Digestive Diseases and Sciences

, Volume 57, Issue 1, pp 182–188

Vitamin D Status and Expression of Vitamin D Receptor and LL-37 in Patients with Spontaneous Bacterial Peritonitis

  • Chong Zhang
  • Lianrong Zhao
  • Li Ma
  • Cheng Lv
  • Yang Ding
  • Tingting Xia
  • Jingyan Wang
  • Xiaoguang Dou
Original Article

DOI: 10.1007/s10620-011-1824-6

Cite this article as:
Zhang, C., Zhao, L., Ma, L. et al. Dig Dis Sci (2012) 57: 182. doi:10.1007/s10620-011-1824-6

Abstract

Background

Vitamin D, which exerts its effect through vitamin D receptor (VDR), and LL-37, a vitamin D-dependent antimicrobial peptide, are involved in many infectious diseases.

Aim

The objective of this study was to evaluate whether vitamin D status and expressions of VDR and LL-37 are involved in the pathogenesis of spontaneous bacterial peritonitis (SBP).

Methods

Serum and ascitic fluid 25-dihydroxyvitamin D [25(OH)D] concentrations and levels of VDR and LL-37 in peritoneal leukocytes were measured by ELISA and real-time PCR methods in cirrhotic patients with SBP (n = 19) and cirrhotic patients with simple ascites (n = 28). The correlations between these levels and clinical variables were evaluated.

Results

Cirrhotic patients with ascites showed low vitamin D concentrations in both serum and ascitic fluid. Lower serum vitamin D concentrations were observed in cirrhotic patients with Child-Pugh C class. 25(OH)D concentrations in ascitic fluid were positive correlated with that in serum (r = 0.74, P < 0.001). The SBP group showed significantly higher levels of both VDR and LL-37 mRNA expressions in peritoneal leukocytes than the simple ascites group (P = 0.005 and P = 0.003, respectively). In the SBP group, VDR and LL-37 expressions in peritoneal leukocytes were positively correlated (r = 0.70, P = 0.001).

Conclusions

Vitamin D insufficiency was universal among cirrhotic patients with ascites, and the situation was more severe with more serious cirrhosis. Expressions of peritoneal leukocytes VDR and LL-37 genes were simultaneously up-regulated in cirrhotic patients with SBP when compared with cirrhotic patients with simple ascites. It is indicated that the vitamin D-VDR system and its downstream gene, LL-37, are involved in the pathogenesis and antibacterial immune response to SBP.

Keywords

Vitamin DVitamin D receptorLL-37CirrhosisSpontaneous bacterial peritonitis

Copyright information

© Springer Science+Business Media, LLC 2011

Authors and Affiliations

  • Chong Zhang
    • 1
  • Lianrong Zhao
    • 1
  • Li Ma
    • 1
  • Cheng Lv
    • 1
  • Yang Ding
    • 1
  • Tingting Xia
    • 1
  • Jingyan Wang
    • 1
  • Xiaoguang Dou
    • 1
  1. 1.Department of Infectious DiseasesShengjing Hospital Affiliated to China Medical UniversityShenyangChina