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

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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.

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Acknowledgment

This study was supported by Health Bureau of Liaoning Province, China through Liaoning Medical Summit Development Program.

Conflict of interest

There are no conflicts of interest regarding this paper.

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Authors and Affiliations

  1. Department of Infectious Diseases, Shengjing Hospital Affiliated to China Medical University, Shenyang, 110004, China

    Chong Zhang, Lianrong Zhao, Li Ma, Cheng Lv, Yang Ding, Tingting Xia, Jingyan Wang & Xiaoguang Dou

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  1. Chong Zhang
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  2. Lianrong Zhao
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  3. Li Ma
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  4. Cheng Lv
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  5. Yang Ding
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  7. Jingyan Wang
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  8. Xiaoguang Dou
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Correspondence to Xiaoguang Dou.

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Zhang, C., Zhao, L., Ma, L. et al. Vitamin D Status and Expression of Vitamin D Receptor and LL-37 in Patients with Spontaneous Bacterial Peritonitis. Dig Dis Sci 57, 182–188 (2012). https://doi.org/10.1007/s10620-011-1824-6

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  • DOI: https://doi.org/10.1007/s10620-011-1824-6

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