The role of vitamin D deficiency in sepsis and potential therapeutic implications

J Infect. 2011 Nov;63(5):321-6. doi: 10.1016/j.jinf.2011.07.002. Epub 2011 Jul 13.


Recent studies have shown that vitamin D has important functions besides bone and calcium homeostasis. Cells of the innate and adaptive immune system express vitamin D receptors and respond to stimulation by 1, 25-dihydroxyvitamin D. Patients with sepsis have a high mortality rate as well as a high prevalence of vitamin D deficiency. In addition, septic patients have decreased vitamin D binding protein levels which further exacerbates vitamin D deficiency. Therapy with vitamin D in animal models of sepsis improves blood coagulation parameters in disseminated intravascular coagulation and modulates levels of systemic inflammatory cytokines including TNF-α and IL-6. Vitamin D can enhance the induction of the antimicrobial peptides cathelicidin and β-defensin which are found on mucosal and epithelial surfaces and act as the body's first line of defense against viral and bacterial pathogens. Vitamin D is potentially an attractive therapeutic agent for sepsis given its low cost and low risk of toxicity and side effects. Further prospective, randomized, controlled clinical trials of adjunctive vitamin D therapy in patients who are deficient are needed in the management of human sepsis syndrome.

Publication types

  • Review

MeSH terms

  • Adaptive Immunity / physiology
  • Animals
  • Disease Models, Animal
  • Humans
  • Immune System / drug effects*
  • Immune System / immunology
  • Immune System / metabolism
  • Immunity, Innate / physiology
  • Receptors, Calcitriol / genetics
  • Receptors, Calcitriol / metabolism*
  • Sepsis / drug therapy
  • Sepsis / etiology*
  • Sepsis / immunology
  • Vitamin D / physiology
  • Vitamin D / therapeutic use*
  • Vitamin D Deficiency / complications*
  • Vitamin D Deficiency / drug therapy
  • Vitamin D Deficiency / immunology


  • Receptors, Calcitriol
  • Vitamin D