dis 2005;9:S225.
[6] Nnoaham, K. et al. Low serum vitamin D levels and tuberculosis: a systematic review and meta-analysis. Int J Epidemiol 2008;37:113-19.
[7]Gibney, K. et al. vitamin D deficiency is associated with tuberculosis and latent tuberculosis infection in immigrants from sub-Saharan Africa. Clin Infect Dis 2008’46:443-46.
[8]Martineau, A et al. A single dose of vitamin D enhances immunity of mycobacteria. A J Respir Crit Care Med 2007;176:208-13.
[9]Liu, P. et al. vitamin D mediated human antimicrobial activity against mycobacterium tuberculosis is dependent on the induction of cathelicidin. J Immunol 2007;179:2060-63.
[10]Liu, W. et al. A case-control study on the vitamin D receptor gene polymorphisms and susceptibility to pulmonary tuberculosis. Zhonghua Liu Xing Bing Xue Za Zhi 2003;24:389-92.
[11] Selvaraj, P et al. Regulatory role of promoter and 3’ UTR variants of vitamin D receptor gene on cytokine response in pulmonary tuberculosis. J Clin Immunol 2008; January 30. Epub ahead of print.
[12]Vidyarani, M. et al. 1, 25 Hydroxyvitamin D3 modulated cytokine response in pulmonary tuberculosis. Cytokine 2007;40:128-34.