Vitamin D supplementation could reduce the risk of acute cellular rejection and infection in vitamin D deficient liver allograft recipients

• Published in: International immunopharmacology 2019-10, Vol.75, p.105811-105811, Article 105811
• Main Authors: Zhou, Qiang, Li, Lixing, Chen, Ying, Zhang, Jinyan, Zhong, Lin, Peng, Zhihai, Xing, Tonghai
• Format: Article
• Language: English
• Subjects: 25-Hydroxyvitamin D; Acute cellular rejection; Adult; Allografts; Bacterial Infections - prevention & control; Calciferol; CD28 antigen; CD8 antigen; Complement; Complement C3 - immunology; Cytotoxicity; Dietary Supplements; Female; Graft rejection; Graft Rejection - prevention & control; Health risks; Humans; Immune system; Immunological tolerance; Infection; Infections; Liver; Liver Transplantation; Lymphocytes; Lymphocytes T; Male; Middle Aged; Mycoses - prevention & control; Rejection; Risk analysis; Risk Factors; Risk reduction; Serum levels; Supplements; T-Lymphocytes - drug effects; T-Lymphocytes - immunology; Transplantation; Vitamin D; Vitamin D - blood; Vitamin D - therapeutic use; Vitamin D Deficiency - drug therapy; Vitamin D Deficiency - immunology; Vitamin D supplementation; Vitamin deficiency; Vitamins - blood; Vitamins - therapeutic use
• ISSN: 1567-5769; 1878-1705
• DOI: 10.1016/j.intimp.2019.105811

Vitamin D regulates the immune system and affects the outcome of allografts. We investigated the mechanisms underlying the preventative potential of vitamin D in acute cellular rejection (ACR) and infection, and determined its effects on the induction of both T cells and complement. A total of 141 patients who received a liver allograft at our center between 2012 and 2016 were enrolled in the study and divided into a vitamin D supplementation group (case group, n = 71) and a non-vitamin D supplementation group (control group, n = 70). Serum was collected in the hours prior to transplantation and within the first month of transplantation. We evaluated the relationship between the serum levels of 25-hydroxyvitamin D ACR, infection, T cells, complement, and graft function. Follow-up was conducted until patient death or June 30, 2018. Vitamin D deficiency was an important independent risk factor for ACR. The incidence of ACR, and bacterial and fungal infection was reduced in patients with vitamin D supplementation. The frequency of Treg, Tmemory, T naïve cells and CD8 + CD28+ T cells (CTL) and the level of complement component 3 were related to ACR in the first month after transplantation. This study showed increased numbers of Treg cells and Tmemory cells and decreased numbers of Naïve cells and CTL in the case group. Vitamin D status was significantly associated with mortality. Vitamin D supplementation is associated with a lower risk of ACR and infection, suggesting that it may promote immune tolerance towards the liver allografts. •Female gender, hepatocellular carcinoma and alcohol consumption contribute to vitamin D deficiency in patients.•Vitamin D severe deficiency was an independent risk factor for ACR and infection in liver allograft recipients.•Vitamin D may induce, treg cells and Tmemory cells differentiation, while suppress T naive cells and CTL.•Vitamin D deficiency or vitamin D supplementation was significantly associated with mortality.