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Vitamin D status and expression of vitamin D receptor and LL-37 in patients with spontaneous bacterial peritonitis. | LitMetric

AI Article Synopsis

  • - The study investigated the role of vitamin D, its receptor (VDR), and the antimicrobial peptide LL-37 in the development of spontaneous bacterial peritonitis (SBP) in cirrhotic patients, comparing those with SBP to those with simple ascites.
  • - Results showed that cirrhotic patients with ascites had low levels of vitamin D, particularly in the more severe cases, while the SBP group had significantly higher expressions of VDR and LL-37 in their immune cells.
  • - The findings suggest that vitamin D deficiency is common in cirrhosis and that the VDR and LL-37 may play important roles in the immune response to SBP, indicating a link between vitamin D signaling and bacterial infections

Article Abstract

Background: Vitamin D, which exerts its effect through vitamin D receptor (VDR), and LL-37, a vitamin D-dependent antimicrobial peptide, are involved in many infectious diseases.

Aim: The objective of this study was to evaluate whether vitamin D status and expressions of VDR and LL-37 are involved in the pathogenesis of spontaneous bacterial peritonitis (SBP).

Methods: Serum and ascitic fluid 25-dihydroxyvitamin D [25(OH)D] concentrations and levels of VDR and LL-37 in peritoneal leukocytes were measured by ELISA and real-time PCR methods in cirrhotic patients with SBP (n = 19) and cirrhotic patients with simple ascites (n = 28). The correlations between these levels and clinical variables were evaluated.

Results: Cirrhotic patients with ascites showed low vitamin D concentrations in both serum and ascitic fluid. Lower serum vitamin D concentrations were observed in cirrhotic patients with Child-Pugh C class. 25(OH)D concentrations in ascitic fluid were positive correlated with that in serum (r = 0.74, P < 0.001). The SBP group showed significantly higher levels of both VDR and LL-37 mRNA expressions in peritoneal leukocytes than the simple ascites group (P = 0.005 and P = 0.003, respectively). In the SBP group, VDR and LL-37 expressions in peritoneal leukocytes were positively correlated (r = 0.70, P = 0.001).

Conclusions: Vitamin D insufficiency was universal among cirrhotic patients with ascites, and the situation was more severe with more serious cirrhosis. Expressions of peritoneal leukocytes VDR and LL-37 genes were simultaneously up-regulated in cirrhotic patients with SBP when compared with cirrhotic patients with simple ascites. It is indicated that the vitamin D-VDR system and its downstream gene, LL-37, are involved in the pathogenesis and antibacterial immune response to SBP.

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Source
http://dx.doi.org/10.1007/s10620-011-1824-6DOI Listing

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