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Enhanced LL-37 expression following vitamin D supplementation in patients with cirrhosis and spontaneous bacterial peritonitis.
- Source :
-
Liver international : official journal of the International Association for the Study of the Liver [Liver Int] 2016 Jan; Vol. 36 (1), pp. 68-75. Date of Electronic Publication: 2015 Sep 18. - Publication Year :
- 2016
-
Abstract
- Background & Aims: The morbidity and mortality of spontaneous bacterial peritonitis (SBP) are high among patients with cirrhosis; however, the mechanisms of SBP pathogenesis are poorly understood. This study aimed to determine the role of the vitamin D-LL-37 pathway in the pathogenesis and treatment in patients with cirrhosis and SBP.<br />Methods: Serum 25-hydroxyvitamin D concentrations of 119 patients with chronic liver diseases were tested. Vitamin D receptor (VDR) and LL-37 in peritoneal leucocytes of cirrhotic and ascitic patients with SBP were detected and compared with those without SBP. Then the peritoneal macrophages of non-infected patients were cultured and activated by lipopolysaccharide (LPS) to analyse the changes of VDR and LL-37 expressions after incubation with vitamin D.<br />Results: Vitamin D deficiency or insufficiency was found in all of patients with cirrhosis. LPS inhibited VDR and LL-37 expression in peritoneal macrophages [1.3-fold decrease (P = 0.003) and 20-fold decrease (P = 0.010) respectively]. However, vitamin D could reverse the inhibition of both VDR and LL-37 [1.5-fold increase (P = 0.001) and 2000-fold increase (P < 0.001) respectively]. The effect of the incubation time following vitamin D supplementation was significant for LL-37 expression, with a peak expression found at 36 h (P < 0.001).<br />Conclusions: When vitamin D levels were low, bacteria inhibited VDR and LL-37 responses in peritoneal macrophages as a mechanism to evade antibacterial defence. Vitamin D supplementation could up-regulate peritoneal macrophage VDR and LL-37 expressions, which resulted in an enhanced immunological defence against SBP in patients with cirrhosis and ascites.<br /> (© 2015 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.)
- Subjects :
- Adult
Ascitic Fluid metabolism
Ascitic Fluid pathology
Bacterial Physiological Phenomena
Cells, Cultured
Female
Humans
Male
Middle Aged
Receptors, Calcitriol metabolism
Vitamins metabolism
Vitamins pharmacology
Ascites metabolism
Ascites pathology
Ascites prevention & control
Bacterial Infections etiology
Bacterial Infections metabolism
Bacterial Infections pathology
Cathelicidins metabolism
Liver Cirrhosis complications
Liver Cirrhosis immunology
Macrophages, Peritoneal drug effects
Macrophages, Peritoneal metabolism
Macrophages, Peritoneal pathology
Peptide Fragments metabolism
Peritonitis etiology
Peritonitis metabolism
Peritonitis microbiology
Peritonitis pathology
Vitamin D metabolism
Vitamin D pharmacology
Vitamin D Deficiency complications
Vitamin D Deficiency metabolism
Vitamin D Deficiency pathology
Subjects
Details
- Language :
- English
- ISSN :
- 1478-3231
- Volume :
- 36
- Issue :
- 1
- Database :
- MEDLINE
- Journal :
- Liver international : official journal of the International Association for the Study of the Liver
- Publication Type :
- Academic Journal
- Accession number :
- 26058412
- Full Text :
- https://doi.org/10.1111/liv.12888