Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Review
. 2014 Jan 22:2014:105456.
doi: 10.1155/2014/105456. eCollection 2014.

Vitamin D and the Immune System from the Nephrologist's Viewpoint

Cheng-Lin Lang  1 , Min-Hui Wang  2 , Chih-Kang Chiang  3 , Kuo-Cheng Lu  2
Affiliations
Review

Vitamin D and the Immune System from the Nephrologist's Viewpoint

Cheng-Lin Lang et al. ISRN Endocrinol. .

Abstract

Vitamin D and its analogues are widely used as treatments by clinical nephrologists, especially when treating chronic kidney disease (CKD) patients with secondary hyperparathyroidism. As CKD progresses, the ability to compensate for elevations in parathyroid hormone (PTH) and fibroblast growth factor-23 and for decreases in 1,25(OH)2D3 becomes inadequate, which results in hyperphosphatemia, abnormal bone disorders, and extra-skeletal calcification. In addition to its calciotropic effect on the regulation of calcium, phosphate, and parathyroid hormone, vitamin D has many other noncalciotropic effects, including controlling cell differentiation/proliferation and having immunomodulatory effects. There are several immune dysregulations that can be noted when renal function declines. Physicians need to know well both the classical and nonclassical functions of vitamin D. This review is an analysis from the nephrologist's viewpoint and focuses on the relationship between the vitamin D and the immune system, together with vitamin's clinical use to treat kidney diseases.

PubMed Disclaimer

Figures

Figure 1
Figure 1
Several factors are related to immune dysregulation when renal function declines and when a patient is on renal replacement therapy.
Figure 2
Figure 2
Vitamin D and innate immune system. 1,25(OH)2D3 promotes innate immunity when macrophage (MΦ) is activated by TLRs; CYP27B1 is induced enabling the macrophage to produce 1,25(OH)2D3, which subsequently gives rise to cathelicidin. On the other hand, 1,25(OH)2D3 inhibits the expression of costimulatory molecules (DC40, CD80/86) and major histocompatibility complex class II (MHC II) on the surface of monocyte-derived dendritic cell (DC) and inhibits the production of inflammatory cytokines, such as interleukin-12 (IL-12).
Figure 3
Figure 3
Vitamin D and adaptive immune system. The adaptive immune system is like Tai-Chi, namely, that it separates the Yin and the Yang. 1,25(OH)2D3 directly modulates T cell responses and polarization related to the inflammatory molecules Th1 and Th17 in order to give rise to protective Th2 and Treg cells. In addition, 1,25(OH)2D3 also inhibits the inflammatory Th1 and Th17 cytokines and upregulates the protective Th2 and Treg cytokines. When these effects are integrated, the adaptive immune system may produce lower levels of inflammation, atherosclerosis, and autoimmunity.
Figure 4
Figure 4
Overview of biological functions of vitamin D in clinical nephrology.
See this image and copyright information in PMC

Similar articles

See all similar articles

Cited by

See all "Cited by" articles

References

    1. National Kidney Foundation. K/DOQI clinical practice guidelines for chronic kidney disease: evaluation, classification, and stratification. American Journal of Kidney Diseases. 2002;39(2):S1–S266. - PubMed
    1. Uhlig K, Berns JS, Kestenbaum B, et al. KDOQI US commentary on the 2009 KDIGO clinical practice guideline for the diagnosis, evaluation, and treatment of CKD-mineral and bone disorder (CKD-MBD) American Journal of Kidney Diseases. 2010;55(5):773–799. - PubMed
    1. Jeffery LE, Burke F, Mura M, et al. 1,25-Dihydroxyvitamin D3 and IL-2 combine to inhibit T cell production of inflammatory cytokines and promote development of regulatory T cells expressing CTLA-4 and FoxP3. Journal of Immunology. 2009;183(9):5458–5467. - PMC - PubMed
    1. Knight JA, Lesosky M, Barnett H, Raboud JM, Vieth R. Vitamin D and reduced risk of breast cancer: a population-based case-control study. Cancer Epidemiology Biomarkers and Prevention. 2007;16(3):422–429. - PubMed
    1. Chiang KC, Yeh CN, Hsu JT, et al. MART-10, a novel vitamin D analog, inhibits head and neck squamous carcinoma cells growth through cell cycle arrest at G0/G1 with Upregulation of p21 and p27 and Downregulation of Telomerase. The Journal of Steroid Biochemistry and Molecular Biology. 2013;138:427–434. - PubMed

LinkOut - more resources