Calcitriol therapy modulates the cellular immune responses in hemodialysis patients

Am J Nephrol. Mar-Apr 2000;20(2):129-37. doi: 10.1159/000013569.

Abstract

We studied the in vitro and in vivo effects of calcitriol (1,25D) on the cellular immune responses in 19 hemodialysis (HD) patients. In vitro 5-day treatment with 1,25D markedly reduced the HLA-DR expression by peripheral blood CD14(+) monocytes from both HD patients and normal subjects in a similar fashion. The HLA-DR expression by monocytes and the phorbol myristate acetate (PMA)-induced superoxide production (SOP) by neutrophils were significantly higher in the HD patients than in the normal subjects (p < 0.01 and p < 0.05, respectively). The phagocytic activity in the HD patients was significantly lower than that in the normal subjects (p < 0.05). Moreover, the mitogen response of HD peripheral blood lymphocytes against pokeweed mitogen (PWM) was significantly lower than that of the controls (p < 0.01) but was only slightly and insignificantly lower against Con A. Oral 1,25D pulse therapy resulted in a marked decrease in the HLA-DR expression by peripheral blood monocytes 2 and 4 days after the first 1,25D administration (p < 0.01) in HD patients. Moreover, the treatment significantly enhanced the PMA-induced SOP 2 days after the treatment (p < 0.01). However, the phagocytic activity by neutrophils and the mitogen responses to Con A and PWM by lymphocytes were not significantly affected by this treatment. These results suggest that 1,25D plays a significant role in the regulation of both the monocyte and neutrophil functions in HD patients.

Publication types

  • Comparative Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Administration, Oral
  • Adult
  • Aged
  • Calcitriol / administration & dosage
  • Calcitriol / therapeutic use*
  • Calcium Channel Agonists / administration & dosage
  • Calcium Channel Agonists / therapeutic use*
  • Cell Division / drug effects
  • Cells, Cultured
  • Concanavalin A / pharmacology
  • HLA-DR Antigens / immunology
  • Humans
  • Immunity, Cellular / drug effects*
  • Immunity, Cellular / immunology
  • Lipopolysaccharide Receptors / immunology
  • Middle Aged
  • Phagocytes / drug effects
  • Phagocytes / immunology*
  • Phagocytes / metabolism
  • Phagocytes / pathology
  • Phagocytosis / drug effects
  • Pokeweed Mitogens / pharmacology
  • Renal Dialysis / adverse effects*
  • Superoxides / metabolism
  • T-Lymphocytes / drug effects
  • T-Lymphocytes / immunology*
  • T-Lymphocytes / metabolism
  • T-Lymphocytes / pathology
  • Uremia / therapy
  • Vitamin D Deficiency / drug therapy*
  • Vitamin D Deficiency / etiology
  • Vitamin D Deficiency / immunology

Substances

  • Calcium Channel Agonists
  • HLA-DR Antigens
  • Lipopolysaccharide Receptors
  • Pokeweed Mitogens
  • Concanavalin A
  • Superoxides
  • Calcitriol