Immunomodulatory effect of in vitro calcitriol in fit and frail elderly.

Introduction: Effect of calcitriol on PBMCs of healthy adults have been well studied but not much is known about its effect on the PBMCs of elderly patients with various degree of frailty syndrome and immune senescence. This study was aimed to assess the effect of in vitro calcitriol immunomodulatory effect on IL-6, IL-10 and IFN-γ in elderly patients who were fit, pre-frail and frail to see which group of patients might get the most benefit of calcitriol.

Methods: This study was an experimental study on the PBMCs of 24 elderly people, of which 8 subjects each were in fit, pre-frail and frail categories based on the Cardiovascular Health Study criteria. IL-6, IL-10, and IFN-γ were examined by ELISA, before and after administration of lipopolysaccharide and 100 pg/mL calcitriol into PBMC cultures in vitro.

Result: The mean serum vitamin D level was 26.2 (2.4) ng/ml. Vitamin D level is decreasing along with worsening of frailty status. After LPS induction, calcitriol did not reduce IL-6 and IFN-γ in all the groups. Calcitriol increased IL-10 in all groups, with the most observed change in the pre-frail group.

Conclusion: In vitro administration of calcitriol showed anti-inflammatory potential by increasing IL-10 mainly in pre-frail subjects.