Alterations in vitamin D status and anti-microbial peptide levels in patients in the intensive care unit with sepsis
Top Cited Papers
Open Access
- 23 April 2009
- journal article
- Published by Springer Science and Business Media LLC in Journal of Translational Medicine
- Vol. 7 (1), 28
- https://doi.org/10.1186/1479-5876-7-28
Abstract
Background Vitamin D insufficiency is common in hospitalized patients. Recent evidence suggests that vitamin D may enhance the innate immune response by induction of cathelicidin (LL-37), an endogenous antimicrobial peptide produced by macrophages and neutrophils. Thus, the relationship between vitamin D status and LL-37 production may be of importance for host immunity, but little data is available on this subject, especially in the setting of human sepsis syndrome and other critical illness. Methods Plasma concentrations of 25-hydroxyvitamin D (25(OH)D), vitamin D binding protein (DBP) and LL-37 in critically ill adult subjects admitted to intensive care units (ICUs) with sepsis and without sepsis were compared to healthy controls. Results Critically ill subjects had significantly lower plasma 25(OH)D concentrations compared to healthy controls. Mean plasma LL-37 levels were significantly lower in critically ill subjects compared to healthy controls. Vitamin D binding protein levels in plasma were significantly lower in critically ill subjects with sepsis compared to critically ill subjects without sepsis. There was a significant positive association between circulating 25(OH)D and LL-37 levels. Conclusion This study demonstrates an association between critical illness and lower 25(OH)D and DBP levels in critically ill patients as compared to healthy controls. It also establishes a positive association between vitamin D status and plasma LL-37, which suggests that systemic LL-37 levels may be regulated by vitamin D status. Optimal vitamin D status may be important for innate immunity especially in the setting of sepsis. Further invention studies to examine this association are warranted.This publication has 33 references indexed in Scilit:
- Unexpected actions of vitamin D: new perspectives on the regulation of innate and adaptive immunityNature Clinical Practice Endocrinology & Metabolism, 2008
- Expression of Antimicrobial Peptides in the Normal and Involved Skin of Patients with Infective CellulitisThe Journal of Infectious Diseases, 2007
- Vitamin D DeficiencyThe New England Journal of Medicine, 2007
- Vitamin D Status of Patients Admitted to a Hospital Rehabilitation UnitAmerican Journal of Physical Medicine & Rehabilitation, 2007
- CorrespondenceEpidemiology and Infection, 2007
- LL-37, the only human member of the cathelicidin family of antimicrobial peptidesBiochimica et Biophysica Acta (BBA) - Biomembranes, 2006
- LL-37 Protects Rats against Lethal Sepsis Caused by Gram-Negative BacteriaAntimicrobial Agents and Chemotherapy, 2006
- Toll-Like Receptor Triggering of a Vitamin D-Mediated Human Antimicrobial ResponseScience, 2006
- 2001 SCCM/ESICM/ACCP/ATS/SIS International Sepsis Definitions ConferenceCritical Care Medicine, 2003
- Plasma concentration of Gc-globulin is associated with organ dysfunction and sepsis after injuryCritical Care Medicine, 2003