Alterations in vitamin D status and anti-microbial peptide levels in patients in the intensive care unit with sepsis

J Transl Med. 2009 Apr 23;7:28. doi: 10.1186/1479-5876-7-28.

Abstract

Background: Vitamin D insufficiency is common in hospitalized patients. Recent evidence suggests that vitamin D may enhance the innate immune response by induction of cathelicidin (LL-37), an endogenous antimicrobial peptide produced by macrophages and neutrophils. Thus, the relationship between vitamin D status and LL-37 production may be of importance for host immunity, but little data is available on this subject, especially in the setting of human sepsis syndrome and other critical illness.

Methods: Plasma concentrations of 25-hydroxyvitamin D (25(OH)D), vitamin D binding protein (DBP) and LL-37 in critically ill adult subjects admitted to intensive care units (ICUs) with sepsis and without sepsis were compared to healthy controls.

Results: Critically ill subjects had significantly lower plasma 25(OH)D concentrations compared to healthy controls. Mean plasma LL-37 levels were significantly lower in critically ill subjects compared to healthy controls. Vitamin D binding protein levels in plasma were significantly lower in critically ill subjects with sepsis compared to critically ill subjects without sepsis. There was a significant positive association between circulating 25(OH)D and LL-37 levels.

Conclusion: This study demonstrates an association between critical illness and lower 25(OH)D and DBP levels in critically ill patients as compared to healthy controls. It also establishes a positive association between vitamin D status and plasma LL-37, which suggests that systemic LL-37 levels may be regulated by vitamin D status. Optimal vitamin D status may be important for innate immunity especially in the setting of sepsis. Further invention studies to examine this association are warranted.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Antimicrobial Cationic Peptides / blood
  • Case-Control Studies
  • Cathelicidins / blood*
  • Critical Illness
  • Demography
  • Female
  • Health
  • Humans
  • Intensive Care Units*
  • Male
  • Middle Aged
  • Sepsis / blood*
  • Vitamin D / analogs & derivatives
  • Vitamin D / blood*
  • Vitamin D-Binding Protein / blood

Substances

  • Antimicrobial Cationic Peptides
  • Cathelicidins
  • Vitamin D-Binding Protein
  • Vitamin D
  • ropocamptide
  • 25-hydroxyvitamin D