Delayed hypersensitivity in primary and secondary hyperparathyroidism. Treatment with active vitamin D.
The vitamin D endocrine system, besides its traditional role in mineral metabolism, also affects the immune system. A recent study demonstrated that vitamin D supplementation restored a blunted delayed hypersensitivity response (DH) in elderly vitamin D-deficient subjects. In the present study the DH, as measured by the tuberculin test (PPD), was studied in two groups of patients with a disturbed vitamin D system, i.e. primary hyperparathyroidism (HPT) and secondary HPT due to chronic renal failure. A significant reduction in DH was found in the patients with chronic renal failure when compared to control subjects (4.1 +/- 5.3 vs 12 +/- 9.3 mm, p less than 0.05) whereas only a non-significant tendency to a reduced DH was seen in the HPT patients (9.5 +/- 9.2 mm). Treatment with alphacalcidol, a synthetic analogue to the active vitamin D metabolite over 3-6 months did not affect the DH in any of the hyperparathyroid patient groups. Thus it seems likely that other factors than vitamin D were involved in their reduced DH response.
Lind
L
L
Department of Internal Medicine Gävle, Uppsala, Sweden.
Wengle
B
B
Sörensen
O H
OH
Ljunghall
S
S
D002117:Calcitriol / Q000097:blood; D004311:Double-Blind Method; D006801:Humans; D006961:Hyperparathyroidism / Q000150:complications*; D006968:Hypersensitivity, Delayed / Q000188:drug therapy* / Q000209:etiology; D007111:Immunity, Cellular / Q000187:drug effects; D007676:Kidney Failure, Chronic / Q000150:complications; D014374:Tuberculin Test; D014807:Vitamin D / Q000494:pharmacology*
D014807:Vitamin D; D002117:Calcitriol