Vitamin D and immune function in chronic kidney disease.
The common causes of death in chronic kidney disease (CKD) patients are cardiovascular events and infectious disease. These patients are also predisposed to the development of vitamin D deficiency, which leads to an increased risk of immune dysfunction. Many extra-renal cells possess the capability to produce local active 1,25(OH)2D in an intracrine or paracrine fashion, even without kidney function. Vitamin D affects both the innate and adaptive immune systems. In innate immunity, vitamin D promotes production of cathelicidin and β-defensin 2 and enhances the capacity for autophagy via toll-like receptor activation as well as affects complement concentrations. In adaptive immunity, vitamin D suppresses the maturation of dendritic cells and weakens antigen presentation. Vitamin D also increases T helper (Th) 2 cytokine production and the efficiency of Treg lymphocytes but suppresses the secretion of Th1 and Th17 cytokines. In addition, vitamin D can decrease autoimmune disease activity. Vitamin D has been shown to play an important role in maintaining normal immune function and crosstalk between the innate and adaptive immune systems. Vitamin D deficiency may also contribute to deterioration of immune function and infectious disorders in CKD patients. However, it needs more evidence to support the requirements for vitamin D supplementation.
Graduate Institute of Clinical Medicine, College of Medicine, Taipei Medical University, No.250, Wuxing Street, Taipei 110, Taiwan; Division of Nephrology, Department of Internal Medicine, Yonghe Cardinal Tien Hospital, No.80, Zhongxing St., Yonghe Dist., New Taipei City 234, Taiwan.
Wen-Chih
WC
Liu
Graduate Institute of Clinical Medicine, College of Medicine, Taipei Medical University, No.250, Wuxing Street, Taipei 110, Taiwan; Division of Nephrology, Department of Internal Medicine, Shuang Ho Hospital, No.291, Zhongzheng Rd., Zhonghe Dist., New Taipei City 235, Taiwan.
Cai-Mei
CM
Zheng
Graduate Institute of Clinical Medicine, College of Medicine, Taipei Medical University, No.250, Wuxing Street, Taipei 110, Taiwan; Division of Nephrology, Department of Medicine, Shin-Kong Wu Ho-Su Memorial Hospital, No.95, Wen Chang Road, Shih Lin Dist., Taipei 111, Taiwan.
Chien-Lin
CL
Lu
Graduate Institute of Clinical Medicine, College of Medicine, Taipei Medical University, No.250, Wuxing Street, Taipei 110, Taiwan; Division of Nephrology, Department of Internal Medicine, Shuang Ho Hospital, No.291, Zhongzheng Rd., Zhonghe Dist., New Taipei City 235, Taiwan.
Yuh-Feng
YF
Lin
Department of Biology and Anatomy, National Defense Medical Center, No.161, Sec. 6, Minquan E. Rd., Neihu Dist., Taipei 114, Taiwan.
Jia-Fwu
JF
Shyu
Division of Nephrology, Department of Medicine, Tri-Service General Hospital, National Defense Medical Center, No.325, Sec. 2, Cheng-Kung Rd., Neihu Dist., Taipei 114, Taiwan. Electronic address: wucc@ndmctsgh.edu.tw.
Chia-Chao
CC
Wu
Department of Medicine, Cardinal Tien Hospital, School of Medicine, Fu Jen Catholic University, No.362, Chung-Cheng Rd, Hsin-Tien Dist., New Taipei City 231, Taiwan. Electronic address: kuochenglu@gmail.com.
Kuo-Cheng
KC
Lu
D056704:Adaptive Immunity; D000818:Animals; D006801:Humans; D007113:Immunity, Innate; D051436:Renal Insufficiency, Chronic / Q000276:immunology* / Q000378:metabolism*; D014807:Vitamin D / Q000378:metabolism*
D014807:Vitamin D
Adaptive immunity; Chronic kidney disease; Innate immunity; Vitamin D