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Does Vitamin D Supplementation Enhance Resolution of Inflammation After Community-acquired Pneumonia?

Not Applicable
Completed
Conditions
Pneumonia
Registration Number
NCT02802722
Lead Sponsor
Queen Mary University of London
Brief Summary

Previous research has shown that people who have been hospitalised for pneumonia are more likely to die of conditions such as heart attacks, stroke and cancer in the weeks to months after their illness. This risk is linked to raised levels of inflammation. Laboratory research shows that vitamin D can help to clear inflammation. Vitamin D deficiency is very common in the United Kingdom. The investigators are conducting this study to find out if taking vitamin D can hasten long-term recovery from pneumonia by reducing inflammation.

Detailed Description

Not available

Recruitment & Eligibility

Status
COMPLETED
Sex
All
Target Recruitment
3
Inclusion Criteria
  1. Adults ≥50 years of age
  2. Vitamin D deficiency at entry, defined as a serum total 25(OH)D concentration <50 nmol/L
  3. Admission to hospital with an acute illness (≤21 days) consistent with community-acquired pneumonia - at least one symptom of a lower respiratory tract infection (cough, sputum production, dyspnoea, wheeze, chest discomfort or pain, fever) and new infiltrate on chest radiograph
  4. Adequate mental capacity to give informed consent for participation in the study and gives written informed consent
Exclusion Criteria
  1. Currently taking any vitamin D supplementation
  2. Known HIV infection, other condition causing immunosuppression, current immunosuppressive therapy or systemic corticosteroids
  3. Known malignancy not in remission for >3 years or terminal illness with prognosis <1year
  4. History of smoking within the previous 1 year
  5. Known or suspected diagnosis of chronic obstructive pulmonary disease (COPD)
  6. Previous hospitalisation within 10 days of admission
  7. Aspiration pneumonia diagnosed by the clinical team
  8. Known diagnosis of cystic fibrosis, bronchiectasis or interstitial lung disease at screening
  9. Complications of pneumonia such as empyema or lung abscess at entry
  10. Recent acute coronary syndrome within the previous 1 month
  11. Long term oxygen therapy, chronic mechanical ventilation dependency or other contraindication to sputum induction
  12. Serum corrected calcium concentration >2.65 mmol/L at entry
  13. Chronic kidney disease stage 4-5 (estimated glomerular filtration rate <30ml/min) on an existing blood sample from the current hospital admission
  14. Known clinical diagnosis of liver failure
  15. Known or suspected diagnosis of active pulmonary tuberculosis
  16. Known diagnosis of primary hyperparathyroidism
  17. Known diagnosis of sarcoidosis
  18. Known diagnosis of nephrolithiasis
  19. Taking carbamazepine, phenytoin, phenobarbital, primidone, cardiac glycosides or benzothiadiazines with concomitant calcium supplementation at entry
  20. Known allergy to vitamin D or its excipients
  21. Currently taking part in another research study

Study & Design

Study Type
INTERVENTIONAL
Study Design
SINGLE_GROUP
Primary Outcome Measures
NameTimeMethod
Plasma IL-6 concentrationsafter 6 weeks of vitamin D3 supplementation

IL-6

Secondary Outcome Measures
NameTimeMethod
Immune cell phenotypes in induced sputum samplesafter 6 weeks of vitamin D3 supplementation

flow cytometry phenotypes, induced sputum

Plasma concentrations of pro- and anti-inflammatory mediators in peripheral bloodafter 6 weeks of vitamin D3 supplementation

Cytokines, lipid mediators, blood

Plasma concentrations of pro- and anti-inflammatory mediators in induced sputum samplesafter 6 weeks of vitamin D3 supplementation

Cytokines, lipid mediators, induced sputum

Total white cell count and differential white cell count in induced sputum samplesafter 6 weeks of vitamin D3 supplementation

WBC and differential counts

Plasma concentrations of pro- and anti-inflammatory mediators in supernatants from whole blood stimulated with antigens ex-vivoafter 6 weeks of vitamin D3 supplementation

Cytokines, lipid mediators, stimulated blood

Whole blood transcriptional profilesafter 6 weeks of vitamin D3 supplementation

mRNA

Pneumonia symptom scoresafter 6 weeks of vitamin D3 supplementation

CAP-Sym scores

Immune cell phenotypes in peripheral bloodafter 6 weeks of vitamin D3 supplementation

flow cytometry phenotypes, blood

Volumes of lung abnormalities on chest CT imagingafter 6 weeks of vitamin D3 supplementation

CT data

Serum CRPafter 6 weeks of vitamin D3 supplementation

CRP

Trial Locations

Locations (1)

Barts Health NHS Trust

🇬🇧

London, United Kingdom

Barts Health NHS Trust
🇬🇧London, United Kingdom

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