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Evaluation of the effect and predictive role of vitamin D and vitamin D receptor expression in CD4 + , CD8 + , CD14 + , CD56 + cells on the development of chronic rejection and graft functions in kidney transplant patients

  • Nephrology - Original Paper
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Abstract

Purpose

It is known that vitamin D has positive effects on graft functions (reduce fibrosis, suppress excessive inflammatory response, improve graft functions). In our study, it was aimed to evaluate the effects and predictive roles of vitamin D, the expression of vitamin D receptor (VDR) in lymphocytes, monocytes, natural killer cells on chronic rejection and graft functions in kidney transplant patients.

Methods

Seventy one people were included in the study and analyses were made by dividing them into 3 groups. Group 1: Healthy control (n = 29), Group 2: Kidney transplant patients with stable kidney function (n = 17), and Group 3: Kidney transplant patients with chronic rejection diagnosis (n = 25). Serum 25-hydroxycholecalciferol, 1.25 dihydroxycholecalciferol levels and VDR percentages in CD4 + , CD8 + , CD14 + , CD56 + cells were measured in 3 groups. ROC analyses and logistic regression models were performed to predict rejection and long-term graft functions.

Results

The percentage of VDR expression in CD4 + lymphocytes (p < 0.001) and CD14( +) monocytes (p < 0.001), 25-hydroxycholecalciferol and 1.25 dihydroxycholecalciferol levels were lower in group 3 was detected. In ROC analyses and logistic regression models, VDR expression in CD4( +)T lymphocytes was shown to have a statistically significant value in the development of chronic rejection (Odds ratio 0.86: 0.76–0.92; p = 0.001/AUC = 0.941, p < 0.001) and prediction of 5th-year graft functions (Odds ratio 0.93: 0.88–0.98; p = 0.017/AUC = 0.745, p = 0.007).

Conclusion

In our study, it was shown that low vitamin D and VDR expression is associated with poor outcome and VDR expression in CD4( +)T lymphocytes is predictive in terms of graft function and rejection.

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Funding

Akdeniz University Scientific Research Projects Management Unit Project number: TTU-2017-2722.

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Authors and Affiliations

  1. Department of Internal Medicine, Division of Allergy and Immunology, Akdeniz University Medical School, Antalya, Turkey

    Tuba Vural

  2. Department of Internal Medicine, Division of Nephrology, Akdeniz University Medical School, Antalya, Turkey

    Vural Taner Yilmaz, Huseyin Kocak & Gultekin Suleymanlar

  3. Department of Microbiology and Clinical Immunology, Akdeniz University Medical School, Antalya, Turkey

    Sadi Koksoy

  4. Department of General Surgery, Akdeniz University Medical School, Antalya, Turkey

    Abdullah Kisaoglu, Ismail Demiryilmaz & Bulent Aydinli

  5. Department of Biostatistics and Medical Informatics, Akdeniz University Medical School, Antalya, Turkey

    Deniz Ozel

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  1. Tuba Vural
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Correspondence to Vural Taner Yilmaz.

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The study was approved by the Akdeniz University Clinical Research Ethics Committee (KAEK decision number: 248, Date: 26.04.2017).

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Vural, T., Yilmaz, V.T., Koksoy, S. et al. Evaluation of the effect and predictive role of vitamin D and vitamin D receptor expression in CD4 + , CD8 + , CD14 + , CD56 + cells on the development of chronic rejection and graft functions in kidney transplant patients. Int Urol Nephrol 55, 2589–2598 (2023). https://doi.org/10.1007/s11255-023-03550-z

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