title: Role of Paricalcitol in Modulating the Immune Response in Patients with Renal Disease.
abstract: Introduction. The aim was to highlight the existence of a relationship between vitamin D deficiency, chronic inflammation, and proteinuria, by measuring neutrophil gelatinase associated lipocalin (NGAL) and common inflammatory markers after administration of paricalcitol, a vitamin D analog, in vivo and in vitro. Methods. 40 patients with end-stage chronic kidney disease (CKD) and secondary hyperparathyroidism and 40 healthy subjects were enrolled. Serum calcium, phosphorus, 25(OH)-vitamin D, parathyroid hormone (PTH), erythrocyte sedimentation rate, high-sensitivity C-reactive protein, interleukin- (IL-) 17, IL-6, IL-1β, interferon-gamma (IFN-γ), tumor necrosis factor-alpha (TNF-α), plasmatic and urinary NGAL, and 24 h albuminuria and proteinuria were measured before and 24 h after an intravenous bolus of paricalcitol (5 mcg). Human peripheral blood mononuclear cells were isolated and stimulated with phytohaemagglutinin. NGAL, IL-1β, IL-17, IL-6, TNF-α, and IFN-γ were measured in the culture medium and in the 24 h urine collection. Results. 25(OH)-vitamin D was lower in CKD than in controls (p < 0.0001), while inflammatory markers were higher in CKD group (p < 0.0001). In vivo and in vitro studies showed a downregulation of NGAL, IL-17, IL-6, IL-1β, TNF-α, and IFN-γ after paricalcitol administration (p < 0.0001). Conclusions. 25(OH)-vitamin D regulates immune and inflammatory processes. Further studies are needed to confirm these data in order to improve the treatment of CKD patients.
authors.affiliation: Chair of Nephrology, Department of Clinical and Experimental Medicine, University of Messina, 98124 Messina, Italy.
authors.forename: Silvia
authors.initials: S
authors.lastname: Lucisano
authors.affiliation: Department of Human Pathology, Unit of Clinical Microbiology, University of Messina, 98124 Messina, Italy.
authors.forename: Adriana
authors.initials: A
authors.lastname: Arena
authors.affiliation: Department of Human Pathology, Unit of Clinical Microbiology, University of Messina, 98124 Messina, Italy.
authors.forename: Giovanna
authors.initials: G
authors.lastname: Stassi
authors.affiliation: Department of Human Pathology, Unit of Clinical Microbiology, University of Messina, 98124 Messina, Italy.
authors.forename: Daniela
authors.initials: D
authors.lastname: Iannello
authors.affiliation: Chair of Nephrology, Department of Clinical and Experimental Medicine, University of Messina, 98124 Messina, Italy.
authors.forename: Gaetano
authors.initials: G
authors.lastname: Montalto
authors.affiliation: Chair of Nephrology, Department of Clinical and Experimental Medicine, University of Messina, 98124 Messina, Italy.
authors.forename: Adolfo
authors.initials: A
authors.lastname: Romeo
authors.affiliation: Chair of Nephrology, Department of Clinical and Experimental Medicine, University of Messina, 98124 Messina, Italy.
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Costantino
authors.affiliation: Chair of Nephrology, Department of Clinical and Experimental Medicine, University of Messina, 98124 Messina, Italy.
authors.forename: Rosaria
authors.initials: R
authors.lastname: Lupica
authors.affiliation: Chair of Nephrology, Department of Clinical and Experimental Medicine, University of Messina, 98124 Messina, Italy.
authors.forename: Valeria
authors.initials: V
authors.lastname: Cernaro
authors.affiliation: Chair of Nephrology, Department of Clinical and Experimental Medicine, University of Messina, 98124 Messina, Italy.
authors.forename: Domenico
authors.initials: D
authors.lastname: Santoro
authors.affiliation: Chair of Nephrology, Department of Clinical and Experimental Medicine, University of Messina, 98124 Messina, Italy.
authors.forename: Michele
authors.initials: M
authors.lastname: Buemi