Micronutrient status and immune function in tuberculosis.

Both macro- and micronutrients have been shown to affect resistance to tuberculosis, which is mediated by macrophages activated by T lymphocytes. Others have demonstrated inhibition of mycobacterial replication in macrophage cultures treated with vitamin D or retinoic acid. We examined the influence of dietary zinc and vitamin D on resistance to tuberculosis. Guinea pigs were fed diets containing varying levels of zinc or vitamin D, and infected 6 weeks later by the respiratory route with virulent Mycobacterium tuberculosis. Zinc-deficient guinea pigs had fewer circulating T cells and reduced tuberculin (PPD) hypersensitivity. The response of peritoneal exudate macrophages to the lymphokine MIF was impaired. Zinc deprivation did not influence disease resistance in BCG-vaccinated or nonvaccinated animals. Vitamin D deficiency adversely affected the tuberculin reaction and ability to control the infection. Lymphocytes from vitamin D-deprived animals did not proliferate normally when cultured with PPD. A diet supplemented with vitamin D enhanced T cell responses to PPD in vivo. These results suggest that zinc and vitamin D status affect immunity to tuberculosis.