title: Influence of 1,25-dihydroxyvitamin D3 on human leukocyte antigen-DR expression, macrophage infiltration, and graft survival in renal allografts.
abstract: Vitamin D plays an important role in the regulation of cellular growth and cell proliferation as well as exerting immunoregulatory activities. We sought to show the influence of vitamin D on renal graft survival. Among 102 patients, 40 were treated with vitamin D (group D) and the remaining 62 cases were not, forming a control group (group C). We studied human leukocyte antigen (HLA)-DR expression on tubules, interstitial cells, peritubular capillaries (PTCs), and evaluated macrophage infiltration of the interstitium and the PTCs. Compared to group C, group D patients showed fewer acute rejection episodes. Compared to group C patients group D patients showed significantly lower degrees of tubular and interstitial HLA-DR expression as well as interstitial and PTC macrophage infiltration. In addition in the PTC, HLA-DR expression was greater and therefore PTC destruction less in group D patients (P<.001). Twenty-seven (43.5%) of 62 group C patients lost their grafts at 29.2±15 months, whereas only 7/40 (17.5%) group D patients lost their grafts at 43.2±13 months. A significant difference was noted between the two groups in regard to the time of graft loss (P<.01). Testing vitamin D therapy along with several other covariates showed an independent effect on 5-year graft survival (P<.001). These data confirmed that vitamin D therapy shows an independent positive impact on long-term graft survival, which may be explained by its immunosuppressive effects of to reduce renal HLA-DR expression and renal macrophage infiltration and in turn mitigate PTC destruction. In conclusion, these results highlighted the potential use of vitamin D in renal allograft patients.
authors: Department of Pathology, Baskent University, Ankara, Turkey. handan27@hotmail.com
authors: B H
authors: BH
authors: Özdemir
authors: A A
authors: AA
authors: Özdemir
authors: S
authors: S
authors: Sezer
authors: T
authors: T
authors: Çolak
authors: M
authors: M
authors: Haberal
mesh_terms: D000293:Adolescent; D000328:Adult; D001706:Biopsy; D002117:Calcitriol / Q000494:pharmacology*; D002196:Capillaries / Q000378:metabolism; D005260:Female; D005786:Gene Expression Regulation; D006084:Graft Rejection; D006085:Graft Survival; D006684:HLA-DR Antigens / Q000096:biosynthesis*; D006801:Humans; D016030:Kidney Transplantation / Q000379:methods*; D007684:Kidney Tubules / Q000378:metabolism; D008264:Macrophages / Q000166:cytology / Q000378:metabolism; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D013997:Time Factors; D016896:Treatment Outcome
chemical_list: D006684:HLA-DR Antigens; D002117:Calcitriol