Evre 3-5 Kronik Böbrek Hastalarında Hematopoetik Hücrelerdeki Vitamin D Reseptör Düzeyi İle İnflamasyon Belirteçlerinin Değerlendirilmesi

Amaç: Bu çalışmada, evre 3-5 kronik böbrek hastalarında (KBH) vitamin D replasmanının CD3+,CD4+, CD8+ ve CD14+ hematopoietik hücre alt gruplarındaki vitamin D reseptör (VDR) yüzdesi ile inflamatuar belirteçlerle ilişkisini değerlendirmeyi amaçladık. Yöntem: Bu prospektif çalışmada evre 3-5 KBH 'sı olan renal replasman tedavisi almayan; tahmini glomerüler filtrasyon hızı (tGFH) ≤60ml/dk/1,73m2 olan 81 hasta katıldı. Serum kreatinin, tGFH,intakt parathormon (iPTH), 25 OH vitamin D düzeyleri, CRP, nötrofil, lenfosit değerleri veCD3+, CD4+, CD8+, CD14+ hematopoietik hücrelerde VDR yüzdeleri hesaplandı. Hastalar, 25OH VD3 düzeylerine göre Vitamin D eksikliği tanısıyla (

Evaluation Of Vitamin D Receptor Level In Hematopoetic Cells And Inflammatory Markers In Stage 3-5 Chronic Renal Patients

Objective: In this study, we aimed to compare the relationship of vitamin D replacement with the percentage of vitamin D receptor (VDR) in CD3+, CD4+, CD8+ and CD14+ hematopoietic cells and inflammatory markers in stage 3-5 CKD patients. Method: In this prospective study, 81 stage 3-5 (not on renal replace- ment treatment) CKD patients with estimated glomerular filtration rate (eGFR)≤60ml/min/1.73m2 were included. Serum creatinine, eGFR, intact parathormone (iPTH), 25 OH Vitamin D3 levels, CRP, neutrophil, lymphocyte values and VDR percentages in CD3+,CD4+,CD8+,CD14+ hematopoi- etic cells were calculated. Patients were divided into groups with a diagnosis of Vitamin D deficiency (

___

  • 1. Dai L, Golembiewska E, Lindholm B, Stenvinkel P. End-Stage Renal Disease, Inflammation and Cardiovascular Outcomes. Contrib Nephrol 2017; 191:32-43.
  • 2. Gupta J, Mitra N, Kanetsky PA, Devaney J, Wing MR, Reilly M, Shah VO, Balakrishnan VS, Guzman NJ, Girndt M, Periera BG, Feldman HI, Kusek JW, Joffe MM, Raj DS, CRIC Study Investigators Association between albuminuria, kidney function, and inflammatory biomarker profile in CKD in CRIC. Clin J Am Soc Nephrol 2012; 7: 1938–46.
  • 3. Cobo G, Lindholm B, Stenvinkel P. Chronic inflammation in end-stage renal disease and dialysis Nephrol Dial Transplant 2018 Oct 1;33(suppl 3): iii35-iii40.
  • 4. Jankowska M, Cobo G, Lindholm B et al. Inflammation and protein-energy wasting in the uremic milieu. Contrib Nephrol 2017; 191: 58–71.
  • 5.Gonzalez EA, Sachdeva A, Oliver DA, Martin KJ. Vitamin D insufficiency and deficiency in chronic kidney disease. A single center observational study. Am J Nephrol 2004; 24:503-10.
  • 6.Figuiredo-Dias V, Cuppari L, Garcia-Lopes MG, de Carvalho AB, Draibe SA, Kamimura MA. Risk factors for hypovitaminosis D in nondialyzed chronic kidney disease patients. J Ren Nutr 2012;22: 4-11.
  • 7.Dusso AS, Brown AJ, Slatopolsky E. Vitamin D. Am. J. Physiol. Ren. Physiol 2005; 289: F8–F28. 8.Fraser DR, Kodicek, E. Unique biosynthesis by kidney of a biological active vitamin D metabolite. Nature 1970; 228: 764–6.
  • 9.Andress DL. Vitamin D in chronic kidney disease: a systemic role for selective vitamin D receptor activation. Kidney Int 2006; 69:33-43.
  • 10.Adams JS, Rafison B, Witzel S, Reyes RE, Shieh A, Chun R, Zavala K, Hewison M, Liu PT. Regulation of the extrarenal CYP27B1-hydroxylase. J Steroid Biochem Mol Biol 2014; 144:22-7.
  • 11.Cunningham J, Zehnder D. New vitamin D analogs and changing therapeutic paradigms. Kidney Int 2011; 79:702-7.
  • 12.Christakos S, DeLuca HF. Minireview: vitamin D: is there a role in extraskeletal health? Endocrinology 2011; 152:2930-6.
  • 13.Zhang Y, Leung DY, Richers BN, Liu Y, Remigio LK, Riches DW, Liu Y, Remigio LK, Riches DW, Goleva E. Vitamin D inhibits monocyte/macrophage proinflammatory cytokine production by targeting MAPK phosphatase-1. J Immunol 2012;188:2127-35.
  • 14.Valdivielso JM, Fernandez E. Vitamin D receptor polymorphisms and diseases. Clin Chim Acta 2006; 371:1-12.
  • 15.Baeke F, Korf, H, Overbergh L, van Etten E, Verstuyf A, Gysemans C, Mathieu, C. Human T. lymphocytes are direct targets of 1,25-dihydroxyvitamin D3 in the immune system. J. Steroid Biochem. Mol. Biol 2010; 121: 221–7.
  • 16.Mahon BD, Wittke A, Weaver V, Cantorna, MT. The targets of vitamin D depend on the differentiation and activation status of CD4 positive T cells. J. Cell. Biochem 2003; 89: 922–32.
  • 17.Takiishi T,Van Belle T, Gysemans C, Mathieu C. Effects of vitamin D on antigenspecific and non-antigen-specific immune modulation: Relevance for type 1 diabetes. Pediatr. Diabetes 2013; 14: 81–9.
  • 18.Jeffery LE, Burke F, Mura M, Zheng Y, Qureshi OS, Hewison, M, Ker LS, Lammas, DA, Raza K, Sansom, DM. 1,25-Dihydroxyvitamin D3 and IL-2 combine to inhibit T cell production of inflammatory cytokines and promote development of regulatory T cells expressing CTLA-4 and FoxP3. J. Immunol 2009; 183: 5458–67.
  • 19.Cantorna, MT, Snyder L, LinYD, Yang, L. Vitamin D and 1,25(OH)2D regulation of T cells. Nutrients 2015; 7: 3011–21.
  • 20. Baeke F, Gysemans C, Korf H, Mathieu C. Vitamin D insufficiency: Implications for the immune system. Pediatr. Nephrol 2010; 25: 1597–606.
  • 21.Li YC, Kong J, Wei M, Chen ZF, Liu SQ, Cao LP. 1, 25-Dihydroxyvitamin D 3 is a negative endocrine regulator of the renin-angiotensin system. J Clin Invest. 2002; 110:229–38.
  • 22.Drechsler C, Verduijn M, Pilz S, Dekker FW, Krediet RT, Ritz E, Wanner C, Boeschoten EW, Brandenburg V; NECOSAD Study Group. Vitamin D status and clinical outcomesin incident dialysis patients: results from the NECOSAD study. Nephrol Dial Transplant 2011; 26:1024-32.
  • 23.Honda H, Qureshi AR, Heimbürger O, Barany P, Wang K, Pecoits-Filho R, Stenvinkel P, Lindholm B. Serum albumin, C-reactive protein, interleukin 6, and fetuin a as predictors of malnutrition, cardiovascular disease, and mortality in patients with ESRD. Am J Kidney Dis 2006; 47:139-48.
  • 24.M Wolf , A Shah, O Gutierrez, E Ankers, M Monroy, H Tamez, D Steele, Y Chang, C A Camargo Jr, M Tonelli, R Thadhani Vitamin D levels and early mortality among incident hemodialysis patients Kidney Int 2007;72:1004-13.
  • 25.Zoccali C, Vanholder R, Massy ZA, Ortiz A, Sarafidis P, Dekker FW, Fliser D, Fouque D, Heine GH, Jager KJ, Kanbay M, Mallamaci F, Parati G, Rossignol P, Wiecek A and London G; on behalf of the European Renal and Cardiovascular Medicine (EURECA-m) Working Group of the European Renal Association – European Dialysis Transplantation Association (ERA-EDTA). The systemic nature of CKD. Nature 2017;13: 344-58.
  • 26.Gupta J , Mitra N, Kanetsky P, Devaney J, Wing MR, Reilly M, Shah VO, Balakrishnan VS, Guzman NJ, Girndt M, Periera BG, Feldman HI, Kusek JW, Joffe MM, Raj DS, CRIC Study Investigators Association between albuminuria, kidney function, and inflammatory biomarker profile in CKD in CRIC. Clin. J Am Soc Nephrol 2012; 7: 1938–46.
  • 27.Cohen G, Haag-Weber M, Horl WH. Immune dysfunction in uremia. Kidney Int Suppl 1997; 62:79–82.
  • 28.Girndt M, Sester M, Sester U, Kaul H, Kohler H. Molecular aspects of T- and B-cell function in uremia.Kidney Int Suppl 2001;78:206–11.
  • 29.Vaziri ND, Pahl MV, Crum A, Norris K. Effect of uremia on structure and function of immune system. J Ren Nutr 2012; 22:149–56.
  • 30.Williams S, Malatesta K, Norris K. Vitamin D and chronic kidney disease. Ethn Dis 2009; 19:8-11.
  • 31.Melamed ML, Thadhani RI. Vitamin D therapy in chronic kidney disease and end stage renal disease. Clin J Am Soc Nephrol 2012; 7:358-65.
  • 32. Franca Gois PH, Wolley M, Ranganathan D, Seguro AC. Vitamin D Deficiency in Chronic Kidney Disease: Recent Evidence and Controversies. Int J Environ Res Public Health. 2018; 15:1773.
  • 33. Martens PJ, Gysemans C, Verstuyf A, Mathieu C. Vitamin D’s Effect on Immune Function Nutrients 2020; 12:1248.
  • 34.Colotta, F., Jansson, B., Bonelli, F. Modulation of inflammatory and immune responses by vitamin D. J Autoimmun 2017; 85: 78–97.
  • 35.Xu, H, Soruri, A, Gieseler RK, Peters, J.H. 1,25-Dihydroxyvitamin D3 exerts opposing effects to IL-4 on MHC class-II antigen expression, accessory activity, and phagocytosis of human monocytes. Scand J Immunol 1993; 38: 535–40.
  • 36.Baeke F,Takiishi T, Korf H, Gysemans C, Mathieu C. Vitamin D: Modulator of the immune system. Curr. Opin. Pharmacol 2010; 10: 482–96.
  • 37.Baeke F, Etten EV, Overbergh, L, Mathieu C. Vitamin D3 and the immune system:Maintaining the balance in health and disease. Nutr Res Rev 2007; 20: 106–18.
  • 38.van Halteren, AG, Tysma OM, van Etten E, Mathieu C, Roep BO. 1alpha,25dihydroxyvitamin D3 or analogue treated dendritic cells modulate human autoreactive T cells via the selective induction of apoptosis. J Autoimmun 2004; 23: 233–9.
  • 39. Carvalho JTG, Schneider M, Cuppari L, Grabulosa CC, T Aoike D, Q Redublo BM, C Batista M, Cendoroglo M, Maria Moyses R, Dalboni MA. Cholecalciferol decreases inflammation and improves Vitamin D regulatory enzymes in lymphocytes in the uremic environment: a randomized controlled pilot trial. PLoS One 2017;30: 12(6): e0179540.
  • 40.Meireles MS , Kamimura MA, Dalboni MA , Carvalho JTG , Aoike DT, Cuppari L. Effect of cholecalciferol on vitamin D-regulatory proteins in monocytes and on inflammatory markers in dialysis patients: A randomized controlled trial Clin Nutr 2016;35:1251-58.
  • 41.Stubbs JR, Idiculla A, Slusser J, Menard R, Quarles LD. Cholecalciferol supplementation Alters Calcitriol-Responsive monocyte proteins and decreases inflammatory cytokines in ESRD. J Am Soc Nephrol 2010; 21:353-61.
  • 42.Sözel H, Köksoy S, Ozdem S, Yılmaz F, Bora F, Ersoy FF. Lymphocyte and monocyte vitamin D receptor expression during paricalcitol or calcitri ol treatments in patients with stage 5 chronic kidney disease. Int Urol Nephrol. 2020; 52:1563-70.
  • 43.KDIGO 2017 Clinical Practice Guideline Update for the Diagnosis, Evaluation, Prevention, and Treatment of Chronic Kidney Disease—Mineral and Bone Disorder (CKD-MBD). Kidney Int. Suppl 2017; 7: 1–59.
  • 44.Levin A, Bakris GL, Molitch M, Smulders M, Tian J, Williams LA, Andress DL. Prevalence of abnormal serum vitamin D, PTH, calcium, and phosphorus in patients with chronic kidney disease: results of the study to evaluate early kidney disease. Kidney Int 2007; 71:31-8.
  • 45.Cannell JJ, Vieth R, Umhau JC, Holick MF, Grant WB, Madronich S, Garland CF, Giovannucci E. Epidemic influenza and vitamin D. Epidemiol Infect 2006; 134: 1129-40.
  • 46.Camargo CA JR, Ganmaa D, Frazier AL, Kirchberg FF, Stuart JJ, Kleinman K, Sumberzul N, Rich-Edwards JW. Randomized trial of vitamin D supplementation and risk of acute respiratory infection in Mongolia. Pediatrics 2012; 130:561-7.
  • 47.Selvaraj P, Harishankar M, Afsal K. Vitamin D: Immuno- modulation and tuberculosis treatment. Can J Physiol Pharmacol 2015; 93: 377-84.
  • 48. Ravani P, Malberti F, Tripepi G, Pecchini, P, Cutrupi, S, Pizzini, P, Mallamaci F, Zoccali C. Vitamin D levels and patient outcome in chronic kidney disease. Kidney Int. 2009; 75: 88–95.
  • 49.Mucsi I, Almási C, Deák G, Marton A, Ambrus, C, Berta K, Lakatos P, Szabó A, Horváth, C. Serum 25(OH)-vitamin D levels and bone metabolism in patients on maintenance hemodialysis. Clin Nephrol 2005; 64:288–94.
  • 50.Milinkovi ́c, NL, Majki ́c-Singh NT, Mirkovi ́c DD, Beleti ́c AD, Pejanovi ́c, SD, Vujani ́c ST. Relation between 25(OH)-vitamin D deficiency and markers of bone formation and resorption in haemodialysis patients. Clin Lab 2009; 55: 333–9.
  • 51.Holick, M. Vitamin D for Health and In Chronic Kidney Disease. Semin. Dial 2005; 8: 266–75.
Akdeniz Tıp Dergisi-Cover
  • Yayın Aralığı: Yılda 3 Sayı
  • Başlangıç: 2015
  • Yayıncı: Akdeniz Üniversitesi Tıp Fakültesi
Sayıdaki Diğer Makaleler

Besin Bağımlılığı ve Obezite İlişkisi

Büşra DEMİRER, Aylin AÇIKGÖZ PINAR

Levetirasetam Kullanan Gebede Fetal Sol El Yokluğu: Olgu Sunumu

Hülya KANDEMİR, Cem Yaşar SANHAL, Mehmet SAKINCI

Ekstrahepatik Kolanjiokarsinomalı Hastalarda Safra Sıvısında Tespit Edilen P53 Gen Mutasyonunun Tanı ve Prognozu Belirlemedeki Rolü

Arzu DENLER KILIÇ, Muhammed Cem KOÇKAR, Mete AKIN, Pınar ASLAN KOŞAR, Nilüfer ŞAHİN CALAPOĞLU

YouTube Videolarının Retina Dekolmanı Hakkındaki İçerik Kalitesinin Değerlendirilmesi

Aslı ÇETİNKAYA YAPRAK, Emine Hazal AKTAŞ

Evre 3-5 Kronik Böbrek Hastalarında Hematopoetik Hücrelerdeki Vitamin D Reseptör Düzeyi İle İnflamasyon Belirteçlerinin Değerlendirilmesi

Onur Yazdan BALÇIK, Feyza BORA, Sadi KÖKSOY, Fettah Fevzi ERSOY

Mide Kanserinin Operabilite ve Anrezektabilitesini Belirlemede Tümör Belirteçleri

Nihat Zafer UTKAN, Nuh Zafer CANTÜRK, Sertaç Ata GÜLER, Alican GÜREŞİN, Turgay ŞİMŞEK, Neşet Nuri GÖNÜLLÜ

Meme Kanseri Nedeni ile Meme Koruyucu Cerrahi Uygulanan Hastalarda Re-eksizyon Uygulanmasını Etkileyen Faktörler

Demet SARIDEMiR ÜNAL, Mustafa SARAÇOĞLU, Volkan DOĞRU, Veli VURAL, Muhittin YAPRAK, Ayhan MESCİ, Cumhur ARICI, Ahmet Nezihi OYGÜR

Türk Popülasyonunda ABO ve Rh Kan Grupları ve COVID-19 Duyarlılığı ve Hastalık Şiddeti İlişkisi - Retrospektif Bir Vaka Kontrol Çalışması

Faruk KARANDERE, Hakan KOÇOĞLU, Ramazan KORKUSUZ, Betül ERİŞMİŞ, Mehmet HURŞİTOĞLU, Kadriye KART YAŞAR

Akut Transvers Miyelit Olgularının Klinik, Radyolojik ve Etiyolojik Spektrumu: Tek Merkez Deneyimi ve Literatürün Gözden Geçirilmesi

Onur AKAN, Canan EMİR, Serap ÜÇLER

Bir Üniversite Hastanesi Sağlık Çalışanlarının Çocuk İstismarına Yaklaşımları Ve Çocuk İzlem Merkezleri Hakkındaki Farkındalıklarının Değerlendirilmesi

Hatice İKİIŞIK, Alpaslan ARI, Merve KIRLANGIÇ, Tuğçe YENİ, Melike KORKUT, Mustafa TAŞDEMİR, Işıl MARAL