Department of Internal Medicine, Division of Allergy and Immunology, Akdeniz University Medical School, Antalya, Turkey.
Department of Internal Medicine, Division of Nephrology, Akdeniz University Medical School, Antalya, Turkey.
Int Urol Nephrol. 2023 Oct;55(10):2589-2598. doi: 10.1007/s11255-023-03550-z. Epub 2023 Mar 17.
It is known that vitamin D has positive effects on graft functions (reduce fibrosis, suppress excessive inflammatory response, improve graft functions). In our study, it was aimed to evaluate the effects and predictive roles of vitamin D, the expression of vitamin D receptor (VDR) in lymphocytes, monocytes, natural killer cells on chronic rejection and graft functions in kidney transplant patients.
Seventy one people were included in the study and analyses were made by dividing them into 3 groups. Group 1: Healthy control (n = 29), Group 2: Kidney transplant patients with stable kidney function (n = 17), and Group 3: Kidney transplant patients with chronic rejection diagnosis (n = 25). Serum 25-hydroxycholecalciferol, 1.25 dihydroxycholecalciferol levels and VDR percentages in CD4 + , CD8 + , CD14 + , CD56 + cells were measured in 3 groups. ROC analyses and logistic regression models were performed to predict rejection and long-term graft functions.
The percentage of VDR expression in CD4 + lymphocytes (p < 0.001) and CD14( +) monocytes (p < 0.001), 25-hydroxycholecalciferol and 1.25 dihydroxycholecalciferol levels were lower in group 3 was detected. In ROC analyses and logistic regression models, VDR expression in CD4( +)T lymphocytes was shown to have a statistically significant value in the development of chronic rejection (Odds ratio 0.86: 0.76-0.92; p = 0.001/AUC = 0.941, p < 0.001) and prediction of 5th-year graft functions (Odds ratio 0.93: 0.88-0.98; p = 0.017/AUC = 0.745, p = 0.007).
In our study, it was shown that low vitamin D and VDR expression is associated with poor outcome and VDR expression in CD4( +)T lymphocytes is predictive in terms of graft function and rejection.
已知维生素 D 对移植物功能有积极影响（减少纤维化、抑制过度炎症反应、改善移植物功能）。在我们的研究中，旨在评估维生素 D 及其在淋巴细胞、单核细胞、自然杀伤细胞中的维生素 D 受体 (VDR) 表达对慢性排斥反应和肾移植患者移植物功能的影响和预测作用。
将 71 人纳入研究，并通过将他们分为 3 组进行分析。第 1 组：健康对照组（n=29），第 2 组：肾功能稳定的肾移植患者（n=17），第 3 组：慢性排斥反应诊断的肾移植患者（n=25）。在 3 组中测量血清 25-羟胆钙化醇、1,25-二羟胆钙化醇水平和 CD4+、CD8+、CD14+、CD56+细胞中的 VDR 百分比。进行 ROC 分析和逻辑回归模型以预测排斥反应和长期移植物功能。
第 3 组中 CD4+淋巴细胞（p<0.001）和 CD14+单核细胞（p<0.001）中 VDR 表达的百分比较低，检测到 25-羟胆钙化醇和 1,25-二羟胆钙化醇水平较低。在 ROC 分析和逻辑回归模型中，CD4+T 淋巴细胞中的 VDR 表达在慢性排斥反应的发展中显示出统计学意义（优势比 0.86:0.76-0.92；p=0.001/AUC=0.941，p<0.001）和 5 年移植物功能的预测（优势比 0.93:0.88-0.98；p=0.017/AUC=0.745，p=0.007）。
在我们的研究中，表明低维生素 D 和 VDR 表达与不良结果相关，CD4+T 淋巴细胞中的 VDR 表达在移植物功能和排斥反应方面具有预测性。
