title: The role of vitamin D deficiency in sepsis and potential therapeutic implications.
abstract: 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.
authors.affiliation: Division of Infectious Diseases, Akron General Medical Center, Akron, OH 44302, USA. rwatkins@agmc.org
authors.forename: Richard R
authors.initials: RR
authors.lastname: Watkins
authors.forename: Alexandra V
authors.initials: AV
authors.lastname: Yamshchikov
authors.forename: Tracy L
authors.initials: TL
authors.lastname: Lemonovich
authors.forename: Robert A
authors.initials: RA
authors.lastname: Salata
mesh_terms: D056704:Adaptive Immunity / Q000502:physiology; D000818:Animals; D004195:Disease Models, Animal; D006801:Humans; D007107:Immune System / Q000187:drug effects* / Q000276:immunology / Q000378:metabolism; D007113:Immunity, Innate / Q000502:physiology; D018167:Receptors, Calcitriol / Q000235:genetics / Q000378:metabolism*; D018805:Sepsis / Q000188:drug therapy / Q000209:etiology* / Q000276:immunology; D014807:Vitamin D / Q000502:physiology / Q000627:therapeutic use*; D014808:Vitamin D Deficiency / Q000150:complications* / Q000188:drug therapy / Q000276:immunology
chemical_list: D018167:Receptors, Calcitriol; D014807:Vitamin D