Vitamin D and the immune system: Beyond rickets

Evaluation of diagnostic potential of CD38 in rickets

BACKGROUND

Rickets occurs in infants and children (aged 2 months to 3 years), compromising their skeletal development and damaging nervous, hematopoietic, immune, and other system functions. This study aimed to explore the significance of CD38 in rickets.

METHODS

The microarray dataset GSE22523 was analyzed to obtain differentially expressed genes in rickets patients. A total of 36 rickets patients and healthy controls were recruited for the study, and their blood samples were collected, followed by detecting mRNA levels of CD38 using quantitative real-time polymerase chain reaction (qRT-PCR). Moreover, the significance of CD38 in rickets patients was analyzed by receiver operating characteristic (ROC) analysis, while the correlation between CD38 and 25-hydroxy-vitamin D (25OHD)/parathyroid hormone (PTH) was analyzed with Pearson's correlation.

RESULTS

Results showed that CD38 mRNA levels and PTH contents were significantly increased in the rickets patients while 25OHD contents were decreased. Correlation analysis indicated that CD38 was positively correlated with PTH and negatively correlated with 25OHD in both serum and plasma samples of rickets patients. Moreover, ROC analysis showed that serum CD38 was 0.9005 (95 % CI: 0.8313-0.9696), and the AUCs of plasma CD38 was 0.7215 (95 % CI: 0.6031-0.8398) in differentiating rickets patients from healthy persons, advocating serum CD38 had better diagnostic value.

CONCLUSION

CD38 mRNA levels were upregulated in rickets patients and closely correlated with PTH and 25OHD contents, indicating CD38 might be a diagnostic marker of rickets patients. Further research on the diagnostic utility of CD38 is necessary for the diagnosis and treatment of ricketsin rickets in the future.

Effects of vitamin D3 injection in close-up period on insulin resistance and energy balance in transition dairy cows

Background

Many studies in dairy cows are towards calcium homeostasis and there is a lack of knowledge about the effect of vitamin D in preventing insulin resistance and improving energy balance in the transition period of dairy cows.

Methods

The trial was conducted in a commercial dairy farm with about 1500 lactating cows in Tehran province, Iran. Twenty‐four Holstein cows had been randomly selected and divided into control and treatment groups. In the treatment group, 12 cows, received a single dose of 8,000,000 IU vitamin D3 intramuscularly and in the control group, 12 cows were injected placebo (distilled water) 2–8 days before the expected calving time. Blood samples were collected between 8 and 10 AM 2 h after feeding on 21 and 7 days before calving and 1,3,7,15 and 30 days after calving. 25(OH)vitamin D, insulin‐like growth factor 1 (IGF‐1), insulin, nonesterified fatty acid (NEFA), β‐hydroxybutyric acid (BHBA), albumin, total protein, glucose, urea, triglyceride, cholesterol and aspartate amino transferase (AST) were measured by commercially available kits. The insulin resistance index was calculated.

Results

Vitamin D3 injection significantly affected the amounts of 25(OH) vitamin D, urea, insulin and insulin resistance index (p ≤ 0.05). On the other hand, the amounts of glucose, NEFA, BHBA concentration and AST activity were higher in control group (p ≤ 0.05). Time had a significant effect on the amounts of most measured variables except IGF‐1 and insulin. There were no group and time interactions for measured variables.

Conclusion

It seems that injection of vitamin D3 in close up period influenced lipolysis potentially modifying energy metabolism and resulted in reducing insulin resistance.

Recent advances of vitamin D in immune, reproduction, performance for pig: a review

Vitamin D (VD) has been reported to play multiple and significant roles in improving pig health via modulating calcium and phosphorus homeostasis, skeletal muscle development and the immune system. Apart from food, photochemical action of 7-dehydrocholesterol in the skin is the main source of this molecule for pigs. The VD from dietary intake or photosynthesized via skin can be absorbed into the liver for hydroxylation, and further hydroxylated into the hormone form of VD (1,25-dihydroxyvitamin D3 or 1,25(OH)2D3) in the kidney. As a sterol hormone, 1,25(OH)2D3 is able to bind with the VD receptor (VDR), and this ligand-receptor complex (VDR/retinoic X receptor) translocates from the cytoplasm into the nucleus to regulate gene expression, thus modulating metabolism. In this review, we summarized the recent studies regarding the non-skeletal health benefits of VD for pigs, and focused on the recent advances in the cellular and molecular mechanisms of VD that affects the immune system and reproductive health. This review provides a reference for future research and application of VD in pigs.

Efficacy of Oral Administration of a Reliable AD3E Treatment on Vitamin D3 Deficiency in Najdi Sheep

This study was aimed to assess the efficacy of oral treatment of commercial product of vitamin D3 (VITOL-80 C ORAL®, Interchemie, Holland) in growing Najdi sheep suffering from musculoskeletal illness due to vitamin D3 deficiency in Basra province, Iraq. Using a Najdi sheep model bred in Iraq, here we focused on measuring the serum levels of total vitamin D3, calcium, phosphorus, parathyroid hormone (PTH), alkaline phosphatase (ALP) and alanine aminotransferase (ALT) as well as complete blood count (CBC) and clinical examinations pre and post-treatment with VITOL-80 C ORAL®. No significant changes (P > 0.05) of the vitamin D status were recorded in Najdi sheep with vitamin D3 deficiency post treatment with (VITOL-80 C ORAL®). However, a sharp (P < 0.0001) decline of the total serum vitamin D3 concentration were observed in those Najdi sheep per-administration (21.95 ± 1.82 ng/ml) and postadministration (22.29 ± 1.34 ng/ml) of vitamins therapy contrast to control healthy Najdi sheep (89.75 ± 6.84 ng/ml). An interaction between vitamin D3 status and the serum concentrations of calcium/phosphorus, PTH, ALP and ALT was observed. With vitamin D3-deficient Najdi sheep; values of CBC, and calcium/phosphorus concentrations were lower while PTH, ALP and ALT were higher than the healthy control Najdi sheep; thus, no significant changes (P > 0.05) of these values were recorded post treatment of (VITOL-80 C ORAL®). In conclusion, vitamin D3 deficiency threats the health of local Najdi sheep and has a potential role through suppressing their immunity. Oral administration of the commercial product as a source of vitamin D3 is not effective suggesting involvement of vitamin D receptors (VDR) and/or dysfunction of liver and kidneys.

Polymeric Nanoparticles Containing Both Antigen and Vitamin D3 Induce Antigen-Specific Immune Suppression

The active form of vitamin D₃, 1,25-dihydroxyvitamin D₃ (aVD₃), is known to exert beneficial effects in the treatment of autoimmune diseases because of its immunosuppressive effects. However, clinical application of aVD₃ remains limited because of the potential side effects, particularly hypercalcemia. Encapsulation of aVD₃ within biodegradable nanoparticles (NPs) would enhance the delivery of aVD₃ to antigen presenting cells, while preventing the potential systemic side effects of aVD₃. In the present study, polymeric NPs containing ovalbumin (OVA) and aVD₃ (NP[OVA+aVD₃]) were prepared via the water-in-oil-in-water double emulsion solvent evaporation method, after which their immunomodulatory effects were examined. Bone marrow-derived immature dendritic cells (DCs) treated with NP(OVA+aVD₃) did not mature into immunogenic DCs but were converted into tolerogenic DCs, which express low levels of co-stimulatory molecules and MHC class II molecules, produce lower levels of pro-inflammatory cytokines while increasing the production of IL-10 and TGF-β, and induce the generation of Tregs. Intravenous injection with NP(OVA+aVD₃) markedly suppressed the generation of OVA-specific CTLs in mice. Furthermore, OVA-specific immune tolerance was induced in mice orally administered with NP(OVA+aVD₃). These results show that biodegradable NPs encapsulating both antigen and aVD₃ can effectively induce antigen-specific immune suppression.

25-Hydroxyvitamin D concentrations in dogs with naturally acquired blastomycosis

Background

Hypovitaminosis D is common in humans with tuberculosis, and adequate serum 25‐hydroxyvitamin D [25(OH)D] concentrations may improve response to therapy. The pathomechanism of Blastomyces dermatitidis is similar to that of Mycobacterium tuberculosis, but the 25(OH)D status of dogs with blastomycosis has not been investigated.

Objectives

To determine if dogs with blastomycosis have lower 25(OH)D concentrations compared with healthy controls and to explore the prognostic value of 25(OH)D concentrations in blastomycosis.

Animals

35 control dogs (16 client‐owned, healthy dogs and 19 healthy, random‐source hound mixes) and 22 dogs with blastomycosis.

Methods

Prospective study. Serum concentrations of 25(OH)D, parathyroid hormone (PTH), ionized calcium were measured, and biochemistry and hematology profiles were performed. The 25‐hydroxyvitamin D concentrations were compared between groups, and factors associated with 25(OH)D variation were investigated in dogs with blastomycosis. Dogs with blastomycosis were followed for up to 5 years after discharge and factors associated with survival were investigated.

Results

Dogs with blastomycosis had significantly lower concentrations of 25(OH)D and PTH and higher concentrations of ionized calcium than did control dogs. In dogs with blastomycosis, 25(OH)D concentrations were independently associated with neutrophil count, pCO₂, and with bone and skin involvement. The 25‐hydroxyvitamin D concentration was not associated with survival in dogs with blastomycosis, whereas lactate concentrations; bone, skin, and lymph node involvement; number of affected sites; and, presence of respiratory signs were associated with survival.

Conclusions and Clinical Importance

Dogs with blastomycosis had lower 25(OH)D concentrations than did healthy controls. Despite no impact on survival, investigating the effect of 25(OH)D supplementation on recovery is warranted.

Vitamin D and toll like receptors

It has been demonstrated that vitamin D (VD) significantly modulates immune responses. Toll like receptors (TLRs) are the main innate immunity receptors which are expressed on the cell membrane and intracellular vesicles and recognize several pathogen associated molecular patterns (PAMPs) and damage associated molecular patterns (DAMPs) to induce immune responses. Based on the important roles played by TLRs in physiologic and pathologic functions of immune responses and due to the immunomodulatory functions of VD, it has been hypothesized that VD may present its immunomodulatory functions via modulation of TLRs. This review article collates recent studies regarding the interactions between VD and TLRs and discussed the controversial investigations.

Human macrophages differentiated in the presence of vitamin D3 restrict dengue virus infection and innate responses by downregulating mannose receptor expression

Background

Severe dengue disease is associated with high viral loads and overproduction of pro-inflammatory cytokines, suggesting impairment in the control of dengue virus (DENV) and the mechanisms that regulate cytokine production. Vitamin D₃ has been described as an important modulator of immune responses to several pathogens. Interestingly, increasing evidence has associated vitamin D with decreased DENV infection and early disease recovery, yet the molecular mechanisms whereby vitamin D reduces DENV infection are not well understood.

Methods and principal findings

Macrophages represent important cell targets for DENV replication and consequently, they are key drivers of dengue disease. In this study we evaluated the effect of vitamin D₃ on the differentiation of monocyte-derived macrophages (MDM) and their susceptibility and cytokine response to DENV. Our data demonstrate that MDM differentiated in the presence of vitamin D₃ (D₃-MDM) restrict DENV infection and moderate the classical inflammatory cytokine response. Mechanistically, vitamin D₃-driven differentiation led to reduced surface expression of C-type lectins including the mannose receptor (MR, CD206) that is known to act as primary receptor for DENV attachment on macrophages and to trigger of immune signaling. Consequently, DENV bound less efficiently to vitamin D₃-differentiated macrophages, leading to lower infection. Interestingly, IL-4 enhanced infection was reduced in D₃-MDM by restriction of MR expression. Moreover, we detected moderate secretion of TNF-α, IL-1β, and IL-10 in D₃-MDM, likely due to less MR engagement during DENV infection.

Conclusions/Significance

Our findings reveal a molecular mechanism by which vitamin D counteracts DENV infection and progression of severe disease, and indicates its potential relevance as a preventive or therapeutic candidate.

Dengue represents a major worldwide concern for public health. Clinical complications rely on vascular leak of fluids and molecules from the bloodstream that leads to a potentially fatal hemodynamic compromise. Disease progression has been related to poor control of dengue virus (DENV) dissemination and excessive production of pro-inflammatory mediators that affect the endothelial function. Vitamin D has been shown to modulate immune responses and to alleviate dengue disease. Here, we studied how addition of vitamin D during macrophage differentiation modulates the functional features of these cells in the context of DENV infection. We observed that vitamin D reduced susceptibility of these cells to DENV infection and down-regulated the virus-induced cytokine response. This phenotype was attributed to downregulation of MR, a molecule hijacked by the virus to gain entry into the cells and a key receptor of the MR/CLEC5A complex that links binding and immune activation during DENV infection. Our study sheds light on the mechanism by which vitamin D can restrict DENV dissemination and the cytokine response in macrophages, indicating the potential relevance of this hormone as a preventive and therapeutic candidate.

The Role of Vitamin D in the Immune System as a Pro-survival Molecule

PURPOSE

Vitamin D is a fascinating and attractive molecule that has gained particular attention in medicine in recent years. Its immunomodulatory and anti-inflammatory potential might resemble the activity of many nature-derived molecules (eg, flavonoids), but its role in biology was selected during a long evolutionary pathway to dampen the damaging effect of cell stress response and of the immune reaction. In this sense, this molecule can be considered an ancient hormone that serves, in its primary role, as a pro-survival agent. The goal of this review was to elucidate this topic.

METHODS

The article reviews current literature on the field, focusing on issues regarding the role of vitamin D in immunity.

FINDINGS

Vitamin D participates in the survival machinery used by the cell, and in particular it plays a major role in synchronizing calcium oscillatory signaling to allow cell autophagy or apoptosis during a stress response.

IMPLICATIONS

Vitamin D should be better highlighted in its molecular action and vitamin D receptor genomics to conceive a more suited therapeutic supplementation protocol in clinics.

Was skin cancer a selective force for black pigmentation in early hominin evolution?

Melanin provides a crucial filter for solar UV radiation and its genetically determined variation influences both skin pigmentation and risk of cancer. Genetic evidence suggests that the acquisition of a highly stable melanocortin 1 receptor allele promoting black pigmentation arose around the time of savannah colonization by hominins at some 1-2 Ma. The adaptive significance of dark skin is generally believed to be protection from UV damage but the pathologies that might have had a deleterious impact on survival and/or reproductive fitness, though much debated, are uncertain. Here, I suggest that data on age-associated cancer incidence and lethality in albinos living at low latitudes in both Africa and Central America support the contention that skin cancer could have provided a potent selective force for the emergence of black skin in early hominins.

Dietary resistant starch prevents urinary excretion of 25-hydroxycholecalciferol and vitamin D-binding protein in type 1 diabetic rats

Diabetes is a rapidly growing epidemic affecting millions of Americans and has been implicated in a number of devastating secondary complications. We previously demonstrated that type 2 diabetic rats exhibit vitamin D deficiency due to aberrant megalin-mediated endocytosis and excessive urinary excretion of 25-hydroxycholecalciferol (25D3) and vitamin D-binding protein (DBP). Here, we examined whether a model of type 1 diabetes [T1D; streptozotocin (STZ)-treated Sprague-Dawley rats] would similarly excrete abnormally high concentrations of 25D3 and DBP due to renal damage and compromised expression of megalin and its endocytic partner, disabled-2 (Dab2). Moreover, we tested whether feeding diabetic rats starch that is resistant to digestion could alleviate these abnormalities. Control (n = 12) rats were fed a standard, semipurified diet (AIN-93G) containing 55% total dietary starch and STZ-treated rats were fed the AIN-93G diet (n = 12) or a diet containing 55% high-amylose maize that is partially resistant to digestion [20% total dietary resistant starch (RS); n = 12] for 2 and 5 wk. The RS diet attenuated weight loss and polyuria in STZ-treated rats. Histology and immunohistochemistry revealed that dietary RS also attenuated the loss of Dab2 expression in renal proximal tubules. Moreover, urinary concentrations of both 25D3 and DBP were elevated ∼10-fold in STZ-treated rats (5 wk post STZ injection), which was virtually prevented by the RS. We also observed a ∼1.5-fold increase in megalin mRNA expression in STZ-treated rats, which was attenuated by feeding rats the RS diet for 2 wk. Taken together, these studies indicate that consumption of low-glycemic carbohydrates can attenuate disruption of vitamin D homeostasis in T1D through the rescue of megalin-mediated endocytosis in the kidney.

Regression of endometrial implants treated with vitamin D3 in a rat model of endometriosis

Endometriosis is one of the most frequent gynecological diseases. In addition to their side effects, available medical therapies may decrease fertility. Current understanding of endometriosis focuses on the role of the immune system in its pathophysiology. Recent research shed light on the immunomodulatory effect of vitamin D3. Thus, this study was designed to study the effect of vitamin D3 on regression of endometriotic implants in a rat surgical model. Vitamin D3 reduced cyst cross sectional area by 48.8%. Histologically, vitamin D treatment produced fibrosis as well as apoptosis in the stroma. The results of the present study suggest that vitamin D3 administration may have a beneficial effect in treating endometriosis.