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Calcitriol sepsis

Darren Patrick Moloney, Liam Chawke, Mairead Therese Crowley, Terence M O'Connor
Hypercalcaemia occurs in many granulomatous diseases. Among them, sarcoidosis and tuberculosis are the most common causes. Other causes include berylliosis, coccidioidomycosis, histoplasmosis, Crohn's disease, silicone-induced granulomas, cat-scratch disease, Wegener's granulomatosis and Pneumocystis carinii pneumonia. Hypercalcaemia in granulomatous disease occurs as a consequence of dysregulated production of 1,25-(OH)2 D3 (calcitriol) by activated macrophages in granulomas. Hypercalcaemia in patients with Mycobacterium tuberculosis infection has been reported in 0%-28% of cases...
January 26, 2018: BMJ Case Reports
Lynda Katherine Cameron, Katie Lei, Samantha Smith, Nanci Leigh Doyle, James F Doyle, Kate Flynn, Nicola Purchase, John Smith, Kathryn Chan, Farida Kamara, Nardos Ghebremedhin Kidane, Lui G Forni, Dominic Harrington, Geeta Hampson, Marlies Ostermann
INTRODUCTION: Acute kidney injury (AKI) affects more than 50% of critically ill patients. The formation of calcitriol, the active vitamin D metabolite, from the main inactive circulating form, 25-hydroxyvitamin D (25(OH)D), occurs primarily in the proximal renal tubules. This results in a theoretical basis for reduction in levels of calcitriol over the course of an AKI. Vitamin D deficiency is highly prevalent in critically ill adults, and has been associated with increased rates of sepsis, longer hospital stays and increased mortality...
July 12, 2017: BMJ Open
Zhu-Xia Tan, Yuan-Hua Chen, Shen Xu, Hou-Ying Qin, Hua Wang, Cheng Zhang, De-Xiang Xu, Hui Zhao
Acute lung injury is a common complication of sepsis in intensive care unit patients with an extremely high mortality. The present study investigated the effects of calcitriol, the active form of vitamin D, on tumor necrosis factor alpha (TNF-α) and macrophage inflammatory protein-2 (MIP-2) in sepsis-induced acute lung injury. Mice were intraperitoneally (i.p.) injected with lipopolysaccharide (LPS, 1.0mg/kg) to establish the animal model of sepsis-induced acute lung injury. Some mice were i.p. injected with calcitriol (1...
August 2016: Steroids
Malcolm D Kearns, Jessica A Alvarez, Natan Seidel, Vin Tangpricha
BACKGROUND: Observational studies have linked vitamin D status and infectious disease. This association is supported by the presence of the vitamin D receptor and CYP27B1 in immune cells. This review aims to consolidate data from clinical trials that used vitamin D for the treatment or prevention of infectious disease. METHODS: The authors searched the term "(vitamin D OR ergocalciferol OR cholecalciferol OR vitamin D2 OR vitamin D3 OR calcitriol) AND (infection OR tuberculosis OR sepsis OR pneumonia)" with limits preset to manuscripts published in English and with human subjects...
March 2015: American Journal of the Medical Sciences
Jenny E Han, Thomas R Ziegler
No abstract text is available yet for this article.
September 1, 2014: American Journal of Respiratory and Critical Care Medicine
P Zajic, K Amrein
In the last decade, few substances have been discussed as controversially as vitamin D. In the last few years, vitamin D research has now also found its way into the intensive care unit (ICU). Vitamin D deficiency is commonly found in the ICU and is associated with adverse outcomes including excess mortality, longer length of stay, higher sepsis incidence, longer mechanical ventilation. But how should one single vitamin be capable of such an impact? It has to be kept in mind that vitamin D is not a classic vitamin at all...
December 2014: Minerva Endocrinologica
David E Leaf, Anas Raed, Michael W Donnino, Adit A Ginde, Sushrut S Waikar
RATIONALE: Vitamin D and its metabolites have potent immunomodulatory effects in vitro, including up-regulation of cathelicidin, a critical antimicrobial protein. OBJECTIVES: We investigated whether administration of 1,25-dihydroxyvitamin D (calcitriol) to critically ill patients with sepsis would have beneficial effects on markers of innate immunity, inflammation, and kidney injury. METHODS: We performed a double-blind, randomized, placebo-controlled, physiologic study among 67 critically ill patients with severe sepsis or septic shock...
September 1, 2014: American Journal of Respiratory and Critical Care Medicine
Ozge Altun Koroglu, Huseyin Onay, Bilin Cakmak, Betul Bilgin, Mehmet Yalaz, Seckin Tunc, Ferda Ozkinay, Nilgun Kultursay
BACKGROUND: Vitamin D and its receptor (VDR) have important roles in perinatal lung development. The aim of this study was to investigate the relationship between VDR gene polymorphism and bronchopulmonary dysplasia (BPD) in preterm infants. METHODS: VDR Fok I, Bsm I, Apa I, and Taq I polymorphisms were genotyped using restriction fragment length polymorphism in 109 preterm infants (47 with BPD, 62 without BPD). RESULTS: In univariate analysis, Ff (odds ratio (OR) = 3...
August 2014: Pediatric Research
Blake L Erdel, Rattan Juneja, Carmella Evans-Molina
OBJECTIVE: To present the case of a patient with a history of thyroid cancer, postsurgical hypoparathyroidism, chronic calcitriol use, and normal renal function who presented with painful skin lesions secondary to calciphylaxis. METHODS: We describe the history, biochemistry, histopathology, evaluation, and management of this patient. RESULTS: A 47-year-old female with hypoparathyroidism, chronically treated with calcitriol and calcium, presented with exquisitely painful skin ulcerations...
June 2014: Endocrine Practice
Juan Kong, Xiangdong Zhu, Yongyan Shi, Tianjing Liu, Yunzi Chen, Ishir Bhan, Qun Zhao, Ravi Thadhani, Yan Chun Li
Acute lung injury (ALI) is a hallmark of systemic inflammation associated with high mortality. Although the vitamin D receptor (VDR) is highly expressed in the lung, its role in lung physiology remains unclear. We investigated the effect of VDR deletion on ALI using a lipopolysaccharide (LPS)-induced sepsis model. After LPS challenge VDR-null mice exhibited more severe ALI and higher mortality compared with wild-type (WT) counterparts, manifested by increased pulmonary vascular leakiness, pulmonary edema, apoptosis, neutrophil infiltration, and pulmonary inflammation, which was accompanied by excessive induction of angiopoietin (Ang)-2 and myosin light chain (MLC) phosphorylation in the lung...
December 2013: Molecular Endocrinology
Søren Møller, Finn Laigaard, Klaus Olgaard, Claus Hemmingsen
BACKGROUND: In addition to the regulation of calcium homeostasis, vitamin D affects the cellular immune system, targets the TNF-alpha pathway and increases vasoconstrictor response to angiotensin II. We therefore examined the effect of 1,25-dihydroxy-vitamin D(3) on coagulation and organ failure in experimental sepsis in the rat. METHODS: Three series of placebo-controlled studies were conducted. All rats were pre-treated with daily SC injections of 1,25-dihydroxy-vitamin D(3) 100 ng/kg or placebo vehicle for 3 days...
2007: International Journal of Medical Sciences
M H A Malik, F Jury, A Bayat, W E R Ollier, P R Kay
BACKGROUND: Matrix metalloproteinase (MMP)1, interleukin(IL)6 and vitamin D receptor (VDR) have been implicated in the biological cascade of events initiated by particulate wear debris and bacterial infection, resulting in periprosthetic bone loss around loosened total hip replacements (THRs). The individual responses to such stimuli may be dictated by genetic variation. OBJECTIVE: To study the effect of single-nucleotide polymorphisms (SNPs) within these candidate genes...
August 2007: Annals of the Rheumatic Diseases
Kambis Sadeghi, Barbara Wessner, Ute Laggner, Martin Ploder, Dietmar Tamandl, Josef Friedl, Ullrich Zügel, Andreas Steinmeyer, Arnold Pollak, Erich Roth, George Boltz-Nitulescu, Andreas Spittler
Toll-like receptors (TLR) represent an ancient front-line defence system that enables the host organism to sense the presence of microbial components within minutes. As inducers of inflammation, TLR act as important triggers of distinct entities such as sepsis or autoimmune disease exacerbation. We report here that vitamin D3 [1alpha,25-dihydroxycholecalciferol, 1,25(OH)(2)D3] suppresses the expression of TLR2 and TLR4 protein and mRNA in human monocytes in a time- and dose-dependent fashion. Despite 1,25(OH)(2)D3-induced up-regulation of CD14, challenge of human monocytes with either LPS or lipoteichoic acid resulted in impaired TNF-alpha and procoagulatory tissue factor (CD142) production, emphasizing the critical role of TLR in the induction of inflammation...
February 2006: European Journal of Immunology
M Válek, S Sulková, E Schestauberová, F Svára, H Mann, V Polakovic
Calciphylaxis is a rate complication of unknown pathogenesis in patients with end stage renal disease. It is characterized by calcification of tunica media of small arteries associated with intimal fibrosis and thrombus formation which leads to the development of skin and subcutaneous tissue necrosis. Superinfection of skin lesions is a common consequence of this syndrome which may lead to the sepsis. The prognosis of this condition in serious. We performed a retrospective study of 6 subjects (4 men and 2 women) in the age of 35 to 59 years...
June 7, 2002: Casopís Lékar̆ů C̆eských
M M Goldenberg
Patients with end-stage renal disease commonly develop secondary hyperparathyroidism. Calcitriol may be administered to such patients to decrease the synthesis and secretion of parathyroid hormone (PTH) and to help maintain calcium and phosphorus homeostasis. However, the doses of calcitriol required to suppress serum PTH concentrations can lead to hypercalcemia or hyperphosphatemia in many patients undergoing hemodialysis. Paricalcitol is a new vitamin D analogue that is safe and effective in suppressing elevated concentrations of PTH in patients with established hyperparathyroidism who are maintained on chronic hemodialysis...
March 1999: Clinical Therapeutics
D M Nierman, J I Mechanick
STUDY OBJECTIVE: Chronically critically ill (CCI) patients are primarily elderly people who have survived a life-threatening episode of sepsis but remain profoundly debilitated and ventilator dependent. The objective of this study was to determine the prevalence of bone hyperresorption and parathyroid hormone (PTH)-vitamin D axis abnormalities in these patients. DESIGN: Prevalence survey. SETTING: Respiratory care step-down unit (RCU) at a tertiary care teaching hospital...
October 1998: Chest
J Pugin, R J Ulevitch, P S Tobias
Optimal activation of endothelial cells by nanomolar quantities of endotoxin (lipopolysaccharide, LPS) requires the presence of plasma or serum. We and others have demonstrated that soluble CD14 (sCD14) and LPS binding protein (LBP) were the key plasma proteins mediating endothelial cell responses to LPS. The role of LBP is to transfer LPS to sCD14 and newly formed LPS-sCD14 will in turn activate endothelial cells via an as yet unknown surface receptor. This plasma-dependent pathway of endothelial cells activation is referred as to the direct pathway...
1995: Progress in Clinical and Biological Research
G P Zaloga, B Chernow
To learn about the pathogenesis of sepsis-associated hypocalcemia, we measured serum ionized calcium concentrations in 60 critically ill patients with bacterial sepsis; 12 (20%) had hypocalcemia. The mortality rate in the hypocalcemic patients with sepsis (50%) was higher than that in the normocalcemic patients with sepsis (29%). Only patients with gram-negative sepsis became hypocalcemic, and hypocalcemia contributed to hypotension in 7 of the 12 hypocalcemic patients. Serum calcium concentrations returned to normal in each of those patients with sepsis who survived...
July 1987: Annals of Internal Medicine
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