Alterations in vitamin D status and anti-microbial peptide levels in patients in the intensive care unit with sepsis.

Academic Article

Abstract

  • BACKGROUND: Vitamin D insufficiency is common in hospitalized patients. Recent evidence suggests that vitamin D may enhance the innate immune response by induction of cathelicidin (LL-37), an endogenous antimicrobial peptide produced by macrophages and neutrophils. Thus, the relationship between vitamin D status and LL-37 production may be of importance for host immunity, but little data is available on this subject, especially in the setting of human sepsis syndrome and other critical illness. METHODS: Plasma concentrations of 25-hydroxyvitamin D (25(OH)D), vitamin D binding protein (DBP) and LL-37 in critically ill adult subjects admitted to intensive care units (ICUs) with sepsis and without sepsis were compared to healthy controls. RESULTS: Critically ill subjects had significantly lower plasma 25(OH)D concentrations compared to healthy controls. Mean plasma LL-37 levels were significantly lower in critically ill subjects compared to healthy controls. Vitamin D binding protein levels in plasma were significantly lower in critically ill subjects with sepsis compared to critically ill subjects without sepsis. There was a significant positive association between circulating 25(OH)D and LL-37 levels. CONCLUSION: This study demonstrates an association between critical illness and lower 25(OH)D and DBP levels in critically ill patients as compared to healthy controls. It also establishes a positive association between vitamin D status and plasma LL-37, which suggests that systemic LL-37 levels may be regulated by vitamin D status. Optimal vitamin D status may be important for innate immunity especially in the setting of sepsis. Further invention studies to examine this association are warranted.
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    Keywords

  • Antimicrobial Cationic Peptides, Case-Control Studies, Cathelicidins, Critical Illness, Demography, Female, Health, Humans, Intensive Care Units, Male, Middle Aged, Sepsis, Vitamin D, Vitamin D-Binding Protein
  • Digital Object Identifier (doi)

    Author List

  • Jeng L; Yamshchikov AV; Judd SE; Blumberg HM; Martin GS; Ziegler TR; Tangpricha V
  • Start Page

  • 28
  • Volume

  • 7