Hübel E, Kiefer T, Weber J, Mettang T, Kuhlmann U
Robert-Bosch-Hospital, Department of Internal Medicine, Stuttgart, Germany.
Kidney Int. 1991 Nov;40(5):927-33. doi: 10.1038/ki.1991.296.
1,25-dihydroxyvitamin D3 [1,25(OH)2D3] has been shown to modulate the immune function of monocytes and macrophages. Patients with end-stage renal disease (ESRD) on chronic hemodialysis treatment usually present a deficiency of this active form of vitamin D3. The aim of this study was to investigate the effect of 1,25(OH)2D3 replacement therapy on phagocytosis, bactericidal capacity, and oxidative metabolism of peripheral blood polymorphonuclear leukocytes (PMNL) and monocytes (MN) in chronic hemodialysis patients. Phagocyte function tests were performed before and after four weeks of an oral replacement therapy with 0.5 micrograms/day of 1,25(OH)2D3 (Rocaltrol). The superoxide (O2-) generation of monocytes, measured by cytochrome c reduction and lucigenin-enhanced chemiluminescence (CL) from patients receiving hemodialysis treatment was significantly diminished compared to healthy controls. After the replacement therapy with 1,25(OH)2D3 the O2- production showed a significant improvement, resulting in an increased cytochrome c reduction and lucigenin-CL response. The bactericidal capacity of MN was also impaired and exhibited a significant enhancement of their killing activity after the administration of 1,25(OH)2D3. On the other hand, the luminol-enhanced CL, which reflects the myeloperoxidase-dependent oxidative metabolism, and the phagocytic ability of MN was not affected by the hormone. The function of polymorphonuclear leukocytes (PMNL) from hemodialysis patients showed no impairment in the state of 1,25(OH)2D3 deficiency and the replacement of the hormone did not enhance their function. These results suggest that the deficiency of 1,25(OH)2D3 in patients with ESRD on chronic hemodialysis treatment may be responsible for an impaired monocyte function, which could be improved by an in vivo replacement of the hormone.
1,25 - 二羟基维生素D3 [1,25(OH)2D3] 已被证明可调节单核细胞和巨噬细胞的免疫功能。接受慢性血液透析治疗的终末期肾病（ESRD）患者通常存在这种活性形式的维生素D3缺乏。本研究的目的是探讨1,25(OH)2D3替代疗法对慢性血液透析患者外周血多形核白细胞（PMNL）和单核细胞（MN）的吞噬作用、杀菌能力及氧化代谢的影响。在用0.5微克/天的1,25(OH)2D3（罗钙全）进行口服替代治疗四周前后进行吞噬细胞功能测试。与健康对照相比，接受血液透析治疗患者的单核细胞通过细胞色素c还原和光泽精增强化学发光（CL）测定的超氧化物（O2-）生成显著减少。在用1,25(OH)2D3替代治疗后，O2-产生显示出显著改善，导致细胞色素c还原增加和光泽精 - CL反应增强。MN的杀菌能力也受损，在给予1,25(OH)2D3后其杀伤活性显著增强。另一方面，反映髓过氧化物酶依赖性氧化代谢的鲁米诺增强CL以及MN的吞噬能力不受该激素影响。血液透析患者的多形核白细胞（PMNL）功能在1,25(OH)2D3缺乏状态下未受损，激素替代也未增强其功能。这些结果表明，慢性血液透析治疗的ESRD患者中1,25(OH)2D3缺乏可能导致单核细胞功能受损，体内补充该激素可改善这种情况。
