Background : The toll-like receptor is an essential receptor that stimulates the innate immunity response. In tuberculosis, toll-like receptors, particularly the TLR-2, and TLR-4 are crucial in recognizing various ligands with a lipoprotein structure in the bacilli. Vitamin D deficiency leads to lower expression of these receptors, Hence the immune response against Mycobacterium tuberculosis will be altered. Various studies addressed the importance of vitamin D supplementation in pulmonary tuberculosis but the effect of vitamin D in extrapulmonary tuberculosis, particularly spondylitis tuberculosis is not sufficiently identified. Objectives: To assess the effect of oral vitamin D supplementation on the expression of TLR-2, TLR-4, and clinical outcomes in spondylitis tuberculosis patients. Methodology: This study proposes a randomized clinical trial of oral vitamin D supplementation in spondylitis tuberculosis patients. Multiple arms will be established with different doses and control groups. The outcome of interest includes the clinical outcomes, the expression of TLR-2, and TLR 4 Hypothesis : It is assumed that oral supplementation of Vitamin D will increase the activation of Toll-Like Receptors and improves the clinical condition of Spondylitis Tuberculosis patients
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The Oswestry Disability Index
Timeframe: Changes of Score from Baseline to 8 weeks
The Visual Analogue Scale
Timeframe: Changes of Score from Baseline to 8 weeks
Toll-Like Receptor 2 (TLR-2)
Timeframe: Changes of TLR-2 level from Baseline to 8 weeks
Toll-Like Receptor 4 (TLR-2)
Timeframe: Changes of TLR-4 level from Baseline to 8 weeks