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Mediators of Inflammation
Volume 2014, Article ID 670475, 6 pages
http://dx.doi.org/10.1155/2014/670475
Clinical Study

Selective Vitamin D Receptor Activation as Anti-Inflammatory Target in Chronic Kidney Disease

1Research Unit, University Hospital Nuestra Señora de Candelaria, 38010 Santa Cruz de Tenerife, Spain
2GEENDIAB (Grupo Español para el Estudio de la Nefropatía Diabética) and REDINREN (RD12/0021/0019), Spain
3Nephrology Service, University Hospital Nuestra Señora de Candelaria, 38010 Santa Cruz de Tenerife, Spain
4Clinical Analysis Service, University Hospital Nuestra Señora de Candelaria, 38010 Santa Cruz de Tenerife, Spain

Received 3 October 2013; Revised 18 November 2013; Accepted 9 December 2013; Published 6 January 2014

Academic Editor: Jonathan Peake

Copyright © 2014 J. Donate-Correa et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Paricalcitol, a selective vitamin D receptor (VDR) activator used for treatment of secondary hyperparathyroidism in chronic kidney disease (CKD), has been associated with survival advantages, suggesting that this drug, beyond its ability to suppress parathyroid hormone, may have additional beneficial actions. In this prospective, nonrandomised, open-label, proof-of-concept study, we evaluated the hypothesis that selective vitamin D receptor activation with paricalcitol is an effective target to modulate inflammation in CKD patients. Eight patients with an estimated glomerular filtration rate between 15 and 44 mL/min/1.73 m2 and an intact parathyroid hormone (PTH) level higher than 110 pg/mL received oral paricalcitol (1 μg/48 hours) as therapy for secondary hyperparathyroidism. Nine patients matched by age, sex, and stage of CKD, but a PTH level <110 pg/mL, were enrolled as a control group. Our results show that five months of paricalcitol administration were associated with a reduction in serum concentrations of hs-CRP (13.9%, ), TNF-α (11.9%, ), and IL-6 (7%, ), with a nonsignificant increase of IL-10 by 16%. In addition, mRNA expression levels of the TNFα and IL-6 genes in peripheral blood mononuclear cells decreased significantly by 30.8% ( ) and 35.4% ( ), respectively. In conclusion, selective VDR activation is an effective target to modulate inflammation in CKD.