Antonen J, Saha H, Lagerstedt A, Krohn K, Pasternack A
Department of Medicine, Tampere University Hospital, Finland.
Nephron. 1996;74(4):680-6. doi: 10.1159/000189474.
Ten hemodialysis patients were treated with intravenous calcitriol (1-1.5 micrograms 3 times per week) for 3 months and parameters reflecting cell-mediated immunity were measured before and at the end of treatment. Peripheral blood CD4+ cells increased from 33.1 +/- 14.2 to 43.8 +/- 5.8% (p < 0.05) causing a comparable increase in CD3+ cells (67.3 +/- 14.3 vs. 77.1 +/- 7.9%, p < 0.05), whereas CD8+ cells did not change significantly (22.2 +/- 5.4 vs. 25.5 +/- 3.0%). Mitogen-induced lymphocyte stimulation responses were normal even before treatment and did not change. Antigen-induced T-cell responses were very heterogeneous before calcitriol therapy; those 5 with initially unmeasurably low serum 1,25-dihydroxyvitamin D3 (1,25-(OH)2D3) had a weaker response than the other patients (3,873 +/- 1,528 vs. 22,948 +/- 13,684 cpm, p < 0.05). After calcitriol treatment the patients with pretherapy unmeasurably low serum 1,25-(OH)2D3 had a comparable response to other patients (16,220 +/- 9,674 vs. 22,064 +/- 10,331 cpm). Our study shows that calcitriol therapy restores the depressed antigen-induced T-cell response of the hemodialysis patients most deficient in 1,25-(OH)2D3.
10名血液透析患者接受静脉注射骨化三醇治疗（每周3次，每次1 - 1.5微克），为期3个月，并在治疗前及治疗结束时测量反映细胞介导免疫的参数。外周血CD4 +细胞从33.1±14.2%增至43.8±5.8%（p < 0.05），导致CD3 +细胞有类似增加（67.3±14.3%对77.1±7.9%，p < 0.05），而CD8 +细胞无显著变化（22.2±5.4%对25.5±3.0%）。丝裂原诱导的淋巴细胞刺激反应在治疗前即为正常且未改变。抗原诱导的T细胞反应在骨化三醇治疗前非常不均一；最初血清1,25 - 二羟维生素D3（1,25-(OH)2D3）水平低至无法测量的5名患者的反应比其他患者弱（3,873±1,528对22,948±13,684 cpm，p < 0.05）。骨化三醇治疗后，治疗前血清1,25-(OH)2D3水平低至无法测量的患者的反应与其他患者相当（16,220±9,674对22,064±10,331 cpm）。我们的研究表明，骨化三醇治疗可恢复1,25-(OH)2D3严重缺乏的血液透析患者中受抑制的抗原诱导T细胞反应。
