title: Inflammation, vitamin D and dendritic cell precursors in chronic kidney disease.
abstract: Decreased blood dendritic cell precursors (DCP) count is linked with atherosclerotic disease, while reduction of circulating DCP is also seen in patients with chronic kidney disease (CKD). As poor vitamin D status could be linked to a compromised innate immune response, we hypothesized that vitamin D status might be involved in the decrease in circulating DCP in CKD. Moreover, the potential role of inflammation was considered. Circulating myeloid (mDCP), plasmacytoid (pDCP) and total DCP (tDCP) were analysed using flow cytometry in 287 patients with CKD stage 3. Serum 25(OH)D and 1,25(OH)2D levels were measured using enzyme-linked immunosorbent assays (ELISA), interleukin (IL)-6, IL-10 and tumour necrosis factor (TNF)-α using cytometric bead array, C-reactive protein (CRP) using a high-sensitivity (hs) ELISA. Contrary to our hypothesis, there was no association between vitamin D levels and DCP, although their number was decreased significantly in CKD (P < 0·001). Instead, mDCP (r = -0·211) and tDCP (r = -0·188,) were associated slightly negatively with hsCRP but positively with the estimated glomerular filtration rate (eGFR, r = 0·314 for tDCP). According to multivariate linear regression, only higher hsCRP concentration and the presence of diabetes mellitus had a significant negative influence on DCP count (P < 0·03, respectively) but not vitamin D, age and eGFR. A significant impact of vitamin D on the reduction of circulating DCP in CKD 3 patients can be neglected. Instead, inflammation as a common phenomenon in CKD and diabetes mellitus had the main influence on the decrease in DCP. Thus, a potential role for DCP as a sensitive marker of inflammation and cardiovascular risk should be elucidated in future studies.
authors.affiliation: Department of Internal Medicine III, Jena University Hospital, Friedrich-Schiller University, Jena, Germany.
authors.forename: K
authors.initials: K
authors.lastname: Paul
authors.affiliation: Department of Internal Medicine III, Jena University Hospital, Friedrich-Schiller University, Jena, Germany.
authors.forename: S
authors.initials: S
authors.lastname: Franke
authors.affiliation: Institute of Medical Biometry, Informatics and Epidemiology at Rhenish Friedrich-Wilhelm University, Bonn, Germany.
authors.forename: J
authors.initials: J
authors.lastname: Nadal
authors.affiliation: Institute of Medical Biometry, Informatics and Epidemiology at Rhenish Friedrich-Wilhelm University, Bonn, Germany.
authors.forename: M
authors.initials: M
authors.lastname: Schmid
authors.affiliation: Department of Internal Medicine II, Division of Cardiology, Elisabeth Klinikum Schmalkalden GmbH, Schmalkalden, Germany.
authors.forename: A
authors.initials: A
authors.lastname: Yilmaz
authors.affiliation: Department of Internal Medicine I, Division of Cardiology and Intensive Care Medicine, Jena University Hospital, Friedrich-Schiller University, Jena, Germany.
authors.forename: D
authors.initials: D
authors.lastname: Kretzschmar
authors.affiliation: Chair of Medical Informatics, University of Erlangen-Nürnberg, Erlangen, Germany.
authors.forename: B
authors.initials: B
authors.lastname: Bärthlein
authors.affiliation: Department of Nephrology and Hypertension, University of Erlangen-Nürnberg, Erlangen, Germany.
authors.forename: S
authors.initials: S
authors.lastname: Titze
authors.affiliation: Department of Medicine IV, University Hospital Freiburg, Freiburg, Germany.
authors.forename: A
authors.initials: A
authors.lastname: Koettgen
authors.affiliation: Department of Internal Medicine III, Jena University Hospital, Friedrich-Schiller University, Jena, Germany.
authors.forename: G
authors.initials: G
authors.lastname: Wolf
authors.affiliation: Department of Internal Medicine III, Jena University Hospital, Friedrich-Schiller University, Jena, Germany.
authors.forename: M
authors.initials: M
authors.lastname: Busch
mesh_terms: D000368:Aged; D015415:Biomarkers; D002097:C-Reactive Protein; D002452:Cell Count; D015897:Comorbidity; D003713:Dendritic Cells; D005260:Female; D006801:Humans; D007249:Inflammation / Q000150:complications*; D008297:Male; D008875:Middle Aged; D051436:Renal Insufficiency, Chronic / Q000097:blood* / Q000209:etiology*; D012307:Risk Factors; D013234:Stem Cells; D014807:Vitamin D / Q000097:blood*
chemical_list: D015415:Biomarkers; D014807:Vitamin D; D002097:C-Reactive Protein
keywords: cytokines; dendritic cells; inflammation