Department of General Surgery, Shanghai General Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai 200080, China.
Department of General Surgery, Shanghai General Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai 200080, China.
Int Immunopharmacol. 2019 Oct;75:105811. doi: 10.1016/j.intimp.2019.105811. Epub 2019 Aug 15.
Vitamin D regulates the immune system and affects the outcome of allografts. We investigated the mechanisms underlying the preventative potential of vitamin D in acute cellular rejection (ACR) and infection, and determined its effects on the induction of both T cells and complement.
A total of 141 patients who received a liver allograft at our center between 2012 and 2016 were enrolled in the study and divided into a vitamin D supplementation group (case group, n = 71) and a non-vitamin D supplementation group (control group, n = 70). Serum was collected in the hours prior to transplantation and within the first month of transplantation. We evaluated the relationship between the serum levels of 25-hydroxyvitamin D ACR, infection, T cells, complement, and graft function. Follow-up was conducted until patient death or June 30, 2018.
Vitamin D deficiency was an important independent risk factor for ACR. The incidence of ACR, and bacterial and fungal infection was reduced in patients with vitamin D supplementation. The frequency of Treg, Tmemory, T naïve cells and CD8 + CD28+ T cells (CTL) and the level of complement component 3 were related to ACR in the first month after transplantation. This study showed increased numbers of Treg cells and Tmemory cells and decreased numbers of Naïve cells and CTL in the case group. Vitamin D status was significantly associated with mortality.
Vitamin D supplementation is associated with a lower risk of ACR and infection, suggesting that it may promote immune tolerance towards the liver allografts.
维生素 D 可调节免疫系统，并影响移植物的预后。我们研究了维生素 D 在急性细胞排斥（ACR）和感染中的预防作用机制，并确定了其对 T 细胞和补体诱导的影响。
本研究纳入了 2012 年至 2016 年期间在我院接受肝移植的 141 例患者，将其分为维生素 D 补充组（病例组，n=71）和非维生素 D 补充组（对照组，n=70）。分别在移植前和移植后 1 个月内采集血清。评估血清 25-羟维生素 D 与 ACR、感染、T 细胞、补体和移植物功能的关系。随访至患者死亡或 2018 年 6 月 30 日。
维生素 D 缺乏是 ACR 的重要独立危险因素。维生素 D 补充组的 ACR、细菌和真菌感染发生率降低。移植后 1 个月时 Treg、Tmemory、Tnaive 细胞和 CD8+CD28+T 细胞（CTL）的频率以及补体成分 3 的水平与 ACR 相关。本研究显示病例组 Treg 细胞和 Tmemory 细胞数量增加，Naive 细胞和 CTL 数量减少。维生素 D 状态与死亡率显著相关。
维生素 D 补充与 ACR 和感染风险降低相关，提示其可能促进对肝移植物的免疫耐受。
